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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
#1
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/28096573/prolonged-patient-emergence-time-among-clinical-anesthesia-resident-trainees
#2
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/28091841/transumbilical-abdominal-incision-for-laparoscopic-colorectal-surgery-does-not-increase-the-risk-of-postoperative-surgical-site-infection
#3
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/28078466/does-stoma-site-specimen-extraction-increase-postoperative-ileostomy-complication-rates
#4
Wanglin Li, Cigdem Benlice, Luca Stocchi, Hermann Kessler, Emre Gorgun, Meagan Costedio
BACKGROUND: Minimizing incisions has the potential to decrease hernia formation and wound complications following laparoscopic surgery. It is currently unknown if using the stoma site for specimen extraction affects outcomes. This study aims to evaluate the impact of stoma site extraction on postoperative complication rates in laparoscopic colorectal surgery. METHODS: After IRB approval, a retrospective comparative review of 738 consecutive patients (405 M) who underwent laparoscopic colorectal surgery with ileostomy between January 2008 and December 2014 was performed...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28070914/risk-of-cesarean-scar-defect-in-single-versus-double-layer-uterine-closure-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#5
REVIEW
Attilio Di Spiezio Sardo, Gabriele Saccone, Rebekah McCurdy, Emmanuel Bujold, Giuseppe Bifulco, Vincenzo Berghella
OBJECTIVE: A growing body of evidence suggests that the surgical technique for uterine closure influences uterine scar healing, but there is still no consensus about optimal uterine closure during cesarean delivery (CD). The aim of this systematic review and meta-analysis was to compare the effect of single- versus double-layer closure on the risk of uterine scar defect. METHODS: MEDLINE, Scopus, http://ClinicalTrials.gov, the PROSPERO International Prospective Register of Systematic Reviews, EMBASE and the Cochrane Central Register of Controlled Trials were searched from inception of each database until May 2016...
January 10, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28065230/effectiveness-of-secundum-atrial-septal-defect-occlusion-with-the-septal-occluder-through-right-chest-small-incision-clinical-analysis-of-140-cases
#6
Song-Yi Qian, Zong-Gang Zhang, Jun Liu, Yong-Zhong Guo, Sheng Guo, Zhong-Yuan Ma, Yu-Kui DU, Ti Ai Li Ai Ze-Zi Mai, Jian-Shuang Tao, Peng Liu
Objective To evaluate the feasibility and effectiveness of secundum atrial septal defect(ASD)occlusion with the septal occluder through right-chest small incision. Methods The clinical data of 140 secundum ASD patients (47 males and 93 females) aged 3-63 years who were treated in our center from August 2004 to July 2014 were retrospectively analyzed. The diameter of ASD was 6 to 36 mm. Under general anesthesia, all patients underwent intraoperative transtsophageal echocardiography (TEE), during which no associated cardiac deformity was found...
December 20, 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28058229/systematic-review-of-the-negative-pressure-wound-therapy-in-kidney-transplant-recipients
#7
Badri Man Shrestha
AIM: To review negative pressure wound therapy (NPWT) as an important addition to the conventional methods of wound management. METHODS: A systematic review, performed by searching the PubMed, EMBASE and Cochrane Library databases, showed 11 case reports comprising a total of 22 kidney transplantation (KT) patients (range, 1 to 9), who were treated with NPWT. Application of NPWT was associated with successful healing of wounds, leg ulcer, lymphocele and urine leak from ileal conduit...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28043766/re-operative-urethroplasty-after-failed-hypospadias-repair-how-prior-surgery-impacts-risk-for-additional-complications
#8
W Snodgrass, N C Bush
PURPOSE: The primary aim of this report was to compare urethroplasty complications for primary distal and proximal repairs with those after 1, 2, 3, and 4 or more re-operations. METHODS: Prospectively collected data on consecutive hypospadias repairs (tubularized incised plate (TIP), inlay, two-stage graft) from 2000 to 2015 were reviewed. Isolated fistula closures were excluded. Extracted information included patient age, meatal location, repair type, primary vs...
December 7, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28040750/a-minimally-invasive-approach-for-open-surgical-thoracoabdominal-aortic-replacement-experimental-concept-for-a-novel-surgical-procedure
#9
Terézia B Andrási, Violetta Kékesi, Béla Merkely, Marius Grossmann, Bernhard C Danner, Friedrich A Schöndube
OBJECTIVES: We aimed to develop a simple, reliable, and timesaving technique for the therapy of thoracoabdominal aortic (TAA) aneurysms that are not suitable for endovascular repair. METHODS: In this pilot study, we sought to combine the advantages of classic open vascular procedure with the use of endoscopic surgical tools and small skin incisions to develop a minimally invasive approach for TAA replacement. The following procedures were used: endoscopic exposure and closure of the lower intercostal arteries; small posterolateral thoracotomy and left retroperitoneal incisions to expose the anastomotic regions of the aorta; partial anticoagulation; passive bypass and sequential aortic clamping; tunnelling of the graft through the native aortic lumen (endoaneurysmorrhaphy) and open performance of vascular anastomosis...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28018810/transmediastinal-trachea-closure-after-dilational-tracheotomy-positioned-too-low-down
#10
Andreas Kirschbaum, Tanja Maier, Afsin Teymoortash
Dilational tracheotomy is a minimally invasive method that can be performed at the bedside on patients requiring long-term mechanical ventilation. In our 70-year-old male patient, percutaneous dilational tracheotomy (Ciaglia Blue Rhino, Cook Medical Inc., Bloomington, Indiana, United States) was performed because of bilateral pneumonia with sepsis. There were no initial problems. Nine days later, while the patient was being repositioned, the tracheal cannula became dislocated. Despite extending the cervical incision it was not possible to recannulate...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28003941/negative-pressure-wound-therapy-with-instillation-in-a-chronic-non-healing-right-hip-trochanteric-pressure-ulcer
#11
Kevin W Broder, Brian Nguyen, Richard M Bodor
Complex pressure ulcer wound sites often present with a wide scope of barriers to healing ranging from high colonization of multi-drug-resistant pathogens to tortuous internal anatomy which make the wound recalcitrant to traditional wound care including standard negative pressure wound therapy (NPWT). Negative pressure wound therapy with instillation (NPWTi-d) provides an opportunity to manage and heal wounds with indications not met by standard NPWT such as cavitating wounds with complex undermining and tunneling...
November 14, 2016: Curēus
https://www.readbyqxmd.com/read/27996083/dressings-for-the-prevention-of-surgical-site-infection
#12
REVIEW
Jo C Dumville, Trish A Gray, Catherine J Walter, Catherine A Sharp, Tamara Page, Rhiannon Macefield, Natalie Blencowe, Thomas Kg Milne, Barnaby C Reeves, Jane Blazeby
BACKGROUND: Surgical wounds (incisions) heal by primary intention when the wound edges are brought together and secured, often with sutures, staples, or clips. Wound dressings applied after wound closure may provide physical support, protection and absorb exudate. There are many different types of wound dressings available and wounds can also be left uncovered (exposed). Surgical site infection (SSI) is a common complication of wounds and this may be associated with using (or not using) dressings, or different types of dressing...
20, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27989501/a-randomized-blinded-multicenter-trial-of-a-gentamicin-vancomycin-gel-dfa-02-in-patients-undergoing-abdominal-surgery
#13
Elliott Bennett-Guerrero, Scott M Berry, Sergio D Bergese, Phillip R Fleshner, Harold S Minkowitz, Alvaro M Segura-Vasi, Kamal M F Itani, Karen W Henderson, Felicia P Rackowski, Laura H Aberle, Martin E Stryjewski, G Ralph Corey, Kent S Allenby
BACKGROUND: SI is a significant medical problem. DFA-02 is an investigational bioresorbable modified release gel consisting of both gentamicin (16.8 mg/mL) and vancomycin (18.8 mg/mL). A Phase 2a study, where the drug was applied during surgical incision closure, suggested safety and tolerability but was not designed to assess its efficacy. STUDY DESIGN: In a Phase 2b randomized, blinded trial patients undergoing abdominal, primarily colorectal, surgery were randomized (4:1:1) to one of three study arms: DFA-02, matching placebo gel, or standard of care (SOC) involving irrigation of the wound with normal saline...
November 18, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27987018/-osteosynthesis-of-distal-fibular-fractures-with-illuminoss-video-article
#14
M Zyskowski, M Crönlein, E Heidt, P Biberthaler, C Kirchhoff
OBJECTIVE: The aim was minimally invasive osteosynthesis of a distal fibular fracture under the premises of poor soft tissue conditions and existing chronic comorbidities to enable rapid recovery and to reduce soft tissue stress in order to avoid postoperative infections and achieve early weight bearing. INDICATIONS: This involved a distal fibula fracture, classified as 44 B1.1, B1.2, B1.3 according to the working group for osteosynthesis (AO) or a B fracture after Danis and Weber with indications for surgery (cortical disruption and shaft offset > 5 mm), age > 65 years, poor soft tissue conditions and a Charlson score ≥ 1...
January 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/27979464/topical-vanadate-enhances-the-repair-of-median-laparotomy-incisions
#15
Sprague W Hazard, Charles F Zwemer, Donald R Mackay, Srinivas V Koduru, Dino J Ravnic, H Paul Ehrlich
BACKGROUND: There are over two million laparotomies performed in the United States each year with an incisional hernia rate between 2% and 11%. A total of 100,000 ventral hernia repairs are undertaken each year with recurrences as high as 50%. MATERIALS AND METHODS: Full thickness midline fascia incisions from the xiphoid to the pubic symphysis were made in rats. The fascia and/or muscular layer was sutured closed and a gel with 300 μM of sodium orthovanadate or saline was placed over the suture line with the skin closed over it...
January 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27977577/negative-pressure-wound-therapy-aids-recovery-following-surgical-debridement-due-to-severe-bacterial-cellulitis-with-abdominal-abscess-post-cesarean-a-case-report-care-compliant
#16
Christopher N J Young, Ka Ying Bonnie Ng, Vanessa Webb, Sarah Vidow, Rajeswari Parasuraman, Sameer Umranikar
INTRODUCTION: Bacterial cellulitis post-Cesarean section is rare. Negative pressure wound therapy (NPWT) is widely used in various medical specialities; its effectiveness in obstetrics however remains the topic of debate-used predominantly as an adjunct to secondary intention specific to high-risk patient groups. Its application in the treatment of actively infected wounds post-Cesarean is not well documented. Here, we document NPWT in the treatment of an unusually severe case of bacterial cellulitis with abdominal abscess postpartum...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27934790/abdomino-endoscopic-perineal-excision-of-the-rectum-for-benign-and-malignant-pathology-technique-considerations-for-true-transperineal-verus-transanal-total-mesorectal-excision-endoscopic-proctectomy
#17
Hazar Al Furajii, Niall Kennedy, Ronan A Cahill
PURPOSE: Transanal minimally invasive surgery using single port instrumentation is now well described for the performance of total mesorectal excision with restorative colorectal/anal anastomosis most-often in conjunction with transabdominal multiport assistance. While non-restorative abdomino-endoscopic perineal excision of the anorectum is conceptually similar, it has been less detailed in the literature. METHODS: Consecutive patients undergoing non-restorative ano-proctectomy including a transperineal endoscopic component were analysed...
January 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27933278/a-simple-method-for-closure-of-urethrocutaneous-fistula-after-tubularized-incised-plate-repair-preliminary-results
#18
Mehdi Shirazi, Ali Ariafar, Amir Hossein Babaei, Abdosamad Ashrafzadeh, Ali Adib
BACKGROUND: Urethrocutaneous fistula (UCF) is the most prevalent complication after hypospadias repair surgery. Many methods have been developed for UCF correction, and the best technique for UCF repair is determined based on the size, location, and number of fistulas, as well as the status of the surrounding skin. OBJECTIVES: In this study, we introduced and evaluated a simple method for UCF correction after tubularized incised plate (TIP) repair. METHODS: This clinical study was conducted on children with UCFs ≤ 4 mm that developed after TIP surgery for hypospadias repair...
November 2016: Nephro-urology Monthly
https://www.readbyqxmd.com/read/27923215/timing-of-antibiotic-prophylaxis-for-preventing-surgical-site-infections-in-foot-and-ankle-surgery
#19
Direk Tantigate, Eugene Jang, Mani Seetharaman, Peter C Noback, A M Heijne, Justin K Greisberg, J Turner Vosseller
BACKGROUND: Surgical site infections (SSIs) are one of the most troublesome complications after foot and ankle surgery. Previous literature has emphasized the significance of appropriate timing of antibiotic prophylaxis. However, the optimal timing of antibiotic prophylaxis for SSI prevention is still inconclusive. Our study aimed to investigate the optimal timing of antibiotic administration and to elucidate the risk factors for SSIs in foot and ankle surgery. METHODS: A retrospective review of 1933 foot and ankle procedures in 1632 patients from January 1, 2011, through August 31, 2015, was performed...
October 23, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27913737/postinfarction-ventricular-septal-rupture-closure-without-ventriculotomy
#20
Dai Kawashima, Satoru Maeba, Masahiro Saito, Minoru Ono
Postinfarction ventricular septal rupture is a life-threatening complication of acute myocardial infarction. Although some novel techniques of ventricular septal rupture closure have been introduced, they involve ventriculotomy, a procedure that can cause a degree of impairment of the incised ventricle. We describe a case in which we closed a ventricular septal rupture through the tricuspid valve, without ventriculotomy.
December 2, 2016: Asian Cardiovascular & Thoracic Annals
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