Background Kangri cancer is a heat-induced skin carcinoma associated with the use of the Kangri. This Kangri, which is a traditional fire pot, is an ingenious mode of providing warmth. The Kangri is ...an earthenware container with an outer encasement of wickerwork that is filled with ignited coal inside for providing a source of heat in winter months. Its prolonged use may result in formation of erythema ab igne, a reticulate hypermelanosis with erythema, which may transform into cutaneous cancer. Currently, this skin cancer rarely is found in the Kashmir valley. Methods Between 2003 and 2008, all those having Kangri cancer were studied. Results A 5-year study was conducted during which 17 patients who were documented with a Kangri cancer were treated. Sixteen patients had cancer on a thigh and 1 had cancer on the abdominal wall. All had an excision of the neoplasm. Histopathology documented squamous cell carcinoma in all patients. Conclusion Kangri cancer still occurs in patients who live in remote areas of Kashmir where there is a chilling cold in winter months and have no modern and alternative cheap means of warming other than the Kangri.
The aim of this paper was to review the recent literature to create recommendations for the day-to-day diagnosis and surgical management of small bowel and colon injuries. Where knowledge gaps were ...identified, expert consensus was pursued during the 8th International Congress of the World Society of Emergency Surgery Annual (September 2021, Edinburgh). This process also aimed to guide future research.
Surgical site infections (SSI) represent a considerable burden for healthcare systems. They are largely preventable and multiple interventions have been proposed over past years in an attempt to ...prevent SSI. We aim to provide a position paper on Operative Room (OR) prevention of SSI in patients presenting with intra-abdominal infection to be considered a future addendum to the well-known World Society of Emergency Surgery (WSES) Guidelines on the management of intra-abdominal infections.
The literature was searched for focused publications on SSI until March 2019. Critical analysis and grading of the literature has been performed by a working group of experts; the literature review and the statements were evaluated by a Steering Committee of the WSES.
Wound protectors and antibacterial sutures seem to have effective roles to prevent SSI in intra-abdominal infections. The application of negative-pressure wound therapy in preventing SSI can be useful in reducing postoperative wound complications. It is important to pursue normothermia with the available resources in the intraoperative period to decrease SSI rate. The optimal knowledge of the pharmacokinetic/pharmacodynamic characteristics of antibiotics helps to decide when additional intraoperative antibiotic doses should be administered in patients with intra-abdominal infections undergoing emergency surgery to prevent SSI.
The current position paper offers an extensive overview of the available evidence regarding surgical site infection control and prevention in patients having intra-abdominal infections.
Despite the current therapeutic options for the treatment of inflammatory bowel disease, surgery is still frequently required in the emergency setting, although the number of cases performed seems to ...have decreased in recent years. The World Society of Emergency Surgery decided to debate in a consensus conference of experts, the main pertinent issues around the management of inflammatory bowel disease in the emergent situation, with the need to provide focused guidelines for acute care and emergency surgeons.
A group of experienced surgeons and gastroenterologists were nominated to develop the topics assigned and answer the questions addressed by the Steering Committee of the project. Each expert followed a precise analysis and grading of the studies selected for review. Statements and recommendations were discussed and voted at the Consensus Conference of the 6th World Society of Emergency Surgery held in Nijmegen (The Netherlands) in June 2019.
Complicated inflammatory bowel disease requires a multidisciplinary approach because of the complexity of this patient group and disease spectrum in the emergency setting, with the aim of obtaining safe surgery with good functional outcomes and a decreasing stoma rate where appropriate.
Abstract Introduction : Rectal cancer continues to be devastating malignancy worldwide. Sphincter preservation is the need of the hour. Distal anastomosis is more prone to leaks. Proximal diversion ...in form of ileostomy may be used to protect distal anastomosis. Aim : To compare two groups of low anterior resection with and without diversion ileostomy in rectal cancer patients. Material and methods : A prospective, hospital based study of 78 rectal carcinoma patients were taken for the study. Inclusion criteria was operable rectal cancer 4–12 cm from anal verge. Patients were randomized into two groups. Group – A (34 patient) patients with low anterior resection with ileostomy (LAR with ileostomy); Group – B (44 patients) patients with low anterior resection without ileostomy (LAR without ileostomy). Quality of life was assessed by scoring done by self designed method. A total score of 0–20 given for various parameters. Results : Skin excoriation was the commonest complication. Stomal retraction and stomal obstruction was seen in 1 patient each (3%). Hypokalemia was the commonest electrolyte imbalance present in ileostomy group. Anastomotic leak was present in 6% of Group A and 11% of Group B patients. Mean time of closure of ileostomy was 16 ± 4.3 weeks. Conclusion : LAR with ileostomy has certain advantages over LAR without ileostomy in terms of anastomotic leak, postoperative ileus, resumption of diet, wound infection, small bowel obstruction and in terms mortality and recurrence. However stoma related complications were main disadvantage in LAR with ileostomy.
Despite the call to enhance accuracy and value of operation records few international recommended minimal standards for operative notes documentation have been described. This study undertook a ...systematic review of existing operative reporting systems for laparoscopic cholecystectomy (LC) to fashion a comprehensive, synoptic operative reporting template for the future.
A search for all relevant articles was conducted using PubMed version of Medline, Scopus and Web of Science databases in June 2021, for publications from January 1st 2011 to October 25th 2021, using the keywords: laparoscopic cholecystectomy AND operation notes OR operative notes OR proforma OR documentation OR report OR narrative OR audio-visual OR synoptic OR digital. Two reviewers (NOC, GMC) independently assessed each published study using a MINORS score of ≥ 16 for comparative and ≥ 10 for non-comparative for inclusion. This systematic review followed PRISMA guidelines and was registered with PROSPERO. Synoptic operative templates from published data were assimilated into one "ideal" laparoscopic operative report template following international input from the World Society of Emergency Surgery board.
A total of 3567 articles were reviewed. Following MINORS grading 25 studies were selected spanning 14 countries and 4 continents. Twenty-two studies were prospective. A holistic overview of the operative procedure documentation was reported in 6/25 studies and a further 19 papers dealt with selective surgical aspects of LC. A unique synoptic LC operative reporting template was developed and translated into Chinese/Mandarin, French and Arabic.
This systematic review identified a paucity of publications dealing with operative reporting of LC. The proposed new template may be integrated digitally with hospitals' medical systems and include additional narrative text and audio-visual data. The template may help define new OR (operating room) recording standards and impact on care for patients undergoing LC.
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