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Hannah M Carl, A Karim Ahmed, Nancy Abu-Bonsrah, Rafael De la Garza Ramos, Eric W Sankey, Zachary Pennington, Ali Bydon, Timothy F Witham, Jean-Paul Wolinsky, Ziya L Gokaslan, Justin M Sacks, C Rory Goodwin, Daniel M Sciubba
OBJECTIVE Resection of metastatic spine tumors can improve patients' quality of life by addressing pain or neurological compromise. However, resections are often complicated by wound dehiscence, infection, instrumentation failures, and the need for reoperation. Moreover, when reoperations are needed, the most common indication is surgical site infection and wound breakdown. In turn, wound reoperations increase morbidity as well as the length and cost of hospitalization. The aim of this study was to examine perioperative risk factors associated with increased rate of wound reoperations after metastatic spine tumor resection...
March 16, 2018: Journal of Neurosurgery. Spine
Jeroen G V Habets, Roel H L Haeren, Suen A N Lie, Noel J C Bauer, Jim T A Dings
BACKGROUND: We present a case of orbital compartment syndrome (OCS) leading to monocular irreversible blindness following a pterional craniotomy for clipping of an anterior communicating artery (ACoA) aneurysm. OCS is an uncommon but vision-threatening entity requiring urgent decompression to reduce the risk of permanent visual loss. Iatrogenic orbital roof defects are a common finding following pterional craniotomies. However, complications related to these defects are rarely reported...
March 12, 2018: World Neurosurgery
C M S Hassing, T F Tvedskov, N Kroman, T L Klausen, J B Drejøe, J F Tvedskov, T-L Lambine, H Kledal, G Lelkaitis, L Langhans
BACKGROUND: Radioactive seed localisation (RSL) is a preoperative localisation method using a small titanium seed containing iodine-125. The method is increasingly applied for localising non-palpable lesions in the treatment of breast cancer. We believe that RSL has the potential to be used in various surgical specialties. The aim of this feasibility study was to test RSL as a preoperative localisation of non-palpable lymph nodes. METHODS: Between November 24, 2015 and October 26, 2016, 15 patients with suspicious lymph nodes on imaging were included in the study...
March 6, 2018: European Journal of Surgical Oncology
L Z Wang, C N Wei, F Xiao, X Y Chang, Y F Zhang
BACKGROUND: China has one of the highest rates of caesarean delivery in the world. The aim of this study was to investigate the incidence and risk factors for chronic pain after caesarean delivery in a Chinese cohort. METHODS: Patients undergoing elective caesarean delivery with a Pfannenstiel incision under spinal anaesthesia were recruited prospectively at a Chinese tertiary women's hospital. The State Trait Anxiety Inventory was measured before surgery. Postoperative analgesia was provided by intravenous patient-controlled analgesia for 48 hours...
February 2, 2018: International Journal of Obstetric Anesthesia
Simon W Young, Mei Zhang, Grant A Moore, Rocco P Pitto, Henry D Clarke, Mark J Spangehl
BACKGROUND: In primary TKA, prophylaxis with low-dose vancomycin through intraosseous regional administration (IORA) achieves tissue concentrations six to 10 times higher than systemic administration and was shown to provide more effective prophylaxis in an animal model. However, in revision TKA, the presence of a tibial implant may compromise IORA injection, and tourniquet deflation during a prolonged procedure may lower tissue concentrations. QUESTIONS/PURPOSES: (1) Does low-dose IORA reliably provide equal or higher tissue concentrations of vancomycin compared with systemic IV administration in revision TKA? (2) Are tissue concentrations of vancomycin after IORA maintained for the duration of the revision TKA despite a period of tourniquet deflation? (3) Is there any difference in early postoperative (< 6 weeks) complications between IORA and systemic IV administration in revision TKA? METHODS: Twenty patients undergoing aseptic revision TKA were randomized to two groups...
January 2018: Clinical Orthopaedics and related Research
Maryam Rezapoor, Timothy L Tan, Mitchell G Maltenfort, Javad Parvizi
BACKGROUND: Iodophor-impregnated adhesive incise drapes are widely used during surgeries for reducing surgical site contamination. There is little evidence to support the latter belief. This study evaluated the efficacy of iodophor-impregnated adhesive drapes for reducing bacterial contamination and counts at the incision site during hip surgery. METHODS: In this prospective, randomized clinical trial, we enrolled 101 patients undergoing open joint preservation procedure of the hip...
February 2, 2018: Journal of Arthroplasty
A Arezzo, R Passera, E Forcignanò, L Rapetti, R Cirocchi, M Morino
BACKGROUND: Over the last decade, single-incision laparoscopic cholecystectomy (SLC) has gained popularity, although it is not evident if benefits of this procedure overcome the potential increased risk. Aim of the study is to compare the outcome of SLC with conventional multi-incision laparoscopic cholecystectomy (MLC) in a meta-analysis of randomized controlled trials only. METHODS: A systematic Medline, Embase, and Cochrane Central Register of Controlled Trials literature search of articles on SLC and MLC for any indication was performed in June 2017...
March 9, 2018: Surgical Endoscopy
Neha Bansal, Henry L Walters, Daisuke Kobayashi
Purulent pericarditis is a rare infectious disease with significant mortality, even in the modern antibiotic era. The presenting signs can often be subtle and patients can deteriorate rapidly with cardiac tamponade. We report a previously healthy 16-month-old female who developed purulent pericarditis associated with paronychia and sepsis caused by methicillin-sensitive Staphylococcus aureus. In addition to antibiotic treatment, she required emergent pericardiocentesis for cardiac tamponade, followed by two surgical interventions including full median sternotomy incision and partial pericardiectomy...
January 1, 2018: World Journal for Pediatric & Congenital Heart Surgery
Zhi-Peng Wang, Jue Ma, Sheng Wang, Li-Na Yu, Jin-Feng Wei, Jin-Dong Xu
OBJECTIVE: To compare the safety of sevoflurane anesthesia with laryngeal mask and tracheal intubation in cesarean section in women with heart disease. METHODS: Fifty-two pregnant women with heart diseases undergoing cesarean section were randomized into laryngeal mask (LAM) group and tracheal intubation group. In LAM group, 6% sevoflurane was given at the rate of 6 L/min for induction with a maintenance sevoflurane concentration of 3%. In the intubation group, 1...
February 20, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Lucas Olivo Martins Pereira, Wagner Vilegas, Marcelo Marucci Pereira Tangerina, Karuppusamy Arunachalam, Sikiru Olaitan Balogun, Paulo Eduardo Orlandi Matos, Domingos Tabajara de Oliveira Martins
ETHNOPHARMACOLOGICAL IMPORTANCE: Lafoensia pacari A. St.-Hil., (Lythraceae) is a native tree of Brazilian Cerrado and commonly known in Brazil as "mangava-brava". Its leaves are used in Brazilian folk medicine in wound healing, cutaneous mycoses, and in the treatment of gastritis and ulcers. AIM OF THE STUDY: The present study was designed to evaluate the wound healing activity and mechanism of action of the hydroethanolic extract of Lafoensia pacari A...
February 28, 2018: Journal of Ethnopharmacology
David Peleg, Ronan Said Ahmad, Steven L Warsof, Naama Marcus-Braun, Yael Sciaky-Tamir, Inbar Ben Shachar
BACKGROUND: Knotless barbed sutures are monofilament sutures with barbs cut into them. These sutures self-anchor, maintaining tissue approximation without the need for surgical knots. OBJECTIVE: The hypothesis of this study was that knotless barbed suture could be used on the myometrium to close the hysterotomy at cesarean delivery. The objective was to compare uterine closure time, need for additional sutures, and blood loss between this and a conventional suture...
March 2018: American Journal of Obstetrics and Gynecology
Otto Zuhr, Stephan F Rebele, Stefani L Cheung, Markus B Hürzeler
Diverse clinical advancements, together with some relevant technical innovations, have led to an increase in popularity of tunneling flap procedures in plastic periodontal and implant surgery in the recent past. This trend is further promoted by the fact that these techniques have lately been introduced to a considerably expanded range of indications. While originally described for the treatment of gingival recession-type defects, tunneling flap procedures may now be applied successfully in a variety of clinical situations in which augmentation of the soft tissues is indicated in the esthetic zone...
March 1, 2018: Periodontology 2000
Y Du, W Zhou, Y Pan, Y Tang, L Wan, H Jiang
BACKGROUND: Older alveolar cleft patients (>12 years old) often have wide bone defect as well as teeth loss, resulting in poor osseous healing with conventional alveolar bone grafting (ABG). In this study, we investigated a surgical technique of block iliac bone grafting for the alveolar cleft reconstruction and evaluated the clinical and radiological outcomes of these cleft patients. MATERIAL AND METHODS: Fifteen patients were included in this study. All cases received preoperative cone bean computed tomography (CBCT) scans for the alveolar cleft evaluation...
February 24, 2018: Medicina Oral, Patología Oral y Cirugía Bucal
Shelby Brown, Michael Mirmanesh, Ping Song, Demetrius Coombs, David Rengifo, Lee L Q Pu
BACKGROUND: Although many aesthetic surgeons believe that beveling the angle of an incision improves the aesthetic outcome with regard to scaring, the literature remains scarce largely because few studies have been conducted. OBJECTIVE: This systematic review therefore aims to identify whether using a beveled incision adds an aesthetic benefit, to determine whether there is a specific angle that yields a superior outcome, and for the first time, to present a complete discussion of this subject for practicing surgeons...
February 23, 2018: Aesthetic Plastic Surgery
B J A Smarius, C H A L Guillaume, G Jonker, A B Mink van der Molen, C C Breugem
OBJECTIVES: Throat packs are commonly used to prevent ingestion or aspiration of blood and other debris during cleft lip/palate surgery. However, dislodgement or (partial) retainment after extubation could have serious consequences. The aim of the present study was to investigate the effect of omitting pharyngeal packing during cleft lip/palate surgery on the incidence of early postoperative complications in children. MATERIALS AND METHODS: A retrospective study was performed on all children who underwent cleft lip/palate surgery at the Wilhelmina Children's Hospital...
February 22, 2018: Clinical Oral Investigations
Dana Vitner, Inna Bleicher, Eyal Levy, Ronen Sloma, Einav Kadour-Peero, Yossi Bart, Shlomi Sagi, Amir Aviram, Ron Gonen
OBJECTIVE: We aimed to compare maternal morbidity and mortality of cesarean sections (CS) in the second versus first stage of labor. STUDY DESIGN: Retrospective study of all CS at a single, university-affiliated medical center, between January 2010 and December 2014. Eligibility was limited to term, singleton pregnancies with cephalic presentation. Maternal outcomes of second-stage CS were compared to those of first-stage CS. The primary outcome was defined as estimated blood loss >1000 ml...
February 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
M Nersesjan, D Hägi-Pedersen, J H Andersen, O Mathiesen, J B Dahl, L Broeng, K H Thybo
BACKGROUND: The lateral femoral cutaneous nerve (LFCN) block may be used for post-operative pain management in patients undergoing total hip arthroplasty. The aim of this trial was to investigate the sensory coverage of the posterior and the lateral incision lines and the involvement of the femoral nerve after an LFCN block. METHODS: The study was a randomised, blinded trial in 20 healthy volunteers. All subjects received a bilateral LFCN block randomised to 8 ml ropivacaine on the right side and 8 ml isotonic saline on the left side, or vice versa...
February 21, 2018: Acta Anaesthesiologica Scandinavica
Andy C Kiser, Thomas G Caranasos, Mark D Peterson, David M Holzhey, Philipp Kiefer, L Wiley Nifong, Michael A Borger
OBJECTIVE: Recently, the PARTNER 2A trial reported results of transcatheter aortic valve replacement versus surgical aortic valve replacement in 2032 intermediate-risk patients at 2 years. Two hundred thirty-six patients (24%) required an access route other than transfemoral. Compared with transfemoral and surgical aortic valve replacement, nontransfemoral transcatheter aortic valve replacement was associated with a numerically higher rate of death and disabling stroke at 30 days. This underscores the need for a better alternative surgical approach for patients with marginal femoral access...
February 17, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
M Zimlitski, L Natchkebia, G Loria, G Zimlitski, V Gvazava, A Gardeev
In this paper, we have studied the difference between classic Watson Jones anterolateral approach and modified anterolateral approach started in our institution from 2004 y. in group of patients with BMI more then 30 - 412 patients, mean age was 66,5 y., male -157 (38.2%), female - 255 (61,8%). Primary diagnosis were: Idiopathic osteoarthritis - 379 (92%), Rheumatoid ostheoarthritis - 16 (4%), DDH - 12 (3%). All surgeries were performed on supine position. All surgeries were performed by single surgeon. In 321 (78%) of cases modified approach was used...
January 2018: Georgian Medical News
Jarrod R Troy, Susan J Holcombe, Callie A Fogle, Kira L Epstein, J Brett Woodie
OBJECTIVE: To determine the influence of hyaluronate-carboxymethylcellulose (HA-CMC) membranes applied to intestinal anastomoses or enterotomies on postoperative complications after emergency exploratory celiotomy. STUDY DESIGN: Multicenter retrospective case-controlled series. ANIMALS: Adult horses (59 in the HA-CMC group and 91 controls). METHODS: Medical records from 4 referral hospitals were searched for horses ≥1 year of age, treated between 2008 and 2014 with emergency exploratory celiotomy, and surviving at least 24 hours postoperatively...
February 20, 2018: Veterinary Surgery: VS
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