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New methods of in vivo monitoring and management of colonic anastomoses leak in experimental study
Kalvach, Jaroslav ; Pohnán, Radek (advisor) ; Kala, Zdeněk (referee) ; Klos, Dušan (referee)
The primary aim of the project was to assess two different minimally invasive techniques (Transanal minimally invasive surgical approach - TAMIS and endoscopic closure) in the treatment of colorectal anastomosis dehiscence on an experimental model. The secondary aim was to evaluate microdialysis (MD), and confocal laser endomicroscopy (CLE) as novel methods potentially suitable for postoperative monitoring of colo-rectal anastomosis. In the first step, large animal model of dehiscent colo-rectal anastomosis was developed. Two novel techniques of dehiscence closure were then compared with conventional surgical repair and laparotomy with anastomotic diversion. Thus 4 intervention groups and one untreated control group were included. Transanal repair using TAMIS and endoscopic closure were technically feasible with high healing rate. Both techniques reduced the incidence of intra- abdominal septic complications compared to control. With regards to secondary aim, colorectal anastomosis was monitored using MD and CLE before and after the induction of ischaemia. Moreover, intramural and serosal positioning of MD sensors were compared. Both methods revealed hypoperfusion of anastomosis promptly and were proven as suitable for early detection of impaired healing. Based on the results of this project, a...
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Cardiac surgery patient with surgical wound dehiscence
BENDULOVÁ, Adriana
Dehiscence or wound spacing is characterized by failure of wound healing and it is a very serious postoperative complication that occurs most frequently in patients who suffer from an associated disease. It usually develops between the fifth and ninth postoperative day. The cause of dehiscence is an infection in the wound, which is caused by proliferation of bacterial strains. The thesis on "Cardiac surgery patient with surgical wound dehiscence{\crqq} is focused on theoretical and practical parts. The theoretical part deals with the development of cardiac surgery and important personalities, medical indications for a cardiac surgery, cardiac surgery, surgical wound healing, surgical wound complications and nursing care of patients with dehiscence. The practical part was carried out by a quality - quantitative survey. The research sample for the qualitative research, which was conducted by the semi-structured interview technique with open questions, consisted of four cardiac surgery patients with wound dehiscence. The research sample for the quantitative research, which was carried out through anonymous questionnaires, consisted of 100 nurses working in cardiac surgery centers, Czech Republic, and 30 cardiac surgery patients with wound dehiscence. The results were processed into tables, graphs and diagrams. This work may serve as a resource for the interpretation of the subject matter or as a source of information for Cardiac Surgery Centers to improve the needs satisfaction in patients with wound dehiscence.
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