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Background: Surgical site infections (SSIs) pose a significant challenge to healthcare systems by elevating patient morbidity and mortality and driving up financial costs. Preoperative skin preparation is crucial for preventing SSIs; however, certain traditional methods of hair removal have been found to increase the risk of SSI development. Mechanical epilation and waxing constitute two relatively explored methods of hair removal, which may hold potential to accelerate wound healing due to the activation of stem cells within hair follicles. This review assesses the efficacy of preoperative hair removal via waxing and mechanical epilation in reducing SSI incidence., Methods: This systematic review was prospectively registered with PROSPERO (ref: CRD42023423798) and a protocol previously published in a peer-reviewed journal. All findings are reported according to PRISMA guidelines. A comprehensive search of Medline, Embase, CENTRAL, ClinicalTrials.gov and CINAHL. Inclusion criteria encompassed adult patients undergoing any surgical procedure, comparing waxing or epilation against other hair removal methods or no hair removal, with SSI incidence as the primary outcome. There was no restriction on study size or quality to ensure a comprehensive literature evaluation., Results: The review found no studies meeting the selection criteria out of 576 records screened., Discussion/conclusion: This review has identified no literature regarding the use of waxing and mechanical epilation as methods of preoperative hair removal. The lack of experimental evidence combined with the potential physiological advantages of these techniques indicate that this could be a valuable area of future research. These techniques may represent novel approaches to SSI prevention, particularly beneficial in high-risk surgical disciplines like vascular surgery., Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=423798, PROSPERO (CRD42023423798)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Cutteridge, Garrido, Staniland, Lim, Totty, Lathan, Smith and Chetter.)

Background: The most appropriate management following primary traumatic anterior shoulder dislocation in young adults is unclear. This systematic review and meta-analysis evaluated operative versus non-operative management. The primary outcome measure was re-dislocation rate, in contrast to the often reported 'recurrent instability', which includes subjective instability., Methods: Our review was prospectively registered with PROSPERO (CRD42022322600) and reported as per PRISMA guidelines. Selection criteria included mean age of participants between 15 and 25 and minimum follow-up of 1 year., Results: 21 studies meet the inclusion criteria with 5142 patients included. The mean age of patients was 23, with 87% male. There was a median of 54 patients per study and a mean follow up of 46 months per study. The mean re-dislocation rate was 16.08% in the operative group and 24.84% in the non-operative group. In the subgroup meta-analysis, including only RCTs, comparing arthroscopic stabilisation vs non-operative there was an odds ratio of 0.09, strongly favouring intervention., Discussion: This systematic review found the literature available supports surgical intervention in patients under the age of 25, in order to reduce re-dislocation. However, there is a lack of cost-effectiveness data to support these findings, and this should be an area of future research., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: Tetraspanin-7 (Tspan7) is an islet autoantigen involved in autoimmune type 1 diabetes and known to regulate β-cell L-type Ca 2+ channel activity. However, the role of Tspan7 in pancreatic β-cell function is not yet fully understood., Methods: Histological analyses were conducted using immunostaining. Whole-body metabolism was tested using glucose tolerance test. Islet hormone secretion was quantified using static batch incubation or dynamic perifusion. β-cell transmembrane currents, electrical activity and exocytosis were measured using whole-cell patch-clamping and capacitance measurements. Gene expression was studied using mRNA-sequencing and quantitative PCR., Results: Tspan7 is expressed in insulin-containing granules of pancreatic β-cells and glucagon-producing α-cells. Tspan7 knockout mice (Tspan7 y/- mouse) exhibit reduced body weight and ad libitum plasma glucose but normal glucose tolerance. Tspan7 y/- islets have normal insulin content and glucose- or tolbutamide-stimulated insulin secretion. Depolarisation-triggered Ca 2+ current was enhanced in Tspan7 y/- β-cells, but β-cell electrical activity and depolarisation-evoked exocytosis were unchanged suggesting that exocytosis was less sensitive to Ca 2+ . TSPAN7 knockdown (KD) in human pseudo-islets led to a significant reduction in insulin secretion stimulated by 20 mM K + . Transcriptomic analyses show that TSPAN7 KD in human pseudo-islets correlated with changes in genes involved in hormone secretion, apoptosis and ER stress. Consistent with rodent β-cells, exocytotic Ca 2+ sensitivity was reduced in a human β-cell line (EndoC-βH1) following Tspan7 KD., Conclusion: Tspan7 is involved in the regulation of Ca 2+ -dependent exocytosis in β-cells. Its function is more significant in human β-cells than their rodent counterparts., (© 2022 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.)

Introduction The COVID-19 pandemic has caused mass disruption to all aspects of society, with elective orthopaedics not spared. The pandemic has the potential to cause a tsunami of health burden in the community if elective services are not resumed to pre-pandemic levels of activity. Studies have shown that elective orthopaedics can be safely carried out in a COVID-19 free hospital. This study reviewed the transition in operating at an independent COVID-19 free hospital to an NHS hospital concurrently treating patients with COVID-19. Methods A strategy of phased relaxation of clinical comorbidity criteria was followed. Patients from the orthopaedic waiting list were selected according to these criteria and observed recommended preoperative isolation protocols. Operations were undertaken in the independent sector under the COVID-19 contract and the NHS site. Patients were assessed from all phases in the resumption of services. In-hospital and post-operative complications with specific enquiries regarding the development of COVID-19 symptoms or the need and outcome for COVID-19 testing at 14 days and six weeks was recorded. Results This study included 263 patients, of which 155 were female. The mean age of patients was 52.45. The mean BMI of all patients was 29.1 kg/m2. Additionally, 124 patients were American Society of Anesthesiologists (ASA) grade 1, 117 ASA grade 2 and 22 ASA grade 3 and 167 patients underwent a major operation, with total hip replacement being the most common operation. There were no in-hospital complications. No patients had a positive test result or symptoms of COVID-19 in the six-week post-operative period. Conclusion In summary, we demonstrated that elective orthopaedic surgery can be safely undertaken via a green pathway in a higher risk patient cohort when COVID-19 is prevalent in the community., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Dixon et al.)