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https://www.readbyqxmd.com/read/29241164/peritoneal-dialysis-catheter-revision-and-replacement-by-nephrologist-for-peritoneal-dialysis-catheter-malfunction
#1
Terry King-Wing Ma, Kai Ming Chow, Bonnie Ching-Ha Kwan, Jack Kit-Chung Ng, Agnes Shin-Man Choy, Vickie Wai-Ki Kwong, Wing-Fai Pang, Chi Bon Leung, Philip Kam-To Li, Cheuk Chun Szeto
BACKGROUND: Catheter malfunction is an important cause of technique failure for peritoneal dialysis (PD) patients, and is commonly managed by surgeons or intervention radiologists. We reviewed our experience in catheter revision or replacement by nephrologists. METHOD: We reviewed the clinical outcome and complication rate of 95 consecutive patients who had PD catheter malfunction, with catheter revision or replacement by nephrologist. RESULT: Amongst the 95 patients, 32 had catheter revision, 24 catheter replacement via the original wound, and 39 catheter replacement via a new mini-laparotomy wound...
December 14, 2017: Nephron
https://www.readbyqxmd.com/read/29241108/the-efficacy-of-posterior-hemivertebra-resection-with-lumbosacral-fixation-and-fusion-in-the-treatment-of-congenital-scoliosis-a-more-than-2-year-follow-up-study
#2
Qiunan Lyu, Bowen Hu, Chunguang Zhou, Limin Liu, Yueming Song, Xi Yang, Liang Wang, Lei Wang
OBJECTIVE: Hemivertebrae (HV) located at the lower lumbar or lumbosacral region often produce early trunk imbalance and long compensatory curves. Because of the biomechanical characteristics of the lumbosacral junction, the rate of instrumentation failures at the region has always been high. Our study aimed to evaluate the results of posterior HV resection with lumbosacral fixation and fusion in the treatment of congenital scoliosis and to make a preliminary analysis of the possible risk factors for instrument failures...
December 9, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29240273/endothelial-dysfunction-may-promote-keloid-growth
#3
Chikage Noishiki, Gen Takagi, Yoshiaki Kubota, Rei Ogawa
Keloid is a cutaneous fibroproliferative disorder. It results from impaired wound healing that generates persistent inflammation and extensive deposition of collagen fibers in the wound/scar. Keloids tend to be worse in hypertensive patients. The present prospective cross-sectional study assessed whether endothelial dysfunction, which occurs in hypertension, associates with keloid formation and progression. This study included randomly-selected patients with keloids who were assessed for surgical keloid treatment in 2013-2014...
December 14, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29240005/efficacy-of-a-dual-ring-wound-protector-for-prevention-of-surgical-site-infections-after-pancreaticoduodenectomy-in-patients-with-intrabiliary-stents-a-randomized-clinical-trial
#4
Alexsander K Bressan, Jean-Michel Aubin, Guillaume Martel, Elijah Dixon, Oliver F Bathe, Francis R Sutherland, Fady Balaa, Richard Mimeault, Janet P Edwards, Sean C Grondin, Susan Isherwood, Keith D Lillemoe, Sara Saeed, Chad G Ball
OBJECTIVE: To evaluate the efficacy of a dual-ring wound protector for preventing incisional surgical site infection (SSI) among patients with preoperative biliary stents undergoing pancreaticoduodenectomy (PD). METHODS AND ANALYSIS: This study was a parallel, dual-arm, double-blind randomized controlled trial. Adult patients with a biliary stent undergoing elective PD at 2 tertiary care institutions were included (February 2013 to May 2016). Patients were randomly assigned to receive a surgical dual-ring wound protector or no wound protector, and also the current standard of care...
December 12, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29239852/management-specificities-for-abdominal-pelvic-and-vascular-penetrating-trauma
#5
E Hornez, F Béranger, T Monchal, Y Baudouin, G Boddaert, H De Lesquen, S Bourgouin, Y Goudard, B Malgras, G Pauleau, V Reslinger, N Mocellin, C Natale, L Meyrat, J-P Avaro, P Balandraud, S Gaujoux, S Bonnet
Management of patients with penetrating trauma of the abdomen, pelvis and their surrounding compartments as well as vascular injuries depends on the patient's hemodynamic status. Multiple associated lesions are the rule. Their severity is directly correlated with initial bleeding, the risk of secondary sepsis, and lastly to sequelae. In patients who are hemodynamically unstable, the goal of management is to rapidly obtain hemostasis. This mandates initial laparotomy for abdominal wounds, extra-peritoneal packing (EPP) and resuscitative endovascular balloon occlusion of the aorta (REBOA) in the emergency room for pelvic wounds, insertion of temporary vascular shunts (TVS) for proximal limb injuries, ligation for distal vascular injuries, and control of exteriorized extremity bleeding with a tourniquet, compressive or hemostatic dressings for bleeding at the junction or borderline between two compartments, as appropriate...
November 24, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29239728/wound-healing-of-cutaneous-substance-losses-based-on-infectious-inflammatory-and-traumatic-skin-disorders-the-experience-of-a-center
#6
K Khoshim, B Hersant, C Hotz, M SidAhmed-Mezi, J P Meningaud
INTRODUCTION: There is no reference available concerning the standard healing time based on dermatological diseases responsible for cutaneous substance losses. The aim of our study was to assess the healing time after surgical debridement of necrotizing fasciitis (NF), hidradenitis suppurativa (HS) and skin necrosis due to trauma (SNT) based on multiples existing co-morbidities among these patients to provide surgeons with accurate scientific data in order to inform and educate patients and nurses who are practicing care under the supervision of the surgeon...
November 24, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29238688/second-branchial-anomalies-a-study-of-94-cases
#7
Vijay Kumar Kalra, Kamal Nain Rattan, Samar Pal Singh Yadav, Sandeep Bhukar, S Dheeraj
Ninety-four patients with second branchial anomalies were retrospectively analysed at a tertiary care centre from January 2006 to September 2016 to determine the demographical data and management. Branchial sinus and fistula presented earlier as compared to branchial cyst. The mean age at presentation in case of branchial sinuses, fistulae and cysts was 5.07, 5.79 and 7.31 years respectively. There was preponderance in males as compared to females, more so in bilateral cases. Male to female sex ratio was 2...
December 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/29238669/use-of-amnion-chorion-and-umbilical-cord-grafts-in-conjunction-with-penile-implant-procedures
#8
Andrew C Kramer
Biologics have increased in popularity lately as a novel and exciting new therapy for men with a spectrum of sexual dysfunction ailments-ranging from erectile dysfunction, Peyronie's disease, and ejaculatory disorders. In this series, sequential patients were analyzed who received biologic materials at the time of their penile implant surgery, with various metrics assessed. The information gathered includes recovery time, need for postoperative analgesics, and satisfaction with the final outcome. In this study, early metrics appear to point to improved outcomes in select criteria...
November 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/29238640/high-risk-subgroup-membership-is-a-predictor-of-30-day-morbidity-following-anterior-lumbar-fusion
#9
Rachel S Bronheim, Jun S Kim, John Di Capua, Nathan J Lee, Parth Kothari, Sulaiman Somani, Kevin Phan, Samuel K Cho
Study Design: Retrospective cohort study. Objective: To determine if membership in a high-risk subgroup is predictive of morbidity and mortality following anterior lumbar fusion (ALF). Methods: The American College of Surgeons National Surgical Quality Improvement Program database was utilized to identify patients undergoing ALF between 2010 and 2014. Multivariate analysis was utilized to identify high-risk subgroup membership as an independent predictor of postoperative complications...
December 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29238639/the-use-of-vacuum-dressings-for-dead-space-management-in-deep-surgical-site-infections-allows-implant-and-bone-graft-retention
#10
James P Watt, Robert N Dunn
Study Design: Retrospective, descriptive study. Objectives: Managing early surgical site infection following elective lumbar spine surgery remains a challenge with controversy regarding retention of instrumentation and bone graft. Wound closure may also pose considerable challenges. We aim to report on our method of managing deep surgical site infections complicating elective spine surgery with surgeon assembled deep vacuum dressings. Identification of causative organisms with their sensitivities was a secondary objective...
December 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29238634/asa-classification-as-a-risk-stratification-tool-in-adult-spinal-deformity-surgery-a-study-of-5805-patients
#11
Sulaiman Somani, John Di Capua, Jun S Kim, Kevin Phan, Nathan J Lee, Parth Kothari, Joung-Heon Kim, James Dowdell, Samuel K Cho
Study Design: Retrospective analysis of prospectively collected data. Objectives: Adult spinal deformity (ASD) surgery is a highly complex procedure that has high complication rates. Risk stratification tools can improve patient management and may lower complication rates and associated costs. The goal of this study was to identify the independent association between American Society of Anesthesiologists (ASA) class and postoperative outcomes following ASD surgery...
December 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29238110/intrawound-vancomycin-powder-as-the-prophylaxis-of-surgical-site-infection-after-invasive-spine-surgery-with-a-high-risk-of-infection
#12
Tetsuro Hida, Kei Ando, Kazuyoshi Kobayashi, Kenyu Ito, Mikito Tsushima, Akiyuki Matsumoto, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Shunsuke Kanbara, Sadayuki Ito, Yoshihiro Nishida, Naoki Ishiguro, Shiro Imagama
Surgical site infections (SSIs) are one of the most serious complications in spine surgery. We investigated the efficacy of locally administered vancomycin (VCM) powder for prophylaxis on SSI after invasive spine surgery. We retrospectively studied 174 consecutive patients who underwent spine surgery. In patients of the VCM group (n = 81), VCM powder was administered in the wound before closing wound. Patients who did not receive VCM treatment were set as a control group (n = 93). We compared the patients' background, operation time, intraoperative blood loss, usage of implants, presence of deep SSI, and side effects between the two groups...
November 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/29237218/-cylindric-abdominoperineal-rectum-exstirpation-with-partial-vulvar-and-vaginal-resection-as-well-as-perineal-and-vaginal-defect-reconstruction-by-a-vertical-rectus-abdominis-myocutaneous-vram-flap
#13
Christian Krautz, Klaus Weber, Roland Croner, Axel Denz, Matthias Maak, Raymund E Horch, Robert Grützmann
Introduction Patients with low rectal cancer or anal cancer undergoing abdominoperineal excision (APE) benefit from extended surgery and the subsequent avoidance of surgical "waisting" at the level of the puborectalis muscle. The method of cylindrical APE was introduced by T. Holm and led to a reduction of intraoperative perforations and involvement of circumferential resection margins, and subsequently reduced the risk of local recurrence. The use of myocutaneous flaps reduces perineal wound complications, which occur in up to 60% of patients with primary closure of perineal defects, especially following neoadjuvant radiochemotherapy...
December 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29236278/head-and-neck-surgical-reconstruction-in-operation-iraqi-freedom-and-operation-enduring-freedom-afghanistan-a-systematic-review
#14
Samantha J Mikals, Joshua M Jabaut, Art A Ambrosio
Historically, head and neck injuries constituted 16 to 20% of all nonfatal combat injuries. However, advances in body and vehicle armor in the context of the use of ambushes and improvised explosive devices by enemy combatants have resulted in fewer fatalities from head and neck wounds, and thus the incidence of nonfatal head and neck injuries has risen to as high as 52%. Despite this increase, data regarding specific injury distributions, surgical cases, and approaches to repair are lacking in the current literature...
December 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/29234733/late-sterile-abscess-formation-in-carotid-endarterectomy-following-use-of-bioglue-a-word-of-caution
#15
A Singh, M Wyatt, M Clarke, L Wales
Introduction: BioGlue (CryoLife Inc., Kennesaw, GA) is a commonly used surgical adhesive, designed to achieve haemostasis following large vessel cardiovascular operations. Report: An 88-year-old female presents with an enlarging right sided neck mass 9 months after carotid endarterectomy with bovine pericardial patch repair which utilised BioGlue seal the patch suture line. Conclusion: BioGlue should be used properly and with caution. In cases of late wound complication following BioGlue use, simple drainage, debridement, and removal of BioGlue remnants may be a satisfactory approach...
2017: EJVES Short Reports
https://www.readbyqxmd.com/read/29232903/pediatric-thermal-burns-and-treatment-a-review-of-progress-and-future-prospects
#16
REVIEW
Elton Mathias, Madhu Srinivas Murthy
Burn injuries are a devastating critical care problem. In children, burns continue to be a major epidemiologic problem around the globe resulting in significant morbidity and death. Apparently, treating these burn injuries in children and adults remains similar, but there are significant physiological and psychological differences. The dermal layer of the skin is generally thinner in neonates, infants, and children than in adults. Enhanced evaporative loss and need for isotonic fluids increases the risk of hypothermia in the pediatric population...
December 11, 2017: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/29232685/surgical-management-of-deep-brain-stimulator-scalp-erosion-without-hardware-removal
#17
Michael D Staudt, Navid Pourtaheri, Gregory E Lakin, Hooman T Soltanian, Jonathan P Miller
BACKGROUND: Scalp erosion in patients with deep brain stimulation (DBS) hardware is an uncommon complication that lacks a clearly defined management strategy. Previous studies have described various therapies including conservative treatment with antibiotics and surgical debridement with or without hardware removal. OBJECTIVES: The aim of this study was to review the efficacy of a hardware-sparing management strategy for the treatment of scalp erosion. METHODS: Five patients with previous DBS implantation presented with scalp erosion and visible hardware exposure at the calvarial burr hole site, and underwent tension-free, vascularized, rotational scalp flap, with preservation of the leads under the pericranium...
December 13, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/29232297/long-term-success-with-driveline-exit-site-relocation-for-deep-driveline-infection-in-left-ventricular-assist-device-patients
#18
Leora B Balsam, Adam Jacoby, Eddie Louie, Jamie P Levine
OBJECTIVE: Driveline infection is a common complication of durable left ventricular assist device support. The majority involve the driveline exit site and can be treated with antibiotics and local wound care. Less frequently, these infections extend into deeper tissues and surgical debridement is necessary. Few studies have described the surgical strategy for treatment of deep driveline infection or have reported long-term outcomes. With a growing population of patients being implanted as destination therapy, there is an obvious need to evaluate and optimize treatment for complex driveline infections...
December 7, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29232212/cost-of-major-complications-after-liver-resection-in-the-united-states-are-high-volume-centers-cost-effective
#19
Jay J Idrees, Fabian M Johnston, Joseph K Canner, Mary Dillhoff, Carl Schmidt, Elliott R Haut, Timothy M Pawlik
OBJECTIVE: The aim of the study was to estimate the cost of major complications after liver resection and determine whether high-volume (HV) centers are cost-effective. METHODS: From 2002 to 2011, 96,107 cases of liver resection performed in the United States were identified using Nationwide Inpatient Sample. Hospitals were categorized as HV (150+ cases/yr), medium-volume (51-149 cases/yr), and low-volume (LV) (1-50 cases/yr) centers. Multivariable regression analysis identified predictors of cost...
December 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29229160/postoperative-anti-pd-1-antibody-treatment-to-reduce-recurrence-in-a-cancer-ablation-surgical-wound
#20
Nayeon Choi, Da-Yong Shin, Hye Jin Kim, Uk Yeol Moon, Kwan-Hyuck Baek, Han-Sin Jeong
BACKGROUND: Postoperative radiation and chemotherapy are routinely applied for microscopic residual diseases; however, treatment outcomes are not optimal, and patients frequently suffer from treatment-related toxicities. To search for an effective and less-toxic adjuvant treatment for patients with high risk of recurrence, the preventive effect of anti-programmed cell death protein 1 (PD-1) treatment was evaluated in an in vivo animal model of post-surgical tumor recurrence. MATERIALS AND METHODS: An animal model of postsurgical tumor recurrence (SCCVII tumors in C3H mice) was established by reinoculating tumor cells (105 cells) into surgical wound of primary tumor resection...
January 2018: Journal of Surgical Research
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