FG is a life-threatening necrotizing fasciitis with a high mortality rate. In our study, prognostic variables were heart disease, admission serum urea, potassium, alkaline phosphatase, and FGSIS. More studies are needed to validate these findings.

Abstract:Objective: To analyse hospital costs in the pre-, and intra-and post-operative periods associated with patients undergoing rectal resection with anastomosis, comparing the costs per patient with and without the use of fibrin-based biological adhesive(Tissucol Duo ® ). Methods: The cost analysis was designed with a subsample of 37 patients who underwent rectal anastomosis in a randomised, single-blind, controlled, parallel comparison between two groups, to evaluate the effectiveness of fibrin-based biological adhesive used to prevent anastomotic leakage. The total costs included diagnostic tests, laboratory tests, hospital stay, adhesive cost, surgery, reintervention and drug treatment. Results: The patients had a mean age of 64.33 years, with a higher proportion of men (62.2%). The study groups were homogeneous and comparable. The average total cost in the group with biological adhesive was€ 10,304.84 compared to € 17,845.12 in the group without biological adhesive. Significant differences were found in the average cost of reintervention between groups: € 119.76 with adhesive vs. € 639.20 for the control group. Conclusions: The total cost decreased by 42% in the group in which a biological adhesive was applied compared to the group in which the adhesive was not applied. This percentage represented a difference of € 7,540.28 in the total average cost per patient.

The use of topical HOFAs, in conjunction with the application of an elastic bandage before applying an SPT, is a safe and effective way of preventing SPT-induced skin lesions.

Background: Fibrin-based biological adhesives are used for tissue adhesion improving the outcome of gastrointestinal sutures. The objective was to assess the effectiveness of fibrin-based biological adhesives for prevention of anastomotic leakage in high-risk gastrointestinal anastomoses. Methods: A randomized clinical trial was designed to recruit patients underwent a rectal resection surgery. A subgroup of patients with rectal anastomosis were recruited from 2 different hospital centres. Patients in which a biological fibrin-based biological adhesive was applied to the suture line (study group) were compared versus a control group under standard practice. The main outcome measures was presence or absence of leakage and need for reoperation. Results: Thirty seven patients underwent a rectal resection and anastomosis. In 21 standard practice was applied and a fibrin-based adhesive was used in 16. Fourteen patients (37.8%) had a clinical or subclinical anastomotic leak, 11 belonging to control group versus 3 patients in the study group (p-value of 0.04). Statistically significant difference (p-value of 0.048) in the need for reoperation. We found no association between the use of drains and anastomotic leakage. There were only 3 leaks in the group in which a drain was placed, as compared to 11 leaks in the group in which no drain was placed, but these findings were probably due to chance (p = 0.54). Conclusions: The use of these adhesives could not only reduce serious postoperative complications related to dehiscence but also improve the prognosis and oncological outcome of rectal and sigmoid cancer treatment.

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