WUTH publication: Clinical outcomes of triamcinolone-assisted anterior vitrectomy after phacoemulsification complicated by posterior capsule rupture.

Citation: Journal of Cataract and Refractive Surgery, 2013, Jan 18
Author: Kasbekar S, Prasad S, Kumar BV
Abstract: PURPOSE: To compare the clinical outcomes in patients who had triamcinolone acetate-assisted anterior vitrectomy and patients who had anterior vitrectomy without triamcinolone acetate after phacoemulsification complicated by posterior capsule rupture and vitreous loss.
SETTING: Arrowe Park Hospital, Wirral, United Kingdom.
DESIGN: Retrospective consecutive case note review.
METHODS: Consecutive case notes of patients who had anterior vitrectomy assisted by triamcinolone acetonide (triamcinolone group) or without triamcinolone acetate (no-triamcinolone group) after posterior capsule rupture between January 2007 and January 2011 were identified and examined. Data recorded at the clinic visit preoperatively and 1 day and 3 months postoperatively were collated. Information recorded on the pro forma included visual acuity, ocular comorbidities, intraocular pressure (IOP), vitreous strands in the anterior chamber, and other adverse events.
RESULTS: No statistically significant difference was found in the visual acuity or IOP between 17 patients in the triamcinolone group and 34 patients in the no-triamcinolone group at any time point. Vitreous strands in the anterior chamber were noted in 1 patient in the triamcinolone group and 7 patients in the no-triamcinolone group. Cystoid macular edema (CME) was present in 3 patients in the no-triamcinolone group, including 1 patient with vitreomacular traction.
CONCLUSIONS: There was no significant increase in IOP after triamcinolone acetate-assisted anterior vitrectomy. Higher rates of CME and residual anterior chamber vitreous strands in the no-triamcinolone acetate group support the clinical use of triamcinolone acetate.
FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

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WUTH publication: Standardized definition of contamination and evidence-based target necessary for high-quality blood culture contamination rate audit.

Citation: Journal of Hospital Infection. 2013 Jan 9.
Author: Harvey DJ, Albert S

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WUTH publication: A systematic review on the use of prophylactic mesh during primary stoma formation to prevent parastomal hernia formation.

Citation: Colorectal Disease, 2012, 14(8), 931-6.
Author: Shabbir J, Chaudhary BN, Dawson R
Abstract: AIM: Despite advances in surgical technique, parastomal herniation is common. This systematic review aims to assess the efficacy of prophylactic mesh at primary operation in reducing the incidence of parastomal hernia.
METHOD: Medline, EMBASE and CENTRAL were searched for relevant publications between January 1980 and January 2010. The search strategy included text terms and MESH headings for parastomal hernia, mesh and prevention and/or prophylaxis of hernia. No language restrictions were applied. Bibliographies from the papers requested in full were manually checked. All randomized controlled trials were included regardless of the language of publication. Results were extracted from the papers by two observers independently on a predefined data sheet. Disagreements were resolved by discussion. REVMAN 5 was used for statistical analysis.
RESULTS: Of 27 possible studies three randomized controlled trials fulfilled the criteria for systematic review, with a total of 128 patients (mesh 64, no mesh 64). The two study groups were well matched demographically. The incidence of parastomal hernia in the mesh group was 12.5% (8/64) compared with 53% (34/64) in the control group (P < 0.0001). There was no difference in mesh related morbidity in the two groups.
CONCLUSION: Although only three trials with 128 patients fulfilled the criteria for this systematic review, the data suggest that the use of prophylactic prosthetic mesh at the time of primary stoma formation reduces the incidence of parastomal hernia.

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