Parastomal hernia: incidence, prevention and treatment strategies

Abstract

Sepsis kills more people than lung cancer, and more people than bowel and breast cancer put together. The costs to the NHS are significant; it is estimated that in Europe, patients with severe sepsis cost healthcare funders around 7.6 billion euros per year (Daniels et al, 2007). Costs in the United States are estimated at $16 billion annually (Angus et al, 2001), and in the United Kingdom up to 46% of intensive care unit (ICU) bed days are used by patients with severe sepsis (Padkin et al, 2003), with each ICU bed costing around pounds sterling1700 per day. In 2002 an international campaign was launched: the Surviving Sepsis Campaign. The main aim of this campaign is to reduce mortality from sepsis by 25% by 2009. A lot of the early work has concentrated on improving sepsis care in intensive care units, but many patients on general wards develop sepsis, and the need to educate nurses throughout all areas of the hospital has been recognized. In September 2007 a new part of the campaign was launched called Survive Sepsis, which aims to deliver sepsis education to ward nurses and junior doctors. This article discusses how to recognize severe sepsis and explains how nurses can dramatically improve a patient's chance of survival by ensuring that six simple things (Sepsis Six) are done in the first hour.

PPAR-γ/IL-10 Axis Inhibits MyD88 Expression and Ameliorates Murine Polymicrobial Sepsis

“…This study demonstrates the therapeutic potential of the PPAR-γ ligand pioglitazone in the most widely used models of sepsis and septic shock, which resemble human sepsis in many parameters (31, 46, 47). Specifically, we demonstrate that prolonged PPAR-γ activation protects mice against severe CLP-induced sepsis by ameliorating important steps in the pathogenesis of sepsis which leads to increased survival, including: 1) restoring neutrophil recruitment to the site of infection, 2) increasing bacterial clearance at the site of infection and in blood, 3) decreasing cytokine storm, and 4) inhibiting MyD88 expression and, therefore, the actions of TIR (Toll-IL-1 receptor) domains, such as members of the Interleukin-1 Receptor and Toll-Like Receptor Superfamily.…”

Ventral hernia: Patient selection, treatment, and management

“…Parastomal hernias have a much higher postoperative prevalence (33-50% at one-year follow-up) compared to incisional hernias associated with other abdominal wall surgeries [229][230][231] . Parastomal hernias usually occur within two years of the initial surgery and their prevalence increases over time.…”

“…Risk factors for parastomal hernia include larger aperture size, increased age, colostomy, obesity, diabetes, and emergent surgery [232][233][234] . Notably, patients who acquire a parastomal hernia had a 7 times greater odds of developing an incisional hernia compared with patients without a parastomal hernia 229,235 .…”

Parastomal Hernia

“…• Parastomal Hernia http://dx.doi.org/10.5772/intechopen.68876objects, weight loss, diet changes, and abdominal exercises to strengthen the abdominal muscle, are successful strategies for conservative management of PSHs [2,15,18,26]. Unfortunately, despite all atempts, one-third of all patients with PSH require surgical repair [15,17,[27][28][29].…”