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Surgical closure

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https://www.readbyqxmd.com/read/28544511/computational-fluid-dynamics-evaluation-of-posterior-septectomy-as-a-viable-treatment-option-for-large-septal-perforations
#1
Bradley A Otto, Chengyu Li, Alexander A Farag, Benjamin Bush, Jillian P Krebs, Ryan D Hutcheson, Kanghyun Kim, Bhakthi Deshpande, Kai Zhao
BACKGROUND: Numerous surgical techniques exist to treat nasal septal perforation (NSP). The surgical closure of large NSPs (>2 cm) is still challenging. Posterior septectomy has been reported as a simple alternative to treat large NSP, yet its mechanisms for symptom relief are not clear, and if failed, its consequence cannot be easily reversed. METHODS: Ten NSP patients were recruited: 5 underwent posterior septectomy and 5 underwent conventional flap or button repair...
May 23, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28543756/perventricular-device-closure-of-doubly-committed-sub-arterial-ventricular-septal-defects-via-a-left-infra-axillary-approach
#2
Sijie Zhou, Liyun Zhao, Taibing Fan, Bin Li, Weijie Liang, Haoju Dong, Shubo Song, Lin Liu
BACKGROUND: This study sought to evaluate the feasibility, safety, and efficacy of perventricular device closure of a doubly committed sub-arterial ventricular septal defect (dcVSD) through a left infra-axillary approach. METHOD: Forty-five patients, with a dcVSD of less than 8 mm in diameter, were enrolled in this study. The pericardium was exposed and opened through a left infra-axillary mini-incision. Two parallel purse-string sutures were placed on the right ventricle outflow tract and under transesophageal echocardiography guidance, a delivery sheath loaded with the device was inserted into the right ventricle and advanced through the defect into the left ventricle...
May 24, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28543533/an-acquired-gerbode-defect-from-the-left-ventricle-to-the-coronary-sinus-following-mitral-valve-replacement
#3
Richard Collis, Jonathan Afoke, Christopher Ga McGregor
We report the management of an acquired Gerbode defect, from the left ventricle to the coronary sinus, following mechanical mitral valve replacement. Following a failed percutaneous closure, surgical patch closure of the defect was performed.
May 24, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28541880/reconstruction-of-a-large-leg-defect-with-a-combined-hatchet-flap-technique
#4
Roberto Cecchi, Laura Bartoli, Luigi Brunetti, Giovanni Troiano
The repair of lower leg defects, not amenable to primary closure, may be challenging, since the skin at this level is scarcely elastic and difficult to mobilize. Local skin flaps are generally utilized only to restore moderately sized losses, whereas grafting becomes a realistic choice in presence of larger wounds. We present the case of a 70-year-old man with a wide defect on his right leg following the surgical excision of a squamous cell carcinoma. The wound was successfully closed with a combination of three hatchet flaps...
April 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28541864/surgical-site-infection-rate-drops-to-0-using-a-vacuum-assisted-closure-in-contaminated-dirty-infected-laparotomy-wounds
#5
Gerardo Lozano-Balderas, Alejandro Ruiz-Velasco-Santacruz, José Antonio Díaz-Elizondo, Juan Antonio Gómez-Navarro, Eduardo Flores-Villalba
Wound site infections increase costs, hospital stay, morbidity, and mortality. Techniques used for wounds management after laparotomy are primary, delayed primary, and vacuum-assisted closures. The objective of this study is to compare infection rates between those techniques in contaminated and dirty/infected wounds. Eighty-one laparotomized patients with Class III or IV surgical wounds were enrolled in a three-arm randomized prospective study. Patients were allocated to each group with the software Research Randomizer® (Urbaniak, G...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28541853/treatment-options-for-pilonidal-disease
#6
Denis Ehrl, Cornelia Choplain, Paul Heidekrueger, Holger C Erne, Horst-Guenter Rau, P Niclas Broer
Pilonidal disease can be treated medically; however, surgical excision remains the gold standard. Nonetheless, all current surgical approaches are still associated with potential for tissue loss, wound healing disorders, and high rates of recurrence. Aim of this study is to assess the long-term outcomes of the minimal-invasive pit-picking operation in comparison to the well-established technique of Karydakis flap-closure. Medical records of all patients undergoing either Karydakis flap-closure or the pit-picking operation for pilonidal disease at our department were reviewed retrospectively...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28541427/percutaneous-cannulation-for-cardiopulmonary-bypass-in-minimally-invasive-surgery-is-associated-with-reduced-groin-complications
#7
Alexandros Moschovas, Paulo A Amorim, Mariana Nold, Gloria Faerber, Mahmoud Diab, Tobias Buenger, Torsten Doenst
OBJECTIVES: Femoral cutdown is standard in most centres if groin cannulation is used for cardiopulmonary bypass in minimally invasive cardiac surgery (MICS). Arterial closure devices (ACDs) allow placement of larger cannulas percutaneously, but its benefit in MICS is unclear. We assessed our results with percutaneous groin cannulation using ACDs in comparison with conventional surgical access in patients undergoing MICS. METHODS: We reviewed 445 consecutive patients having undergone MICS between October 2010 and March 2015...
May 25, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28539252/the-outcomes-of-overlay-myringoplasty-endoscopic-versus-microscopic-approach
#8
Yuvatiya Plodpai, Nanatphong Paje
PURPOSE: To investigate the outcomes of overlay myringoplasty by comparing the endoscopic versus the microscopic approach. MATERIALS AND METHODS: This is a retrospective comparative study of 181 patients who underwent myringoplasty with overlay techniques between January 2010 and 2016 at Songklanagarind Hospital, Thailand. Group 1 underwent an endoscopic-assisted (n=90), and group 2 underwent the microscopic-assisted (n=91) overlay myringoplasty. The outcomes were graft take rates, the audiometric results, the need of canalplasty, complications and operative time...
May 9, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28539128/impaired-cardiac-output-during-exercise-in-adults-operated-for-ventricular-septal-defect-in-childhood-a-hitherto-unrecognised-pathophysiological-response
#9
Benjamin Asschenfeldt, Johan Heiberg, Steffen Ringgaard, Marie Maagaard, Andrew Redington, Vibeke E Hjortdal
BACKGROUND: Recent studies have demonstrated that surgical ventricular septal defect closure in childhood is associated with reduced functional capacity and disruption of the right ventricular force-frequency relationship during exercise. To further describe long-term cardiac function, we performed a non-invasive assessment of cardiac index during exercise in adults having undergone surgery for ventricular septal defect in early childhood. METHODS: A total of 20 patients (surgical age 2...
May 25, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28538648/less-is-more-antibiotic-duration-and-outcomes-in-fournier-s-gangrene
#10
Margaret Lauerman, Olga Kolesnik, Kinjal Sethuraman, Ronald Rabinowitz, Manjari Joshi, Emily Clark, Deborah Stein, Thomas Scalea, Sharon Henry
BACKGROUND: Antibiotic management of Fournier's gangrene (FG) is without evidence-based guidelines, and is based on expert opinion. The effect of duration of antibiotic therapy on outcomes in FG is unknown. METHODS: A retrospective review was performed of FG patients from 2012-2015 at a single institution. Patients were managed by our institutional practice of complete primary wound closure as possible, with antibiotic duration according to physician judgement. Patients were stratified into multiple durations of antibiotic administration...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538451/similar-anatomical-reduction-and-lower-complication-rates-with-the-sinus-tarsi-approach-compared-with-the-extended-lateral-approach-in-displaced-intra-articular-calcaneal-fractures
#11
Tim Schepers, Manouk Backes, Siem A Dingemans, Vincent M de Jong, Jan S K Luitse
OBJECTIVES: To investigate whether the sinus tarsi approach (STA) allows for a similar anatomical reduction of the posterior talocalcaneal facet as the extended lateral approach (ELA) and compare the rate of postoperative wound complications. DESIGN: Retrospective. SETTING: Level 1 trauma center. PATIENTS: All consecutive patients from 2012 to 2015 with a closed displaced intra-articular calcaneal fracture Sanders type II and III surgically treated with the ELA (N = 60) and the STA (N = 65)...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28538215/the-use-of-polyvinyl-alcohol-sponge-and-cyanoacrylate-glue-in-the-treatment-of-large-and-chronic-bronchopleural-fistulae-following-lung-cancer-resection
#12
Paolo Battistoni, Umberto Caterino, Sandro Batzella, Raffaele Dello Iacono, Gabriele Lucantoni, Giovanni Galluccio
BACKGROUND: Bronchopleural fistulae represent a relatively rare complication of pulmonary resection. For inoperable patients, several endoscopic procedures have been described. In the presence of large and chronic bronchopleural fistulae, persistent air leaks require a surgical therapy, while endoscopic airway stent represents a useful palliative treatment. OBJECTIVE: We describe the successful closure of large and chronic bronchopleural fistulae using an expandable polyvinyl alcohol (PVA) sponge and cyanoacrylate glue...
January 25, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28535522/restenosis-in-hemodialytic-fistulas-and-chronic-kidney-disease-associated-vascular-disease-two-pathologies-driven-by-metakaryotic-stem-cells
#13
Gianandrea Pasquinelli, William G Thilly, Elena V Gostjeva, Paola Todeschini, Giuseppe Cianciolo, Claudio Ronco, Gaetano La Manna
Chronic kidney disease (CKD) exacerbating vascular disease poses a major challenge to nephrology. Surgically placed vascular fistulas, as an aid to hemodialysis prior to kidney transplant, have extended many lives, while post-surgical restenosis closure of the fistula by smooth muscle cells affects many lives. When post-surgical restenosis is developed, palliative measures are almost always surgical: there are no effective drug treatments. In this study, we offer a testable hypothesis that effects of CKD on widely distributed vascular diseases and the phenomenon of fistula restenosis are both driven by the pathologic creation of non-dividing smooth muscle cells via asymmetric division of exponentially increasing metakaryotic stem cells...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28534175/-aseptic-loosening-of-total-ankle-replacement-two-stage-revision-with-bone-augmentation-of-osseous-defects-and-secondary-prosthesis-implantation
#14
A Barg, M Wiewiorski, V Valderrabano
OBJECTIVE: To remove loosened ankle prosthesis components, perform osseous defect augmentation, and reimplant definitive prosthesis components to preserve ankle range of motion. INDICATIONS: Aseptic loosening of the tibial and/or talar ankle prosthesis components with substantial bone defect. CONTRAINDICATIONS: General surgical/anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy, substantial nonreconstructable osseous defects with or without cysts on the tibial and/or talar side, noncompliance, primary total ankle replacement (TAR) using intramedullary fixation (stem fixation), severely reduced bone quality, insulin-dependent diabetes mellitus, smoking, unrealistic patients' expectations, high activity in sports...
May 22, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28533002/the-radial-aspect-of-the-distal-radial-metaphysis-diaphysis-as-a-source-of-cortical-bone-graft
#15
REVIEW
Steven Regal, Aakash Chauhan, Peter Tang
Cortical bone grafting is commonly required in the finger, hand, and carpus when managing bony trauma. A donor site that can provide a small or large amount of cortical bone graft that is easily accessible and within the same surgical field would be the ideal donor site. In high-energy injuries, a long cortical graft may be needed to reconstruct massive bony defects. In low-energy injuries such as scaphoid nonunions in which a wedge graft is needed, a reliable and easily accessible source of bone grafting would be beneficial...
May 19, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28530255/endoscopic-repair-of-nasal-septal-perforation
#16
M Cassano
Surgical closure of nasal septal perforation is one of the most challenging procedures in nasal surgery. During the last decade, many endoscopic repair techniques have been described with a success of post-operative repair between 76.4% and 100%. The advantages of this approach are its minimal invasiveness (with no external scars), optimal exposure of the operative field (with better visibility of structures) and good control of perforation margins. The drawbacks are that it is time-consuming and can be difficult to perform, requiring years of endoscopic experience...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28530217/-phonosurgical-methods-of-treatment-in-unilateral-vocal-folds-paralysis
#17
REVIEW
Bozena Kosztyła-Hojna, Greta Berger, Maciej Zdrojkowski
Glottal insufficiency (GI) is a cause of breathy voice that can profoundly affect quality of voice. Main causes are unilateral vocal fold paralysis or endoscopic cordectomy for the early treatment of laryngeal cancer of the glottis. The main strategy in surgical treatment is type I medialization thyroplasty according to Isshiki with the use of implants e.g. silastic, hydroxyapatite, titanium, Gore-Tex or Montgomery. Other procedures are arytenoid adduction, the injection laryngoplasty via thyrohyoid and cricothyroid approach and laryngeal reinnervation...
April 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28529863/ceramic-biocomposites-as-biodegradable-antibiotic-carriers-in-the-treatment-of-bone-infections
#18
REVIEW
Jamie Ferguson, Michael Diefenbeck, Martin McNally
Local release of antibiotic has advantages in the treatment of chronic osteomyelitis and infected fractures. The adequacy of surgical debridement is still key to successful clearance of infection but local antibiotic carriers seem to afford greater success rates by targeting the residual organisms present after debridement and delivering much higher local antibiotic concentrations compared with systemic antibiotics alone. Biodegradable ceramic carriers can be used to fill osseous defects, which reduces the dead space and provides the potential for subsequent repair of the osseous defect as they dissolve away...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529859/treatment-of-periprosthetic-joint-infection-using-antimicrobials-dilute-povidone-iodine-lavage
#19
REVIEW
John A Ruder, Bryan D Springer
Periprosthetic joint infections (PJI) remain a challenge for the orthopaedic surgeon to treat and remain a leading cause of failure of both primary and revision total joint arthroplasty. Once a PJI develops, surgical treatment is generally indicated and includes an aggressive irrigation and debridement. One component of the irrigation and debridement involves the use of an antiseptic irrigating solution. In primary and revision TJA, dilute povidone-iodine lavage can be performed prior to wound closure. Approximately 17...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529685/computed-tomography-guided-catheter-drainage-with-urokinase-and-ozone-in-management-of-empyema
#20
Bing Li, Chuan Liu, Yang Li, Han-Feng Yang, Yong Du, Chuan Zhang, Hou-Jun Zheng, Xiao-Xue Xu
AIM: To retrospectively compare the outcomes of catheter drainage, urokinase and ozone in management of empyema. METHODS: Retrospective study included 209 patients (111 males and 98 females; age range 19 to 72 years) who were diagnosed with empyema. The patients were divided into 3 groups based on the therapy instituted: catheter drainage only (group I); catheter drainage and urokinase (group II); catheter drainage, urokinase and ozone (group III). Drainage was considered successful if empyema was resolved with closure of cavity, clinical symptoms were resolved, and need for any further surgical procedure was avoided...
April 28, 2017: World Journal of Radiology
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