Comparison of prolene with parietex composite® mesh in laparoscopic intraperitoneal mesh hernioplasty for paraumbilical hernia.

Objective: To compare the outcomes of prolene macroporous mesh with Parietex Composite® mesh in patients undergoing Laparoscopic hernioplasty for management of Paraumbilical hernia. Study Design: Prospective Comparative study. Setting: Jinnah Hospital Lahore. Period: 1st January 2016 to 1st January 2018. Material & Methods: A total of 100 patients with diagnosis of Paraumbilical hernia, aged >18 years were included. There were two groups. In group A (n=50) prolene macroporous mesh (Covidien) was placed. In group B (n=50) Parietex Composite® mesh (Covidien) was placed. After hernioplasty all patients were followed for a period of 2 years for evaluation of primary procedure and any complications like seroma, hematoma and intestinal obstruction. Results: The mean length of stay was 2.74±2.13 days in group A, versus 2.23±1.25 in group B (p-value 0.15). Seroma formation was seen in 4 (8.0%) patients in group A versus in 02 (4.0%) patients in group B (p-value 0.40). Hematoma formation was seen in 01 (2.0%) patients in group A versus 0.0% patients in group B (p-value 0.10). There was no recurrence and intestinal obstruction in any group in two years follow up. Conclusion: There was no difference in surgical outcome and the complication between two groups of patients undergoing laparoscopic Paraumbilical hernia repair with prolene macroporous and Parietex Composite mesh. Moreover, parietex composite mesh are difficult to insert and much expensive. Therefore, prolene mesh can be safely used in patients undergoing Laparoscopic Paraumbilical hernioplasty.

P090 LONG-TERM OUTCOMES FOLLOWING HYBRID BIOMATERIAL REPAIR OF VENTRAL HERNIAS: A MULTICENTER, RETROSPECTIVE STUDY

Aim To analyze device safety and clinical outcomes of ventral hernia repair with a hybrid composite mesh Material and Methods This retrospective, multicenter, case review analyzed device/procedure endpoints and patient-reported outcomes in patients treated for hernia repair ≥ 1 year from study enrollment. Results There were 459 patients with 469 ventral hernias with a mean age of 58 ±15 years and 77% Ventral Hernia Working Group 2 (VHWG2). Mean hernia size was 18.9 cm2. Laparoscopic or robotic approach were utilized in 95% of patients, incisional hernias accounted for 57%. Mesh location was 75% intraperitoneal and bridging repair was performed in 57%. Procedure related adverse events within 30-days occurred in 5%, including: surgical site infection (SSI), surgical site occurrence (SSO), ileus, readmission, and re-operation. Procedure-related SSI or SSO events were 3.75% through 12-months. SSO events requiring procedural intervention (SSOPI) were 2.57% through 24-months. An estimated 7% of subjects had hernia recurrence through the study with a mean follow-up of 32-months (14-53 months) using a patient-reported outcome measure. Subgroup comparison of fixation type (permanent vs absorbable, p = 0.93) and repair (bridging vs reinforcement, p = 0.99) were conducted for recurrence and were not statistically significant. Conclusions In this analysis, ventral hernia repair with hybrid, composite mesh results in successful outcomes in the majority of patients. This study represents a heterogeneous patient population undergoing repair using various approaches, mesh fixation, and mesh placement locations. These data appear to confirm long-term acceptable safety and device performance with a low rate of recurrence in a predominantly VHWG2 population.

Association of Type of Splint, Rationale for Splinting and Survival of Splint, Based on Different Clinical Scenarios with Long Term Follow Up in Chennai Population

BACKGROUND The revival of older treatment modalities like splinting requires the assessment of newer patient centric parameters like survival, compliance, anaesthetics apart from changing the biomaterials employed alone. The purpose of this study was to assess the association between type of splint, chief complaint and survival of splint based on different clinical scenarios with long term follow-up. METHODS The present study was a prospective university based clinical trial with convenience sampling to include clinical scenarios which required splinting in a Chennai Dental College. Ninety-five adult patients were included in the study comprising 50 men and 45 women, aged between 19 - 65 years where parameters like demographic distribution, type of splint, location of the splint, patient compliance and survival were included. The primary end point of the present study was recall of patients periodically every month till 6 - 8 months to assess the duration of survival of splints and associate the same with age, gender, patient compliance, type of splint and rationale for splinting. RESULTS Among the 95 patients included (524 teeth splinted together), all patients completed the treatment protocol, stainless steel wire composite splints were given to 70 patients while composite mesh splints were used in 20 patients. A likelihood ratio of 0.024 (P < 0.05) was seen while associating composite mesh splints, rationale for use, survival time and patient compliance. CONCLUSIONS Within the limits of the present study, a conclusion was made that one must emphasise on the importance of retaining natural teeth based on appropriate clinical scenarios where maximum benefit could be obtained among compliant patients. KEY WORDS Periodontal Splints, Survival Rate, Patient Compliance, Rationale for Splinting, Tooth Fractures, Tooth Reimplantation

The Expression of Cultural Identities in Hong Kong’s Anti-Extradition Law Amendment Bill Movement: A Semantic Network Analysis of Tweets

Building upon the theories of nested identity and optimal distinctiveness, this study examines the identity structure of Hong Kong Twitter users as reflected in their tweets and how their structure changed over time during the Anti-Extradition Movement. By employing semantic network analysis and discursive historical analysis, we found that the identity structure expressed by Hong Kong Twitter users manifested a composite mesh of a sense of victimization, democratic values, sense of autonomy, and sense of helplessness. Moreover, the way Hong Kong Twitter users distinguished themselves from others was hybrid and miscible, justified by an affirmation for morality. The identity expression changed its emphasis regarding different identity concepts as the movement evolved. Implications on how social movement impacts identity politics, and vice versa, are also discussed.