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Patient Safety in Surgery

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https://www.readbyqxmd.com/read/28321265/introducing-the-bone-screw-fastener-for-improved-screw-fixation-in-orthopedic-surgery-a-revolutionary-paradigm-shift
#1
Philip F Stahel, Nicholas A Alfonso, Corey Henderson, Todd Baldini
BACKGROUND: Conventional screws used for fracture fixation in orthopedic surgery continue to rely on the historic buttress thread design. While buttress screws generally provide solid resistance against unidirectional axial loading forces, their design suffers from several limitations, as the buttress thread does not adequately resist multiaxial forces. Furthermore, the buttress screw is prone to stripping at the bone-screw interface and can cause microfracturing of the surrounding bone due to its thread design...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28184249/atlantoaxial-rotatory-fixation-as-a-rare-complication-from-head-positioning-in-otologic-surgery-report-of-two-cases-in-young-children
#2
Hiroshi Sakaida, Koji Akeda, Akihiro Sudo, Kazuhiko Takeuchi
BACKGROUND: Atlantoaxial rotatory fixation is a condition in which the first and second vertebrae of the cervical spine become interlocked in a rotated position. This condition can result in serious consequences and thus have a significant impact on patients, especially when diagnosis and treatment are delayed. Some cases of atlantoaxial rotatory fixation have been described in association with otologic surgery or plastic surgery involving the ear. We present the cases of two pediatric patients who developed atlantoaxial rotatory fixation following otologic surgery and we review the relevant literature...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28163786/changes-in-safety-climate-and-teamwork-in-the-operating-room-after-implementation-of-a-revised-who-checklist-a-prospective-interventional-study
#3
Sofia Erestam, Eva Haglind, David Bock, Annette Erichsen Andersson, Eva Angenete
BACKGROUND: Inter-professional teamwork in the operating room is important for patient safety. The World Health Organization (WHO) checklist was introduced to improve intraoperative teamwork. The aim of this study was to evaluate the safety climate in a Swedish operating room setting before and after an intervention, using a revised version of the WHO checklist to improve teamwork. METHODS: This study is a single center prospective interventional study. Participants were personnel working in operating room teams including surgeons, anesthesiologists, scrub nurses, nurse anaesthetists and nurse assistants...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28115991/the-impact-of-economic-rationalization-prioritization-and-rationing-on-job-satisfaction-motivation-and-team-cohesion-in-hospitals-a-survey-among-retired-physician-executives-in-germany
#4
Joerg Schnoor, Elmar Braehler, Mohamed Ghanem, Christoph E Heyde
BACKGROUND: The growing economization of the health care system and implication of market principles in the medical field have risen new and serious questions on the meaning of the medical profession, the doctor-patient relationship and the orientation of medicine itself. The impact of the dynamic clinical structures on the doctor-doctor and the doctor-patient interaction appear even unpredictable. Therefore, the impact of market-based methods, i.e. rationalization, prioritization and rationing, on job satisfaction, motivation and team cohesion should be quantified...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28105080/current-practice-of-antibiotic-prophylaxis-for-surgical-fixation-of-closed-long-bone-fractures-a-survey-of-297-members-of-the-orthopaedic-trauma-association
#5
Itai Gans, Amit Jain, Norachart Sirisreetreerux, Elliott R Haut, Erik A Hasenboehler
BACKGROUND: The risk of postoperative surgical site infection after long bone fracture fixation can be decreased with appropriate antibiotic use. However, there is no agreement on the superiority of a single- or multiple-dose perioperative regimen of antibiotic prophylaxis. The purpose of this study is to determine the following: 1) What are the current practice patterns of orthopaedic trauma surgeons in using perioperative antibiotics for closed long bone fractures? 2) What is the current knowledge of published antibiotic prophylaxis guidelines among orthopaedic trauma surgeons? 3) Are orthopaedic surgeons willing to change their current practices? METHODS: A questionnaire was distributed via email between September and December 2015 to 955 Orthopaedic Trauma Association members, of whom 297 (31%) responded...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28096899/why-do-surgeons-continue-to-perform-unnecessary-surgery
#6
EDITORIAL
Philip F Stahel, Todd F VanderHeiden, Fernando J Kim
No abstract text is available yet for this article.
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27999617/intraoperative-radiation-safety-in-orthopaedics-a-review-of-the-alara-as-low-as-reasonably-achievable-principle
#7
REVIEW
Daniel J Kaplan, Jay N Patel, Frank A Liporace, Richard S Yoon
The use of fluoroscopy has become commonplace in many orthopaedic surgery procedures. The benefits of fluoroscopy are not without risk of radiation to patient, surgeon, and operating room staff. There is a paucity of knowledge by the average orthopaedic resident in terms proper usage and safety. Personal protective equipment, proper positioning, effective communication with the radiology technician are just of few of the ways outlined in this article to decrease the amount of radiation exposure in the operating room...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27980675/is-immediate-weight-bearing-safe-for-periprosthetic-distal-femur-fractures-treated-by-locked-plating-a-feasibility-study-in-52-consecutive-patients
#8
Wade R Smith, Jason W Stoneback, Steven J Morgan, Philip F Stahel
BACKGROUND: Periprosthetic distal femur fractures associated with total knee replacement are increasing in incidence. We hypothesized that a standardized management protocol would result in few implant failures and a low rate of postoperative complications. METHODS: Retrospective observational cohort study at an urban level 1 trauma center and academic level 2 trauma center. Consecutive patients with periprosthetic distal femur fractures and stable total knee arthroplasty were included between January 1, 2011 and December 31, 2014...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27822310/anaphylactic-shock-during-cement-implantation-of-a-total-hip-arthroplasty-in-a-patient-with-underlying-mastocytosis-case-report-of-a-rare-intraoperative-complication
#9
Anita Ten Hagen, Pieter Doldersum, Tom van Raaij
BACKGROUND: Cemented total hip arthroplasty (THA) is a safe and common procedure. In rare cases life threatening bone cement implantation syndrome (BCIS) may occur, which is commonly caused by pulmonary embolism (PE). CASE PRESENTATION: We describe the rare case of a 70-year old patient who underwent an elective total hip replacement. Before surgery he was diagnosed with underlying systemic indolent mastocytosis, a rare pathological disorder that may result in anaphylaxis after massive systemic mast cell activation...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27822309/trends-in-intubation-rates-and-durations-in-ventilated-severely-injured-trauma-patients-an-analysis-from-the-traumaregister-dgu%C3%A2
#10
Khalid Almahmoud, Michel Teuben, Hagen Andruszkow, Klemens Horst, Rolf Lefering, Frank Hildebrand, Hans Christoph Pape, Roman Pfeifer
BACKGROUND: Endotracheal intubation in severely injured patients is known to be a risk factor for systemic complications. We aimed to examine the changes in intubation rates and durations in severely injured trauma patients, and rates of the systemic complications associated with ventilation changes by using a large trauma registry over the period of 13 years. METHODS: Patient demographics, Injury Severity Score (ISS), ventilation days, ventilation free days (VFD), and prevalence of systemic complications (sepsis and multiple organ failure (MOF)) were obtained from the TraumaRegister DGU® and were compared over the study period...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27800019/adverse-events-in-orthopedic-care-identified-via-the-global-trigger-tool-in-sweden-implications-on-preventable-prolonged-hospitalizations
#11
Hans Rutberg, Madeleine Borgstedt-Risberg, Pelle Gustafson, Maria Unbeck
BACKGROUND: The national incidence of adverse events (AEs) in Swedish orthopedic care has never been described. A new national database has made it possible to describe incidence, nature, preventability and consequences of AEs in Swedish orthopedic care. METHODS: We used national data from a structured two-stage record review with a Swedish modification of the Global Trigger Tool. The sample was 4,994 randomly selected orthopedic admissions in 56 hospitals during 2013 and 2014...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27800018/endoscopic-removal-of-a-retained-surgical-sponge-in-a-young-syrian-refugee-after-caesarean-section-a-case-report-with-discussion-of-cultural-and-political-consequences
#12
Johannes Ackermann, Moritz Kanzow, Micaela Mathiak, Ulrich Pecks, Nicolai Maass, Ibrahim Alkatout
BACKGROUND: Inadvertently retained sponges and instruments still constitute a major but preventable complication in surgery. Given the high geographic mobility of patients, the fluctuation of physician-patient contact, and communication problems due to language barriers, the conscientious use of structured safety protocols in clinical routine is an essential aspect of quality in health care. CASE PRESENTATION: We report the case of a 24-year-old refugee from Syria who presented at our gynecological outpatient department with a tumor in the lower abdomen, suspected to be a lump in the ovary or the uterus...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27790289/challenging-the-knowledge-base-and-skillset-for-providing-surgical-consent-by-orthopedic-and-plastic-surgeons-in-the-netherlands-an-identified-area-of-improvement-in-patient-safety
#13
Wouter K G Leclercq, Sarah Sloot, Bram J Keulers, Saskia Houterman, Johan Legemaate, Margot Veerman, Leslie Thomas, Marc R Scheltinga
BACKGROUND: Successfully completing a surgical informed consent process is an important element of the preoperative consult. A previous study of Dutch general surgeons demonstrated that the implementation of SIC did not meet acceptable standards. However, the quality of the SIC process in the orthopedic surgical or plastic surgical arena is unknown. METHODS: Following ethical approval, an online survey investigating specifics of surgical informed consent was performed among members of the Dutch Scientific Association of Orthopedic Surgeons and the Dutch Society for Plastic Surgery...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27688807/how-to-perform-a-root-cause-analysis-for-workup-and-future-prevention-of-medical-errors-a-review
#14
REVIEW
Ryan Charles, Brandon Hood, Joseph M Derosier, John W Gosbee, Ying Li, Michelle S Caird, J Sybil Biermann, Mark E Hake
Providing quality patient care is a basic tenant of medical and surgical practice. Multiple orthopaedic programs, including The Patient Safety Committee of the American Academy of Orthopaedic Surgeons (AAOS), have been implemented to measure quality of surgical care, as well as reduce the incidence of medical errors. Structured Root Cause Analysis (RCA) has become a recent area of interest and, if performed thoroughly, has been shown to reduce surgical errors across many subspecialties. There is a paucity of literature on how the process of a RCA can be effectively implemented...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27610201/comparison-of-awareness-about-precautions-for-needle-stick-injuries-a-survey-among-health-care-workers-at-a-tertiary-care-center-in-pakistan
#15
Abdul Rafay Qazi, Furqan Ali Siddiqui, Salman Faridi, Urooj Nadeem, Nida Iqbal Umer, Zainab Saeed Mohsini, Muhammad Muzzammil Edhi, Mehmood Khan
BACKGROUND: Needle stick injuries (NSIs) have the potential of causing Hepatitis B and Hepatitis C, which is constantly adding to the burden of chronic liver disease in our country. It poses a risk to Health Care Workers (HCWs) and the patients they deal with. In order to limit the spread of these viruses, it is imperative that these HCWs be fully equipped with knowledge regarding prevention of NSIs and dealing with one, regardless of their designation. We therefore aimed to assess and compare the level of awareness about precautions for needle stick injuries amongst all those greatest at risk...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27462369/the-dangers-of-lithotomy-positioning-in-the-operating-room-case-report-of-bilateral-lower-extremity-compartment-syndrome-after-a-90-minutes-surgical-procedure
#16
Nicole Stornelli, Frank B Wydra, Justin J Mitchell, Philip F Stahel, Stefka Fabbri
BACKGROUND: Lower extremity acute compartment syndrome after gynecologic surgery in the lithotomy position is a rare, yet potentially devastating complication. A high level of suspicion is paramount for early recognition and mitigation of acute compartment syndrome originating from prolonged surgery in lithotomy position. CASE PRESENTATION: A 23-year-old female, gravida 1, para 0, underwent a laparoscopic salpingectomy for a ruptured ectopic pregnancy. Surgical time was 90 min...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27429648/is-total-hip-arthroplasty-safely-performed-in-lung-transplant-patients-current-experience-from-a-retrospective-study-of-the-zurich-lung-transplant-cohort
#17
Jürgen W Schmitt, Christian Benden, Claudio Dora, Clément M L Werner
BACKGROUND: In recent years, the number of lung transplants has increased rapidly, with higher quality of life and improved survival rates in transplant recipients, including patients with advanced age. This, in turn, means that more transplant recipients will seek musculoskeletal care to treat degenerative joint disease and also trauma incidents. Safety concerns regarding elective and posttraumatic hip arthroplasty in transplant patients include an increased risk of infection, wound healing problems, periprosthetic fractures and loosening of the implants...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27293483/monitoring-of-liver-function-in-a-73-year-old-patient-undergoing-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-case-report-applying-the-novel-liver-maximum-function-capacity-test
#18
Felix Oldhafer, Kristina I Ringe, Kai Timrott, Moritz Kleine, Wolf Ramackers, Sebastian Cammann, Mark D Jäger, Juergen Klempnauer, Hueseyin Bektas, Florian W R Vondran
BACKGROUND: The two-stage liver resection combining in situ liver transection with portal vein ligation, also referred to as ALPPS (Associating Liver Partition and Portal vein ligation for Staged hepatectomy), has been described as a promising method to increase the resectability of liver tumors. However, one of the most important issues regarding the safety of this procedure is the optimal timing of the second stage at the point of sufficient hypertrophy of the future liver remnant. The recently developed liver maximum function capacity test (LiMAx) can be applied to monitor the liver function postoperatively and hence could be a useful tool for decision-making regarding the timing of the second stage of ALPPS...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27274767/a-survey-on-patients-knowledge-and-expectations-during-informed-consent-for-spinal-surgery-can-we-improve-the-shared-decision-making-process
#19
Sebastian Weckbach, Tugrul Kocak, Heiko Reichel, Friederike Lattig
BACKGROUND: The informed medical consent in surgery requires to some point basic medical knowledge. The treating physicians while explaining the details and risks of the recommended procedure often imply this. We hypothesized, that patients do not have adequate medical understanding to decide about the ongoing therapy and its potential complications based on knowledge jeopardizing the patients' safety. METHODS: We conducted a retrospective analysis of a prospective database using a multiple choice questionnaire with 10 basic questions about anatomy, clinical symptoms and therapies of spinal diseases in our spine clinic at a German university hospital...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27213016/the-risk-of-intra-urethral-foley-catheter-balloon-inflation-in-spinal-cord-injured-patients-lessons-learned-from-a-retrospective-case-series
#20
Vaidyanathan Subramanian, Bakul M Soni, Peter L Hughes, Gurpreet Singh, Tun Oo
BACKGROUND: Inflating the balloon of Foley catheter in urethra is a complication of urethral catheterisation. We report five patients in whom this complication occurred because of unskilled catheterisation. Due to lack of awareness, the problem was not recognised promptly and patients came to harm. CASE SERIES: A tetraplegic patient developed pain in lower abdomen and became unwell after transurethral catheterisation. CT pelvis revealed full bladder with balloon of Foley catheter in dilated urethra...
2016: Patient Safety in Surgery
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