Cyanoacrylate adhesives offer the surgeon and patient an alternative to subcuticular suturing. LiquiBand® Surgical S (LBSS) is a new formulation with a blend of monomeric n-butyl and 2-octyl cyanoacrylates. In this study, the effectiveness, safety, and clinical utility of LBSS was compared to Vicryl™ sutures for the closure of laparoscopic incisions. This was a prospective randomized study of LBSS skin adhesive versus Vicryl™ sutures for the topical closure of laparoscopic surgical incisions. Subjects were asked to return at 2 weeks postsurgery to report complications and adverse events. Wounds were evaluated for apposition and cosmesis using a modified Hollander Wound Evaluation Scale (HWES). The Shapiro–Wilk test of normality was done. Independent-samples T test, Mann Whitney U test, and chi-square test were used to compare variables between the two wound closure methods. A total of 114 subjects participated in this trial completing all aspects of the study. Fifty-five subjects received sutures for topical wound closure, with 59 subjects receiving LBSS. Surgeons were found to be satisfied with 100 % of all applications using the LBSS device. One hundred percent of wounds closed with sutures and 98.9 % wounds closed with LBSS achieving an optimal HWES of 0. There was no statistical difference in cosmesis or complications for either method. Closure with LBSS was significantly faster by a mean of 2 min. LiquiBand® Surgical S is as good as sutures for the closure of laparoscopic wounds in terms of cosmesis and complications with the added benefit of being significantly faster.
Heterotopic pregnancy is the simultaneous coexistence of both intrauterine and extrauterine pregnancies. Cornual heterotopic pregnancies can cause catastrophic haemorrhage because of their location. Available evidence suggests that they have usually been managed surgically by laparotomy and cornual resection, few were managed medically and two expectantly. Of the surgical group, only three underwent laparoscopic management. We report the first case of successful management of cornual heterotpic pregnancy by Harmonic ACE® and a favourable outcome of the intrauterine pregnancy.
Inland recreational swimming sites provide significant social value globally. This study focused on public recreational swimming sites across the Murrumbidgee River and its tributaries in the Australian Capital Territory (ACT) throughout the swimming season (September–April) from 2009 to 2020 to determine whether high intestinal enterococci concentrations could be predicted with flow exceedance and routinely monitored physical and chemical parameters of water quality. Enterococci concentrations were positively correlated with the turbidity associated with high-flow conditions. The predictive accuracy of high enterococci levels during high-flow conditions was good (mean percentage correctly classified, 60%). The prediction of high enterococci levels at low flows was significantly less reliable (mean percentage correctly classified, 12–15%). As the ACT is expected to experience decreases in rainfall overall but increases in extreme rainfall events due to climate change, understanding the drivers of elevated intestinal enterococci under extreme flow conditions remains important from a public health perspective.
Background An outbreak of gastroenteritis was investigated following complaints of illness after eating donuts from a food premises in the Australian Capital Territory (ACT). Methods Food poisoning complainants and contacts were surveyed using a standard gastroenteritis questionnaire including menu items from the food premises. Descriptive analyses were performed on data collected for all responses. A case-control study was conducted for a group of 140 people at a catered function. Food safety inspections were conducted with food and environmental samples tested at the ACT Government Analytical Laboratory. Stool specimens were collected from cases who were ill at the time of interview. Neither active case finding, nor viral testing of food or environmental samples, could be conducted. Results Three hundred and one people were surveyed, and 215 individuals (71.4%) reported vomiting and/or diarrhoea following consumption of a donut purchased from the business over a five-day period. All ill respondents reported eating a donut. The medians of incubation period and illness duration were 34 hours (interquartile range, IQR: 29–42 hours) and 48 hours (IQR: 29–72 hours) respectively. Diarrhoea, vomiting and abdominal pain were the most commonly reported symptoms. Eight out of 11 specimens collected from ill individuals were positive for norovirus. For the case-control study, data from 59 attendees were collected, with an attack rate of 46% (27/59). Eating any kind of filled donut was associated with a person becoming ill (odds ratio: 10.4; 95% confidence interval: 1.18–478.13). No single flavour was identified as the likely source of infection. Elevated levels of coliforms were present in two samples of donut filling obtained during the food safety inspection. Conclusion Donuts are a novel vehicle for norovirus infection. This implicated pathogen, plus evidence collected at the food premises suggestive of faecal contamination, indicates the source of this outbreak was likely an ill food handler. The findings of this outbreak highlight the importance of excluding food handlers from work while ill. While this was one of the largest foodborne outbreaks investigated in the ACT, the true extent of illness remains unknown. Active case finding should be pursued to determine the magnitude of outbreaks.
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