Pub Date : 2025-07-09DOI: 10.1016/S1479-666X(25)00118-0
{"title":"List of editors","authors":"","doi":"10.1016/S1479-666X(25)00118-0","DOIUrl":"10.1016/S1479-666X(25)00118-0","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 4","pages":"Page i"},"PeriodicalIF":2.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-09DOI: 10.1016/j.surge.2025.04.008
Gavin P. Dowling , Gordon R. Daly , Sandra Hembrecht , Sorcha O'Grady , Aisling Hegarty , Trudi Roche , Gerard Hill , Gabriel Orsi , Oisin Brennan , Jan Sorenson , Colm Power , David Kearney , Abeeda Butt , Michael Boland , Ishwarya Balasubramanian , Andrew Maguire , Niamh McCawley , Deborah McNamara , John Burke , William Robb , Arnold D.K. Hill
{"title":"Laparoscopic-assisted Transversus Abdominis Plane Block versus Port-site Infiltration in Appendectomy: A Multicentre, Single-blinded Randomised Controlled Trial","authors":"Gavin P. Dowling , Gordon R. Daly , Sandra Hembrecht , Sorcha O'Grady , Aisling Hegarty , Trudi Roche , Gerard Hill , Gabriel Orsi , Oisin Brennan , Jan Sorenson , Colm Power , David Kearney , Abeeda Butt , Michael Boland , Ishwarya Balasubramanian , Andrew Maguire , Niamh McCawley , Deborah McNamara , John Burke , William Robb , Arnold D.K. Hill","doi":"10.1016/j.surge.2025.04.008","DOIUrl":"10.1016/j.surge.2025.04.008","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 4","pages":"Page 254"},"PeriodicalIF":2.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144579451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-09DOI: 10.1016/j.surge.2025.04.012
James Connor , John O’Kelly , Steven Anderson , Ailish Naughton , David Galvin , Kieran Breen , Diarmaid Moran , Mark Quinlan , Barry McGuire , Niall Davis
{"title":"Early ureteroscopy and laser lithotripsy in the management of obstructing urolithiasis with associated urosepsis – A prospective multi-institutional study","authors":"James Connor , John O’Kelly , Steven Anderson , Ailish Naughton , David Galvin , Kieran Breen , Diarmaid Moran , Mark Quinlan , Barry McGuire , Niall Davis","doi":"10.1016/j.surge.2025.04.012","DOIUrl":"10.1016/j.surge.2025.04.012","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 4","pages":"Page 255"},"PeriodicalIF":2.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-09DOI: 10.1016/j.surge.2025.04.014
I. Marinescu , E. Phoenix , E. Geary , D. Mclaughlin , C. Morrison , R. Dolan
{"title":"The MISHAP Trial: Managing Injuries - a Study of Hand Appearance and Psychosocial Dysfunction","authors":"I. Marinescu , E. Phoenix , E. Geary , D. Mclaughlin , C. Morrison , R. Dolan","doi":"10.1016/j.surge.2025.04.014","DOIUrl":"10.1016/j.surge.2025.04.014","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 4","pages":"Page 256"},"PeriodicalIF":2.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-08DOI: 10.1016/j.surge.2025.07.001
Dilek Soylu , Adem Doğaner
Purpose
Organ donation is influenced by culture, religion, death rituals, and the perceived needs of the body after death. This study examined the moderating role of death anxiety in the effect of self-confidence and life satisfaction on attitudes to organ donation.
Methods
This study was descriptive, cross-sectional, and relationship-seeking. The study was conducted with a total of 247 nursing students between January and February 2024. Moderator effect was used, using the Death Anxiety Scale. In the data collection, a Personal Information Form, the Organ Donation Attitude Scale, Life Satisfaction Scale, Self-Confidence Scale were used.
Results
Death Anxiety Scale was determined to have a significant moderating effect on the Organ Donation Attitude Scale (β = 0.0452, p < 0.001) and there was seen to be a moderating role of Death Anxiety Scale on the effect of Life Satisfaction Scale on Organ Donation Attitude Scale (β = 0.1586, p = 0.033).
Conclusions
There was determined to be a moderating role of Death Anxiety Scale in the effect of Self-Confidence Scale and Life Satisfaction Scale on Organ Donation Attitude Scale.
{"title":"The effect of self-confidence, life satisfaction and death anxiety on organ donation in student nurses: Moderator effect","authors":"Dilek Soylu , Adem Doğaner","doi":"10.1016/j.surge.2025.07.001","DOIUrl":"10.1016/j.surge.2025.07.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Organ donation is influenced by culture, religion, death rituals, and the perceived needs of the body after death. This study examined the moderating role of death anxiety in the effect of self-confidence and life satisfaction on attitudes to organ donation.</div></div><div><h3>Methods</h3><div>This study was descriptive, cross-sectional, and relationship-seeking. The study was conducted with a total of 247 nursing students between January and February 2024. Moderator effect was used, using the Death Anxiety Scale. In the data collection, a Personal Information Form, the Organ Donation Attitude Scale, Life Satisfaction Scale, Self-Confidence Scale were used.</div></div><div><h3>Results</h3><div>Death Anxiety Scale was determined to have a significant moderating effect on the Organ Donation Attitude Scale (β = 0.0452, p < 0.001) and there was seen to be a moderating role of Death Anxiety Scale on the effect of Life Satisfaction Scale on Organ Donation Attitude Scale (β = 0.1586, p = 0.033).</div></div><div><h3>Conclusions</h3><div>There was determined to be a moderating role of Death Anxiety Scale in the effect of Self-Confidence Scale and Life Satisfaction Scale on Organ Donation Attitude Scale.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 5","pages":"Pages 288-295"},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-08DOI: 10.1016/j.surge.2025.06.004
John David Kehoe, Robert O'Connell, Eimear Linehan, Niall Hardy, Ben Creavin, Tamara Gall, Gerry McEntee, John Conneely
Introduction
A selection of international guidelines suggest that emergency cholecystectomy within 72 h of admission is the treatment of choice for acute cholecystitis. The aim of this study was to analyse the interval from presentation to operative intervention for acute cholecystitis in Ireland and its impact on peri-operative outcomes.
Methods
This was a national retrospective observational study of all patients that underwent an emergency cholecystectomy for acute cholecystitis in Ireland between January 2017 and July 2023. Data collected included: demographics, co-morbidities, length of stay, operative approach, post-operative interventions, in-patient mortality, and readmissions. Subjects were stratified based on time from presentation to theatre and outcomes were compared between groups.
Results
3585 patients underwent an emergency cholecystectomy for acute cholecystitis–2005(55.9 %) within 72 h of admission, 1072(29.9 %) within 72 hours-7 days, 416(11.6 %) within 8–14 days and 92(2.6 %) beyond 14 days. Earlier progression to theatre was predicted by female sex (X2(3) = 10.402,p = 0.015), less co-morbidities (X2(12) = 95.723,p=<0.001), and younger age (H(3) = 92.591,p=<0.001).
On logistic regression, age >65(OR 1.565,p < 0.001), male sex(OR 1.348,p = 0.002), increasing co-morbidities(OR 1.586,p = 0.009) and increased “time to theatre”(72hrs-7days(OR 1.616,p < 0.001), 8–14days(OR 3.84,p < 0.001), >14days(OR 5.929,p < 0.001)) were risk factors for a composite of adverse outcomes (mortality, 30-day readmission, post-operative ERCP/IR drain, conversion to open, CBD injury). Subgroup analysis of the <72 h group displayed no difference in outcome.
Conclusion
Despite international guidance, just over half of emergency cholecystectomies for acute cholecystitis are performed within 72 h in Ireland. Prolonging “time to theatre” is associated with a stepwise deterioration in outcomes across a wide variety of measures.
引言：一些国际指南建议在入院后72小时内进行急诊胆囊切除术是急性胆囊炎的首选治疗方法。本研究的目的是分析爱尔兰急性胆囊炎从出现到手术干预的时间间隔及其对围手术期结果的影响。方法：这是一项全国性的回顾性观察研究，纳入了2017年1月至2023年7月在爱尔兰因急性胆囊炎接受紧急胆囊切除术的所有患者。收集的数据包括：人口统计学、合并症、住院时间、手术方式、术后干预、住院死亡率和再入院率。根据从演讲到剧院的时间对受试者进行分层，并比较各组之间的结果。结果：3585例急性胆囊炎患者行急诊胆囊切除术，其中入院72小时内2005例（55.9%），72小时-7天内1072例（29.9%），8-14天内416例（11.6%），14天以上92例（2.6%）。女性更早进入手术室（X2(3) = 10.402,p = 0.015），更少的合病(X2(12) = 95.723,p=65（OR 1.565, OR 5.929,p）结论：尽管有国际指导，在爱尔兰，超过一半的急性胆囊炎急诊胆囊切除术在72小时内完成。延长“进入手术室的时间”与各种措施的结果逐步恶化有关。
{"title":"The effect of timing of emergency cholecystectomy for acute cholecystitis on peri-operative outcomes: A national registry-based study","authors":"John David Kehoe, Robert O'Connell, Eimear Linehan, Niall Hardy, Ben Creavin, Tamara Gall, Gerry McEntee, John Conneely","doi":"10.1016/j.surge.2025.06.004","DOIUrl":"10.1016/j.surge.2025.06.004","url":null,"abstract":"<div><h3>Introduction</h3><div>A selection of international guidelines suggest that emergency cholecystectomy<span> within 72 h of admission is the treatment of choice for acute cholecystitis<span>. The aim of this study was to analyse the interval from presentation to operative intervention for acute cholecystitis in Ireland and its impact on peri-operative outcomes.</span></span></div></div><div><h3>Methods</h3><div>This was a national retrospective observational study of all patients that underwent an emergency cholecystectomy for acute cholecystitis in Ireland between January 2017 and July 2023. Data collected included: demographics, co-morbidities, length of stay, operative approach, post-operative interventions, in-patient mortality, and readmissions. Subjects were stratified based on time from presentation to theatre and outcomes were compared between groups.</div></div><div><h3>Results</h3><div>3585 patients underwent an emergency cholecystectomy for acute cholecystitis–2005(55.9 %) within 72 h of admission, 1072(29.9 %) within 72 hours-7 days, 416(11.6 %) within 8–14 days and 92(2.6 %) beyond 14 days. Earlier progression to theatre was predicted by female sex (X<sup>2</sup>(3) = 10.402,p = 0.015), less co-morbidities (X<sup>2</sup>(12) = 95.723,p=<0.001), and younger age (H(3) = 92.591,p=<0.001).</div><div><span>On logistic regression, age >65(OR 1.565,p < 0.001), male sex(OR 1.348,p = 0.002), increasing co-morbidities(OR 1.586,p = 0.009) and increased “time to theatre”(72hrs-7days(OR 1.616,p < 0.001), 8–14days(OR 3.84,p < 0.001), >14days(OR 5.929,p < 0.001)) were risk factors for a composite of </span>adverse outcomes<span> (mortality, 30-day readmission, post-operative ERCP/IR drain, conversion to open, CBD injury). Subgroup analysis of the <72 h group displayed no difference in outcome.</span></div></div><div><h3>Conclusion</h3><div>Despite international guidance, just over half of emergency cholecystectomies for acute cholecystitis are performed within 72 h in Ireland. Prolonging “time to theatre” is associated with a stepwise deterioration in outcomes across a wide variety of measures.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 5","pages":"Pages 301-305"},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-08DOI: 10.1016/j.surge.2025.07.003
Floortje Huizing , Vincent Q. Sier , Annelot D. Sark , Heleen S. Snijders , Joost R. van der Vorst , Roderick F. Schmitz , Abbey Schepers , Joris J. Blok , Future Surgeon Initiative
Background and purpose
Intergenerational differences in surgery create both challenges and opportunities. While differening perspectives and expectations may deter younger generations from pursuing surgical careers, it is crucial to balance these with the core values that define the surgical profession. This narrative review was conducted to better understand how the profession needs to evolve.
Methods
A structured literature search on generational changes in surgery was conducted using PubMed and Google Scholar. Relevant search terms were employed, covering (i) surgeons/surgery, (ii) generation/cohort and (ii) culture/identity/behaviour. After independent title and abstract screening by three authors, consensus was reached to include relevant studies published in English up to November 2023.
Main findings
Full-text evaluation led to an inclusion of 50 studies, reviewed for returning themes. Identified themes included: generations (n = 9), work engagement (n = 8), work-life balance (n = 7), training and education (n = 4) and attractiveness of the profession (n = 8). An additional 14 relevant studies were included based on reference lists and external sources.
Conclusions
This review summarizes key factors contributing to surgical well-being and generational dynamics. Awareness of these factors is increasing. While generational differences exist, many distinctions may be attributed to life phases, lifestyles or systemic changes in the past decades. Addressing these topics daily can foster intergenerational dialogue and a supportive environment for future surgeons.
{"title":"Bridging generational gaps in Surgery: A narrative review on values, well-being, and training preferences","authors":"Floortje Huizing , Vincent Q. Sier , Annelot D. Sark , Heleen S. Snijders , Joost R. van der Vorst , Roderick F. Schmitz , Abbey Schepers , Joris J. Blok , Future Surgeon Initiative","doi":"10.1016/j.surge.2025.07.003","DOIUrl":"10.1016/j.surge.2025.07.003","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Intergenerational differences in surgery create both challenges and opportunities. While differening perspectives and expectations may deter younger generations from pursuing surgical careers, it is crucial to balance these with the core values that define the surgical profession. This narrative review was conducted to better understand how the profession needs to evolve.</div></div><div><h3>Methods</h3><div>A structured literature search on generational changes in surgery was conducted using PubMed and Google Scholar. Relevant search terms were employed, covering (i) surgeons/surgery, (ii) generation/cohort and (ii) culture/identity/behaviour. After independent title and abstract screening by three authors, consensus was reached to include relevant studies published in English up to November 2023.</div></div><div><h3>Main findings</h3><div>Full-text evaluation led to an inclusion of 50 studies, reviewed for returning themes. Identified themes included: generations (n = 9), work engagement (n = 8), work-life balance (n = 7), training and education (n = 4) and attractiveness of the profession (n = 8). An additional 14 relevant studies were included based on reference lists and external sources.</div></div><div><h3>Conclusions</h3><div>This review summarizes key factors contributing to surgical well-being and generational dynamics. Awareness of these factors is increasing. While generational differences exist, many distinctions may be attributed to life phases, lifestyles or systemic changes in the past decades. Addressing these topics daily can foster intergenerational dialogue and a supportive environment for future surgeons.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 6","pages":"Pages 333-341"},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-30DOI: 10.1016/j.surge.2025.06.003
Lachlan Dick, Sannah Ali, Katie Hughes
{"title":"Enhancing medical student learning in the operating theatre: the need for integrated preparation","authors":"Lachlan Dick, Sannah Ali, Katie Hughes","doi":"10.1016/j.surge.2025.06.003","DOIUrl":"10.1016/j.surge.2025.06.003","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 5","pages":"Pages 324-325"},"PeriodicalIF":2.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-28DOI: 10.1016/j.surge.2025.06.002
Michele Schiano di Visconte
Background
Acute hemorrhoidal disease (AHD) is a prevalent anorectal condition that significantly impacts patients' quality of life and healthcare systems. Despite the availability of various conservative treatments, comparative efficacy data remains limited. This retrospective study evaluates two treatment regimens for AHD, focusing on symptom relief, patient-reported outcomes, and treatment tolerability.
Methods
Medical records of 123 patients with AHD treated at a tertiary care center between October 2022 and October 2024 were reviewed. Patients were divided into two groups: Group A treated with oral diosmin/hesperidin, bromelain, and topical lidocaine, and Group B treated with oral diosmin/hesperidin, bromelain, and topical nifedipine. Symptoms were evaluated using the Hemorrhoidal Disease Symptom Score (HDSS), Visual Analog Scale (VAS) for pain, and Short Health Scale for Hemorrhoidal Disease (SHS-HD) at baseline and on days 7, 14, and 21.
Results
Both groups showed significant improvements in symptoms during the study period. Group A demonstrated faster pain reduction (VAS day 7:0.17 ± 0.52 vs. 2.20 ± 1.11, p < 0.001) and greater improvement in HDSS score (day 7: 0.02 ± 0.87 vs. 10.16 ± 3.38, p < 0.001). Improvements in SHS-HD scores were more rapid for Group A, with scores on day 7 showing a significant difference (Group A: 7.58 ± 2.58 vs. Group B: 12.27 ± 4.21, p < 0.001). Both regimens were well tolerated, with no significant adverse events.
Conclusions
The combination of oral diosmin/hesperidin, bromelain, and lidocaine provides superior initial symptom relief compared with nifedipine-based regimens. Lidocaine is the preferred topical agent for rapid pain management in AHD patients. Further studies are required to confirm these results.
背景：急性痔疮病（AHD）是一种常见的肛肠疾病，严重影响患者的生活质量和医疗保健系统。尽管有各种保守治疗方法，但相对疗效数据仍然有限。本回顾性研究评估了AHD的两种治疗方案，重点关注症状缓解、患者报告的结果和治疗耐受性。方法：回顾2022年10月至2024年10月在某三级保健中心治疗的123例AHD患者的病历。患者分为两组：A组口服地奥司明/橙皮苷、菠萝碱，外用利多卡因；B组口服地奥司明/橙皮苷、菠萝碱，外用硝苯地平。在基线和第7、14和21天使用痔疮疾病症状评分（HDSS）、疼痛视觉模拟量表（VAS）和痔疮疾病短期健康量表（SHS-HD）对症状进行评估。结果：两组患者在研究期间症状均有明显改善。A组疼痛减轻更快（VAS日：0.17±0.52 vs. 2.20±1.11,p）结论：与硝苯地平为主的方案相比，口服地奥司明/橙皮苷、菠萝酶和利多卡因联合使用可更好地缓解初始症状。利多卡因是AHD患者快速止痛的首选外用药物。需要进一步的研究来证实这些结果。
{"title":"Comparative efficacy of lidocaine- and nifedipine-based conservative therapies in acute hemorrhoidal disease: A retrospective cohort study","authors":"Michele Schiano di Visconte","doi":"10.1016/j.surge.2025.06.002","DOIUrl":"10.1016/j.surge.2025.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Acute hemorrhoidal disease (AHD) is a prevalent anorectal condition that significantly impacts patients' quality of life<span> and healthcare systems. Despite the availability of various conservative treatments, comparative efficacy data remains limited. This retrospective study evaluates two treatment regimens for AHD, focusing on symptom relief, patient-reported outcomes, and treatment tolerability.</span></div></div><div><h3>Methods</h3><div><span>Medical records of 123 patients with AHD treated at a tertiary care center between October 2022 and October 2024 were reviewed. Patients were divided into two groups: Group A treated with oral diosmin/hesperidin, </span>bromelain<span><span>, and topical lidocaine, and Group B treated with oral diosmin/hesperidin, bromelain, and topical </span>nifedipine<span>. Symptoms were evaluated using the Hemorrhoidal Disease Symptom Score (HDSS), Visual Analog Scale (VAS) for pain, and Short Health Scale for Hemorrhoidal Disease (SHS-HD) at baseline and on days 7, 14, and 21.</span></span></div></div><div><h3>Results</h3><div>Both groups showed significant improvements in symptoms during the study period. Group A demonstrated faster pain reduction (VAS day 7:0.17 ± 0.52 vs. 2.20 ± 1.11, <em>p</em><span> < 0.001) and greater improvement in HDSS score (day 7: 0.02 ± 0.87 vs. 10.16 ± 3.38, p < 0.001). Improvements in SHS-HD scores were more rapid for Group A, with scores on day 7 showing a significant difference (Group A: 7.58 ± 2.58 vs. Group B: 12.27 ± 4.21, p < 0.001). Both regimens were well tolerated, with no significant adverse events.</span></div></div><div><h3>Conclusions</h3><div><span>The combination of oral diosmin/hesperidin, bromelain, and lidocaine provides superior initial symptom relief compared with nifedipine-based regimens. Lidocaine is the preferred topical agent for rapid pain management in AHD patients. Further studies are required to confirm these results</span><strong>.</strong></div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 6","pages":"Pages 406-411"},"PeriodicalIF":2.3,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-27DOI: 10.1016/j.surge.2025.06.001
Bibi Ayesha Bassa , Michele Fernandes , Elizabeth Little , Kaitlin Alexander , Frank Lyons , Valeria Lima Passos , Fionnuala Ni Ainle , Etimbuk Umana
Aim
Due to complex injury patterns, the safe timing of venous thromboembolism (VTE) prophylaxis in trauma patients is challenging. The purpose of this study was to characterize current thromboprophylaxis practice in trauma patients amongst trauma providers in Ireland.
Methods
We conducted a national, cross-sectional survey of trauma providers. The survey was sponsored by the Irish Network for VTE Research (INViTE) and disseminated through the national trauma and VTE office. The survey was a 35-item questionnaire and collected information regarding non-pharmacologic prophylaxis practice, preferred pharmacologic agent and dose, timing to initiation of prophylaxis in high-risk patients and selection of patients for extended thromboprophylaxis post discharge.
Results
A total of 116 trauma providers responded (estimated response rate among surgical specialities 11 %). Majority of respondents (72/116; 65 %) were consultant doctors or fellows. Thirty-seven percent of respondents (43/116) reported having a VTE guideline for trauma patients at their institution. Majority of respondents (115/116; 99 %) reported using some form of mechanical prophylaxis. The most common pharmacologic dosing regimen reported was enoxaparin 40 mg 24-hourly (44/116; 38 %). Forty-four percent of respondents (51/116) indicated adjusting doses in patients with obesity. A high degree of variability in initial timing of prophylaxis following traumatic brain injury, solid organ injury, and spinal column injuries was observed.
Conclusion
There is variable VTE prevention practice among trauma providers in Ireland. A standardized, national approach to VTE prevention in trauma care is needed.
{"title":"Venous thromboembolism (VTE) prevention in the trauma patient: A national survey of practice","authors":"Bibi Ayesha Bassa , Michele Fernandes , Elizabeth Little , Kaitlin Alexander , Frank Lyons , Valeria Lima Passos , Fionnuala Ni Ainle , Etimbuk Umana","doi":"10.1016/j.surge.2025.06.001","DOIUrl":"10.1016/j.surge.2025.06.001","url":null,"abstract":"<div><h3>Aim</h3><div>Due to complex injury patterns, the safe timing of venous thromboembolism (VTE) prophylaxis in trauma patients is challenging. The purpose of this study was to characterize current thromboprophylaxis practice in trauma patients amongst trauma providers in Ireland.</div></div><div><h3>Methods</h3><div>We conducted a national, cross-sectional survey of trauma providers. The survey was sponsored by the Irish Network for VTE Research (INViTE) and disseminated through the national trauma and VTE office. The survey was a 35-item questionnaire and collected information regarding non-pharmacologic prophylaxis practice, preferred pharmacologic agent and dose, timing to initiation of prophylaxis in high-risk patients and selection of patients for extended thromboprophylaxis post discharge.</div></div><div><h3>Results</h3><div>A total of 116 trauma providers responded (estimated response rate among surgical specialities 11 %). Majority of respondents (72/116; 65 %) were consultant doctors or fellows. Thirty-seven percent of respondents (43/116) reported having a VTE guideline for trauma patients at their institution. Majority of respondents (115/116; 99 %) reported using some form of mechanical prophylaxis. The most common pharmacologic dosing regimen reported was enoxaparin 40 mg 24-hourly (44/116; 38 %). Forty-four percent of respondents (51/116) indicated adjusting doses in patients with obesity. A high degree of variability in initial timing of prophylaxis following traumatic brain injury, solid organ injury, and spinal column injuries was observed.</div></div><div><h3>Conclusion</h3><div>There is variable VTE prevention practice among trauma providers in Ireland. A standardized, national approach to VTE prevention in trauma care is needed.</div></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"23 6","pages":"Pages 412-419"},"PeriodicalIF":2.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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