Surgical meshes, in particular those used to repair hernias, have been in use since 1891. Since then, research in the area has expanded, given the vast number of post-surgery complications such as infection, fibrosis, adhesions, mesh rejection, and hernia recurrence. Researchers have focused on the analysis and implementation of a wide range of materials: meshes with different fiber size and porosity, a variety of manufacturing methods, and certainly a variety of surgical and implantation procedures. Currently, surface modification methods and development of nanofiber based systems are actively being explored as areas of opportunity to retain material strength and increase biocompatibility of available meshes. This review summarizes the history of surgical meshes and presents an overview of commercial surgical meshes, their properties, manufacturing methods, and observed biological response, as well as the requirements for an ideal surgical mesh and potential manufacturing methods.

Stress shielding is a well-known failure factor in hip implants. This work proposes a design concept for hip implants, using a combination of metallic stem with a polymer coating (polyether ether ketone (PEEK)). The proposed design concept is simulated using titanium alloy stems and PEEK coatings with thicknesses varying from 100 to 400 μm. The Finite Element analysis of the cancellous bone surrounding the implant shows promising results. The effective von Mises stress increases between 81 and 92% for the complete volume of cancellous bone. When focusing on the proximal zone of the implant, the increased stress transmission to the cancellous bone reaches between 47 and 60%. This increment in load transferred to the bone can influence mineral bone loss due to stress shielding, minimizing such effect, and thus prolonging implant lifespan.

La pandemia declarada por la Organización Mundial de la Salud impacta en múltiples sectores económicos y sociales, que incluye el de salud y educación superior. Especialmente, las facultades de medicina y ciencias de la salud se debaten ante la dualidad de formar profesionales de la salud socialmente responsables, para proteger su integridad física y emocional, y contribuir en los escenarios de mayor necesidad. Los docentes se enfrentan a una oleada de necesidades de atención a pacientes contagiados, según las estimaciones de los expertos y autoridades, y con ello a un alto riesgo y saturación de labores.Se propone un modelo de directrices como plan de acción ante la expansión del COVID-19. En primer lugar, se debe privilegiar la Protección y Seguridad de la comunidad educativa a través de la disminución o suspensión de actividades no prioritarias, con el propósito de capacitarlos adecuadamente para poder enfrentar la contingencia. En segundo lugar, la Continuidad académica con educación a distancia lo cual se logra en diversas etapas que van desde la preparación, diseño, implementación y evaluación con un uso intensivo de tecnología, recursos digitales y simulación con escenarios virtuales. Un tercer componente es el de Comunicación y acompañamiento emocional de la comunidad académica para atenuar la ansiedad, incertidumbre y soledad de quienes conforman la universidad: estudiantes, profesores, padres de familia y personal de apoyo. Por último, se especifica la Respuesta y responsabilidad social que las instituciones para la formación de profesionales de la salud pueden contribuir para la educación, prevención y apoyo a las personas impactadas por la situación de pandemia, permitiendo el desarrollo de competencias en los estudiantes. Se concluye sobre la oportunidad de conciliar de manera inédita la labor clínica y la necesidad de soporte para esta nueva realidad.

Wound site infections increase costs, hospital stay, morbidity, and mortality. Techniques used for wounds management after laparotomy are primary, delayed primary, and vacuum-assisted closures. The objective of this study is to compare infection rates between those techniques in contaminated and dirty/ infected wounds. Eighty-one laparotomized patients with Class III or IV surgical wounds were enrolled in a three-arm randomized prospective study. Patients were allocated to each group with the software Research Randomizer® (Urbaniak, G. C, & Plous, S., Version 4.0). Presence of infection was determined by a certified board physician according to Centers for Disease Control's Criteria for Defining a Surgical Site Infection. Twenty-seven patients received primary closure, 29 delayed primary closure, and 25 vacuum-assisted closure, with no exclusions for analysis. Surgical site infection was present in 10 (37%) patients treated with primary closure, 5 (17%) with primary delayed closure, and 0 (0%) patients receiving vacuum-assisted closure. Statistical significance was found between infection rates of the vacuum-assisted group and the other two groups. No significant difference was found between the primary and primary delayed closure groups. The infection rate in contaminated/dirty-infected laparotomy wounds decreases from 37 and 17 per cent with a primary and delayed primary closures, respectively, to 0 per cent with vacuum-assisted systems.

The aim of this study was to evaluate the effect of bupivacaine irrigated at the surgical bed on postoperative pain relief in laparoscopic cholecystectomy patients. This study included 60 patients undergoing elective laparoscopic cholecystectomy who were prospectively randomized into 2 groups. The placebo group (n=30) received 20cc saline without bupivacaine, installed into the gallbladder bed. The bupivacaine group (n=30) received 20cc of 0.5% bupivacaine in at the same surgical site. Pain was assessed at 0, 6, 12, and 24 hours by using a visual analog scale (VAS). A significant difference (P=.018) was observed in pain levels between both groups at 6 hours postoperatively. The average analgesic requirement was lower in the bupivacaine group, but this did not reach statistical significance. In our study, the use of bupivacaine irrigated over the surgical bed was an effective method for reducing pain during the first postoperative hours after laparoscopic cholecystectomy.

INTRODUCTION After a cholecystectomy, the current and traditional practice is to send each resected gallbladder to the pathologist for analysis. Some reports have suggested the possibility of selecting only those gallbladders that need to be analysed. The purpose of this study was to show a simple method for selecting which gallbladders should be sent to the pathologist. METHODS A prospective comparative study was carried out. Two ‘tests’ were performed in 150 patients to detect or rule out gallbladder cancer. The first test included the patient's variables and a macroscopic gallbladder analysis performed by the surgeon (MGAS). The second test was the analysis performed by the pathologist. The results were compared. RESULTS Of the 150 patients, 132 were women and 18 men; 130 were under 60 years old. One patient had inflammatory bowel disease, seven had changes on ultrasonography and in four cases intra-operative disturbances were observed. During the MGAS, disturbances were found in 30 patients. Eighty-one cases (54%) had at least one or more risk factors for gallbladder cancer. CONCLUSIONS In almost half of the gallbladders, it would be safe not to send the specimen to the pathology department, decreasing costs significantly.