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Surgical closure

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https://www.readbyqxmd.com/read/28107284/postsurgical-perforation-of-the-esophagus-can-be-treated-using-a-fully-covered-stent-in-children
#1
Chantal Chauvet, Arnaud Bonnard, Alexis Mosca, Marc Bellaïche, Pascale Philippe-Chomette, Jérôme Viala
OBJECTIVES: Surgery and conservative treatment of esophageal or gastric perforations are both often associated with poor results and carry a high morbidity and mortality rate. The aim of the present study was to evaluate the effectiveness and safety of using fully covered self-expending metallic stents (SEMS) in children with upper digestive leaks. METHODS: This retrospective study reviewed all children with esophageal or gastric perforation who were treated with placement of an SEMS from January 2011 to January 2015...
February 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28107239/management-of-pharyngeal-fistulas-after-anterior-cervical-spine-surgery-a-treatment-algorithm-for-severe-complications
#2
Christian Simon, Carl H Fürstenberg, Markus Eichler, Stefan Rohde, Cem Bulut, Bernd Wiedenhöfer
STUDY DESIGN: This study is a retrospective database query to identify all anterior spinal approaches. OBJECTIVES: The objectives were to assess all patients with pharyngocutaneous fistulas (PCFs) after anterior cervical spine surgery. SUMMARY OF BACKGROUND DATA: Patients with the diagnosis of PCFs were treated at the University of Heidelberg Spine Medical Center, Spinal Cord Injury Unit and Department of Otolaryngology (Germany), between 2005 and 2011...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28107224/abdominal-sepsis
#3
Quirine J J Boldingh, Fleur E E de Vries, Marja A Boermeester
PURPOSE OF REVIEW: To summarize the recent evidence on the treatment of abdominal sepsis with a specific emphasis on the surgical treatment. RECENT FINDINGS: A multitude of surgical approaches towards abdominal sepsis are practised. Recent evidence shows that immediate closure of the abdomen has a better outcome. A short course of antibiotics has a similar effect as a long course of antibiotics in patients with intra-abdominal infection without severe sepsis. SUMMARY: Management of abdominal sepsis requires a multidisciplinary approach...
January 19, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28106963/wire-skills-for-the-surgeon-femoral-access-safety-net-and-vascular-closure-devices-in-transfemoral-transcatheter-aortic-valve-implantation-procedures
#4
Simon Sndermann, Axel Unbehaun, Alexander Meyer, Volkmar Falk, Jrg Kempfert
Transfemoral transcatheter aortic valve implantation procedures are widely used to treat patients with aortic stenosis and high surgical risk. Major vascular complications are common and are associated with higher mortality rates. We describe the use of vascular access site closure systems and a safety net to prevent and handle these complications.
December 14, 2016: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/28106513/long-term-follow-up-of-superior-gluteal-artery-perforator-flap-closure-of-large-myelomeningoceles
#5
Brett A Whittemore, Dale M Swift, Bradley E Weprin, Frederick J Duffy
OBJECTIVE Large myelomeningocele defects and poor surrounding tissue quality make some defects particularly difficult to close primarily. This paper describes the superior gluteal artery perforator (SGAP) flap technique for defect closure and long-term clinical outcomes. METHODS The technique for closing a myelomeningocele with an SGAP flap is described. A retrospective chart review was performed on a cohort of 11 patients who underwent closure in this manner. RESULTS Between 1999 and 2015, 271 myelomeningoceles were closed, 11 of which were SGAP flap closures...
January 20, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28105901/negative-pressure-wound-therapy-staged-excision-and-definitive-closure-with-split-thickness-skin-graft-for-axillary-hidradenitis-suppurativa-a-retrospective-study
#6
F B Pearce, K A Richardson
OBJECTIVE: Bilateral axillary hidradenitis is a chronic, suppurative, and scarring disease that is most effectively treated by complete excision of all hair-bearing tissues. We assessed our staged procedure for excision and placement of a split-thickness skin graft for bilateral axillary hidradenitis in terms of costs, outcomes, and timing of excision. METHOD: An IRB approved retrospective case analysis was performed on patients that underwent bilateral axillary hidradenitis skin excision with eventual placement of split-thickness skin grafting using the current LSUHSC/University Health hidradenitis surgical treatment protocol...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28101722/the-effect-of-antibiotic-coated-sutures-on-the-incidence-of-surgical-site-infections-in-abdominal-closures-a-meta-analysis
#7
Basheer Elsolh, Lisa Zhang, Sunil V Patel
OBJECTIVE: This meta-analysis aims to determine if antibiotic-impregnated sutures for abdominal fascial closure prevent postoperative surgical site infections (SSIs), hernias, and/or dehiscence. METHODS: MEDLINE and EMBASE databases (1946-2016) were searched. Randomized controlled trials comparing antibiotic-impregnated sutures to standard sutures for abdominal closure were eligible. Risk of bias was evaluated using the Cochrane Handbooks definitions. RESULTS: Four-hundred fifty articles were reviewed; five eligible studies (N = 3117) were identified...
January 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28099357/bilayered-negative-pressure-wound-therapy-preventing-leg-incision-morbidity-in-coronary-artery-bypass-graft-patients-a-randomized-controlled-trial
#8
Yongchao Yu, Zhigang Song, Zhiyun Xu, Xiaofei Ye, Chunyu Xue, Junhui Li, Hongda Bi
BACKGROUNDS: The harvesting of great saphenous veins for coronary artery bypass graft (CABG) patients may result in significant complications, including lymphorrhagia, lymphoedema, incision infection, wound dehiscence, and skin flap necrosis. We investigated the function of a self-designed bilayered negative pressure wound therapy (b-NPWT) for reducing the above-mentioned complications using a clinical randomized controlled trial. METHODS: A single-center, pilot randomized controlled trial was conducted...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28097936/experimental-study-on-tissue-phantoms-to-understand-the-effect-of-injury-and-suturing-on-human-skin-mechanical-properties
#9
Arnab Chanda, Vinu Unnikrishnan, Zachary Flynn, Kim Lackey
Skin injuries are the most common type of injuries occurring in day-to-day life. A skin injury usually manifests itself in the form of a wound or a cut. While a shallow wound may heal by itself within a short time, deep wounds require surgical interventions such as suturing for timely healing. To date, suturing practices are based on a surgeon's experience and may vary widely from one situation to another. Understanding the mechanics of wound closure and suturing of the skin is crucial to improve clinical suturing practices and also to plan automated robotic surgeries...
January 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28096573/prolonged-patient-emergence-time-among-clinical-anesthesia-resident-trainees
#10
L McLean House, Nathan H Calloway, Warren S Sandberg, Jesse M Ehrenfeld
BACKGROUND AND AIMS: Emergence time, or the duration between incision closure and extubation, is costly nonoperative time. Efforts to improve operating room efficiency and identify trainee progress make such time intervals of interest. We sought to calculate the incidence of prolonged emergence (i.e., >15 min) for patients under the care of clinical anesthesia (CA) residents. We also sought to identify factors from resident training, medical history, anesthetic use, and anesthesia staffing, which affect emergence...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28094473/transmeatal-tympanoplasty-of-subtotal-and-anterior-perforations-a-single-institution-experience-including-94-patients
#11
E A J de Savornin Lohman, J Borgstein
Transmeatal myringoplasty is suitable for all cases of eardrum perforations. Results are 90% closure rate; comparable to other published series of retroauricular techniques. Operation can be completed in 15-20 minute, meaning cost-effective use of surgical resources. Far less patient discomfort and lower morbidity compared to a retroauricular approach. Tragal perichondrium is found to be a suitable and reliable graft material. This article is protected by copyright. All rights reserved.
January 17, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28093615/the-open-abdomen-route-by-eurahs-introduction-of-the-data-set-and-initial-results-of-procedures-and-procedure-related-complications
#12
A Willms, F Muysoms, C Güsgen, R Schwab, J Lock, S Schaaf, C Germer, I Richardsen, U Dietz
INTRODUCTION: Open abdomen management has become a well-established strategy in the treatment of serious intra-abdominal pathologies. Key objectives are fistula prevention and high fascial closure rates. The current level of evidence on laparostoma is insufficient. This is due to the rareness of laparostomas, the heterogeneity of study cohorts, and broad diversity of techniques. Collecting data in a standardised, multicentre registry is necessary to draw up evidence-based guidelines. MATERIALS AND METHODS: In order to improve the level of evidence on laparostomy, CAMIN (surgical working group for military and emergency surgery) of DGAV (German Society for General and Visceral Surgery), initiated the implementation of a laparostomy registry...
January 16, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28093318/massive-vulvar-linear-verrucous-epidermal-nevus-presenting-at-menarche
#13
Jaclyn Morrison, Adrienne Bonham
BACKGROUND: Epidermal nevi are benign hamartomatous growths of the skin that present at birth and develop in early childhood often linearly along the "lines of Blaschko". Verrucous linear epidermal nevi are the most common epidermal nevi and often are located on the trunk or extremities. There is minimal evidence regarding vulvar involvement and subsequent management of the associated cosmetic deformity in this anatomic location. CASE: An 11 year-old menarchal female who underwent full-thickness dermal excision of a 9...
January 13, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28091841/transumbilical-abdominal-incision-for-laparoscopic-colorectal-surgery-does-not-increase-the-risk-of-postoperative-surgical-site-infection
#14
Mizunori Yaegashi, Koki Otsuka, Toshimoto Kimura, Masanori Hakozaki, Megumu Kamishima, Tomoki Hatanaka, Kei Sato, Hitoshi Fujii, Teppei Matsuo, Akira Sasaki
PURPOSE: Besides antibiotic prophylaxis, antiseptic skin preparation is an important measure to prevent surgical site infection (SSI). No reports have detailed the relationship between SSI and umbilical microflora following laparoscopic colorectal cancer with a transumbilical longitudinal incision. METHODS: Risk factors and the rate of SSI were investigated in 453 patients who underwent laparoscopic colorectal resection over a 3-year period. Microbiological samples were collected from the umbilicus and SSI areas...
January 13, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28090817/coronary-or-ventricular-rupture-after-blunt-chest-trauma-a-clinical-dilemma
#15
Anton Sabashnikov, Guido Michels, Javid Fatullayev, Kaveh Eghbalzadeh, Mohamed Zeriouh, Stephan Baldus, Jens Wippermann, Thorsten Wahlers, Navid Madershahian
Cardiac rupture (CR) is one of the most serious and life-threatening complications of blunt chest trauma (BCT) usually associated with high mortality. Moreover, its diagnosis and treatment strategies may be extremely challenging for clinicians due to various anatomical localisations of the tear. Whereas most injuries fall under the category of right atrial ruptures, left ventricular lesions represent a rare type of this injury, with greater mortality, particularly in cases of multi-chamber injuries. However, not only cardiac chamber or great vessel ruptures may occur as a result of BCT; a growing number of reports also describe BCT-induced isolated coronary artery injuries, including ruptures...
January 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28090708/effect-of-semi-quantitative-culture-results-from-complex-host-surgical-wounds-on-dehiscence-rates
#16
Tammer Elmarsafi, Caitlin S Garwood, John S Steinberg, Karen K Evans, Christopher E Attinger, Paul J Kim
The primary aim of this study was to determine the effect of positive bacterial cultures at the time of closure on dehiscence rates. Pre and post-débridement wound cultures from patients undergoing serial surgical débridement of infected wounds were compared with outcomes 30 days postoperatively. One-hundred patients were enrolled; 35 were excluded for incomplete culture data. Sixty-five patients were evaluated for species counts, including Coagulase negative Staphylococcus, and semi-quantitative culture data for each débridement...
January 16, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28090519/a-rare-case-of-a-blood-clot-masquerading-as-a-retained-surgical-drain
#17
Sean Wl Ho, Ivan Th Chua
Surgical drains are commonly used in surgery to reduce post-operative fluid collections. Whilst rare, a retained surgical drain may result in clinical complications and distress to the patient. A retained surgical drain is a potentially avoidable event and surgeons should be aware on how to confirm the presence of a retained surgical drain. We report a rare case of a blood clot masquerading as a retained surgical drain in a patient. The patient is a 55-year-old Malay male who presented with left gluteal necrotizing fasciitis...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28090504/fortune-of-temporary-ileostomies-in-patients-treated-with-laparoscopic-low-anterior-resection-for-rectal-cancer
#18
Mustafa Haksal, Nuri Okkabaz, Ali Emre Atici, Osman Civil, Yasar Ozdenkaya, Ayhan Erdemir, Nihat Aksakal, Mustafa Oncel
PURPOSE: The current study aims to analyze the risk factors for the failure of ileostomy reversal after laparoscopic low anterior resection for rectal cancer. METHODS: All patients who underwent a laparoscopic low anterior resection for rectal cancer with a diverting ileostomy between 2007 and 2014 were abstracted. The patients who underwent and did not undergo a diverting ileostomy procedure were compared regarding patient, tumor, treatment related parameters, and survival...
January 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28090047/platypnea-orthodeoxia-syndrome-in-a-patient-with-an-atrial-septal-defect-the-diagnosis-and-choice-of-treatment
#19
Shuichiro Kazawa, Takashi Enomoto, Naomasa Suzuki, Tomoyasu Koshikawa, Yuka Okubo, Shinpei Yoshii, Masahito Sato, Masaaki Okabe, Akira Yamashina, Yoshifusa Aizawa
A 77-year-old woman developed dyspnea over three years which occurred during sitting, standing or walking. Her physical examination, chest X-ray, ECG and cardiac catheterization results were all normal. A marked fall in arterial oxygen saturation was observed on sitting or standing. Transesophageal echocardiography showed an increase of right to left shunt flow on sitting. The patient was diagnosed with platypnea-orthodeoxia syndrome and underwent the surgical closure of an atrial septal defect of 19 mm in diameter...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28087048/-characteristics-and-risk-factors-for-recurrence-of-cutaneous-squamous-cell-carcinoma-with-conventional-surgery-and-surgery-with-delayed-intraoperative-margin-assessment
#20
Judith Domínguez-Cherit, Georgina Rodríguez-Gutiérrez, Verónica Narváez Rosales, Sonia Toussaint Caire, Verónica Fonte Avalos
BACKGROUND: Non-melanoma skin cancer includes basal cell carcinoma and squamous cell carcinoma (SCC). Basal cell carcinoma is the most common and least aggressive but in a low percentage of cases, despite appropriate wide surgical margins, it can be aggressive, producing local invasion, recurrences and distance metastasis. SCC has a more aggressive behaviour invading first the skin, the lymph nodes and less frequently produces distance metastasis OBJECTIVE: To identify the characteristics of recurrent SCC and frequency of new SCC after conventional surgical and primary closure or closure delayed until a histological reporting of tumour-free surgical margins, in order to achieve a better surgical option, in our Mexican population...
January 10, 2017: Cirugia y Cirujanos
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