Lycksele

This research aims to determine if hip replacement surgery arthroplasty can reduce the need for additional operations compared to internal fixation in elderly patients with an undisplaced femoral neck fracture. Patients aged 75 years and older with this type of fracture will be included and randomly assigned to one of two treatments through the Swedish Fracture Register platform. The study focuses on combining reoperation rates and mortality into a single main outcome measure to evaluate which treatment offers better results. Participants will receive either arthroplasty, which may be hemi or total hip replacement depending on the patients condition and surgeons decision, or internal fixation using screws, pins, or a sliding hip screw device based on hospital routine. The study is a randomized controlled trial without blinding, comparing these two device-based treatments for hip fractures in elderly patients. During the study, researchers will monitor the combined rate of reoperations and mortality for 1 to 2 years after surgery. Additional outcomes include reoperation rates, short- and long-term mortality, and patient-reported physical function one year after surgery. Participants will be followed up to assess these outcomes, with care taken to track their progress and safety over the study period.

Researchers are studying complications after closing a temporary loop ileostomy in patients who had surgery for rectal cancer. The study aims to answer two main questions whether the choice of anastomotic method affects recovery after surgery, and if using a mesh to close the stoma site can reduce hernias. This is a prospective randomized trial involving multiple centers to explore these surgical techniques. Participants are randomly assigned to receive either a stapled anastomosis using a linear staple device or a hand-sewn anastomosis with a running monofilament suture. Additionally, there is an optional randomization to close the stoma site either with a lightweight mesh placed under the muscle or with a long-lasting suture. The skin and fascia are closed with running monofilament sutures, including a pursestring technique for the skin. During the study, researchers will monitor participants for postoperative bowel obstruction within 30 days and for stoma site hernias over 2 years. They will also assess other complications and hospital stay length within 30 days. Participants will undergo follow-up visits to evaluate these outcomes and ensure proper recovery. The total participation timeline includes short-term and long-term monitoring to capture relevant surgical results.

Researchers are evaluating a multimodal preoptimisation programme for patients with ventral hernia defects between four and eight centimeters wide. This randomized controlled trial compares this prehabilitation approach to surgery without structured preoptimisation, aiming to reduce complications three months after surgery. The study also explores molecular changes related to collagen metabolism by collecting tissue biopsies and blood samples around the time of surgery. Participants in the intervention group follow a home-based prehabilitation programme lasting at least three months before surgery. This programme targets physical inactivity, obesity, comorbidities, smoking, and alcohol use, and is designed for both rural and urban populations. The control group receives basic advice on physical activity and weight management during their preoperative consultation. During the study, researchers collect biopsies of skin, muscle, and fascia during surgery and take blood samples before and after surgery to analyze molecular effects. Participants will be monitored for complications up to three months postoperatively, with additional assessments at twelve months including pain, quality of life, aesthetic outcomes, hernia recurrence, physical activity, weight, and various laboratory tests. The total participation time covers preoperative optimization and follow-up visits extending up to one year after surgery.