Aims To compare the compliance of the Surgical Safety Checklist in two groups of users: early (Group A) and late (Group B) adopters, and to detect change over time. Method Observational study. We collected all Surgical Safety Checklist protocols in one calendar month period and, eight months later, we repeated collection for another month. Analysis was then performed to compare the compliance in different groups and over time. Results There was no statistical difference in the overall compliance between the two groups or between elective and emergency cases. Equally, there was no significant change in compliance over time in Group A. In Group B, however, there was a trend to an improved compliance over time. Compliance to the Surgical Safety Checklist was significantly lower during operations performed by consulting surgeons in comparison to internally employed surgeons.

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Purpose Diverticular disease is common in the western world. Due to the risk of undetected underlying colorectal cancer, most guidelines recommend a follow-up colonoscopy after an episode of diverticulitis. With the increased accuracy of computer tomography scans, there is an increased challenge to these guidelines in cases of uncomplicated diverticulitis. The aim of this study was to investigate the compliance to the recommended follow-up colonoscopies and to report the incidence of detection of advanced neoplasms. Methods In this single-center retrospective cohort study, all patients > 18 years that were admitted to the Hospital Center Biel with an episode of acute uncomplicated diverticulitis between 01.01.2013 and 31.12.2017 were identified. The incidence of advanced neoplasia was calculated by analyzing the follow-up colonoscopies performed and reviewing the histological findings. Results 257 Patients with uncomplicated diverticulitis were included in this study. The mean age of the patients was 63 (range 22–96) years, and 54.5% were female. In 197 (77%) patients we recommended a follow-up colonoscopy. However, only 144 (73%) of these patients underwent the procedure. In the histological analysis, 2 (1.2%) carcinomas, one high-grade adenoma (0.6%) and 20 low-grade adenomas (12%) were detected. Conclusion The compliance to the recommendation of follow-up colonoscopies after uncomplicated diverticulitis is poor and has to be improved. A follow-up colonoscopy has its justification because of relevant findings in almost 14% of patients, more so in patients above screening age with 20% pathological findings, including 2 (5%) carcinomas.

Background: Emergency presentations of hernias can pose significant morbidity. In addition, providing optimal surgical intervention can be challenging due to patient and disease factors with multiple treatment modalities available. Recently there have been several guidelines written to help standardize practices in hernia management. The aim of our study was to review emergency hernia operations at our tertiary level teaching hospital, the method of repair and how this matched to international guidelines. Methods: We performed a retrospective chart review of all the patients who underwent emergency hernia surgery for strangulated/incarcerated hernias in our department over a 3-year period. Adherence to guidelines was assessed looking at appropriateness of mesh utilization, as well as the appropriateness of antibiotic usage. Results: A total of 184 cases from April 1st 2018 to March 31st 2021 were included. Of these hernias 12% contained necrotic or perforated bowel, 42% contained viable incarcerated bowel, and 45% contained just incarcerated fat. The compliance to the appropriate use of mesh overall was 85%, with a variation by hernia type. The global compliance to appropriate antibiotic therapy was high, at 89.7%. With antibiotic use compliance being very high in clean wounds (95.6%), and dirty wounds (100%). But lower in clean/contaminated or contaminated wounds (36.8%). Conclusion: Compliance at our hospital was globally good. Areas of decreased compliance seem to be mostly regarding mesh use and antibiotic use in potentially contaminated fields and the concept of risk of bacterial translocation versus actual contamination, as well as in mesh use in smaller umbilical hernias. MethodsWe performed a retrospective chart review of all the patients who underwent emergency hernia surgery for strangulated/incarcerated hernias in our department over a 3-year period. All paediatric patients (age under 18) were excluded.

Background: Ruptured umbilical hernias in patients with ascites (Flood Syndrome) is an uncommon problem with high morbidity and mortality. The treatment of patients experiencing Flood Syndrome is controversial, with a multitude of different treatments being proposed. Method: This paper presents our experience in treating Flood syndrome, and presents a standardized way of treating these patients. Results: Six consecutive patients with Flood syndrome were treated with the same standardized management and surgical technique. All patients had Cirrhosis (Child B and C). All were treated as open emergency operations, with no recurrence or post-operative complications. Conclusion: Though there is a lack of level I or II evidence, the data suggests that ruptured umbilical hernias in cirrhotic patients are a surgical emergency that can be optimally managed with operative management. We present a standardized technique for the repair of these hernias which is simple, reliable and appears to have reproducible results. The technique aims to provide a hermetic seal immediately peri-operatively and is supported by medical optimization of the post-operative period. Our small case series represents effective and safe management in appropriately selected patients.