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Oral and Maxillofacial Surgery Clinics of North America

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https://www.readbyqxmd.com/read/28528739/understanding-the-surgical-margin-a-molecular-assessment
#1
REVIEW
David J ClarK, Li Mao
The inclusion of molecular characteristics into surgical margin analysis may not only yield a more sensitive and accurate assessment of the cells in these margins, but may also provide insight into their impacts on patients' postoperative prognosis. This concept of the "molecular surgical margin" is advantageous, as it integrates recent advances in our understanding of head and neck carcinogenesis, while also retaining the established methodology of histopathology. This multidisciplinary approach may facilitate the development of a uniform criterion for defining the surgical margin, which will likely result in a reduced recurrence rate and improved overall patient survival...
May 18, 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28279584/simulation-training-for-the-office-based-anesthesia-team
#2
REVIEW
Richard M Ritt, Jeffrey Bennett, David Todd
An OMS office is a complex environment. Within such an environment, a diverse scope of complex surgical procedures is performed with different levels of anesthesia, ranging from local anesthesia to general anesthesia, on patients with varying comorbidities. Optimal patient outcomes require a functional surgical and anesthetic team, who are familiar with both standard operational principles and emergency recognition and management. Offices with high volume and time pressure add further stress and potential risk to the office environment...
March 6, 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28259386/proper-management-of-medications-to-limit-errors-what-the-oral-surgeon-should-know-to-limit-medication-errors-and-adverse-drug-events
#3
REVIEW
Daniel S Sarasin, Jarom E Mauer
Providing safe and effective ambulatory anesthesia is a key component in delivering optimal care to oral and maxillofacial patients. Unfortunately, medication errors and adverse drug events (ADEs) occur in offices, as they do in hospital operating rooms. Preparing and delivering medication seems simple. In reality, this is a complex process with multiple opportunities for drug errors leading to actual or potential ADEs. This article reviews medication errors and ADEs, introduces a medication safety paradigm for oral and maxillofacial surgery facilities, and provides practical safety initiatives that can be implemented to achieve the goal of optimal anesthesia patient care and safety...
March 1, 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28417895/preface
#4
EDITORIAL
David W Todd, Jeffrey D Bennett
No abstract text is available yet for this article.
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28417894/quality-improvement-and-reporting-systems-what-the-oral-and-maxillofacial-surgeon-should-know
#5
REVIEW
Justine S Moe, Shelly Abramowicz, Steven M Roser
Health care is an inherently dangerous environment, and patient safety should be an explicit goal of oral and maxillofacial surgery. Important components of a safety program include a nonpunitive safety culture, the implementation of patient safety practices, standardized incident reporting and adverse event analysis, regular self-assessment, and internal and external benchmarking. Implementation of a safety program requires the strong commitment of leadership and the engagement and empowerment of all employees...
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28417893/equipment-safety-maintenance-and-inspection-what-the-oral-surgeon-needs-to-know
#6
REVIEW
Katherine A Keeley
Many oral and maxillofacial surgical procedures are done in an office-based setting, with many oral and maxillofacial surgeons involved in oversight of equipment maintenance. Goals in equipment management are to prevent harm to patients and staff, stay compliant with current regulations, and increase equipment longevity. This article covers the safety, maintenance, and inspection related to electrical equipment used in the treatment of patients, autoclaves, radiograph machines, nitrous oxide and oxygen medical gases, and required back-up power and lighting...
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28417892/discharge-criteria-impact-of-the-patient-and-the-procedure-what-the-oral-surgeon-should-know
#7
REVIEW
Kyle J Kramer
This article is a concise review of discharge criteria following sedation or anesthesia relevant to the oral and maxillofacial surgeon. Topics covered include a general overview of the need for objective discharge criteria, a review of standardized criteria, and a brief discussion on specific anesthetic, patient, and surgical factors that can impact the safety of the immediate postoperative recovery and postdischarge periods.
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28417891/outpatient-anesthetic-safety-considerations-for-obstructive-sleep-apnea
#8
REVIEW
Kevin J Butterfield
Most patients with obstructive sleep apnea (OSA) are not diagnosed preoperatively. The STOP-Bang questionnaire may identify patients at risk of OSA, especially those with severe OSA. Patients with mild to moderate OSA, with optimized comorbidities, can usually safely undergo outpatient surgery. Patients with severe OSA, who are not optimized medically, should avoid outpatient surgery.
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28417890/fire-safety-for-the-oral-and-maxillofacial-surgeon-and-surgical-staff
#9
REVIEW
LisaMarie Di Pasquale, Elie M Ferneini
Fire in the operating room is a life-threatening emergency that demands quick, efficient intervention. Because the circumstances surrounding fires are generally well-understood, virtually every operating room fire is preventable. Before every operating room case, thorough preprocedure "time outs" should address each team members' awareness of specific fire risks and agreement regarding fire concerns and emergency actions. Fire prevention centers on 3 constituent parts of the fire triad necessary for fire formation...
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28417889/monitoring-for-the-oral-and-maxillofacial-surgeon
#10
REVIEW
Robert C Bosack
Parenteral medications are titrated in the oral and maxillofacial surgery office to achieve moderate sedation, deep sedation, or general anesthesia while continuously maintaining spontaneous ventilation with an open airway. After initial drug administration, the provider assesses and interprets both the level of anesthesia and the presence/severity of adverse side effects, both of which guide further drug titration, cessation, reversal, or medical management. This assessment is called monitoring, which guides the conduct of anesthesia delivery and becomes the essence of this art...
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28417888/general-concepts-of-patient-safety-for-the-oral-and-maxillofacial-surgeon
#11
REVIEW
David W Todd
Whether managing patients in private offices or as part of a care team at hospitals, oral and maxillofacial surgeons owe it to patients to understand medical error and take action to reduce its frequency and adverse effects. This article reviews general concepts of patient safety, including high-reliability organization, crew resource management, simulation training, root cause analysis, and just culture.
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28291573/preoperative-preparation-and-planning-of-the-oral-and-maxillofacial-surgery-patient
#12
REVIEW
Jeffrey D Bennett
Every patient is different and has the potential to respond unfavorably to anesthetic and surgical intervention. Preparation is the key to optimizing patient outcome.
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28254407/patient-safety-and-the-malpractice-system
#13
REVIEW
James Q Swift
The cost of health care in the United States and malpractice insurance has escalated greatly over the past 30 years. In an ideal world, the goals of the tort system would be aligned with efforts at improving safety. In fact, there is little evidence that the tort system and the processes of risk management and informed consent have improved patient safety. The article explores the disunion between patient safety and the malpractice system.
February 26, 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28254406/preventing-wrong-site-surgery-in-oral-and-maxillofacial-surgery
#14
REVIEW
Leon A Assael
This article discusses the risk for wrong-site surgery in oral and maxillofacial surgery and discusses the development and utility of checklists. The intent of checklists and the specific applicability of each of them to ambulatory oral and maxillofacial surgery are presented. Checklists and other considerations to mitigate the risk of wrong-site surgery are evaluated. The role of interprofessional teams in improving patient care outcomes with the checklist as a vehicle is evaluated. Recommendations for the use of checklists and related methods in the ambulatory oral and maxillofacial surgery setting are made...
February 26, 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27890232/regeneration-and-beyond
#15
EDITORIAL
Alan S Herford
No abstract text is available yet for this article.
February 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27890231/soft-tissue-regeneration-incorporating-3-dimensional-biomimetic-scaffolds
#16
REVIEW
Gaurav Shah, Bernard J Costello
Soft tissue replacement and repair is crucial to the ever-developing field of reconstructive surgery as trauma, pathology, and congenital deficits cannot be adequately restored if soft tissue regeneration is deficient. Predominant approaches were sometimes limited to harvesting autografts, but through regenerative medicine and tissue engineering, the hope of fabricating custom constructs is now a feasible and fast-approaching reality. The breadth of this field includes tissues ranging from skin, mucosa, muscle, and fat and hopes to not only provide construct to replace a tissue but also to replace its function...
February 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27890230/soft-tissue-engineering
#17
REVIEW
Roderick Youngdo Kim, Sam Seoho Bae, Stephen Elliott Feinberg
There is a recognized need to reconstruct and restore complex craniomaxillofacial soft tissues. The objective of this article is to focus on the role that tissue engineering/regenerative medicine can play in addressing various barriers (vascularity, tissue bulk, volitional control, and esthetics) and impediments (timing, regional applicability/dissemination, and regulation by the US Food and Drug Administration) to optimal tissue reconstruction of complex soft tissue structures. We will use the lips as an example to illustrate our points...
February 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27890229/maxillofacial-defects-and-the-use-of-growth-factors
#18
REVIEW
Alan S Herford, Meagan Miller, Fabrizio Signorino
The development and increase in knowledge of the benefits and applications of growth factors in craniofacial reconstruction adds a novel tool in the reconstructive surgeon's armamentarium. The use of growth factors varies according to presentation. Growth factors help to promote healing, angiogenesis, and formation of bone of improved quality and quantity. Growth factors used with stem cells and scaffolds provide a solution or alternative to discomfort created by donor autograft sites. The application and results of these growth factors are displayed in various examples of maxillofacial defects in this article, including reconstruction of a premaxillary cleft and of maxillary augmentation...
February 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27890228/tissue-engineered-prevascularized-bone-and-soft-tissue-flaps
#19
REVIEW
F Kurtis Kasper, James Melville, Jonathan Shum, Mark Wong, Simon Young
The complex shapes of skeletal components of the craniofacial region combined with the prominence of the face and paucity of overlying soft tissue create significant challenges for the reconstructive surgeon. The in vivo bioreactor strategy is a promising alternative to microvascular surgical techniques that combines tissue engineering principles with microvascular reconstructive techniques to create patient-specific, prevascularized bone flaps for reconstruction of complex maxillofacial defects. This article discusses the use of traditional vascularized bone flaps; preclinical studies using the in vivo bioreactor approach; case reports that have attempted this novel technique; and future challenges and considerations in the development of patient-specific, prevascularized bone flaps for maxillofacial reconstruction...
February 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27890227/emerging-biomaterials-in-trauma
#20
REVIEW
Kirollos E Zakhary, Jayini S Thakker
Emerging technologies and research into the science of biomaterials have developed exponentially and provide facial reconstructive surgeons with a plethora of options for a multitude of varying presentations. This article presents a comprehensive discussion in the ever-evolving field of material science and emerging biomaterials. A complete understanding of the current status of such materials is necessary for the appropriate incorporation and applicability to adequate clinical situations. The rapid progress seen in biomaterials is evidenced through the forward direction of bioengineered tissues, the incorporation of growth factors in varying scenarios, and the unique characteristics of 3-D printing of patient specific scaffolds...
February 2017: Oral and Maxillofacial Surgery Clinics of North America
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