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https://www.readbyqxmd.com/read/28942397/catastrophic-cement-reaction-following-cementation-for-megaprosthesis-for-proximal-femoral-fracture
#1
Muhammad Nouman Baig, William Curtin, Michael Andrew Callaghan, Colin G Murphy
Bone cement implantation syndrome (BCIS) is a well-described and potentially fatal complication of orthopaedic surgery involving pressurised bone cement. Although also described for certain spinal procedures, it is most commonly associated with cemented hip and knee arthroplasty and with cemented hemiarthroplasty following neck of femur fracture in particular.Donaldson et alproposed the definition of BCIS as a syndrome "characterized by hypoxia, hypotension or both and/or unexpected loss of consciousness occurring around the time of cementation, prosthesis insertion, reduction of the joint or, occasionally, limb tourniquet deflation in a patient undergoing cemented bone surgery"...
September 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28940518/sandwich-compression-with-rubbery-tourniquet-sheets-and-cotton-balls-for-auricular-pseudocyst
#2
Ming-Ying Wu, Chun-Bing Chen, Yi-Hsi Chen, Catherine Chang, Kai-Chieh Chan
OBJECTIVES/HYPOTHESIS: Pseudocyst of the auricle is a benign, noninflammatory cystic disease that is more common in Asians than in Caucasians. When managed conservatively, the results are often unsatisfactory and recurrences are common. We aimed to introduce a novel modified surgical method that involves a deroofing technique followed by a sandwich compression suture using two rubber tourniquet sheets and an iodine-soaked cotton ball for the treatment of auricular pseudocysts and to ascertain its effectiveness...
September 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28922709/non-drainage-versus-drainage-in-tourniquet-free-knee-arthroplasty-a-prospective-trial
#3
Kai Zhou, Haoyang Wang, Jinglong Li, Duan Wang, Zongke Zhou, Fuxing Pei
BACKGROUND: It is still unknown whether drainage is necessary and non-drainage is safe and acceptable after tourniquet-free total knee arthroplasty (TKA). We aim to investigate whether non-drainage use is accepted in TKA that is performed without a tourniquet. METHODS: Clinical data of 80 adult patients who did or did not receive drainage in our centres from August 2015 to December 2015 were prospective investigated. RESULTS: The drainage group exhibited reduced hidden blood loss (47...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28914680/outcomes-in-patients-treated-with-a-novel-simple-method-for-hemostasis-of-dermal-avulsion-injuries
#4
Sean Taylor Dowling, Brian Wai Lin
OBJECTIVE: A recently described technique proposes a simple method to achieve permanent hemostasis of distal fingertip dermal avulsion injuries. It is simple to learn and easy to perform with readily available materials found in most emergency departments. However, long-term outcomes for patients treated with this technique have not yet been evaluated. A primary objective of the current article is to provide safety data for the technique using an off-label product indication. SETTING: Emergency department of Kaiser Permanente Medical Center, San Francisco, California...
October 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28910469/prehospital-administration-of-tranexamic-acid-by-ground-forces-in-afghanistan-the-prehospital-trauma-registry-experience
#5
Steven G Schauer, Michael D April, Jason F Naylor, Jonathan Wiese, Kathy L Ryan, Andrew D Fisher, Cord W Cunningham, Noah Mitchell, Mark A Antonacci
BACKGROUND: Tranexamic acid (TXA) was shown to reduce overall mortality and death secondary to hemorrhage in a large prospective study. This intervention is time sensitive. As such, the Tactical Combat Casualty Care (TCCC) guidelines recommend use of this low-cost, safe intervention among patients with possible hemorrhagic shock, penetrating trauma to the thorax or trunk, or extremity amputation. OBJECTIVE: Prehospital administration of TXA by ground forces in the Afghanistan combat theater is described...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28910464/unwrapping-a-first-aid-tourniquet-from-its-plastic-wrapper-with-and-without-gloves-worn-a-preliminary-study
#6
John F Kragh, James K Aden, Connor D Lambert, Virgil K Moore, Michael A Dubick
BACKGROUND: The purpose of this study was to gather data about unwrapping a packaged limb tourniquet from its plastic wrapper while wearing different types of gloves. Because already unwrapped tourniquets require no time to unwrap, unwrapping data may provide insights into the issue of having tourniquets unwrapped when stowed in a first aid kit of a Serviceperson at war. MATERIALS AND METHODS: In a laboratory setting, 36 tests of nine glove groups were performed in which four people, gloved and ungloved, unwrapped tourniquets...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28905770/re-a-comparison-between-tourniquet-application-and-epinephrine-injection-for-hemostasis-during-hypospadias-surgery-the-effect-on-bleeding-and-postoperative-outcome
#7
https://www.readbyqxmd.com/read/28899856/release-of-the-tourniquet-immediately-after-the-implantation-of-the-components-reduces-the-incidence-of-deep-vein-thrombosis-after-primary-total-knee-arthroplasty
#8
P Zan, M O Mol, J J Yao, L Fan, D Yang, K Liu, G Li
AIMS: The length of the tourniquet time during total knee arthroplasty (TKA) is related to the incidence of post-operative deep vein thrombosis (DVT). Our aim in this study was to investigate the effect of the early release of the tourniquet on the incidence of DVT in patients undergoing TKA. METHODS: A total of 200 patients who underwent TKA between November 2015 and November 2016 were prospectively enrolled. The tourniquet was inflated before surgery and released immediately after the introduction of the components (early release group)...
September 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28886668/conceptual-origins-current-practice-and-views-of-wide-awake-hand-surgery
#9
Donald H Lalonde
This article reviews historical background, essential practice principles, and the new emerging area of wide awake hand surgery. It outlines the reasons that wide awake, local anaesthesia, no tourniquet surgery has emerged so quickly in the last 10 years over the world. I explain the origin of the concepts and some of the challenges of getting the technique accepted; in particular, the debunking of the myth of epinephrine danger in the finger. I review the most recent developments in several operations in this rapidly changing field of the tourniquet-free approach...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28885969/the-use-of-the-abdominal-aortic-and-junctional-tourniquet-during-cardiopulmonary-resuscitation-following-traumatic-cardiac-arrest-in-swine
#10
Jason Rall, Jennifer M Cox, Joseph Maddry
BACKGROUND: Standard cardiopulmonary resuscitation (CPR) is ineffective in treating traumatic cardiac arrest (TCA) following hemorrhagic shock despite fluid resuscitation. CPR adjuncts, including abdominal compressions and external counter pressure, have shown some success in laboratory settings. The Abdominal Aortic and Junctional Tourniquet (AAJT) is a device that occludes both venous and arterial blood at the level of the aortic bifurcation and likely increases thoracic pressure when applied to the abdomen...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28879617/high-but-not-moderate-intensity-endurance-training-increases-pain-tolerance-a-randomised-trial
#11
Thomas J O'Leary, Johnny Collett, Ken Howells, Martyn G Morris
PURPOSE: To examine the effect of high-intensity interval training (HIIT) compared to volume-matched moderate-intensity continuous training (CONT) on muscle pain tolerance and high-intensity exercise tolerance. METHODS: Twenty healthy adults were randomly assigned (1:1) to either 6 weeks of HIIT [6-8 × 5 min at halfway between lactate threshold and maximal oxygen uptake (50%Δ)] or volume-matched CONT (~60-80 min at 90% lactate threshold) on a cycle ergometer...
September 6, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28878898/tourniquet-induced-common-peroneal-nerve-injury-in-a-pediatric-patient-after-knee-arthroscopy-raising-the-red-flag
#12
Kah Ming Saw, Hwan Ing Hee
Peripheral nerve injury following the use of arterial tourniquets is a rare but potentially debilitating complication. Further education on the safe and appropriate practice of tourniquets is imperative to reduce the incidence of tourniquet-related complications.
September 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28871521/astragaloside-iv-prevents-acute-kidney-injury-and-inflammation-by-normalizing-muscular-mitochondrial-function-associated-with-a-nitric-oxide-protective-mechanism-in-crush-syndrome-rats
#13
Isamu Murata, Yuji Abe, Yuka Yaginuma, Kayako Yodo, Yuka Kamakari, Yurika Miyazaki, Daichi Baba, Yuko Shinoda, Toru Iwasaki, Kunihiko Takahashi, Jun Kobayashi, Yutaka Inoue, Ikuo Kanamoto
BACKGROUND: Crush syndrome (CS) is a serious medical condition characterized by muscle cell damage resulting from decompression after compression (i.e., ischemia/reperfusion injury). A large number of CS patients develop cardiac failure, kidney dysfunction, and systemic inflammation, even when fluid therapy is administered. We evaluated whether the administration of astragaloside-IV (AS)-containing fluid improved survival by preventing kidney and muscular mitochondrial dysfunction in a rat model of CS...
September 4, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28867906/open-carpal-tunnel-release-outcomes-performed-wide-awake-versus-with-sedation
#14
Jacob E Tulipan, Nayoung Kim, Jack Abboudi, Christopher Jones, Frederic Liss, William Kirkpatrick, Michael Rivlin, Mark L Wang, Jonas Matzon, Asif M Ilyas
Background  Carpal tunnel release (CTR) is the most common surgery of the hand, and interest is growing in performing it under local anesthesia without tourniquet. To better understand differences, we hypothesized that patients undergoing CTR under wide-awake local anesthesia with no tourniquet (WALANT) versus sedation (monitored anesthesia care [MAC]) would not result in a difference in outcome. Methods  Consecutive cases of electrodiagnostically confirmed open CTR across multiple surgeons at a single center were prospectively enrolled...
August 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28867520/comparison-of-the-iassist-handheld-guidance-system-to-conventional-instruments-for-mechanical-axis-restoration-in-total-knee-arthroplasty
#15
Matthew C Kinney, Krishna R Cidambi, Dustyn L Severns, Francis B Gonzales
BACKGROUND: Recent advances in total knee arthroplasty (TKA) include an intelligent instrument system designed to provide intraoperative guidance to reduce mechanical alignment errors. Internal position-sensing technology is integrated into microelectronic pods that attach to cutting blocks. The purpose of this prospective, randomized study was to determine whether this iAssist system enables the surgeon to make more accurate bone resections and better restore the mechanical axis compared to conventional instruments in TKA...
June 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28867250/extensor-retinaculum-reconstruction-using-the-wide-awake-approach
#16
REVIEW
Takehiko Takagi, Yuka Kobayashi, Masahiko Watanabe
De Quervain tenosynovitis is often treated by simple release of the first compartment. However, patients can suffer from persistent postoperative problems, including "clumsy" use of the thumb, as a result of redislocation or bowstringing of the extensor pollicis brevis/abductor pollicis longus tendons or irritation of the superficial branch of the radial nerve. Here we describe our method for first compartment reconstruction, in which the flaps are sutured after double-flap incision of the compartment. Because the tendons can become recompressed or redislocate if the sutures are too tight or loose, respectively, we achieve proper tension by suturing the flaps with the patient fully awake, under local anesthesia, and without a tourniquet...
August 31, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28865632/back-to-basics-pneumatic-tourniquet-use
#17
Lisa Spruce
Pneumatic tourniquets are commonly used in surgeries involving the limbs to achieve a nearly bloodless surgery and an optimal operating field or when administering regional anesthesia during surgery on a limb. Complications can arise from the use of tourniquets, including nerve injuries, pain, compartment syndrome, pressure injuries, chemical burns, and tissue necrosis. More serious injuries-including deep vein thrombosis, thermal damage to tissues, severe ischemic injuries, and rhabdomyolysis-also can occur...
September 2017: AORN Journal
https://www.readbyqxmd.com/read/28863083/for-the-patient-evolution-in-the-management-of-vascular-trauma
#18
David V Feliciano
There has been an evolution in the diagnosis and management of vascular trauma over the past 100 years. The primary stimulus to these changes has been the increased volume of patients with cervical, truncal, and peripheral vascular injuries during military conflicts and in civilian life.Patients with "hard" signs of a vascular injury are taken to surgery emergently with a few exceptions to be described. In contrast, patients with "soft" signs of a vascular injury undergo a careful physical examination including measurement of vascular index to determine if radiologic imaging is necessary...
August 31, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28853118/occlusion-training-pilot-study-for-postoperative-lower-extremity-rehabilitation-following-primary-total-knee-arthroplasty
#19
Christopher L Gaunder, Michael P Hawkinson, David J Tennent, Creighton C Tubb
With continued emphasis on the value of healthcare, factors such as quality of life and patient reported outcomes are critical in evaluating high-demand procedures such as knee replacement surgery. Equally important to the surgery itself is maximizing the effectiveness and efficiency of the treatment, both preoperatively and postoperatively, which can have a significant effect the final outcome. Technical outcomes of total knee replacement are generally considered excellent; however, many patients continue to have postoperative pain, functional limitations, and low treatment satisfaction...
July 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/28852453/myomectomies-for-massive-hemoperitoneum-from-spontaneous-bleeding-of-a-uterine-myoma
#20
I Kassegne, K Kolani, B Tchangai, K Kanassoua, K Adabra, F Alassani, A K Amavi, E D J Dosseh
Massive hemoperitoneum from spontaneous bleeding of uterine myoma is an extremely rare condition, that needs urgent surgical exploration. We report a 40-year-old woman, admitted for acute onset of abdominal pain. Physical examination revealed hypovolemic shock. The hemoglobin level was of 5 g/dL. Ultrasonography revealed hemoperitoneum. Emergency surgical exploration was planned. There was hemoperitoneum of 3 L, uterine myomas with multiple subserous myomas, bleeding from superficial ruptured varice overlying the most largest subserous myoma, which measured 15 cm...
July 2017: Journal of Surgical Case Reports
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