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Patient Safety in Surgery

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https://www.readbyqxmd.com/read/30181776/complications-of-pelvic-and-acetabular-fractures-in-1331-morbidly-obese-patients-bmi-%C3%A2-40-a-retrospective-observational-study-from-the-national-trauma-data-bank
#1
James T Carson, Sabin G Shah, Gezzer Ortega, Sorawut Thamyongkit, Erik A Hasenboehler, Babar Shafiq
Background: There have been no large-scale epidemiological studies of outcomes and perioperative complications in morbidly obese trauma patients who have sustained closed pelvic ring or acetabular fractures. We examined this population and compared their rate of inpatient complications with that of control patients. Methods: We retrospectively reviewed the records of patients treated for closed pelvic ring or acetabular fracture, aged 16-85 years, with Injury Severity Scores ≤15 from the National Trauma Data Bank Research Dataset for the years 2007 through 2010...
2018: Patient Safety in Surgery
https://www.readbyqxmd.com/read/30159033/preserving-the-marginal-mandibular-branch-of-the-facial-nerve-during-submandibular-region-surgery-a-cadaveric-safety-study
#2
Dimonge Joseph Anthony, Basnayaka Mudiyanselage Oshan Deshanjana Basnayake, Yasith Mathangasinghe, Ajith Peiris Malalasekera
Background: The marginal mandibular branch of the facial nerve is vulnerable to iatrogenic injuries during surgeries involving the submandibular region. This leads to significant post-operative morbidity. Studies assessing accurate anatomical landmarks of the marginal mandibular branch are sparse in South Asian countries. Present study was conducted to assess the relationship between the marginal mandibular branch and the inferior border of the body of mandible. Methods: Twenty-two preserved cadavers of Sri Lankan nationality were selected...
2018: Patient Safety in Surgery
https://www.readbyqxmd.com/read/30154916/incidence-and-causes-of-cancellations-of-elective-operation-on-the-intended-day-of-surgery-at-a-tertiary-referral-academic-medical-center-in-ethiopia
#3
Melaku Desta, Addissu Manaye, Abiot Tefera, Atalay Worku, Alemitu Wale, Alemlanchi Mebrat, Negesso Gobena
Background: Elective surgical case cancellation refers to any elective surgical case that is the list on the day prior to surgery but not operated upon as scheduled. Case cancellation has a major cause of psychological trauma to patients and their families. Despite little is known in Ethiopia. Therefore, this study aimed to assess incidence and reasons of cancellations of elective operation on the intended day of surgery at tertiary referral academic medical center in Ethiopia. Methods: A prospective hospital-based cross-sectional study design was conducted in a tertiary referral academic medical center in Ethiopia among 146 participants...
2018: Patient Safety in Surgery
https://www.readbyqxmd.com/read/30154915/intraoperative-real-time-fluorescence-angiography-with-indocyanine-green-for-evaluation-of-intestinal-viability-during-surgery-for-an-incarcerated-obturator-hernia-a-case-report
#4
Dimitra Daskalopoulou, Joseph Kankam, Jens Plambeck, Peter C Ambe, Konstantinos Zarras
Background: Bowel incarceration represents a dreaded complication amongst patients with hernias. The intraoperative evaluation of the bowel perfusion following hernia reduction with regard to the need for resection of ischaemic bowel can be challenging. In this case report we discuss intraoperative fluorescence angiography with indocyanine green (ICG) as an objective means of accessing bowel perfusion following hernia reduction. Case presentation: The case of a 92-year-old, caucasian, female patient presenting with symptoms of small bowel obstruction secondary to an incarcerated left sided obturator hernia is presented...
2018: Patient Safety in Surgery
https://www.readbyqxmd.com/read/30127854/transmigration-of-a-retained-surgical-sponge-a-case-report
#5
Tushar Patial, Namit Rathore, Angesh Thakur, Digvijay Thakur, Kanika Sharma
Background: A retained surgical sponge remains a dreaded complication of modern surgery. Despite the increasing focus on patient safety instances of "a sponge being left in the abdomen", are all too common in popular media. In this article we report the rare phenomenon of transmigration of a retained surgical sponge in a patient who underwent laparoscopic sterilization. Case presentation: A 30-year-old female presented with progressive abdominal pain for about one month and vomiting with obstipation for 2 days...
2018: Patient Safety in Surgery
https://www.readbyqxmd.com/read/30123323/safety-and-efficacy-of-a-new-thromboprophylaxis-regiment-for-total-knee-and-total-hip-replacement-a-retrospective-cohort-study-in-265-patients
#6
Mohammad Amre Fallaha, Sarkhell Radha, Sheena Patel
Background: Venous thromboembolism (VTE) remains a significant complication following knee and hip arthroplasty. National and international guidelines recommend pharmacological and mechanical thromboprophylaxis following surgery, unless contraindicated, to reduce the risk of VTE. This study aimed to explore the safety and efficacy profile of an adapted thromboprophylaxis regimen consisting of sequential enoxaparin and rivaroxaban for thromboprophylaxis following knee or hip arthroplasty at a London teaching hospital...
2018: Patient Safety in Surgery
https://www.readbyqxmd.com/read/29988638/retained-surgical-sponges-a-descriptive-study-of-319-occurrences-and-contributing-factors-from-2012-to-2017
#7
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
https://www.readbyqxmd.com/read/29988472/comparison-of-flow-pressures-in-different-3-way-infusion-devices-an-in-vitro-study
#8
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
https://www.readbyqxmd.com/read/29983745/an-improved-technical-trick-for-identification-of-the-thoracodorsal-nerve-during-axillary-clearance-surgery-a-cadaveric-dissection-study
#9
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
https://www.readbyqxmd.com/read/29977337/development-of-an-emergency-general-surgery-process-improvement-program
#10
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
https://www.readbyqxmd.com/read/29946360/the-grass-is-not-always-greener-a-multi-institutional-pilot-study-of-marijuana-use-and-acute-pain-management-following-traumatic-injury
#11
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
https://www.readbyqxmd.com/read/29942349/incidence-of-early-postoperative-complications-requiring-surgical-revision-for-recurrent-lumbar-disc-herniation-after-spinal-surgery-a-retrospective-observational-study-of-9-310-patients-from-the-german-spine-register
#12
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
https://www.readbyqxmd.com/read/29930708/use-of-reprocessed-external-fixators-in-orthopaedic-surgery-a-survey-of-243-orthopaedic-trauma-surgeons
#13
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
https://www.readbyqxmd.com/read/29910837/intra-articular-injection-of-the-anti-inflammatory-compound-lmwf-5a-in-adults-with-severe-osteoarthritis-a-double-blind-prospective-randomized-controlled-multi-center-safety-and-efficacy-trial
#14
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
https://www.readbyqxmd.com/read/29881460/the-diagnostic-value-of-99m-tc-gsa-scintigraphy-for-liver-function-and-remnant-liver-volume-in-hepatic-surgery-a-retrospective-observational-cohort-study-in-27-patients
#15
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
https://www.readbyqxmd.com/read/29881459/incidence-of-total-knee-replacement-subsequent-to-intra-articular-injection-of-the-anti-inflammatory-compound-lmwf-5a-versus-saline-a-long-term-follow-up-study-to-a-randomized-controlled-trial
#16
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
https://www.readbyqxmd.com/read/29881458/assessment-of-attitudes-towards-future-implementation-of-the-surgical-risk-preoperative-assessment-system-surpas-tool-a-pilot-survey-among-patients-surgeons-and-hospital-administrators
#17
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
https://www.readbyqxmd.com/read/29796090/predictors-of-hydrocephalus-as-a-complication-of-non-traumatic-subarachnoid-hemorrhage-a-retrospective-observational-cohort-study-in-107-patients
#18
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
https://www.readbyqxmd.com/read/29796089/a-novel-technique-of-harmonic-tissue-dissection-reduces-seroma-formation-after-modified-radical-mastectomy-compared-to-conventional-electrocautery-a-single-blind-randomized-controlled-trial
#19
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
https://www.readbyqxmd.com/read/29743955/mechanical-failure-of-a-femoral-lengthening-nail-a-case-report
#20
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
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