Local anesthetic wound infiltration (WI) provides anesthesia for minor surgical procedures and improves postoperative analgesia as part of multimodal analgesia after general or regional anesthesia. Although pre-incisional block is preferable, in practice WI is usually done at the end of surgery. WI performed as a continuous modality reduces analgesics, prolongs the duration of analgesia, and enhances the patient’s mobilization in some cases. WI benefits are documented in open abdominal surgeries (Caesarean section, colorectal surgery, abdominal hysterectomy, herniorrhaphy), laparoscopic cholecystectomy, oncological breast surgeries, laminectomy, hallux valgus surgery, and radical prostatectomy. Surgical site infiltration requires knowledge of anatomy and the pain origin for a procedure, systematic extensive infiltration of local anesthetic in various tissue planes under direct visualization before wound closure or subcutaneously along the incision. Because the incidence of local anesthetic systemic toxicity is 11% after subcutaneous WI, appropriate local anesthetic dosing is crucial. The risk of wound infection is related to the infection incidence after each particular surgery. For WI to fully meet patient and physician expectations, mastery of the technique, patient education, appropriate local anesthetic dosing and management of the surgical wound with “aseptic, non-touch” technique are needed.

Serial measurement of CRP is recommended for screening of infectious complications of colorectal resection. Patients with CRP values above 139 mg/L on POD 5 cannot be discharged from hospital, and require an intensive search for infectious complications, particularly AL. MMP-9 measurement in drainage fluid is not relevant in the detection of AL in patients with colorectal resection.

Serial measurement of CRP in drainage fluid can reliably be used in the detection of AL in patients with colorectal resection. The most significant values obtained on the PODs 5 and 7 were positively correlated with the values registered in

We reported a patient with giant esophageal pedunculated tumor with clinical manifestations of inflammatory pseudotumor and histopathological picture of fibrovascular polyp, that we have not found described in the literature before.

Background/Aim. Hospital-acquired pneumonia (HAP) in a surgical population significantly increases morbidity and mortality, prolongs hospitalization and increases total treatment costs. In the present study, we aimed to determine incidence, in-hospital mortality and risk factors (RFs) of HAP in patients with intra-abdominal surgical procedures hospitalized in a tertiary hospital in Belgrade (Serbia). Methods. Through regular hospital surveillance of patients who underwent intra-abdominal surgical procedures, we prospectively identified postoperative HAP during five years. In the matched case-control study, every surgical patient with HAP was compared with four control patients without HAP. In the group of patients with HAP, those who died were compared with those who survived. Results. Overall 1.4% of all intra-abdominal surgical patients developed HAP in the postoperative period. The incidence of HAP (per 1,000 operative procedures) was greatest in patients undergoing exploratory laparotomy (102.6), followed by small bowel surgery (36.6), and gastric surgery (22.7). Multivariate logistic regression analysis (MLRA) identified three independent risk factors (RF) associated with HAP: multiple transfusion [p = 0.011; odds ratio (OR): 4.26; 95% confidence interval (CI): 1.59-11.33], length of hospital stay (p = 0.024; OR: 1.02; 95%CI: 1.00-1.03) and hospitalization in the Intensive care unit (ICU) (p = 0.043; OR: 2.83; 95%CI: 1.03-7.71). MLRA identified only surgical site infection as an independent RF associated with the poor outcome of HAP (p = 0.017; OR: 5.929; CI95%: 1.37-25.67). Conclusion. The results of the present study are valuable in documenting the relations between RFs and HAP in patients undergoing intra-abdominal surgical procedures.