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Operative wound dehiscence

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https://www.readbyqxmd.com/read/28806210/risk-stratification-for-major-postoperative-complications-in-patients-undergoing-intra-abdominal-general-surgery-using-latent-class-analysis
#1
Minjae Kim, Melanie M Wall, Guohua Li
BACKGROUND: Preoperative risk stratification is a critical element in assessing the risks and benefits of surgery. Prior work has demonstrated that intra-abdominal general surgery patients can be classified based on their comorbidities and risk factors using latent class analysis (LCA), a model-based clustering technique designed to find groups of patients that are similar with respect to characteristics entered into the model. Moreover, the latent risk classes were predictive of 30-day mortality...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28800928/post-operative-bracing-after-pedicle-screw-fixation-for-thoracolumbar-burst-fractures-a-cost-effectiveness-study
#2
REVIEW
Matthew Piazza, Saurabh Sinha, Prateek Agarwal, Arka Mallela, Nikhil Nayak, James Schuster, Sherman Stein
PURPOSE: While frequently prescribed to patients following fixation for spine trauma, the utility of spinal orthoses during the post-operative period is poorly described in the literature. In this study, we calculated rates of reoperation and performed a decision analysis to determine the utility of bracing following pedicle screw fixation for thoracic and lumbar burst fractures. METHODS: Pubmed was searched for articles published between 2005 and 2015 for terms related to pedicle screw fixation of thoracolumbar fractures...
August 8, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28790002/reduced-impact-of-smoking-status-on-30-day-complication-and-readmission-rates-after-elective-spinal-fusion-%C3%A2-3-levels-for-adult-spine-deformity-a-single-institutional-study-of-839-patients
#3
Aladine A Elsamadicy, Owoicho Adogwa, Amanda Sergesketter, Victoria D Vuong, Emily Lydon, Shay Behrens, Joseph Cheng, Carlos A Bagley, Isaac O Karikari
BACKGROUND: Smoking status has been shown to affect postoperative outcomes after surgery. The aim of this study is to determine if patients' smoking status impacts 30-day complication and re-admission rates after elective complex spinal fusion (≥3 levels). METHODS: The medical records of 839 adult spinal deformity patients undergoing elective complex spinal fusion (≥3 levels) at a major academic institution from 2005 to 2015 were reviewed. We identified 124(14...
August 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28770293/case-series-of-patients-with-pathological-dyaphiseal-fractures-from-metastatic-bone-disease
#4
Dinu Vermesan, Radu Prejbeanu, Horia Haragus, Alis Dema, Manuel D Oprea, Diana Andrei, Dan V Poenaru, Marius Niculescu
INTRODUCTION: Fractures on pathologic bone have major impact on life quality. The appropriate treatment is not standardized, but the current literature delineates that surgery must provide adequate stabilization for the life expectancy. We aimed to review the epidemiology, treatment outcomes and survival in our department. MATERIAL AND METHODS: The electronic database from a major referral centre was searched for patients treated for tumours and fractures by the corresponding ICM-10 codes over five years...
August 2, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28746285/a-comparative-analysis-of-recombinant-human-bone-morphogenetic-protein-2-with-a-demineralized-bone-matrix-versus-iliac-crest-bone-graft-for-secondary-alveolar-bone-grafts-in-patients-with-cleft-lip-and-palate-review-of-501-cases
#5
Jeffrey A Hammoudeh, Artur Fahradyan, Daniel J Gould, Fan Liang, Thomas Imahiyerobo, Leo Urbinelli, JoAnna T Nguyen, William Magee, Stephen Yen, Mark M Urata
BACKGROUND: Alveolar cleft reconstruction using iliac crest bone graft is considered standard of care for children with complete cleft lip and palate at the time of mixed dentition. Harvesting bone may result in donor-site morbidity and additional operating time and length of hospitalization. Recombinant human bone morphogenetic protein (rhBMP)-2 with a demineralized bone matrix is an alternative bone source for alveolar cleft reconstruction. The authors investigated the outcomes of rhBMP-2/demineralized bone matrix versus iliac crest bone graft for alveolar cleft reconstruction by reviewing postoperative surgical complications and cleft closure...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28746196/retrospective-review-of-laparoscopic-versus-open-surgery-in-the-treatment-of-appendiceal-abscess-in-pediatric-patients-laparoscopic-versus-open-surgery-for-appendiceal-abscess
#6
COMPARATIVE STUDY
Ping Li, Yan Han, Yang Yang, Hongjie Guo, Fabao Hao, Yan Tang, Chunbao Guo
Laparoscopic appendectomy (LA) has become well accepted, but the role of LA for appendicitis upon presentation with an abscess remains undefined. This study was to assess the postoperative recovery and complications following LA in pediatric patients with appendiceal abscess in comparison with open appendectomy (OA).We conducted a retrospective review of patients presented with appendiceal abscess between 2005 and 2016. Propensity score matching (PSM) was conducted to adjust for any potential selection bias for the surgical approaches...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28736958/intraoperative-indocyanine-green-fluorescent-angiography-assisted-modified-superior-gluteal-artery-perforator-flap-for-reconstruction-of-sacral-pressure-sores
#7
Chun-Kai Chang, Chien-Ju Wu, Chun-Yu Chen, Chi-Yu Wang, Tzi-Shiang Chu, Kuo-Feng Hsu, Han-Ting Chiu, Hung-Hui Liu, Chang-Yi Chou, Chih-Hsin Wang, Chin-Ta Lin, Niann-Tzyy Dai, Yuan-Sheng Tzeng
Pressure sores are often observed in patients who are bedridden. They can be a severe problem not only for patients and their caregivers but also for plastic surgeons. Here, we describe a new method of superior gluteal artery perforator flap harvesting and anchoring with the assistance of intraoperative indocyanine green fluorescent angiography. In this report, we describe the procedure and outcomes for 19 patients with grades III and IV sacral pressure sores who underwent the operation between September 2015 and November 2016...
July 23, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28734498/surgical-site-infection-reduction-bundle-in-patients-with-gynecologic-cancer-undergoing-colon-surgery
#8
Maria B Schiavone, Lea Moukarzel, Kam Leong, Qin C Zhou, Anoushka M Afonso, Alexia Iasonos, Kara Long Roche, Mario M Leitao, Dennis S Chi, Nadeem R Abu-Rustum, Oliver Zivanovic
OBJECTIVE: Surgical site infections (SSIs) can lead to substantial morbidity, prolonged hospitalization, increased costs, and death in patients undergoing colorectal procedures. We sought to investigate the effect of using an SSI reduction bundle on the rate of SSIs in gynecologic cancer patients undergoing colon surgery. METHODS: We identified all gynecologic cancer patients who underwent colon resection at our institution from 2014 to 2016, during which time a service-wide SSI reduction bundle was introduced...
July 19, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28728328/reconstruction-of-large-facial-defects-via-excision-of-skin-cancer-using-two-or-more-regional-flaps
#9
Dong Min Lee, Yong Chan Bae, Su Bong Nam, Seong Hwan Bae, June Seok Choi
BACKGROUND: Free-flap surgery and skin grafting can be used to reconstruct large facial defects that may result after skin cancer removal by Mohs micrographic surgery (MMS). However, these two methods may produce low postsurgical patient satisfaction with aesthetics, and free-flap surgery may produce an undue burden for the majority of skin cancer patients, who are of advanced age. Hence, the authors examined outcomes of large facial defect reconstruction using multiple flaps. METHODS: Among patients undergoing MMS for skin cancer at Pusan National University Hospital between January 2013 and December 2015, we evaluated 7 patients (2 males, 5 females; average age, 73...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28681107/comparison-of-maternal-and-fetal-complications-in-elective-and-emergency-cesarean-section-a-systematic-review-and-meta-analysis
#10
Xiao-Jing Yang, Shan-Shan Sun
BACKGROUND: Though the same types of complication were found in both elective cesarean section (ElCS) and emergence cesarean section (EmCS), the aim of this study is to compare the rates of maternal and fetal morbidity and mortality between ElCS and EmCS. METHODS: Full-text articles involved in the maternal and fetal complications and outcomes of ElCS and EmCS were searched in multiple database. Review Manager 5.0 was adopted for meta-analysis, sensitivity analysis, and bias analysis...
July 5, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28669486/method-of-osteotomy-fixation-and-need-for-removal-following-bimaxillary-orthognathic-osseous-genioplasty-and-intranasal-surgery-a-retrospective-cohort-study
#11
J C Posnick, E Choi, A Chavda
The purpose of this study was to determine the incidence and causes of fixation hardware removal after bimaxillary orthognathic, osseous genioplasty, and intranasal surgery. A retrospective study was performed, involving subjects with a bimaxillary developmental dentofacial deformity (DFD) and symptomatic chronic obstructive nasal breathing. At a minimum, subjects underwent Le Fort I osteotomy, bilateral sagittal ramus osteotomies (SROs), septoplasty, inferior turbinate reduction, and osseous genioplasty. The primary outcome variable studied was fixation hardware removal...
June 29, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28660816/the-role-of-antimicrobial-sutures-in-preventing-surgical-site-infection
#12
D Leaper, P Wilson, O Assadian, C Edmiston, M Kiernan, A Miller, G Bond-Smith, J Yap
INTRODUCTION Healthcare associated infections (HCAIs) are falling following widespread and enforced introduction of guidelines, particularly those that have addressed antibiotic resistant pathogens such as methicillin resistant Staphylococcus aureus or emergent pathogens such as Clostridium difficile, but no such decline has been seen in the incidence of surgical site infection (SSI), either in the UK, the EU or the US. SSI is one of the HCAIs, which are all avoidable complications of a surgical patient's pathway through both nosocomial and community care...
July 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28657669/does-the-use-of-arteriovenous-loops-increase-complications-rates-in-posttraumatic-microsurgical-lower-extremity-reconstruction-a-matched-pair-analysis
#13
Arash Momeni, Michael A Lanni, Lawrence S Levin, Stephen J Kovach
INTRODUCTION: The use of arteriovenous (AV) loops in microsurgical lower extremity reconstruction is a controversial topic. The objective of the present study was to assess the impact of AV loops on complication rates following microsurgical reconstruction of posttraumatic lower extremity defects. PATIENTS AND METHODS: Patients who underwent free flap coverage of posttraumatic defects in combination with an AV loop (Group 1) were identified and matched for age, body mass index (BMI), tobacco use, defect location, and flap type with patients who underwent reconstruction without vein grafts (Group 2)...
June 28, 2017: Microsurgery
https://www.readbyqxmd.com/read/28637564/do-iodine-impregnated-adhesive-surgical-drapes-reduce-surgical-site-infections-during-open-ventral-hernia-repair-a-comparative-analysis
#14
Neal Moores, Steven Rosenblatt, Ajita Prabhu, Michael Rosen
This study evaluated the role of iodine-impregnated adhesive drapes to reduce surgical site infections and occurrences in open ventral hernia repairs. All patients undergoing open ventral hernia repair of clean wounds with a retromuscular repair using synthetic mesh by a single surgeon were prospectively evaluated from the American Hernia Society Quality Collaborative. Patients were divided into those that had an Ioban drape and those that did not. The primary endpoints of this study were postoperative surgical site occurrence and infections...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28633769/blisters-in-ankle-fractures-a-retrospective-cohort-study
#15
David González Quevedo, Juan Manuel Sánchez Siles, Facundo Rojas Tomba, Iskandar Tamimi Mariño, Manuel Francisco Bravo Bardaji, Francisco Villanueva Pareja
The most frequent postoperative complications after an ankle fracture are usually skin related. We present the results of a retrospective study of 112 patients with ankle fracture who had undergone open reduction and internal fixation from January 2014 to December 2014. The following features were analyzed: patient comorbidities, fracture type, the presence of an open fracture or fracture-dislocation, timing and duration of surgery, preoperative glucose level, and short-term complications (i.e., blisters, wound dehiscence, deep and superficial infections, and reintervention)...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28626087/effect-of-obesity-and-underweight-status-on-perioperative-outcomes-of-congenital-heart-operations-in-children-adolescents-and-young-adults-an-analysis-of-data-from-the-society-of-thoracic-surgeons-database
#16
Michael L O'Byrne, Sunghee Kim, Christoph P Hornik, Babatunde A Yerokun, Roland A Matsouaka, Jeffrey P Jacobs, Marshall L Jacobs, Richard A Jonas
Background -Extreme BMI (either very high or very low) has been associated with increased risk of adverse perioperative outcome in adults undergoing cardiac surgery. The effect of body-mass index (BMI) on perioperative outcomes in congenital heart disease patients has not been evaluated. Methods -A multicenter retrospective cohort study was performed studying patients 10-35 years undergoing a congenital heart disease operation in the Society of Thoracic Surgeons Congenital Heart Surgery Database between 1/1/2010-12/31/2015...
June 16, 2017: Circulation
https://www.readbyqxmd.com/read/28624524/a-direct-comparison-of-porcine-strattice%C3%A2-and-bovine-surgimend%C3%A2-acellular-dermal-matrices-in-implant-based-immediate-breast-reconstruction
#17
Jessica F Ball, Yezen Sheena, Dina M Tarek Saleh, Parto Forouhi, Sarah L Benyon, Michael S Irwin, Charles M Malata
INTRODUCTION: Acellular dermal matrix (ADM) assisted implant-based breast reconstruction (IBBR) has grown in popularity over traditional submuscular techniques. Numerous human, bovine or porcine derived ADMs are available with the type used varying considerably worldwide. Yet, comparative evidence for the efficacy of different ADMs particularly xenogenic is limited. This study directly compares early outcomes of porcine (Strattice™) and bovine (Surgimend™) ADMs in IBBR. METHOD: Retrospective study of sequential experience of immediate IBBR using Strattice or Surgimend ADM...
May 19, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28610935/prone-positioning-reduces-perineal-infections-when-performing-the-miles-procedure
#18
Anne M Dinaux, Ramzi Amri, David L Berger
BACKGROUND: Abdominoperineal resection (APR) remains the cornerstone treatment for rectal cancers less than 5 cm from the anal verge. The perineal portion of an APR can be done with the patient in lithotomy or repositioned to prone jack-knife position, which influences accessibility, visualization and ability to close the wound. This paper analyses the effect of patient positioning on perineal wound dehiscence and infections. METHODS: A retrospective review of all rectal cancer patients who underwent an APR at Massachusetts General Hospital between 2004 and 2014 (n = 149)...
August 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28607854/safety-of-immediate-posterior-trunk-soft-tissue-reconstruction-in-older-adults
#19
Nicholas A Calotta, Devin Coon, Justin M Sacks
BACKGROUND: Older patients, especially those older than 65 years, are accounting for an ever-increasing share of hospital costs, especially surgical procedures. Studies regarding the safety of surgery in these patients have been widespread in the past decade. Despite these efforts, there is a paucity of information regarding the safety of reconstruction following spinal surgery in older patients. METHODS: We conducted a retrospective cohort study of patients undergoing soft-tissue reconstruction of the posterior trunk after oncologic spine surgery...
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28607285/rationalisation-of-the-surgical-technique-for-minimally-invasive-laparoscopic-ileal-pouch-anal-anastomosis-after-previous-total-colectomy-for-ulcerative-colitis
#20
Francesco Giudici, Stefano Scaringi, Carmela Di Martino, Ferdinando Ficari, Paolo Bechi
INTRODUCTION: No previous study clearly focuses on laparoscopic technique to perform the second stage surgery (proctectomy with ileal pouch-anal anastomosis [IPAA]) after total colectomy for acute/severe ulcerative colitis (UC). We describe the procedural steps for a simple and rational minimally invasive second stage surgery, reporting intra- and short-term post-operative results. PATIENTS AND METHODS: During the period December 2014-December 2015, 10 consecutive patients (8 males and 2 females) with mean age of 48 years underwent laparoscopic proctectomy and IPAA adopting our novel approach...
July 2017: Journal of Minimal Access Surgery
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