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Surgical Technology International

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https://www.readbyqxmd.com/read/28085989/real-world-clinical-quality-improvement-for-complex-abdominal-wall-reconstruction
#1
Bruce Ramshaw, Brandie Remi Forman, Karla Moore, Eric Heidel, Michael Fabian, Greg Mancini, Girish P Joshi
INTRODUCTION: Traditional methods of clinical research may not be adequate to improve the value of care for patients undergoing abdominal wall reconstruction (AWR). These patients are prone to high complication rates and high costs. Here, we describe a clinical quality improvement (CQI) effort to enhance outcomes for patients undergoing AWR. MATERIALS AND METHODS: CQI was applied for the entire care cycle for consecutive patients who underwent AWR from August 2011-September 2015...
January 13, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28072903/laparoscopic-treatment-of-giant-ventral-hernia-experience-of-35-patients
#2
Michele Grande, Giorgio Lisi, Michela Campanelli, Simona Grande, Dario Venditti, Casimiro Nigro, Francesca Cabry, Massimo Villa
BACKGROUND: Minimal access surgery for incisional hernia repair is still debated, especially for giant wall defects. Laparoscopic repair may reduce pain and hospital stay. This study was designed to evaluate the feasibility of the laparoscopic technique in giant hernia. MATERIALS AND METHODS: From 2007 to 2013, 35 consecutive patients with giant ventral hernia, according to the Chevrel classification, underwent laparoscopic repair. Fourteen patients were obese, with a body mass index (BMI) > 30 and in 21 patients the mean BMI was 24 (range 22-28)...
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28072902/development-of-an-encompassing-questionnaire-for-evaluating-the-outcomes-following-total-knee-arthroplasty
#3
Morad Chughtai, Anton Khlopas, Melbin Thomas, Chukwuweike U Gwam, Julio J Jauregui, Randa K Elmallah, Martin Roche, Michael A Mont
INTRODUCTION: There are many standardized scales and questionnaires used to evaluate TKA patients; however, individually they do not always assess patients adequately. Consequently, many are used in combinations to provide a thorough evaluation. However, this leads to redundancy, confusion, and an excessive patient time-burden. Therefore, the purpose of this study was to develop a usable combined knee questionnaire that combines questions in a non-redundant manner. Specifically, we aimed to: 1) create a combined knee questionnaire that encompasses questions from multiple systems, while eliminating redundancy; 2) correlate the new system with the existing validated questionnaires; and 3) determine the length of time it takes to administer this new questionnaire...
10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28072901/achilles-tendon-repair-using-the-internalbrace%C3%A2-principle
#4
Graeme P Hopper, Gordon M Mackay
Despite extensive research, the management of acute ruptures of the Achilles tendon remains an area of controversy, and there is no consensus regarding the optimal treatment. An InternalBrace™ (Arthrex, Inc., Naples, Florida) is a ligament augmentation repair using high strength sutures/tape and knotless bone anchors which encourages healing and allows early mobilization. This article describes, with video illustration, a knotless Achilles tendon repair technique using the InternalBrace™ principle.
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28072900/efficacy-of-adductor-canal-blockade-compared-to-multimodal-peri-articular-analgesia-following-total-knee-arthroplasty
#5
Chukwuweike U Gwam, Jaydev B Mistry, Priya Jha, Anton Khlopas, Melbin Thomas, Morad Chughtai, Michael A Mont, Ronald E Delanois
INTRODUCTION: Postoperative pain after total knee arthroplasty (TKA) can be an impediment to patient recovery. Many commonly used pain control modalities are effective, but are also associated with adverse effects. Other modalities, such as adductor canal blocks (ACB) and multimodal periarticular analgesia (MPA), have gained popularity due to their efficacy and high safety profile. However, to the best of our knowledge, there are no published studies indicating if a therapeutic advantage exists between the two pain control modalities...
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28072899/endoluminal-vacuum-therapy-as-treatment-for-anastomotic-colorectal-leakage
#6
Giovanni Milito, Giorgio Lisi, Dario Venditti, Michela Campanelli, Elena Aronadio, Simona Grande, Francesca Cabry, Michele Grande
BACKGROUND: The clinical leakage rate after anterior resection varies from 2.8-20%, with a 6-22% mortality rate and a 10-80% risk of permanent stoma. Endo-SPONGE® (B. Braun Melsungen AG, Melsungen, Germany) may treat extraperitoneal anastomotic leakage in the lesser pelvis. It consists of an open-pored sponge inserted into the cavity. A drainage tube fixed to a low vacuum drainage system is then connected to the sponge through the anus. MATERIAL AND METHODS: Between January 2007 and December 2014, 14 patients with anastomotic leakage following low anterior resection were treated with Endo-SPONGE® and were prospectively evaluated...
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28072898/three-year-results-with-a-ringless-third-generation-porous-plasma-sprayed-acetabular-component-in-primary-total-hip-arthroplasty
#7
Keith R Berend, Joanne B Adams, Michael J Morris, Adolph V Lombardi
INTRODUCTION: We previously reported promising early results in patients undergoing primary total hip arthroplasty (THA) with a third-generation cementless acetabular system that has a porous plasma-sprayed coating on a titanium alloy substrate shell, a ringless barb and groove locking mechanism, and a vitamin E-infused highly crosslinked polyethylene insert. The purpose of this study was to examine the outcomes and need for revision in a subset of patients previously reviewed who now have potential for three-year follow-up...
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/27984848/long-term-outcome-after-laparoscopic-repair-of-primary-unilateral-inguinal-hernia-using-a-self-adhering-mesh
#8
Tim Tollens, Halit Topal, Alexander Lucardie, Koen Vermeiren, Chris Aelvoet, Kurt Devroe
Following our previous study about a lightweight self-adhering mesh (Adhesix®, Cousin Biotech, Wervicq-Sud, France; distributed by Davol Inc., subsidiary of C.R. Bard, Inc.), we report the long-term results with the use of this mesh in patients treated for a primary, unilateral inguinal hernia without any other hernias. Prospectively collected data of 100 patients between February 2011 and February 2014 were analyzed. The mean follow-up time was 2.7 years (range 1-4), and mean length of hospital stay was 0...
December 16, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27984847/intraarticular-administration-of-tranexamic-acid-is-safe-and-effective-in-total-knee-arthroplasty-patients-at-high-risk-for-thromboembolism
#9
Ronald E Delanois, Chukwuweike Gwam, Jaydev B Mistry, Morad Chughtai, Melbin Thomas, Prathik P Mudaliar, Anton Khlopas, Vidur Tangri, Michael A Mont
INTRODUCTION: Tranexamic acid (TXA) is an antifibrinolytic agent that can be used to reduce blood loss in total knee arthroplasty (TKA) patients. Due to its thrombogenic properties, intravenous (IV) TXA is contraindicated in patients who have an increased risk of arterial or venous thrombosis. For such patients, intraarticular (IA) TXA may be a safe alternative. In this study, we compare: 1) complication rates; 2) intraoperative blood loss; and 3) need for transfusion in TKA patients who received IA TXA versus patients who used IV TXA...
December 16, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27984597/neurofibroma-of-the-gallbladder-not-associated-with-neurofibromatosis
#10
Tsutomu Namikawa, Yasuhiro Kawanishi, Yuki Fujieda, Kazune Fujisawa, Eri Munekage, Masaya Munekage, Hiromichi Maeda, Hiroyuki Kitagawa, Michiya Kobayashi, Kazuhiro Hanazak
An 82-year-old woman had visited her local clinic with a history of abdominal discomfort and dyspepsia related to meals over a period of several months. Esophagogastroduodenoscopy revealed a superficial spreading tumor that, on biopsy, was proven to be an adenocarcinoma, and colonoscopy revealed an ascending mass that was found to be an adenocarcinoma on biopsy, so the patient was referred to our hospital. Abdominal computed tomography revealed a mass in the ascending colon with regional lymph node swelling and a gallbladder stone measuring 1...
December 16, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27960222/factors-predisposing-to-dislocation-after-primary-total-hip-arthroplasty-a-multivariate-analysis-of-risk-factors-at-7-to-10-years-follow-up
#11
Michele Francesco Surace, Luca Monestier, Fabio D'Angelo, Andrea Bertagnon
BACKGROUND: Dislocation of primary THA (total hip arthroplasty) is one of the most undesirable complications with an incidence ranging from 2% to 5%. Several risk factors are described, related to the patient, surgery, or prosthetic design. The aim of the study was to assess risk factors and their potential influence on dislocation. MATERIALS AND METHODS: 387 primary THA were performed between September 2005 to December 2008 at our institute (Varese, Italy) through a modified posterior-lateral approach...
December 13, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27960026/the-impact-of-a-topical-sexual-enhancement-cream-on-the-female-sexual-response-and-its-relationship-to-clitoral-blood-flow
#12
Michael Pelekanos, Guy M Stofman, Neil Niren
OBJECTIVE: The aim of this investigation was to determine, through two Investigational Review Board (IRB)-approved studies, if a new topical vasodilating cream (NTVC; Life Science Enhancement Corporation, Pittsburgh PA) could improve female sexual response. Study I subjectively evaluated sexual female response as accessed by a modification of the Female Intervention Efficacy Index (FIEI). FIEI was developed at the University of California as an immediate outcome measure of medical intervention to treat female sexual dysfunction...
December 13, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27824434/a-randomized-multicenter-double-blind-study-of-local-infiltration-analgesia-with-liposomal-bupivacaine-for-postsurgical-pain-following-total-knee-arthroplasty-rationale-and-design-of-the-pillar-trial
#13
Stan Dysart, Mark A Snyder, Michael A Mont
INTRODUCTION: Liposomal bupivacaine, a prolonged-release formulation of bupivacaine hydrochloride, is indicated for infiltration into the surgical site for postsurgical analgesia. Results from previous total knee arthroplasty (TKA) studies suggest that analgesic efficacy associated with liposomal bupivacaine may be impacted by variability in infiltration technique. The PILLAR study is designed to assess liposomal bupivacaine efficacy in TKA using a standardized infiltration protocol. Materials and Methods/Design: This phase 4, multicenter, randomized, double-blind, controlled, parallel-group study will compare the safety and efficacy of infiltration with liposomal bupivacaine versus standard bupivacaine for postsurgical pain control in adults undergoing primary unilateral TKA...
November 11, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27780349/early-experience-with-vitamin-e-antioxidant-infused-highly-cross-linked-polyethylene-inserts-in-primary-total-knee-arthroplasty
#14
Emilie M Flament, Keith R Berend, Jason M Hurst, Michael J Morris, Joanne B Adams, Adolph V Lombardi
BACKGROUND: In past decades, polyethylene wear was a major cause of failure in total knee arthroplasty (TKA). Polyethylene for use in arthroplasty has been vastly improved in recent years, with improved materials as well as manufacturing and sterilization processes. Testing has shown that infusion of vitamin E prevents oxidative degradation of polyethylene without remelting, allowing the material to maintain mechanical properties and wear resistance over time. The purpose of this study is to review the early result of patients undergoing primary TKA with vitamin E antioxidant-infused polyethylene inserts...
October 26, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27780348/increased-femoral-component-size-options-improves-manipulation-rate-in-females-and-knee-society-clinical-scores-in-males
#15
Nathan J Turnbull, Keith R Berend, Vincent Y Ng, Joanne B Adams, David A Crawford, Adolph V Lombardi
INTRODUCTION: The gender-specific total knee arthroplasty (TKA) debate focuses on differences in distal femoral mediolateral to anteroposterior aspect ratio between males and females. However, randomized studies have been unable to demonstrate significant differences in outcomes utilizing gender-specific implants. No studies have examined the effect of intermediate femoral component sizes on outcome. We compared outcomes before and after intermediate sizing availability. MATERIALS AND METHODS: We identified 331 patients (413 knees) who underwent primary TKA between 2003 and 2004 with a single complete knee system...
October 26, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27780347/indications-and-complications-associated-with-the-removal-of-506-pieces-of-vaginal-mesh-used-in-pelvic-floor-reconstruction-a-multicenter-study
#16
John R Miklos, Orawee Chinthakanan, Robert D Moore, Deborah R Karp, Gladys M Nogueiras, G Willy Davila
STUDY OBJECTIVE: Synthetic mesh utilized to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can often result in postoperative complications. The objectives of this study were to determine: 1) the most common indications for mesh removal; 2) the incidences of the removal of specific mesh procedures (such as suburethral sling [SUS], transvaginal mesh [TVM], or sacrocolpopexy); and 3) the idences and types of surgical complications associated with mesh removal. DESIGN: This was a retrospective study...
October 26, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27780346/the-indication-and-surgical-treatment-of-286-midurethral-synthetic-sling-complications-a-multicenter-study
#17
Orawee Chinthakanan, John R Miklos, Robert D Moore, Deborah R Karp, Gladys M Nogueiras, G Willy Davila
INTRODUCTION AND HYPOTHESIS: 1) Evaluate the most common indication for sling removal in patients with synthetic mesh slings; 2) identify the location of pain for each of the three types of synthetic sling procedures including retropubic (RP) sling, transobturator (TOT) sling, and single incision slings (SIS), and 3) describe the surgical approach to each of the above and its associated complications. MATERIALS AND METHODS: A retrospective chart review of all patients who underwent surgical removal of a sling due to a mesh-related complications from 2011 to 2013 at three referral centers...
October 26, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27780345/radiofrequency-in-the-management-of-colorectal-liver-metastases-a-10-year-experience-at-a-single-center
#18
Sandra Aissou, Victoire Cartier, Antoine Hamy, Fleur Plumereau, Christophe Aube, Emilie Lermite
BACKGROUND: Liver resection is the curative treatment for patients with colorectal liver metastases (CRLMs), with five-year survival rates of 30-50%. Radiofrequency ablation (RFA) is a local and useful alternative for patients with non-resectable CRLMs to obtain complete tumor clearance. The aim of this study was to analyze survival rates with this local treatment. MATERIALS AND METHODS: All patients who underwent RFA and resection or RFA alone for unresectable CRLMs between 2001 and 2012 were included in a retrospective study...
October 26, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27780344/0-1-polyhexanide-betaine-solution-as-an-adjuvant-in-a-case-series-of-chronic-wounds
#19
Michael Moore, Nanci Dobson, Wes Cetnarowski
INTRODUCTION: The application of 0.1% polyhexanide-betaine gel and irrigating solution was used in place of saline during standard of care wound treatment for 70 chronic wounds of various etiologies. Our goal in this study sample was to investigate the number of days to wound closure, change in absolute wound size, and antimicrobial initiation from baseline visit, following application of polyhexanide-betaine in standard of care wound treatment. Results suggested a benefit of Prontosan® (Polyhexanide-betaine, B...
October 26, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27728956/prevention-of-dislocation-risk-during-hip-revision-surgery-with-the-dual-mobility-concept-study-of-a-new-generation-of-dual-mobility-cups
#20
Antoine Dangin, Sandrine Boulat, Frédéric Farizon, Rémi Philippot
INTRODUCTION: Total hip arthroplasty (THA) is a common surgery presenting well-known failures that may require surgical revision. To reduce the risk of hip dislocation after revision THA, we hypothesize the interest of the use of a new generation dual mobility cup by evaluating its survival and complication rates. MATERIALS AND METHODS: We analyzed the survival and the failures rate of 91 patients who underwent revision THAs with a specific dual mobility cup Novae® E TH (SERF, Décines-Charpieu, France)...
October 26, 2016: Surgical Technology International
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