Surgical practice - is it evidence-based?

Abstract

In order to improve the quality of postoperative recovery and diminish the morbi-mortality rates a number of systematic reviews and meta-analyses have been conducted in the last decade within the field of surgery. As a result a lot of good scientific evidence has been accumulated, particularly in colorectal surgery. Research questions such as the need for preoperative mechanical bowel preparation, pain control by means of epidural analgesia, time interval until starting postoperative administration of oral fluids and food, choice of surgical technique in colorectal anastomoses, use of drains and use of a nasogastric tube after elective laparotomy have been adressed 1,2,3,4,5,6,7 . Most of these studies are Cochrane reviews focusing on important healthcare interventions with particular emphasis given to surgical practice.However recent analysis of the results from a multinational survey of care following colonic operations, in Europe and the United States, has concluded that strategies that can contribute to improved recovery and reduced complications after colonic operations do not appear to be applied optimally in clinical practice 8

Efficacy of desulfated heparin mitigating inflammation in rat burn wound model

“…During the wound healing process, an abundant blood supply is necessary to meet the enormous local demands of debridement, fibroblast proliferation, extracellular matrix synthesis and epithelialization. 22 The formation of a vascularized granulation wound bed (with well-embedded capillaries) is a prerequisite for healthy healing. Granulation tissue provides a substratum for epidermal cells to migrate and cover the wound.…”

Systematic review of animal research

“…The editorial Board of Acta Cirúrgica Brasileira is working on the organization of a special committee for analysis of systematic reviews that address a topic of current interest in surgical practice. 7 …”