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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
Jacob Riis, Rebecca R Lehman, Robert A Perera, John Ryan Quinn, Patricia Rinehart, Hans Robert Tuten, Victoria Kuester
Background: Radiation exposure is a concern in the field of medicine. Deformity spine surgeons depend on modalities that have high exposure through scoliosis x-rays or computed tomography. The use of fluoroscopy has increased with the increased use of pedicle screws. Recently other 3-D imaging devices with navigation have also been brought onto the market to improve accuracy of screw placement. There is concern that because of the use of CT, the radiation dose to the patient is increased, however there is little literature that directly compares the amount of radiation using the 3-D devices to traditional fluoroscopy...
2017: Patient Safety in Surgery
John Michael Yingling, Li Sun, Richard Yoon, Frank Liporace
Background: Candida parapsilosis is a rare opportunistic pathogen that can be found in immunosuppressed patients. There are seldom-reported cases of fungal osteomyelitis surrounding orthopedic implants. Case presentation: This is a case of chronic Candida parapsilosis osteomyelitis in an immunocompromised patient with a prior open reduction and internal fixation for a closed bimalleolar ankle fracture that went on to neglected wound complications. The patient underwent series of treatments including removal of hardware, serial irrigation and debridements, negative pressure wound therapy, and intravenous antifungal therapy...
2017: Patient Safety in Surgery
James M DuBois, John T Chibnall, Emily E Anderson, Heidi A Walsh, Michelle Eggers, Kari Baldwin, Kelly K Dineen
Background: Unnecessary invasive procedures risk harming patients physically, emotionally, and financially. Very little is known about the factors that provide the motive, means, and opportunity (MMO) for unnecessary procedures. Methods: This project used a mixed-methods design that involved five key steps: (1) systematically searching the literature to identify cases of unnecessary procedures reported from 2008 to 2016; (2) identifying all medical board, court, and news records on relevant cases; (3) coding all relevant records using a structured codebook of case characteristics; (4) analyzing each case using a MMO framework to develop a causal theory of the case; and (5) identifying typologies of cases through a two-step cluster analysis using variables hypothesized to be causally related to unnecessary procedures...
2017: Patient Safety in Surgery
Naokazu Chiba, Motohide Shimazu, Kiminori Takano, Go Oshima, Koichi Tomita, Toru Sano, Masaaki Okihara, Yosuke Ozawa, Kosuke Hikita, Takahiro Gunji, Yuta Abe, Kiyoshi Koizumi, Shigeyuki Kawachi
Background: A novel index, total liver LU15, has been identified as a surrogate marker for liver function. We evaluated the ability of preoperative remnant liver LU15 values to predict postoperative hepatic failure. Methods: Preoperative risk factors for postoperative hepatic failure and remnant liver LU15 were evaluated in 123 patients undergoing liver resection for several diseases from September 1st, 2007 to December 1st, 2016. We calculated the remnant liver LU15 value from the total liver LU15 value and the functional remnant liver ratio...
2017: Patient Safety in Surgery
Johannes Dörner, Herbert Spelter, Hubert Zirngibl, Peter C Ambe
Background: Accidental foreign body ingestion is a common phenomenon in children between 6 months to 6 years of age. In adults, foreign body ingestion is commonly observed in the geriatric population and in patients with psychiatric disorders. Over 80% of ingested foreign bodies pass uneventfully through the intestinal tract. Endoscopic retrieval is needed in about 20% while surgical intervention is indicated in less than 1%. Herein we report an extremely rare case of esophagocutaneous fistula following operative retrival of an impacted denture in the esophagus with spontaneous healing within 3 weeks...
2017: Patient Safety in Surgery
Philip F Stahel, Wade R Smith, Ernest E Moore, Philip S Mehler, Sebastian Weckbach, Fernando J Kim, Nathan Butler, Hans-Christoph Pape, Ted J Clarke, Martin A Makary, Pierre-Alain Clavien
No abstract text is available yet for this article.
2017: Patient Safety in Surgery
Manuel Segura-Trepichio, David Candela-Zaplana, José Manuel Montoza-Nuñez, Antonio Martin-Benlloch, Andreu Nolasco
Background: The number of lumbar spine surgeries has been increasing during the last 20 years, which also leads to an increase in hospital costs and complications related to surgery. Therefore, there is a greater concern about the costs and safety of the techniques and implants used. Methods: Patients (aged from 18 to 50 years) presenting with lumbago /sciatica (ICD-10-CM M54.3, M54.4) due to lumbar disc herniation lasting more than 12 weeks, were included. Patients with disc herniation larger than size-2 or size-3 according to the MSU Classification were eligible for participation...
2017: Patient Safety in Surgery
Boyodi Tchangai, Mazamaesso Tchaou, Iroukora Kassegne, Kpatekana Simlawo
BACKGROUND: The term gossypiboma refers to a sponge that has been forgotten in the surgical field. It is the most common retained surgical item, and constitutes a continuing problem for surgical safety. We performed a hospital-based study to examine their incidence, root cause, and outcomes, as an effort toward improving prevention. METHODS: This retrospective study covered 10 years (2006-2015) and included surgically confirmed cases of abdominal gossypibomas occurring after 45,011 abdominal and gynaecological operations in 2 public hospitals in Lome (Togo)...
2017: Patient Safety in Surgery
Teshager Mamo, Tilaye Workneh Abebe, Tesfaye Yitna Chichiabellu, Antehun Alemayehu Anjulo
BACKGROUND: Pregnant women are at risk of infection during labor and delivery. Infection in obstetrics accounts for the second most common cause of maternal mortality next to post partum hemorrhage. Knowing the prevalence and associated risk factors would help to undertake optimal precautions and standard surgical techniques to reduce surgical site infection which poses increased hospital cost and total hospital stay of the patients. METHOD: Facility based retrospective observational study design was carried out purposively to assess the prevalence of surgical site infections and associated risk factors among mothers who had delivery related surgery at obstetric ward of Assela teaching referral hospital from April, 23, 2015 to September 5, 2015...
2017: Patient Safety in Surgery
Sergiu Botolin, Todd F VanderHeiden, Ernest E Moore, Herbert Fried, Philip F Stahel
BACKGROUND: Cervical spine fracture-dislocations in neurologically intact patients represent a surgical challenge due to the risk of inflicting iatrogenic spinal cord compression by closed reduction maneuvers. The use of MRI for early advanced imaging in these injuries remains controversially debated. CASE PRESENTATION: A 54-year old man sustained a fall over the handlebars of his racing bicycle. The helmeted patient sustained a fall on his head which resulted in a hyperflexion injury of the neck...
2017: Patient Safety in Surgery
Dirk Zajonz, Johannes K M Fakler, Anna-Judith Dahse, Fujiaoshou Junping Zhao, Melanie Edel, Christoph Josten, Andreas Roth
BACKGROUND: In spite of the improvement of many aspects around Total knee arthroplasty (TKA), there is still a group of 10% to 34% of patients who is not satisfied with the outcome. The therapy of chronic pain after TKA remains a medical challenge that requires an interdisciplinary therapy concept. The aim of this prospective pilot study was to evaluate the efficacy of a multimodal pain therapy in chronic complaints after TKA. METHODS: In a prospective cohort pilot study, we included patients with chronic pain after TKA who obtained in-patient care, especially multimodal pain therapy (MMPT), for at least 10 days...
2017: Patient Safety in Surgery
A Marzouki, A Naam, S Abdulrazak, B Soumaré, K Lahrach, F Boutayeb
BACKGROUND: Hydatid disease (HD) is a cosmopolitan parasitosis caused by Echinococcus granulosus that can potentially affect any part of the human body. Liver and lungs are the most frequent localizations. Primary musculoskeletal hydatidosis are seldom reported in literature and their incidence is unknown. CASE PRESENTATION: We deem interesting to report a case of a primary hydatid cyst in a 25-year-old patient who presented with a painful swelling of the right elbow...
2017: Patient Safety in Surgery
Sönke Labza, Isabella Fassola, Benedict Kunz, Wolfgang Ertel, Senat Krasnici
BACKGROUND: Ipsilateral femoral shaft and neck fractures are rare injuries, affecting mostly young patients who sustained high-energy traumas. In 19-50% of cases, the femoral fracture is misdiagnosed or overlooked at the initial presentation, with reportedly increased risk of complications such as non-union and avascular necrosis. We present a case of an ipsilateral femoral neck and shaft fracture, which was missed at initial presentation despite radiographic and computed tomography (CT) scan evaluation...
2017: Patient Safety in Surgery
Sebastian Weckbach, Heiko Reichel, Michael Kraus, Tugrul Kocak, Friederike Lattig
BACKGROUND: Sagittal rebalancing of a fixated lumbar hypolordosis (kyphosis) is very important to gain satisfactory results. To correct a misalignment vertebral column resection or pedicle subtraction osteotomies are favored, disregarding the relatively high complication rates. The aim of this study was to evaluate the efficiency and safety of a new modified transforaminal lumbar fusion technique as an alternative. METHODS: We conducted a retrospective review (06/2011-06/2015 ) of a prospective database at an University hospital...
2017: Patient Safety in Surgery
Kelemu Abebe Gelaw, Amlaku Mulat Aweke, Feleke Hailemichael Astawesegn, Birhanu Wondimeneh Demissie, Liknaw Bewket Zeleke
BACKGROUND: A cesarean section is a surgical procedure in which incisions are made through a woman's abdomen and uterus to deliver her baby. Surgical site infections are a common surgical complication among patients delivered with cesarean section. Further it caused to increase maternal morbidity, stay of hospital and the cost of treatment. METHODS: Hospital based cross-sectional study was conducted to assess the magnitude of surgical site infection following cesarean Site Infections and its associated factors at Lemlem Karl hospital July 1, 2013 to June 30, 2016...
2017: Patient Safety in Surgery
Luciana Souza Jorge, Alceu G Chueire, Patricia Silva Fucuta, Mauricio N Machado, Maria Gabriele L Oliveira, Marcelo A Nakazone, Mauro José Salles
BACKGROUND: The incidence of posttraumatic osteomyelitis (PTO) is increasing despite new treatment strategies. Assessment of patients' outcomes following PTO is challenging due to multiple variables. The study goals are to determine the frequency of recurrence following PTO treatment and identify factors predisposing patients to treatment failure. METHODS: Between August 01, 2007 to August 30, 2012, a single-center retrospective cohort study was performed among 193 patients diagnosed with PTO following orthopedic surgery for fracture care...
2017: Patient Safety in Surgery
Alistair M Lock, Ryan Gao, Dorit Naot, Brendan Coleman, Jillian Cornish, David S Musson
BACKGROUND: Surgeons have a range of materials to choose from to complete wound closure, yet surprisingly very little is still known about the body's immune response to the suture materials in current use. The growing literature of adverse suture material reactions provided the objective of this study, to use in vitro assays to quantify levels of inflammation produced by seven commonly used suture materials in surgical procedures. METHODS: Human monocyte/macrophage THP-1 cells were exposed to suture materials for 1, 3 and 5 days...
2017: Patient Safety in Surgery
Joel J Gagnier, Hal Morgenstern, Patrick Kellam
BACKGROUND: This study's objective was to identify adverse events following common orthopaedic procedures, and to estimate the incidence rates and risks of these events and their associations with age, sex, and comorbidities. METHODS: This retrospective cohort study manually reviewed and extracted electronic medical data on the incidence and predictors of adverse events that occurred within 90 days of the 50 most frequent orthopaedic surgeries at an academic hospital in 2010...
2017: Patient Safety in Surgery
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