Browsing by Author "Esen, Ebru"

Now showing 1 - 2 of 2

Do Nano-crystalline Silver-Coated Hernia Grafts Reduce Infection?
(2018) Adiguzel, Elif Nergiz; Esen, Ebru; Aylaz, Gokce; Yagiz, Betuel Keskinkilic; Kiyan, Mehmet; Dogan, Aydin; Unal, Ali Ekrem; 0000-0003-3019-0872; 0000-0002-6748-2070; 29750327; U-4613-2018; HCH-8377-2022; D-2527-2015
Purpose Inguinal hernia repairs are the most common interventions in adults in general surgery clinics. Depending on the type of mesh and repair, the incidence of mesh-related infection ranges from 0.6 to 8%. Methicillin-resistant Staphylococcus aureus is the most common microorganism causing graft infection. The aim of this study was to investigate the efficacy of nano-crystalline silver-coated polypropylene grafts against graft infection created with MRSA in rats. Methods A total of 60 female, Wistar albino rats were used in the study. Polypropylene grafts 1 x 1 cm in size were coated in silver ion-doped, calcium phosphate-based, antibacterial ceramic powder (NS-coated graft) to provide an antimicrobial effect. The MRSA seeding procedure was applied at the same time as surgery. In Group 1, normal graft was applied without MRSA seeding, in Group 2, normal graft with MRSA seeding, in Group 3, NS-coated graft without MRSA seeding, and in Group 4, NS-coated graft with MRSA seeding. For the groups which were to be infected, the bacteria were seeded in the surgical area during the operation. On the 7th day postoperatively, all the animals were killed. The grafts were removed and one from each group was examined under electron microscope and the others were implanted in culture medium and the number of colonies was counted after 24 h. Results In Groups 1 and 3, the incision site was seen t o have healed on day 3, no clinical surgical area infection was seen during follow-up, and in the exploration made on the 7th day, no findings of infection were observed. In Group 2, hyperemia and collection were seen to have formed on day 3, abscess had started to form in all the rats of this group on day 4, a purulent discharge in the wound site had started in 12 animals on day 5, separation of the wound site was observed in 6 on day 6, and in the exploration on day 7, there was seen to be a fibrin and pus-rich collection around the graft in all cases. In Group 4, there were hyperemia and collection in 6 animals on day 4, and in 3 of these, abscess was seen to have formed on the 5th day. No purulent discharge or wound separation was observed. In the exploration on the 7th day, it was seen that in the animals with abscess development, the formation was of a localized abscess. The results of the cultures of the grafts removed from Groups 1 and 3 showed no production, whereas production was seen in all the grafts removed from Groups 2 and 4. Clinical surgical area infection was seen to have developed in 100% of Group 2 and in 40% of Group 4. In the comparison of the number of colonies, a statistically significantly lower number of bacteria were determined in Group 4 compared to Group 2 (p < 0.05). In the SEM images taken of Group 2, bacteria clusters were seen attached to the graft. Conclusion Consistent with previous findings in the literature, the NS-coated polypropylene graft was seen to have a significantly better bactericidal effect than the normal polypropylene graft. Development of NS-coated grafts seems to be a reliable and applicable method to reduce the incidence of postoperative graft infection.
Pay for performance system in Turkey and the world; a global overview
(2022) Sahiner, Ibrahim Tayfun; Esen, Ebru; Ucar, Ahmet Deniz; Karaca, Ahmet Serdar; Yast, Ahmet Cinar; 35873746
Objective: This study aimed to compare the pay for performance system applied nationally in Turkey and in other countries around the world and to reveal the effects of the system applied in our country on the general surgery. Material and Methods: Current literature and countries' programs on the implementation of the pay for performance system were recorded. The results of the Turkish Surgical Association's performance and Healthcare Implementation Communique (HIC) commission studies were evaluated in light of the literature. Results: Many countries have implemented performance systems on a limited scale to improve quality, speed up the diagnosis, treatment, and control of certain diseases, and they have generally applied it as a financial promotion by receiving the support of health insurance companies and non-governmental organizations. It turns out that surgeons in our country feel that they are being wronged because of the injustice in the current system because the property of their works is not appreciated and they cannot get the reward for the work they do. This is also the reason for the reluctance of medical school graduates to choose general surgery. Conclusion: Authorities should pay attention to the opinions of associations and experts in the related field when creating lists of interventional procedures related to surgery. Equal pay should be given to equal work nationally, and surgeons should be encouraged by incentives to perform detailed, qualified surgeries. There is a possibility that the staff positions opened for general surgery, as well as, all surgical branches will remain empty in the near future.