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https://www.readbyqxmd.com/read/28538648/less-is-more-antibiotic-duration-and-outcomes-in-fournier-s-gangrene
#1
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/28538646/defining-the-ge-junction-in-trauma-epidemiology-and-management-of-a-challenging-injury
#2
Morgan Schellenberg, Kenji Inaba, James M Bardes, Daniel OʼBrien, Lydia Lam, Elizabeth Benjamin, Daniel Grabo, Demetrios Demetriades
INTRODUCTION: Injuries to the gastroesophageal (GE) junction are infrequently encountered because of the high mortality of associated injuries. Consequently, there is a paucity of literature on the patient demographics and treatment options. The aim of this study was to examine the epidemiology, surgical management, and outcomes of these rare injuries. METHODS: Patients presenting to LAC+USC Medical Center (01/2008-08/2016) with traumatic esophageal or gastric injury (ICD-9 and -10 codes) were extracted from the trauma registry...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538525/trajectory-of-postoperative-wound-pain-within-the-first-2-weeks-following-posterior-spinal-fusion-surgery-in-adolescent-idiopathic-scoliosis-patients
#3
Mun Keong Kwan, Chee Kidd Chiu, Teik Seng Chan, Kok Ian Chong, Siti Mariam Mohamad, Mohd Shahnaz Hasan, Chris Yin Wei Chan
STUDY DESIGN: A prospective cohort study. OBJECTIVE: The aim of this study was to determine and evaluate the trajectory of surgical wound pain from day 1 to day 14 after posterior spinal fusion (PSF) surgery in patients with adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: Information regarding how the postoperative pain improves with time offers invaluable information not only to the patients and parents but also to assist the clinician in managing postoperative pain...
June 1, 2017: Spine
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
#4
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/28538418/keystone-designed-buried-de-epithelialized-flap-a-novel-technique-for-obliterating-small-to-moderately-sized-dead-spaces
#5
Hoon Kim, Wan Cheol Ryu, Chi Sun Yoon, Kyu Nam Kim
Effective obliteration of dead space after reconstructive surgery facilitates a good cosmetic outcome and prevention of delayed wound healing and recurrent infection.We evaluated the efficacy of a keystone-designed buried de-epithelialized (KBD) flap for the obliteration of small to moderately sized surgical dead spaces.We reviewed the medical records of patients who received a KBD flap following removal of a mass or debridement of necrotic tissue from September 2015 to February 2016. The diagnosis, site, dead space dimensions, flap width, drain data, complications, and follow-up duration were recorded...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28535522/restenosis-in-hemodialytic-fistulas-and-chronic-kidney-disease-associated-vascular-disease-two-pathologies-driven-by-metakaryotic-stem-cells
#6
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/28534258/closed-incision-prophylactic-negative-pressure-wound-therapy-in-patients-undergoing-major-complex-abdominal-wall-repair
#7
F E E de Vries, J J Atema, O Lapid, M C Obdeijn, M A Boermeester
PURPOSE: To evaluate if incisional prophylactic negative pressure wound therapy (pNPWT) reduces wound infections and other wound complications in high-risk patients undergoing major complex ventral abdominal wall repair. METHODS: Retrospective before-after comparison nested in a consecutive series of patients undergoing elective major complex abdominal wall repair. Starting January 2014, pNPWT was applied on the closed incisional wound for a minimum of 5 days. To minimize selection bias, we compared two periods of 14 months before and after January 2014...
May 23, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
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
#8
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/28533805/electronic-brachytherapy-management-of-atypical-fibroxanthoma-report-of-8-lesions
#9
Stephen Doggett, James Brazil, Marketa Limova, Leah Press, Sidney Smith, Jeremy Peck
PURPOSE: To evaluate the suitability of treating atypical fibroxanthoma (AFX), an uncommon skin malignancy, with electronic brachytherapy. MATERIAL AND METHODS: From Feb 2013 to Sep 2014, we were referred a total of 8 cases of AFX in 7 patients, all involving the scalp. All of them were treated with electronic brachytherapy 50 Kev radiations (Xoft Axxent(®), Fremont, California). All lesions received 40 Gy in two fractions per week with 5mm margins. RESULTS: At a median follow-up of 23...
April 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28532963/fully-endoscopic-interlaminar-and-transforaminal-lumbar-discectomy-analysis-of-47-complications-encountered-in-a-series-of-835-patients
#10
Ali Güven Yörükoğlu, Burcu Göker, Alican Tahta, Mehmet Osman Akçakaya, Aydın Aydoseli, Pulat Akın Sabancı, Yavuz Aras, Görkem Alkır, Altay Sencer, Murat Imer, Nail Izgi, Ali Tuncay Canbolat
OBJECTIVE: To report perioperative complications in fully endoscopic lumbar discectomy (FELD). METHODS: From September 2010 to November 2016, 835 patients underwent FELD. In total, 865 disc levels were operated on. Of the 835 patients, the transforaminal (TF) approach was used in 174 patients, while 691 patients were operated on using the interlaminar (IL) approach. Surgical complications occurred in 47 patients, which were retrospectively analyzed. RESULTS: Neurological deficits occurred in six patients...
May 19, 2017: Neurocirugía
https://www.readbyqxmd.com/read/28532943/evaluation-of-preloaded-intraocular-lens-injection-systems-ex%C3%A2-vivo-study
#11
Mayank A Nanavaty, Magdalena Kubrak-Kisza
PURPOSE: To compare preloaded intraocular lens (IOL) injection systems. SETTING: Sussex Eye Hospital, Brighton, United Kingdom. DESIGN: Experimental study. METHODS: In 30 porcine eyes, 5 preloaded +22.0 diopters IOLs were implanted from each of the following preloaded IOL systems: Ultrasert (U), iTec (iT), Eyecee (E), iSert (iS), Rayone (R), and CT Lucia (CT). External and internal wound size was measured. Nozzle damage was assessed using digital photography...
April 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28532914/penetrating-bihemispheric-traumatic-brain-injury-a-collective-review-of-gunshot-wounds-to-the-head
#12
REVIEW
L Turco, D L Cornell, B Phillips
BACKGROUND: Head injuries that cross midline structures of the brain are 'bihemispheric.' Other terms have been used to describe such injuries, but 'bihemispheric' is the most accurate and should be standard nomenclature. Bihemispheric head injuries are associated with higher mortality and morbidity than other penetrating traumatic brain injuries (TBI). Currently, there is a tendency to manage severe gunshot wounds (GSWs) to the head non-operatively, despite reports of improved outcome in military patients treated aggressively...
May 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28532576/-tobacco-and-plastic-surgery-an-absolute-contraindication
#13
C Matusiak, A De Runz, H Maschino, M Brix, E Simon, F Claudot
INTRODUCTION: Smoking increases perioperative risk regarding wound healing, infection rate and failure of microsurgical procedures. There is no present consensus about plastic and aesthetic surgical indications concerning smoking patients. The aim of our study is to analyze French plastic surgeons practices concerning smokers. METHOD: A questionnaire was send by e-mail to French plastic surgeons in order to evaluate their own operative indications: patient information about smoking dangers, pre- and postoperative delay of smoking cessation, type of intervention carried out, smoking cessation supports, use of screening test and smoking limit associated to surgery refusing were studied...
May 19, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28532514/course-of-serum-amyloid-a-saa-plasma-concentrations-in-horses-undergoing-surgery-for-injuries-penetrating-synovial-structures-an-observational-clinical-study
#14
Eva Haltmayer, Ilse Schwendenwein, Theresia F Licka
BACKGROUND: Injuries penetrating synovial structures are common in equine practice and often result in septic synovitis. Significantly increased plasma levels of serum amyloid A (SAA) have been found in various infectious conditions in horses including wounds and septic arthritis. Plasma SAA levels were found to decrease rapidly once the infectious stimulus was eliminated. The purpose of the current study was to investigate the usefulness of serial measurements of plasma SAA as a monitoring tool for the response to treatment of horses presented with injuries penetrating synovial structures...
May 22, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28532074/highly-effective-cu-zn-carbon-micro-nanofiber-polymer-nanocomposite-based-wound-dressing-biomaterial-against-the-p-aeruginosa-multi-and-extensively-drug-resistant-strains
#15
Mohammad Ashfaq, Nishith Verma, Suphiya Khan
Pseudomonas aeruginosa (P. aeruginosa) is the most prevalent bacteria in the infections caused by burn, surgery, and traumatic injuries. Emergence of the P. aeruginosa bacterial resistance against various clinical drugs for wound treatment is the major concern nowadays. The present study describes the synthesis of the polyvinyl alcohol (PVA) and cellulose acetate phthalate (CAP) polymeric composite film (~0.2mm thickness) reinforced with the Cu/Zn bimetal-dispersed activated carbon micro/nanofiber (ACF/CNF), as a wound dressing material...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28532061/wound-healing-effect-of-bioactive-ion-released-from-mg-smectite
#16
Yu Sasaki, Gulsan Ara Sathi, Osamu Yamamoto
Bioactive ions like Mg(2+) and Si(4+) have been known as promotion factors of tissue regeneration. In the present work, Mg-smectite, consisting of Mg(2+) and Si(4+) ions, was synthesized by a solution process, and evaluated for the efficiency of the powder on wound healing in rats. White precipitates were obtained by mixing a magnesium chloride hexahydrate solution and a sodium silicate hexahydrate solution at room temperature. The precipitates mixed with a NaOH aqueous solution were subjected to hydrothermal reaction, and finally crystalline Mg-smectite powder was obtained...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28531930/in-reply-to-optimal-strategy-to-control-surgical-site-infection-following-deep-brain-stimulation-surgery-adequate-management-of-risk-factors-topical-application-of-vancomycin-powder-in-the-surgical-wound-and-preoperative-antibiotic-prophylaxis
#17
https://www.readbyqxmd.com/read/28531929/optimal-strategy-to-control-surgical-site-infection-following-deep-brain-stimulation-surgery-adequate-management-of-risk-factors-topical-application-of-vancomycin-powder-in-the-surgical-wound-and-preoperative-antibiotic-prophylaxis
#18
https://www.readbyqxmd.com/read/28530768/perioperative-management-of-rheumatoid-medications-in-orthopedic-surgery
#19
Kunal Sindhu, Brian Cohen, Joseph A Gil
Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disorder known to cause progressive joint destruction. Over time, untreated RA can lead to pain and increasing disability, making orthopedic intervention necessary. The treatment of RA revolves around a variety of medications that blunt the overall immune response. However, this may increase the risk of infection and impair wound healing. Given the nature of this disease, orthopedists frequently encounter patients with RA in the operative setting. To optimize surgical outcomes, orthopedists must carefully manage and pay special attention to the adverse side effects of the complicated medication regimens of these patients perioperatively...
May 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28529861/local-intra-wound-administration-of-powdered-antibiotics-in-orthopaedic-surgery
#20
REVIEW
Andrew N Fleischman, Matthew S Austin
Surgical site infection (SSI) is one of the most common complications after orthopaedic surgery, leading to significant morbidity and its associated costs. Surgical guidelines strongly recommend the use of systemic antibiotic prophylaxis to reduce the risk for developing SSI. Locally administered powdered antibiotics have the potential to provide remarkably high intra-wound concentrations without risk for systemic toxicity. However, a paucity of high quality evidence in the orthopaedic literature has prevented widespread adoption of this technique...
2017: J Bone Jt Infect
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