Among patients undergoing TKR, use of the SCS was associated with shorter LOS, less resource intensive discharge status, and lower rates of all-cause readmission as compared with skin staples.

Purpose of ReviewThis review provides an overview of the STRATAFIX™ SYMMETRIC PDS™ Plus Knotless Tissue Control Device design and performance characteristics and highlights the device’s relevance for use in gynecological procedures. Various device testing was conducted on tensile strength, fixation tab mass comparison to conventional suture knot tower, initiation stitch strength, and wound holding strength to highlight the STRATAFIX™ SYMMETRIC PDS™ Plus Device’s key product attributes that may benefit general and minimally invasive gynecological procedures.Recent FindingsThis article serves as a technological assessment of the latest barbed suture offered by Ethicon—STRATAFIX™ SYMMETRIC PDS™ Plus Knotless Tissue Control Device. This device is indicated for soft tissue approximation and can be used to close high tension areas, such as fascia.SummaryBarbed sutures were successfully introduced to gynecologic surgery many years ago, and their safety and effectiveness have been demonstrated in a variety of gynecological surgical procedures. By eliminating the need to tie surgical knots, barbed suture provides a few key advantages over conventional suture, such as reducing operating room time, eliminating potential knot-related complications, and reducing suturing difficulty in open and minimally invasive gynecological procedures. Additionally, there are tensile strength and wound holding strength advantages (vs. conventional PDS™ Plus Suture) described in the product testing highlighted in this review that may be relevant for gynecological procedures.

A total of 186 consecutive patients underwent open tension-free inguinal hernia repair, either on one or both sides. Overall, 220 hernias were repaired under local anesthesia conditions after intraoperatively classifying the size of the hernia. The follow-up investigation took place as planned in 165 hernias. The mean follow-up time was 15.5 months, with a range from 6.6 to 30. 8 months, and the follow-up rate was 75.0 %. During this first follow-up it was especially interesting to read the patients, self-assessment concerning their physical restrictions during the first month after the operation. Furthermore, we were interested in learning about the objective and subjective operation-linked consequences in the patients, inguinal region. Most patients (89.7 %) were able to do sports and drive their car; 86.1 % were able to manage their usual physical activity 4 weeks after the operation. Focusing on the operation site, patients complained about chronic unpleasant effects, such as mild pain (21.2 %), local hypoesthesia (12.1 %), weather-dependent changes in sensitivity (7.2 %), moderate pain (3.6 %), inguinal syndrome (1.8 %) and hyperesthesia (1.2 %). Persistent swelling in the parainguinal region was found in 1.8 % of the patients and only one recurrence was found (0.6 %). In the analysis we found that mild chronic pain was not related to the time period after the operation and the age or sex of the patient, but there was a correlation with the size of the hernia. Patients with small hernias significantly more often experienced chronic pain than patients with bigger hernias. These results suggest that open tension-free inguinal hernia repair according to Lichtenstein appears to be overtreatment in patients with small inguinal hernias.

Aim:The burden of abdominal wound failure can be profound. Recent clinical guidelines have highlighted the heterogeneity of laparotomy closure techniques. The aim of this study was to investigate current midline closure techniques and practices for prevention of surgical site infection (SSI).Method: An online survey was distributed in 2021 among the membership of the European Society of Coloproctology and its partner societies. Surgeons were asked to provide information on how they would close the abdominal wall in three specific clinical scenarios and on SSI prevention practices.Results: A total of 561 consultants and trainee surgeons participated in the survey, mainly from Europe (n = 375, 66.8%). Of these, 60.6% identified themselves as colorectal surgeons and 39.4% as general surgeons. The majority used polydioxanone for fascial closure, with small bite techniques predominating in clean-contaminated cases (74.5%, n = 418). No significant differences were found between consultants and trainee surgeons. For SSI prevention, more surgeons preferred the use of mechanical bowel preparation (MBP) alone over MBP and oral antibiotics combined. Most surgeons preferred 2% alcoholic chlorhexidine (68.4%) or aqueous povidone-iodine (61.1%) for skin preparation.The majority did not use triclosan-coated sutures (73.3%) or preoperative warming of the wound site (78.5%), irrespective of level of training or European/non-European practice. Conclusion:Abdominal wound closure technique and SSI prevention strategies vary widely between surgeons. There is little evidence of a risk-stratified approach to wound | 1015

s163 retrospectively reviewed patients who underwent a primary TKA for osteoarthritis from the Premier Perspective Database between 2014 and 2016. Patients with a bicruciate knee system were identified using "journey"-related appropriate keywords from billing records and compared against other TKA patients who did not meet the keywords' criteria. Patients were excluded if they were < 21 years of age; outpatient hospital discharges; evidence of revision TKA; bilateral TKA in same discharge or different discharges. 1:1 Propensity Score Matching was used to control patients, hospital (except hospital bed-size) and clinical characteristics. Generalized Estimating Equation (GEE) model accounted for hospital bed-size with appropriate distribution and link function. Cost data were inflation-adjusted for 2016 U.S. dollar and rounded to the nearest dollar. Results: The study matched 1,692 bicruciate knee system patients with other TKA patients. Length of stay for bicruciate knee patients (mean= 2.45 days; CI= 2.38-2.52) were significantly lower than other TKA patients (mean= 2.66 days; CI= 2.59-2.74). Bicruciate knee patients were 35% (OR= 1.35; CI= 1.13-1.61; p value= < .0001) more likely to be discharged to home/home health care and 41% (OR= 0.59; CI= 0.48-0.74; p value= < .0001) less likely to be discharged to a Skilled Nursing Facility than other TKA patients. Mean total hospital costs were significantly lower for bicruciate knee patients