Read by QxMD icon Read

Patient Safety in Surgery

Victoria M Steelman, Clarissa Shaw, Laurel Shine, Abbey J Hardy-Fairbanks
Background: Unintended retention of foreign bodies remain the most frequently reported sentinel events. Surgical sponges account for the majority of these retained items. The purpose of this study was to describe reports of unintentionally retained surgical sponges (RSS): the types of sponges, anatomic locations, accuracy of sponge counts, contributing factors, and harm, in order to make recommendations to improve perioperative safety. Methods: A retrospective review was undertaken of unintentionally RSS voluntarily reported to The Joint Commission Sentinel Event Database by healthcare facilities over a 5-year period (October 1, 2012- September 30, 2017)...
2018: Patient Safety in Surgery
Jonathan Chua, Arun Ratnavadivel
Background: The use of multiple infusions through one cannula is an increasingly common practice in anaesthesia. High pressures in the line often lead to occlusion alarms and pump disconnection. In this study, we aim to determine the pressures generated in common 3-way infusion devices, using simple low-cost equipment available and currently in use in the operating theatre environment. Methods: We compared three different common and commercially available 3-way infusion devices that allowed multiple infusions through one cannula in vitro...
2018: Patient Safety in Surgery
Dimonge Joseph Anthony, Basnayaka Mudiyanselage Oshan Deshanjana Basnayake, Nambunanayakkara Mahapalliyaguruge Gagana Ganga, Yasith Mathangasinghe, Ajith Peiris Malalasekera
Background: Accurate anatomical landmarks to locate the thoracodorsal nerve are important in axillary clearance surgery. Methods: Twenty axillary dissections were carried out on ten preserved Sri Lankan cadavers. Cadavers were positioned dorsal decubitus with upper limbs abducted to 900 . An incision was made in the upper part of the anterior axillary line. The lateral thoracic vein was identified and traced bi-directionally. The anatomical location of the thoracodorsal nerve was studied in relation to the lateral border of pectoralis minor and from a point along the lateral thoracic vein, 2 cm inferior to its confluence with the axillary vein...
2018: Patient Safety in Surgery
Matthew J Bradley, Angela T Kindvall, Ashley E Humphries, Elliot M Jessie, John S Oh, Debra M Malone, Jeffrey A Bailey, Philip W Perdue, Eric A Elster, Carlos J Rodriguez
Background: The Joint Trauma System has demonstrated improved outcomes through coordinated research and process improvement programs. With fewer combat trauma patients, our military American College of Surgeons level 2 trauma center's ability to maintain a strong trauma Process Improvement (PI) program has become difficult. As emergency general surgery (EGS) patients are similar to trauma patients, our Trauma and Acute Care Surgery (TACS) service developed an EGS PI program analogous to what is done in trauma...
2018: Patient Safety in Surgery
Kristin Salottolo, Laura Peck, Allen Tanner Ii, Matthew M Carrick, Robert Madayag, Emmett McGuire, David Bar-Or
Background: Widespread legislative efforts to legalize marijuana have increased the prevalence of marijuana use and abuse. The effects of marijuana on pain tolerance and analgesic pain management in the acute pain setting have not been reported. Although marijuana has been shown to have antinociceptive effects and is approved for medical use to treat chronic pain, anecdotal evidence suggests marijuana users admitted with traumatic injuries experience poorer pain control than patients who do not use marijuana...
2018: Patient Safety in Surgery
Juan Manuel Vinas-Rios, Martin Sanchez-Aguilar, Fatima Azucena Medina Govea, Viktor Von Beeg-Moreno, Frerk Meyer
Background: The recurrence rate in lumbar disc herniations (LDH) has been reported between 5 and 25%. There are only few data about this phenomenon that occurs within days of the initial operation. We analyse early recurrent LDH by analysis of data from the German Spine register. Methods: Data from patients undergoing disc herniation surgery in the lumbar region were extracted from the German Spine Registry between 1st January 2012 and 31st December 2016. Patients with early recurrent LDH within days of initial surgery were separately analysed...
2018: Patient Safety in Surgery
Sorawut Thamyongkit, Malick Bachabi, John M Thompson, Babar Shafiq, Erik A Hasenboehler
Background: The increasing financial burden of orthopaedic implants on our health care system has prompted cost-control measures, such as implant reprocessing. The purpose of this study was to describe the current usage by orthopaedic trauma surgeons of reprocessed external fixators (EFs) for treatment of complex fractures. Methods: A 16-question survey about use and perceptions of reprocessed EFs was distributed to 894 Orthopaedic Trauma Association members between August 2016 and June 2017 using a web-based survey system...
2018: Patient Safety in Surgery
Kristin Salottolo, Brian Cole, David Bar-Or
Background: There are limited efficacious treatment options for severe osteoarthritis of the knee (OAK). The Low Molecular Weight Fraction of 5% human serum Albumin (LMWF-5A) is in development to treat severe OAK. This study evaluated the safety and efficacy of LMWF-5A for the signs and symptoms of OAK. Methods: This 12-week randomized, double-blind, controlled clinical trial was conducted at thirteen sites across the United States. Patients with symptomatic, severe OAK (Kellgren-Lawrence grade 4 disease) who were fully ambulatory and had no other conditions interfering with the study knee were randomized to a single 4 ml intra-articular injection of LMWF-5A or saline, randomized 6:1...
2018: Patient Safety in Surgery
Naokazu Chiba, Kei Yokozuka, Shigeto Ochiai, Takahiro Gunji, Masaaki Okihara, Toru Sano, Koichi Tomita, Rina Tsutsui, Shigeyuki Kawachi
Background: The aim was to analyze hepatic hypertrophy after portal vein embolization (PVE) and Associating Liver Partition with Portal vein ligation for Staged hepatectomy (ALPPS) to determine whether clinical circumstances associated with major hepatic resections correlated with remnant growth. Methods: Data was abstracted from a retrospectively maintained database on 27 patients undergoing hepatic resection followed by PVE and the ALPPS procedure between October 1, 2007 and December 31, 2016...
2018: Patient Safety in Surgery
John Schwappach, Joseph Schultz, Kristin Salottolo, David Bar-Or
Background: The disease modifying potential of osteoarthritis therapies are of increasing interest, including their effects on delaying total knee replacement (TKR). To date, there have been no studies to determine the effect of LMWF-5A, a novel anti-inflammatory compound derived from human serum albumin, on delaying TKR. Methods: We evaluated time to TKR three years after patients participated in a randomized trial of three intra-articular injections of LMWF-5A or saline...
2018: Patient Safety in Surgery
Anne Lambert-Kerzner, Kelsey Lynett Ford, Karl E Hammermeister, William G Henderson, Michael R Bronsert, Robert A Meguid
Background: Risk assessment in surgery is essential to guide treatment decisions but is highly variable in practice. Providing formal preoperative risk assessment to surgical teams and patients may optimize understanding of risk. Implementation of the Surgical Risk Preoperative Assessment System (SURPAS), an innovative real time, universal, preoperative tool providing individualized risk assessment, may enhance informed consent and reduce adverse outcomes. To ensure optimal development and implementation of SURPAS we performed an in-depth pre-implementation evaluation of SURPAS at an academic tertiary referral center in Colorado...
2018: Patient Safety in Surgery
Juan Manuel Vinas Rios, Martin Sanchez-Aguilar, Thomas Kretschmer, Christian Heinen, Fatima Azucena Medina Govea, Sanchez-Rodriguez Jose Juan, Thomas Schmidt
Background: The predictors of shunt dependency such as amount of subarachnoid blood, acute hydrocephalus (HC), mode of aneurysm repair, clinical grade at admission and cerebro spinal fluid (CSF) drainage in excess of 1500 ml during the 1st week after the subarachnoid hemorrhage (SAH) have been identified as predictors of shunt dependency. Therefore our main objective is to identify predictors of CSF shunt dependency following non-traumatic subarachnoid hemorrhage. Methods: We performed a retrospective study including patients from January 1st 2012 to September 30th 2014 between 16 and 89 years old and had a non-traumatic subarachnoid hemorrhage in cranial computed tomography (CCT)...
2018: Patient Safety in Surgery
Mohammed Faisal, Hamada Fathy, Hamdy Shaban, Sameh T Abuelela, Ahmed Marie, Islam Khaled
Background: Seroma is the most frequent postoperative complication following breast cancer surgery. Our aim was to evaluate the effect of the harmonic focus scalpel versus electrocautery in reducing seroma formation post-mastectomy and axillary clearance. Methods: A prospective randomized controlled trial study was conducted at the Department of Surgery of Suez Canal University Hospital from April 26th 2014 to 30th June 2016. Seventy-two women, in whom a mastectomy and axillary clearance for breast cancer were performed, were randomly allocated to either harmonic dissection ( n  = 36) or electrocautery ( n  = 36)...
2018: Patient Safety in Surgery
WeiWei Wu, Kevin M Kuhn
Background: This case report describes the mechanical failure of a femoral lengthening nail in order to allow early recognition and prevent its occurrence. Case presentation: A femoral lengthening nail was used to achieve goal distraction length over eight weeks and sustained a mechanical failure during progressive weightbearing. Re-distraction was attempted with subsequent non-weight-bearing status. Although the patient was not able to attain the original goal length, radiographs demonstrated stable shortening of the patient's right lower extremity along with early signs of incomplete regenerate bone...
2018: Patient Safety in Surgery
Pasha Normahani, Nita Makwana, Wilhelm von Rosenberg, Sadie Syed, Danilo P Mandic, Valentin Goverdovsky, Nigel J Standfield, Usman Jaffer
Background: We aimed to explore the feasibility and attitudes towards using video replay augmented with real time stress quantification for the self-assessment of clinical skills during simulated surgical ward crisis management. Methods: Twenty two clinicians participated in 3 different simulated ward based scenarios of deteriorating post-operative patients. Continuous ECG recordings were made for all participants to monitor stress levels using heart rate variability (HRV) indices...
2018: Patient Safety in Surgery
Kiyohide Ishihata, Yasuyuki Kakihana, Takuya Yoshimura, Juri Murakami, Soichiro Toyodome, Hiroshi Hijioka, Etsuro Nozoe, Norifumi Nakamura
Background: The prediction of postoperative complications is important for oral and maxillofacial surgeons. We herein aimed to evaluate the efficacy of the Estimation of Physiologic Ability and Surgical Stress (E-PASS) and Acute Physiology, Age, and Chronic Health Evaluation (APACHE) II scoring systems to predict postoperative complications in patients undergoing oral and maxillofacial surgery. Methods: Thirty patients (22 males, 8 females; mean age: 65.1 ± 12...
2018: Patient Safety in Surgery
Luiz Fernando Cocco, Benno Ejnisman, Paulo Santoro Belangero, Moises Cohen, Fernando Baldy Dos Reis
Background: The treatment of humeral fractures remains controversial. Systematic reviews demonstrate similar results between dynamic compression plating and locked intramedullary nailing in the surgical treatment of these fractures. However, it appears that antegrade intramedullary nailing causes higher residual pain in the shoulder. The proposal of this work is to evaluate through the WORC protocol (Western Ontario Rotator Cuff Index) the consequences in the quality of life of patients submitted to osteosynthesis of the humerus with antegrade locked intramedullary nailing...
2018: Patient Safety in Surgery
Joshua Brown, Jeffery Talbert, Ryan Pennington, Qiong Han, Driss Raissi
Background: Retrieval of inferior vena cava filters (IVCFs) is important to decrease the long-term risk of complications associated with indwelling devices. Our hospital experienced low retrieval rates and implemented a low-cost intervention and evaluation for quality improvement. The working hypothesis was that a simple, mailed letter intervention could increase retrieval rates by increasing patient and primary care provider knowledge of the need for retrieval. Methods: For all prospective patients who received a retrievable IVCF during the intervention period from January 1, 2014 to February 29, 2016, patients and their primary care providers were mailed letters encouraging contact with the clinic for evaluation of eligibility for retrieval...
2018: Patient Safety in Surgery
Ulla Caesar, Jon Karlsson, Elisabeth Hansson
Background: Emergency surgery is unplanned by definition and patients are scheduled for surgery with minimal preparation. Some patients who have sustained emergency orthopaedic trauma or other conditions must be operated on immediately or within a few hours, while others can wait until the hospital's resources permit and/or the patients' health status has been optimised as needed. This may affect the prioritisation procedures for both emergency and elective surgery and might result in waiting lists, not only for planned procedures but also for emergencies...
2018: Patient Safety in Surgery
Ronny Grunert, Stefan Schleifenbaum, Robert Möbius, Michael Kopper, Christian Rotsch, Welf-Guntram Drossel, Niels Hammer, Torsten Prietzel
Background: The modularity in total hip arthroplasty (THA) allows orthopaedic surgeons for an exact reconstruction of hip biomechanical parameters especially in revision and tumor arthroplasty. Modular structured femoral stems using taper junctions showed increased implant breakage in the recent past. Presentation of the hypothesis: We hypothesize that a novel modular stem-neck-interface leads to less implant breakage compared to conventional femoral stems. Testing of the hypothesis: For this purpose, a novel modular femoral stem for THA was to design and manufacture...
2018: Patient Safety in Surgery
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"