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Wang L, Li W, Li M, Lai P, Yang C, Wang H, Ma B, Huang R, Zu Y. Bio-Inspired Fractal Robust Hydrogel Catheter for Intra-Abdominal Sepsis Management. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2303090. [PMID: 37822166 PMCID: PMC10646267 DOI: 10.1002/advs.202303090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/10/2023] [Indexed: 10/13/2023]
Abstract
To deal with intra-abdominal sepsis, one of the major global causes of death in hospitalized patients, efficient abscess drainage is crucial. Despite decades of advances, traditional catheters have demonstrated poor drainage and absorption properties due to their simple tubular structures and their dense nonporous surface. Herein, inspired by porous sponges and fractal roots, a multifaceted hydrogel catheter with effective drainage, absorptive, and robust properties, is presented. Its unique fractal structures provide extensive internal branching and a high specific surface area for effective drainage, while the hierarchical porous structures provide a wide range of absorption capabilities. Additionally, its distinctive multi-interpenetration network maintains robust and appropriate mechanical properties, even after absorption multiple times of liquid and mechanical disturbance, allowing for intact removal from the abdominal cavity without harm to the animal in vivo. Besides, the loaded antimicrobial peptides are capable of being released in situ to inhibit the potential for infections. In vivo experiments have demonstrated that this hydrogel catheter efficiently removes lethal abscesses and improves survival. It is believed that this innovative and practical catheter will create a future precedent for hydrogel drainage devices for more effective management of intra-abdominal sepsis.
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Affiliation(s)
- Lichun Wang
- Department of Critical Care MedicineThe Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhou510655China
| | - Wenzhao Li
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision, and Brain Health)Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhouZhejiang325001China
- Department of Biomedical EngineeringThe Hong Kong Polytechnic UniversityHong Kong SAR999077China
| | - Min Li
- Department of Gastrointestinal SurgerySouthern Medical UniversityAffiliated Dongguan Shilong Peoples HospitalSSL Center Hospital Dongguan CityDongguan523326China
| | - Puxiang Lai
- Department of Biomedical EngineeringThe Hong Kong Polytechnic UniversityHong Kong SAR999077China
| | - Chunhua Yang
- Department of Critical Care MedicineThe Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhou510655China
| | - Hui Wang
- Department of General Surgery (Colorectal Surgery) and Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesGuangdong Institute of GastroenterologyBiomedical Innovation CenterThe Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhou510655China
| | - Bo Ma
- Department of UrologyThe Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhou510655China
| | - Rongkang Huang
- Department of General Surgery (Colorectal Surgery) and Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesGuangdong Institute of GastroenterologyBiomedical Innovation CenterThe Sixth Affiliated HospitalSun Yat‐sen UniversityGuangzhou510655China
| | - Yan Zu
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision, and Brain Health)Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhouZhejiang325001China
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Ortenzi M, Balla A, Botteri E, Lepiane P, Guerrieri M, Arezzo A, Sartori A. COVID-19 pandemic: is it time for shared surgical guidelines? A systematic review of the literature. Minerva Surg 2022; 77:171-179. [PMID: 35416005 DOI: 10.23736/s2724-5691.21.09166-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The recent COrona Virus Disease 2019 (COVID-19) pandemic caused a massive disruption of surgical activity and after a year from its first outbreak surgeons still struggle to keep their regular activity coexisting with the virus exhausting requests of healthcare resources. The aim of this paper is to offer a comprehensive overview of the most important recommendations by the International Guidelines about general surgery, and possibly to invite building common shared guidelines to preserve the potential to provide surgical assistance despite the pandemic. EVIDENCE ACQUISITION This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. PubMed, Embase, Cochrane and Web of Science databases were searched. EVIDENCE SYNTHESIS The searches revealed a total of 18579 articles published up to the end of February 2021. Five articles published between March and May 2020, were included in the present study: Guidelines from The European Society of Trauma and Emergency Surgery (ESTES), The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and The European Association for Endoscopic Surgeons (EAES), The Endoscopic and Laparoscopic Surgeons of Asia (ELSA), The European Hernia Society (EHS) and The International Organization for the Study of Inflammatory Bowel Disease (IOS-IBD). CONCLUSIONS In the likely scenario that the SARS-CoV-2 pandemic will become an endemic chronic problem, we should not be forced to choose between COVID-19 or surgery in the future and find a way to make both coexisting.
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Affiliation(s)
- Monica Ortenzi
- Department of General and Emergency Surgery, Polytechnic University of Marche, Ancona, Italy -
| | - Andrea Balla
- General Surgery Unit, San Paolo Hospital, Civitavecchia, Rome, Italy
| | - Emanuele Botteri
- General Surgery Unit, ASST Spedali Civili, Montichiari Hospital, Montichiari, Brescia, Italy
| | - Pasquale Lepiane
- General Surgery Unit, San Paolo Hospital, Civitavecchia, Rome, Italy
| | - Mario Guerrieri
- Department of General and Emergency Surgery, Polytechnic University of Marche, Ancona, Italy
| | - Alberto Arezzo
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Alberto Sartori
- Department of General Surgery, Montebelluna Hospital, Montebelluna, Treviso, Italy
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Bagheripour MH, Zakeri MA. Acute Mesenteric Ischemia in a COVID-19 Patient: Delay in Referral and Recommendation for Surgery. Case Rep Gastrointest Med 2021; 2021:1999931. [PMID: 34777882 PMCID: PMC8589525 DOI: 10.1155/2021/1999931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/10/2021] [Accepted: 10/29/2021] [Indexed: 12/22/2022] Open
Abstract
Coronavirus (COVID-19) is more common with symptoms such as fever, dry cough, and shortness of breath. However, it may be associated with COVID-19-induced gastrointestinal (GI) symptoms including acute mesenteric ischemia (AMI). These conditions make the diagnosis of AMI challenging. Timely referral with correct diagnosis and attention to the uncommon symptoms of COVID-19 can play an important role in the management and treatment of AMI in COVID-19 patients. We present a patient with AMI due to thrombotic complications of COVID-19, who referred to the hospital too late and ignored the recommendation for abdominal surgery.
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Affiliation(s)
| | - Mohammad Ali Zakeri
- Social Determinants of Health Research Centre, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Shen JJ. Psychosocio-economic impacts of COVID-19 on gastroenterology and endoscopy practice. Gastroenterol Rep (Oxf) 2021; 9:205-211. [PMID: 34312585 PMCID: PMC8194579 DOI: 10.1093/gastro/goab012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/31/2020] [Accepted: 01/22/2021] [Indexed: 01/07/2023] Open
Abstract
Beyond posing a major health crisis, the COVID-19 pandemic has inflicted profound psychological, social, and economic impacts on populations worldwide. Mass quarantines and social isolation have affected the mental health of the wider population, exacerbating other stressors, including fear of the virus and its repercussions, general uncertainty, and financial insecurity. The pandemic has challenged the broader delivery of healthcare--ranging from the need to triage limited hospital resources to balancing risk mitigation with maintaining medical care. Specific to gastroenterology, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has not only been associated with complicating extant medical conditions of the gastrointestinal (GI) tract, but has also forced a shift in the practice of gastroenterology by patients, families, and healthcare providers alike. The gastroenterology field has been required to adapt its practices to minimize the possibility of viral spread while still upholding patient care. Healthcare practitioners in GI have helped to treat COVID-19 patients, stratified inpatient and outpatient visits and procedures, and shifted to telemedicine. Still, as is the case with much of the general population, healthcare providers working in GI practice or endoscopy have faced personal and professional stressors, mental health difficulties, social isolation, financial pressures, and familial burdens--all of which can take a toll on practitioners and, by extension, the provision of GI care overall. This article will highlight how the COVID-19 pandemic has affected the psychological wellbeing, social engagement, and economic conditions of the public, healthcare providers, and GI professionals specifically. Recommendations for strategies that can continue GI services while maintaining safety for both caregivers and patients are put forth to help uphold critical GI care during this worldwide crisis.
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Wang Q, Yu C. Letter to the Editor: A Conversation with … Natasha Parekh MD, MS-Expert on Waste and Fraud in the US Healthcare System. Clin Orthop Relat Res 2021; 479:860-861. [PMID: 33704110 PMCID: PMC8083939 DOI: 10.1097/corr.0000000000001705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/09/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Qiang Wang
- Q. Wang, C. Yu, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China
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Stöß C, Steffani M, Kohlhaw K, Rudroff C, Staib L, Hartmann D, Friess H, Müller MW. The COVID-19 pandemic: impact on surgical departments of non-university hospitals. BMC Surg 2020; 20:313. [PMID: 33272227 PMCID: PMC7711305 DOI: 10.1186/s12893-020-00970-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/17/2020] [Indexed: 12/13/2022] Open
Abstract
Background During the first wave of the COVID-19 pandemic, German health care centres were restructured for the treatment of COVID-19 patients. This was accompanied by the suspension of the surgical programme. The aim of the survey was to determine the effects of COVID-19 on surgical care in non-university hospitals in Germany. Methods This cross-sectional study was based on an anonymous online survey, which was accessible from April 24th to May 10th, 2020 for surgeons of the Konvent der leitenden Krankenhauschirurgen (Convention of leading Hospital Surgeons) in Germany. The analysis comprised of 22.8% (n = 148/649) completed surveys. Results Communication and cooperation with authorities, hospital administration and other departments were largely considered sufficient. In the early phase of the COVID-19 pandemic, 28.4% (n = 42/148) of the respondents complained about a short supply of protective equipment available for the hospital staff. 7.4% (n = 11/148) of the participants stated that emergency operations had to be postponed or rescheduled. A decreased quantity of emergency surgical procedures and a decreased number of surgical emergency patients treated in the emergency room was reported in 43.9% (n = 65/148) and 63.5% (n = 94/148), respectively. Consultation and treatment of oncological patients in the outpatient clinic was decreased in 54.1% (n = 80/148) of the surveyed hospitals. To increase the capacity for COVID-19 patients, a reduction of bed and operating room occupancy of 50.8 ± 19.3% and 54.2 ± 19.1% were reported, respectively. Therefore, 90.5% (n = 134/148) of all participants expected a loss of revenue of 28.2 ± 12.9% in 2020. Conclusion The first wave of the COVID-19 pandemic had a significant impact on surgical care in Germany. The reduction in the bed and the operating room capacity may have lead to considerable delays in urgent and semi-elective surgical interventions. In addition to the risk of worsening patient care, we anticipate severe financial damage to the clinics in 2020 and beyond. National and supranational planning is urgently needed to ensure the surgical care of patients during the ongoing COVID-19 pandemic.
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Affiliation(s)
- Christian Stöß
- Department of Surgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Ismaninger St 22, 81675, Munich, Germany
| | - Marcella Steffani
- Department of Surgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Ismaninger St 22, 81675, Munich, Germany
| | - Kay Kohlhaw
- Clinic of General, Visceral, MIS and Vascular Surgery, Clinical Centre Borna, Borna, Germany
| | - Claudia Rudroff
- Clinic of General and Visceral Surgery, Evangelisches Klinikum Köln Weyertal, Cologne, Germany
| | - Ludger Staib
- Clinic of General and Visceral Surgery, Clinical Centre Esslingen, Esslingen, Germany
| | - Daniel Hartmann
- Department of Surgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Ismaninger St 22, 81675, Munich, Germany
| | - Helmut Friess
- Department of Surgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Ismaninger St 22, 81675, Munich, Germany.
| | - Michael W Müller
- Department of Surgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Ismaninger St 22, 81675, Munich, Germany.,Clinic of General and Visceral Surgery, Clinical Centre Ludwigsburg-Bietigheim, Ludwigsburg, Germany
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Wu XS, Wang XA, Sun XH, Ren T, Zhao L, Shen L, Gong YR, Xu YF, Huang S, Dong P, Gong W, Wang XF, Liu YB. Measures taken to alleviate the impact of COVID-19 outbreak on surgical patients. MedComm (Beijing) 2020; 1:249-252. [PMID: 34766122 PMCID: PMC8491226 DOI: 10.1002/mco2.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/24/2020] [Accepted: 06/30/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Xiang-Song Wu
- Department of General Surgery Xinhua Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Xu-An Wang
- Biliary-pancreatic Surgery Department Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Xu-Heng Sun
- Biliary-pancreatic Surgery Department Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Tai Ren
- Department of General Surgery Xinhua Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Li Zhao
- Department of General Surgery Xinhua Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Lin Shen
- Department of General Surgery Xinhua Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Yu-Rong Gong
- Department of General Surgery Xinhua Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Yan-Fei Xu
- Department of General Surgery Xinhua Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Shuai Huang
- Department of General Surgery Xinhua Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Ping Dong
- Department of General Surgery Xinhua Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Wei Gong
- Department of General Surgery Xinhua Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Xue-Feng Wang
- Department of General Surgery Xinhua Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
| | - Ying-Bin Liu
- Biliary-pancreatic Surgery Department Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai China
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Wexner SD. Strategies for the management of gastrointestinal surgery in the COVID-19 pandemic. Gastroenterol Rep (Oxf) 2020; 8:175-176. [PMID: 32661491 PMCID: PMC7333925 DOI: 10.1093/gastro/goaa033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/07/2020] [Indexed: 11/15/2022] Open
Affiliation(s)
- Steven D Wexner
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA
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