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Surgical Technology International

Kevin Woo
Maintaining skin integrity is espoused by several international authorities as a benchmark for patient safety and quality of care. National guidelines advocate the use of prophylactic multi-layer foam dressings over bony prominences for the prevention of pressure ulcers or injuries. The purpose of this study was to evaluate the implementation of best practice guidelines including the use of multi-layer foam dressings for the prevention of pressure injuries. The analysis involved data from a total number of 62 unique patients...
March 12, 2018: Surgical Technology International
Michael Korenkov
The video-assisted subcutaneous destruction of the sinus tract (VADST) is a novel, minimally-invasive technique for the treatment of pilonidal sinus disease (PSD). This is an advancement of the previously described subcutaneous destruction of the sinus tract and the removal of hairs as well as the long-term vessel-loop drainage of the wound channel (DST). Although the first results of this operation seemed to be promising, some of my colleagues felt that the blind approach to this procedure could be its potential "weak point"...
March 12, 2018: Surgical Technology International
Adolph V Lombardi, Antonio G Manocchio, Keith R Berend, Michael J Morris, Joanne B Adams
INTRODUCTION: Short stem femoral components in primary total hip arthroplasty (THA) have increased in popularity since the advent of minimally invasive surgical techniques. The concept of a short stem is particularly compatible with tapered designs where the goal is to offload forces proximally in the femur. The purpose of this retrospective review was to review our early experience with a short, tapered titanium femoral component with updated design features. MATERIALS AND METHODS: Beginning in November 2011 through February 2012, 92 consented patients (93 hips), at a single center, were treated with primary cementless THA using a short stem, tapered femoral component (Taperloc® Complete Microplasty; Zimmer Biomet, Warsaw, Indiana) and were available for review with a minimum two-year follow-up...
March 12, 2018: Surgical Technology International
Steven L Percival
A novel hydrophilic polyurethane (PU) foam dressing which is impregnated with silver chloride, Optifoam® Gentle (OG) Ag+ (Medline Industries Inc., Chicago, Illinois), was evaluated in this study. The aims of this study were to determine the rate of elution of silver from the foam dressing over a period of 168 hours into simulated wound fluid and an evaluation of antimicrobial efficacy using zone of inhibition (ZOI), direct kill, and time-kill viability. Thirty-two microorganisms associated with wounds including Pseudomonas aeruginosa, Methicillin sensitive Staphylococcus aureus (MSSA), Acinetobacter baumannii, Candida albicans, and antibiotic-resistant strains (Methicillin-resistant S...
March 12, 2018: Surgical Technology International
Vittorio Mattugini, Carmine Citarelli, Fabio Cosseddu, Marco Ghilard, Guido Luppichini, Francesco Casella, Giulio Agostini, Federico Sacchetti, Rodolfo Capanna
Fibular head avulsion fractures are rare injuries determined by traction of the fibular attachment of the lateral collateral ligament (LCL). Surgical treatment is often recommended with different techniques such as tension band fixation or lag screws stabilization. In this article, we describe a fixation technique of fibular head fractures obtained through the use of anchors. A 45-year-old athletic patient came to our attention in our traumatologic service after a motorcycle accident. He reported a complex injury of the posterolateral corner with an avulsion fracture of the left fibular head...
March 12, 2018: Surgical Technology International
Karim Sabeh, Milad Alam, Samuel Rosas, Shahrose Hussain, Michaela Schneiderbauer
INTRODUCTION: The growing trends of total knee arthroplasty (TKA) foreshadow an inevitable increase in the financial burden on healthcare expenditure estimated to almost nine billion dollars annually. This study aims to demonstrate the potential savings when using all-polyethylene (AP) compared to metal-backed (MB) tibial components and describes the cost variability amongst three major commercially available implants. MATERIALS AND METHODS: The cost of AP versus MB implants was analyzed using a large nationwide database, Emergency Care Research Institute (ECRI)...
March 12, 2018: Surgical Technology International
Ahmed Siddiqi, Nicole E George, Peter B White, Bartlomiej W Szczech, John V Thompson, Jennifer I Etcheson, Chukwuweike U Gwam, Alexander T Caughran, Ronald E Delanois, James Nace
INTRODUCTION: Periprosthetic joint infection (PJI) following primary total knee arthroplasty (TKA) is a challenging complication for surgeons and patients alike. Although two-stage revision arthroplasty remains the gold standard PJI management in the United States, one-stage revision has had success in many parts of Europe. The aim of this study was to retrospectively review: 1) ultimate treatment success; 2) necessary antibiotic duration; 3) change in knee range of motion (ROM); and 4) final Knee Society Scores (KSS) in a case series of patients managed with retention of articulating antibiotic spacers following PJI...
March 12, 2018: Surgical Technology International
Morad Chughtai, Chukwuweike U Gwam, Nequesha Mohamed, Anton Khlopas, Nipun Sodhi, Assem A Sultan, Anil Bhave, Michael A Mont
Due to an increasing elderly population coupled with a growing obesity epidemic, there has been an increased prevalence in cardiovascular and musculoskeletal diseases. This has led to an increased burden in healthcare expenditures, now estimated to be over 17.8% of gross domestic product. As a result, physical activity has been increasingly encouraged due to its potential prophylactic effects on health. Recent reports have demonstrated a relationship between physical activity and body mass index (BMI) on cardiovascular and musculoskeletal health...
December 22, 2017: Surgical Technology International
Christian Eichler, Carolin Schulz, Nadine Vogt, Mathias Warm
The use of acellular dermal matrices (ADM), sometimes referred to as extracellular matrix (ECM), has become an interesting aspect of breast reconstruction. A great deal of literature is available, totaling over 7000 ADM-based reconstructions. Most often, ADMs are used in a skin sparing mastectomy (SSM) scenario, although heterologous breast augmentation with a sub-pectoral fixation may also require an ADM application. Their use has become an attractive, but expensive option. Available data shows head to head comparisons between individual ADMs to be mostly retrospective in nature with only a few prospective trials available...
December 22, 2017: Surgical Technology International
Vincenzo Consalvo, Antonio Canero, Vincenzo Salsano
BACKGROUND: Obesity is a worldwide disease affecting 13% of the world's adult female population. The reasons and the fetal risk are still unclear. The effect of weight loss as a result of bariatric surgery seems to induce an improvement in fertility in obese women. The main purpose of this prospective study is to demonstrate if there is an association between bariatric surgery-induced weight loss and an improvement in the fertility of women at reproductive age. MATERIALS AND METHODS: From June 2013 to April 2016, all bariatric female patients from our institutes were prospectively evaluated for suitability in this study...
December 22, 2017: Surgical Technology International
Sarmistha Pal, Morad Chughtai, Assem A Sultan, Anton Khlopas, Nipun Sodhi, Nicole E George, Jennifer I Etcheson, Chukwuweike U Gwam, Jared M Newman, Linsen T Samuel, Anil Bhave, Joan E DaVanzo, Michael A Mont
INTRODUCTION: This study evaluated differences in: 1) total episode payments, 2) probability of hospital readmission, 3) probability of inpatient rehab facility (IRF) and utilization, and 4) probability of skilled nursing care facility (SNF) utilization in patients who had disuse atrophy and underwent a total knee arthroplasty (TKA) and either did, or did not, receive preoperative home-based neuromuscular electrical stimulation (NMES) therapy. MATERIALS AND METHODS: We used the Medicare limited dataset for a 5% sample of beneficiaries from 2014 and 2015 to construct episodes-of-care for TKA (DRG-470) patients with disuse atrophy who underwent a TKA during the 30 days prior to hospital admission and 90 days post-discharge...
December 22, 2017: Surgical Technology International
Andrew Doering, Ali Azadi, David Doering, Donald R Ostergard
We report a case of a mid-urethral sling (Advantage Fit™, Boston Scientific Corporation, Marlborough, Massachusetts) freshly removed from its original package. Upon removal from the packaging, the sling was noted to have a deformation in positioning at the midpoint, with curvature opposite the natural curve of the sling in the body. The images show the comparison to a sling with the desired positioning. Mid-urethral slings are commonly made from polypropylene mesh which has memory properties. It is important that manufacturers ensure that any steps in the processing or packaging of slings do not result in changes in the shape of the sling that may have unknown impacts on its clinical outcome...
December 22, 2017: Surgical Technology International
Dean C Perfetti, Nipun Sodhi, Anton Khlopas, Assem A Sultan, Suela Lamaj, Mathew R Boylan, Jared M Newman, Qais Naziri, William A Cantrell, Aditya V Maheshwari, Carl B Paulino, Michael A Mont
INTRODUCTION: Although resident physicians have a critical role in the daily management of patients, based on their limited experiences, they are thought to potentially create inefficiencies in the hospital. With changes set forth by the Comprehensive Care for Joint Replacement (CJR) program, both teaching and non-teaching hospitals are directly compared on efficiency and outcomes. Therefore, the purpose of this study was to compare outcomes between teaching and non-teaching hospitals in the state of New York...
December 22, 2017: Surgical Technology International
Assem A Sultan, William A Cantrell, Morad Chughtai, Prem N Ramkumar, Anton Khlopas, Jared M Newman, Nipun Sodhi, Suela Lamaj, Timothy C Wagner, Linsen T Samuel, Michael A Mont
Knee osteonecrosis is a rare, yet debilitating disease that can lead to knee joint destruction and can be associated with significant pain and disability. Various imaging modalities have different roles in the diagnosis, staging, management, and determination of the prognosis in knee osteonecrosis. Plain radiographic images can show gross joint destruction and secondary arthritic changes. In addition, magnetic resonance imaging (MRI) has become the gold-standard imaging modality to diagnose osteonecrosis. Multiple classification systems have been developed for knee osteonecrosis based on these imaging modalities...
December 22, 2017: Surgical Technology International
Michael F Moore
The discovery of the existence of biofilms in the 1970s has resulted in a greater understanding of how bacteria form a synergistic relationship to facilitate their survival by incorporating and sharing the individual attributes that individual bacteria have with the polymicrobial flora that composes the biofilm. Advances in molecular biology have aided in delineating complexity of biofilms, but the abundance and plethora of the microbial world provides an ongoing and daunting task. The enormity of this task is reflected in the chronic non-healing wound, as it is estimated that 60% of all chronic non-healing wounds have a biofilm component...
December 22, 2017: Surgical Technology International
Nipun Sodhi, Benjamin Yao, Jared M Newman, Michael Jawad, Anton Khlopas, Assem A Sultan, Suela Lamaj, George A Beyer, Alyeesha B Wilhelm, Michael A Mont
INTRODUCTION: To determine the effort required to provide a service, the United States Medicare uses Relative Value Units (RVUs). Consequently, higher RVUs are assigned to the procedures or services that require more effort, which ultimately means the physician will be properly compensated for the additional effort required. In total ankle arthroplasty (TAA), revision cases usually are more technically challenging and require more effort than primary TAA. Therefore, the purpose of this study was to compare the: 1) RVUs; 2) length-of-surgery; 3) RVU per unit of time between primary and revision total ankle arthroplasty; and 4) the individualized idealized surgeon annual cost difference analysis...
December 22, 2017: Surgical Technology International
Todd P Pierce, Jennifer Kurowicki, Kimona Issa, Anthony Festa, Vincent K McInerney, Anthony J Scillia
Medial-sided elbow pain is becoming more common among pediatric overhead sport athletes. One potential cause of this is a partial or complete tear of the ulnar collateral ligament (UCL). Because the growth plate remains open in many of these athletes, the most common injury experienced is an avulsion at the medial epicondyle. However, although rare, there is a potential to tear the UCL, with the most common tears occurring at the anterior bundle. However, tears to the posterior bundle are quite rare in pediatric patients...
December 22, 2017: Surgical Technology International
Nipun Sodhi, Benjamin Yao, Anton Khlopas, Iyooh U Davidson, Assem A Sultan, Linsen T Samuel, Suela Lamaj, Jared M Newman, Robert Pivec, Kristy A Fisher, Benjamin Gaal, Michael A Mont
BACKGROUND: Non-operative management of the elbow, shoulder, and knee typically includes braces, such as the: static progressive stretch (SPS), turnbuckle, and dynamic. However, a paucity of literature exists comparing these three bracing modalities. Therefore, the purpose of this study was to evaluate the current literature on the various bracing modalities for physicians and patients managing elbow, shoulder, or knee joint complications. Specifically, we compared the use of 1) static progressive stretch, 2) dynamic, and 3) turnbuckle braces for the a) elbow, b) knee, and c) shoulder...
December 22, 2017: Surgical Technology International
Heather Bougard, Sven Bringman, William W Hope, Jay A Redan, Carl Doerhoff, Michal Chudy, Christine Romanowski, Peter Charles Jones
INTRODUCTION: Various mesh fixation methods are employed by surgeons during ventral hernia repair. These may include tacks, straps, sutures, glue, or a combination of methods. One of these choices is an absorbable fixation device, Securestrap® (Ethicon Inc., Somerville, New Jersey), consisting of an absorbable copolymer barbed U-shaped strap with a spring-loaded deployment system. MATERIALS AND METHODS: The International Hernia Mesh Registry is a prospective multi-center registry, designed to collect longitudinal data on hernia repair methods, products, and outcomes...
December 22, 2017: Surgical Technology International
Giulia Pilloni, Barbara Massa Mico, Roberto Altieri, Francesco Zenga, Alessandro Ducati, Diego Garbossa, Fulvio Tartara
Facial nerve schwannoma localized in the middle fossa is a rare lesion. We report a case of a facial nerve schwannoma in a 30-year-old male presenting with facial nerve palsy. Magnetic resonance imaging (MRI) showed a 3 cm diameter tumor of the right middle fossa. The tumor was removed using a sub-temporal approach. Intraoperative monitoring allowed for identification of the facial nerve, so it was not damaged during the surgical excision. Neurological clinical examination at discharge demonstrated moderate facial nerve improvement (Grade III House-Brackmann)...
December 22, 2017: Surgical Technology International
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