Search results for: overboard spillage

Authors: N. Moradian, E. Timofeev, R. Tahir

Abstract:

In this work, startability of the Busemann intake family with weak/strong conical shock, as most efficient intakes, via overboard mass spillage method is theoretically analyzed. Masterix and Candifix codes are used to numerically simulate few models of this type of intake and verify the theoretical results. Portions of the intake corresponding to various flow capture angles are considered to have mass spillage in the starting process of this intake. This approach allows for overboard mass spillage via a V-shaped slot with the tip of V coinciding with the focal point of the Busemann flow. The theoretical results, achieved using two different theories, of self-started Busemann takes with weak/strong conical shock show that significant improve in intake startability using overboard spillage technique. The starting phenomena of Busemann intakes with weak conical shock and seven different capture angles are numerically simulated at freestream Mach number of 3 to find the minimum area ratios of self-started intakes. The numerical results confirm the theoretical ones achieved by authors.

Keywords: Busemann intake, conical shock, overboard spillage, startability.

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Authors: Ishwor Paudel, Pratima Gautam, Sandeep Bhattarai

Abstract:

Bile spillage occurs frequently during laparoscopic cholecystectomy, yet its impact on postoperative outcomes remains unknown. It might not be as innocuous as some surgeons tend to believe and in fact might be associated with post-operative surgical site infections (SSI). It often leads to patient dissatisfaction, emergency department visit, with subsequent readmission and additional procedures. Thus, this study sought to examine whether bile spillage is indeed associated with increased risk of postoperative wound infections after laparoscopic cholecystectomy. We hypothesize that patients who experience bile spillage (BS) during operation, have an increased risk of SSI compared to those who do not. This is a prospective observational study conducted in the Department of Surgery, Patan Hospital over a period of one year. Patients undergoing laparoscopic cholecystectomy were included and bile spillage, if happened was noted. All cases were followed up for 30 days and SSI was diagnosed as per Center for disease control and prevention (CDC) defined criteria. Fisher’s test was applied to compare SSI in bile spillage versus non bile spillage cases. A total of 112 patients were included in the final analysis. Bile spillage occurred in 20 cases and absent in the rest i.e., 92 cases. Among bile spillage cases, SSI was found in 4 cases (20%), whereas in non-bile spillage cases SSI was found in 8 cases (8.7%). However, it was statistically not significant (p value > 0.05). 11 (92%) cases were superficial SSI and one was organ-space infection. No mortality or 30-day readmission was found in our study period. Spillage of gallbladder content does not lead to an increase in SSIs. However, as the rate of SSI is still higher, surgeons should be careful to avoid iatrogenic gallbladder perforation and in case of bile spillage, thorough peritoneal irrigation with normal saline should be done.

Keywords: Biliary spillage, organ space infection, Laparoscopic cholecystectomy, surgical site infection.

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