Hemangiomas are benign tumours of infancy and childhood, most commonly located in the head and neck region and occur more frequently in the lips, tongue and palate. The treatment depends upon lesion ...location, size and evolution stage and the patient's age. This paper describes the management of cavernous hemangioma in a 2 -year -old child and 14 -year -old child using different approaches.
•Carcinogenic compounds, such as formaldehyde, exist in surgical smoke.•Carcinogenic compound concentrations exceed occupational safety limits.•Viral DNA is detectable in surgical plume.•Plume ...inhalation leading to infection of nasal epithelial cells has been demonstrated.•Particle count of smoke generated in surgery exceeds Air Quality Index standards.
Surgical smoke refers to the plume produced by usage of energy-generating surgical equipment on tissues. This review aimed to assess the potential of this smoke to be a serious occupational hazard to theatre staff due to its composition, particularly during the COVID-19 pandemic.
A search of Ovid MEDLINE, EMBASE, and PubMed databases was undertaken for publications reporting plume composition, presence of infectious material, carcinogenic potential and comparisons between production in laparoscopic versus open surgery. All human in-vivo and ex-vivo primary studies were included, provided English language translation was available. A narrative synthesis was conducted due to the methodologic heterogeneity of the studies.
25 studies resulted from the primary search, and an additional 3 from cross-referencing, leading to 28 included studies. Studies addressing particle size found that smoke particles were respirable in size. Viral DNA was present in 3 studies, while 2 studies demonstrated the ability for surgical smoke to produce infection of nasal epithelial cells. Chemical composition was explored in 8 studies, revealing the presence of carcinogenic compounds in concentrations above occupational safety limits. These chemicals are recognised as carcinogenic to humans by the International Agency for Research on Cancer criteria. Open surgery was found to generally produce less smoke than laparoscopic, however, both surgical methods resulted in particulate counts higher than Air Quality Index standards.
Surgical smoke contains a myriad of hazardous constituents, such as carcinogenic compounds and infectious materials, however, more research surrounding the implications of inhalation of surgical smoke is required to grasp the true extent to which these plumes may be harmful. Safety measures such as extraction of plumes using local exhaust ventilation, and usage of protective equipment such as N95 masks, should be instilled due to the components of this plume.
To determine the incidence and impact of monopolar cautery use in a cohort of pediatric cochlear implant (CI) users.
Case series from a retrospective chart review and a systematic review of the ...literature.
Tertiary academic referral center.
CI patient charts from 2012 to 2021 were reviewed from a single pediatric hospital system to determine if monopolar cautery was used during a subsequent surgical procedure. In addition, a systematic review of the literature was performed to identify additional, relevant patients. Postoperative CI function was the primary outcome measure.
In total, 190 patients underwent a surgical procedure following cochlear implantation in a single pediatric hospital system. Fifteen patients (7.9%) and 17 distinct surgical procedures were identified in which monopolar cautery was used. Seven of these 17 cases (41.2%) involved the head and neck, and 10 were performed below the clavicles. No patients experienced a device failure or a decline in CI performance following surgery. A systematic review identified an additional 4 patients who underwent a surgery that used monopolar cautery following cochlear implantation, and no change in CI function was identified.
The present study adds additional support to the notion that monopolar cautery does not necessarily injure CI functionality. While the most risk adverse strategy when planning a surgical procedure for a CI patient is to avoid monopolar cautery use altogether, the use of cautery should not immediately be associated with implant dysfunction.
Purpose:
To report a case series of pterygium surgery with conjunctival autograft fixation using bipolar electrocautery.
Design:
A noncomparative, retrospective, interventional case series of ...pterygium surgery with follow-up longer than 12 months to assess recurrence and other complication rates.
Participants:
Fifty-six eyes of 37 patients were treated between April 2011 and January 2018, either for primary (n = 53 cases) or recurrent (n = 3 cases) pterygia.
Intervention:
After pterygium excision, free conjunctival grafts from the inferior bulbar conjunctiva of the same eye were harvested and fixated with the use of bipolar electrocautery.
Main outcome measure:
Recurrence of the pterygium and complications.
Results:
The mean follow-up was 41 months (range 12 to 81 months). There were no intraoperative complications. Recurrence of the lesion was seen in three eyes (5.36%). There were no other postoperative complications such as graft detachment, or formation of dellen or granulomas.
Conclusion:
Conjunctival autograft fixation using bipolar electrocautery seems to be a fast, costly and safe procedure that can be applied in most cases of pterygium surgery.
Flexible bronchoscopy Wickramasinghe, Sugeesha; Munavvar, Mohammed
Medicine (Abingdon. 1995, UK ed.),
October 2023, 2023-10-00, Letnik:
51, Številka:
10
Journal Article
Recenzirano
There have been dramatic advances in the field of bronchoscopy in recent years, with a multitude of standard and specialized techniques being used by bronchoscopists in the diagnosis and management ...of respiratory diseases, especially lung cancer. Standard techniques commonly used in respiratory departments include endobronchial and transbronchial biopsy, bronchial washing and brushing, bronchoalveolar lavage and endobronchial ultrasound-guided transbronchial needle aspiration, particularly for the diagnosis and staging of lung cancer. Newer techniques such as radial endobronchial ultrasound and computer-aided navigational bronchoscopy, cone beam CT, LungVision and robotic bronchoscopy have shown promising results in diagnosing peripheral lung cancers. Specialized techniques such as photodynamic therapy, brachytherapy, electrocautery, argon plasma coagulation, laser ablation, cryotherapy and airway stenting are available as therapeutic tools in central airway obstruction. There have also been exciting advances in the bronchoscopic management of non-malignant respiratory disease (e.g. endobronchial valves), thermal vapour ablation for bronchoscopic lung volume reduction in severe emphysema, and bronchial thermoplasty for severe asthma. This article provides an overview of these techniques.
The aim of this study was to evaluate the use of monopolar radiosurgery (MRS) assisted strabismus surgery and to compare its histologic and immunohistochemical wound healing outcomes with ...conventional surgery.
Superior rectus muscle resection was performed on 30 white rabbits with three different surgical muscle cutting techniques: monopolar radiosurgery (MRS group), conventional scissors preceded by bipolar electrocautery (BEC group), and conventional scissors with no cauterization (control group). Degree of tissue injury, bleeding, inflammation, and fibrosis, as well as wound healing rate (CD68+ cell number), were evaluated.
In CS group, hemorrhage scores were significantly higher than those in the other groups (MRS group: Z = 5.182; p < 0.001 and BEC group: Z = 4.463; p < 0.001) and MRS group had lower scores than BEC group; however, the difference was not significant (Z = 1.423; p = 0.211). The tissue injury score in BEC group was higher when compared with MRS, and the difference was statistically significant (p = 0.028). Median inflammation scores at days 1 and 21 were lowest in MRS group, but the difference was not statistically significant among groups (day 1; p = 0.115, day 21; p = 0.095). The median fibrosis score was higher in the control group, when compared with MRS, and the difference was statistically significant (muscle-sclera; p = 0.011 and muscle-conjunctiva: p = 0.003). The macrophage score (number of CD68+ cells) was lowest in CS group; however, the difference was not significant (p = 0.657).
Monopolar radiosurgery is a novel method for strabismus surgery and provides equivalent hemostasis effects and wound healing properties, compared with conventional methods, and enhances surgeon comfort, as muscle incisions are made in one step with clean surgical area.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Electrosurgical units are used in over 80% of operations worldwide. The consequences of incorrect use of electrosurgical units for patients and the surgical team include skin burns, inhalation of ...electrosurgical smoke, fire, and disruption to the functioning of cardiac pacemakers. Training operating room personnel in the correct use of electrosurgical units and evaluating their performance plays a crucial role in making optimal use of the units and extending their lifetime, reducing occupational hazards for surgical teams, and enhancing the safety of patients. Therefore, the present study was done to investigate the effects of an educational intervention on electrosurgical units by operating room nurses.
In this quasi-experimental research, the performance of 100 operating room nurses concerning their application of electrosurgical units in 200 operations (100 before and 100 one month after the educational intervention) was observed and evaluated. The data collection instruments consisted of a Demographic Information Questionnaire, a surgery checklist, and the checklist for the use of electrosurgical units by operating room nurses. The content of the poster was based upon the standard principles of using electrosurgical units based on the guidelines by the Association of periOperative Registered Nurses (AORN), Association of Surgical Technologists (AST), and the Association for PeriOperative Practice (AFFP).
The average age of the participating nurses were 31.540 ± 6.772 years. Before (18.330 ± 2.666) and after (20.820 ± 3.400) the educational intervention, the results showed a statistically significant difference between the means and standard deviations of the scores of electrosurgical units by operating room nurses.
Introducing operating room nurses to the standard guidelines for applying electrosurgical units can improve the quality of services provided by the nurses, increase the safety of patients, and reduce occupational hazards. Thus, medical managers and policymakers should pay more attention to on-the-job training programs to improve the professional performance of operating room nurses in the use of electrosurgical units.
Introduction: This study aims to report a rare case of a respiratory epithelial adenomatoid hamartoma (REAH) of the lateral nasal wall that had initially presented as a fungating mass, similar to ...that of a sinonasal malignancy, and its complete removal from the lateral nasal wall. Case Report: We report the case of a 58-year-old woman who presented to us with a chief complaint of recurrent right-sided epistaxis and nasal blockage for the past 4 months, which was progressively worsening. Histopathological examination confirmed the presence of a REAH instead of a sinonasal malignancy. The tumor was surgically excised from the lateral nasal wall using electrocautery under endoscopic guidance. The patient was then carefully followed-up after surgery, and the wound was successfully healed 3 months after the initial surgery. There was no evidence of recurrence 6 months after the initial surgery Conclusion: This case demonstrates the rare presentation of a REAH, which had arisen from the lateral nasal wall. Clinically, it is difficult to distinguish a REAH from a more notorious mass such as a sinonasal malignancy. Therefore, biopsy is mandatory in all cases of lateral nasal mass in order to rule out malignancy before confirming nasal REAH. Fortunately, as seen in this case, a lateral nasal REAH, once diagnosed, can be safely and easily removed from the lateral nasal wall using electrocautery with good surgical outcomes and a low rate of recurrence.
Surgical smoke produced by electrosurgery contains various chemical substances such as volatile organic compounds (VOCs) and polycyclic aromatic hydrocarbons (PAHs). The aim of this study is to ...investigate airborne concentrations of VOCs and PAHs during electrosurgery in an operating room, in relation to metabolites in urine in order to assess the absorbed dose.
A 5-day exposure study was set up in a general surgery operation room including surgeons, scrub assistants and circulation nurses (n = 15). Stationary and personal air sampling for VOCs and PAHs were carried out. Pre-, mid- and end-shift analysis of urinary S-phenylmercapturic acid (SPMA), o-cresol, mandelic acid and 1-hydroxypyrene was performed to assess the internal exposure to respectively benzene, toluene, styrene and PAHs.
Several VOCs (styrene, ethyl benzene, benzene and toluene), ranging from 0.7 to 3.27 μg/m3 were detected in the air samples, along with one PAH (naphthalene, ranging from 0.012 to 0.39 μg/m3). There was no significant correlation between air monitoring and urinary biomonitoring. O-cresol levels were increased, especially among assistants and nurses at mid- and end-shift, exceeding current biological exposure indices several times. External and internal exposure for assistants and nurses was substantially more, compared to surgeons.
This study confirms the presence of VOCs and PAHs in surgical smoke and shows the presence of their metabolites in urine, but the association is unclear. Urinary biomonitoring shows especially high concentrations of o-cresol.
The objective of this study was to compare the low-priced monopolar electrocautery to the high-priced, worldwide used, plasma ablation in tonsillotomy among children aged between three and twelve ...years, suffering from obstructive breathing disorders (OBD), with respect to post-operative pain, bleeding and related morbidities.
A randomized case-control study was conducted in the Eye and Ear Hospital International- Lebanon. 103 children aged between three and twelve years suffering from OBD secondary to tonsillar hypertrophy were randomly assigned into two groups. Post-operative pain was evaluated using age-adequate validated scales: “FLACC-R” (Face, Legs, Activity, Cry, Consolability-Revised) for children aged less than five years, and “Wong Baker faces” for older children. Additional post-operative outcomes were evaluated using Pain-PROM (Patient reported Pain-Related Outcome Measures) and TAHSI (Tonsil and Adenoid Health Status Instrument) scales.
Significantly, higher rates of patients who underwent tonsillotomy via plasma ablation technique used analgesics and had severe pain compared to the monopolar electrocautery group. A longer operative duration was significantly associated with higher pain scores, and the plasma ablation technique yielded significantly higher operative mean durations. 10 days post-operatively, a significantly higher percentage of children reported an overall high pain severity and more than expected overall pain when using the plasma ablation technique compared to the monopolar electrocautery one. Overall bleeding rates were similar. No difference was reported one month post-operatively.
When compared to plasma ablation, monopolar electrocautery, can provide the same efficiency in relieving OBD in healthy children, with equal overall bleeding rates, but significantly lower cost, operating time, pain scores and need for analgesics.
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