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https://www.readbyqxmd.com/read/27901277/negative-pressure-wound-therapy-for-prevention-and-treatment-of-surgical-site-infections-after-vascular-surgery
#1
REVIEW
S Acosta, M Björck, A Wanhainen
BACKGROUND: Indications for negative-pressure wound therapy (NPWT) in vascular surgical patients are expanding. The aim of this review was to outline the evidence for NPWT on open and closed wounds. METHODS: A PubMed, EMBASE and Cochrane Library search from 2007 to June 2016 was performed combining the medical subject headings terms 'wound infection', 'abdominal aortic aneurysm (AAA)', 'fasciotomy', 'vascular surgery' and 'NPWT' or 'VAC'. RESULTS: NPWT of open infected groin wounds was associated with shorter duration of wound healing by 47 days, and was more cost-effective than alginate dressings in one RCT...
November 30, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27900093/primary-gastrointestinal-stromal-tumour-of-the-ileum-pre-operatively-diagnosed-as-an-abdominal-abscess
#2
Patrizia Rubini, Francesco Tartamella
The present case report described the acute presentation, diagnosis and management of a primary gastrointestinal stromal tumour (GIST) of the ileum. A male patient (age, 51 years) was admitted to Maggiore Hospital (Parma, Italy) due to presenting with fever, dysuria and lower abdominal pain. Ultrasonography and computed tomography showed a 7,5×5,5-cm pelvic mass containing air and purulent fluid indicative of an intraperitoneal abscess. The patient was subjected to diagnostic laparoscopy, which revealed a huge, soft cystic mass arising from the small bowel...
November 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/27899054/an-unusual-presentation-of-an-incarcerated-spigelian-hernia
#3
Karen Peeters, Frederik Huysentruyt, Peter Delvaux
Spigelian hernias are rare hernias, occurring through a defect in the Spigelian aponeurosis. Like other hernias, they may contain abdominal contents but are more likely to be incarcerated due to the small size of the fascial defect. Multiple intra-abdominal organs have reportedly been found in Spigelian hernias. A search of the literature showed only nine reported cases in which an appendix has been found within a Spigelian hernia. We present a patient with a history of lower abdominal pain since 10 weeks with a large intra-abdominal mass in the right iliac fossa...
November 29, 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/27894385/-effect-of-expanded-lateral-thoracic-abdominal-flap-transferred-with-pedicle-on-repairing-large-area-of-hypertrophic-scar-after-burn-of-the-upper-extremity
#4
C D Xia, J D Xue, H P Di, J L Niu, X L Li, D Y Cao, Q Li, X H Niu
Objective: To observe the effect of expanded lateral thoracic abdominal flap transferred with pedicle on repairing large area of hypertrophic scar after burn of the upper extremity. Methods: Twelve patients with large area of secondary hypertrophic scar 8 month to 3 years after healing of burn wound on the upper extremity were hospitalized in Zhengzhou First People's Hospital from October 2008 to October 2015, with scar area ranging from 11 cm×7 cm to 20 cm×10 cm. Five patients were with limited straightening and bending of elbow...
November 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/27886351/female-primary-bladder-neck-obstruction-role-of-videourodynamics-and-treatment-options-in-a-rare-clinical-entity
#5
Enrico Ammirati, Alberto Manassero, Alessandro Giammò, Francesco Marson, Alberto Gurioli, Roberto Carone
INTRODUCTION: Primary female bladder neck obstruction is a rare clinical condition characterized by the absence/incomplete bladder neck opening during the voiding phase of micturition. METHODS: We present the cases of two women complaining dysuria, abdominal straining and sensation of incomplete bladder emptying. Videourodynamic evaluation was fundamental for a correct diagnosis. RESULTS: Videourodynamic evaluation showed a high detrusor pressure during emptying phase, partial use of abdominal strain, very low urine flow rate and significant postvoid residual; imaging showed a defect in the physiological funneling of the bladder neck, absent or incomplete...
November 14, 2016: Urologia
https://www.readbyqxmd.com/read/27885759/transanal-minimally-invasive-rectal-resection-for-deep-endometriosis-a-promising-technique
#6
Stijn L Vlek, Marit C I Lier, Thomas W A Koedam, Ingeborg Melgers, Judith J M L Dekker, Jaap H Bonjer, Velja Mijatovic, Jurriaan B Tuynman
AIM: Surgical management of patients with deep endometriosis (DE) of the rectum is difficult. Inflammation and subsequent adhesions due to DE impede access to the lower pelvis and may lead to complications during laparoscopic low anterior resection (LAR). Transanal minimally invasive surgery (TAMIS) is an alternative to an abdominal approach with potential advantages. The aim of this study was to provide a description of the TAMIS technique and to present the perioperative results of TAMIS and of conventional LAR in patients with DE...
November 25, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27885425/intrathecal-morphine-versus-intravenous-opioid-administration-to-impact-postoperative-analgesia-in-hepato-pancreatic-surgery-a-randomized-controlled-trial
#7
Sara Dichtwald, Menahem Ben-Haim, Laila Papismedov, Shoshana Hazan, Anat Cattan, Idit Matot
PURPOSE: Inadequate analgesia following abdominal surgery may affect outcome. Data in patients undergoing liver surgery suggested that postoperative coagulopathy might delay epidural catheter removal. Thus, alternative analgesic techniques should be evaluated. METHODS: We compared the analgesic efficacy of intraoperative intrathecal morphine [single injection 4 µg/kg before skin incision (ITM group, n = 23)] to intravenous opioids [iv remifentanil infusion during surgery followed by i...
November 24, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27879993/randomized-clinical-trial-of-preoperative-skin-antisepsis-with-chlorhexidine-gluconate-or-povidone-iodine
#8
H M Park, S-S Han, E C Lee, S D Lee, H M Yoon, B W Eom, S H Kim, K W Ryu, S-J Park, Y W Kim, B Park
BACKGROUND: Skin antiseptic agents are used to prevent surgical-site infection (SSI); few trials have reported the superiority of any specific agent in clean-contaminated abdominal surgery. This RCT was designed to compare the effectiveness of chlorhexidine gluconate and povidone-iodine. METHODS: Consecutive patients who underwent clean-contaminated upper gastrointestinal or hepatobiliary-pancreatic open surgery between 2011 and 2014 were assigned randomly to either chlorhexidine gluconate or povidone-iodine...
November 23, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27874944/rupture-of-liver-abscess-following-hepatogastric-fistula-caused-by-perforation-of-remnant-gastric-carcinoma-a-case-report
#9
L-M Qian, J-G Ge, J-M Huang
OBJECTIVE: We report the case of a 73-year-old man, with a history of proximal subtotal gastrectomy, who suffered acute abdominal symptoms and signs. Laparotomy showed rupture of liver abscess and hepatogastric fistula formation caused by perforation of remnant stomach. CASE REPORT: Residual stomach resection, incision and drainage of liver abscess were performed, and the patient was smoothly discharged from hospital nineteen days after the emergency operation. RESULTS: The final pathology confirmed the remnant gastric adenocarcinoma...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27873747/atypical-presentation-of-appendicitis
#10
Oliver Beaumont, Robert Miller, Richard Guy
A woman aged 64 years presented as an emergency with a mass in the right iliac fossa, clinically within the abdominal wall, but an otherwise soft abdomen. Systemically, she was quite well with normal vital signs. Blood tests revealed raised inflammatory markers, and an abdominal CT scan demonstrated a perforated appendix with associated large subcutaneous abscess. This represents a rare presentation of a common condition, demonstrating how appendicitis can still be a challenging problem for the clinician...
November 10, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27869497/appendicular-abscess-as-an-unprecedented-cause-of-an-inferior-lumbar-hernia
#11
S M Ali, S Subramaniam
Inferior lumbar hernias are uncommon hernias resulting from a defect in the abdominal wall. They can occur during infancy (congenital defect), albeit less frequently, or spontaneously after trauma or surgery with a lumbar incision. With fewer than 300 cases reported over the past 3 centuries, clinical diagnosis is often confusing owing to non-specific symptoms, relating to the gastrointestinal, genitourinary or musculoskeletal systems. We present a case of an inferior lumbar hernia following spontaneous rupture of a retrocaecally tracked appendicular abscess and a brief literature review...
November 21, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27867852/laparoscopic-management-of-urachal-cysts
#12
Salvatore Fabio Chiarenza, Cosimo Bleve
BACKGROUND: The urachus and the urachal remnants represent a failure in the obliteration of the allantois at birth that connects the bladder to the umbilicus. After birth it obliterates and presents as the midline umbilical ligament. Urachal cyst are the most common urachal anomaly in the pediatric population. The traditional surgical approach is a semicircular infraumbilical incision or a lower midline laparotomy. METHODS: In a 10 years period at Pediatric Surgery Department of Vicenza 16 children were diagnosed with urachal anomalies presenting as abdominal or urinary symptoms...
October 2016: Translational pediatrics
https://www.readbyqxmd.com/read/27867048/feasibiility-and-learning-curve-of-robotic-laparo-endoscopic-single-site-surgery-in-gynecology
#13
Alexandre Buckley de Meritens, Julia Kim, Helen Dinkelspiel, Eloise Chapman-Davis, Thomas Caputo, Kevin Holcomb
Single-site laparoscopy has proven to be a desirable option for patients undergoing gynecologic surgery with some studies indicating improved cosmesis and less perioperative pain compared to standard approaches. This study describes the safety and feasibility of a novel robotic laparo-endoscopic single-site surgery (R-LESS) platform as it is incorporated into a surgeon's practice with extensive multiport robotic surgical experience but limited laparo-endoscopic single-site experience. We reviewed 83 women undergoing R-LESS by a single surgeon from September 2013 through August 2015...
November 17, 2016: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27858917/prospective-study-of-the-neurotopographic-adequacy-of-transverse-incision-in-lichtenstein-inguinal-hernioplasty
#14
Carlos J L Mendes, Rodrigo A Silva, Daniel P A Neto, Isabela Brianti, Kassem Saleh, Mirna D Barros, Sergio Roll, Adhemar M Pacheco
Lichtenstein technique requires identification of the iliohypogastric, ilioinguinal, and genital branch of the genitofemoral nerves.The aim of the study was to verify if the transverse incision is suitable for identification of the iliohypogastric, ilioinguinal, and genital branch of the genitofemoral nerves.This study included 29 patients who underwent hernioplasty, and also 10 dissections of the inguinal regions from 5 cadavers. The anthropometric measurements included: incision size (IS) and topography, pubic angle (PA), body mass index (BMI), and the distance from the pubis to the incision and bi-iliac crest plane...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27858523/laparoscopic-assisted-approach-for-penetrating-abdominal-trauma-an-underutilized-technique
#15
Modise Z Koto, Oleh Y Matsevych, Colleen Aldous
INTRODUCTION: Diagnostic laparoscopy is well accepted in the management of penetrating abdominal trauma (PAT). Therapeutic laparoscopy, on the other hand, remains controversial. In patients with multiple hollow viscera injuries, laparoscopy is usually converted to laparotomy. We aim at describing the laparoscopic-assisted technique in the management of patients with PAT. Using our experience with laparoscopy, we tailored the technique to the setting of PAT. METHODS: The laparoscopic-assisted approach (LAA) was adapted to a trauma setting and prospectively evaluated...
November 18, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27837460/fixation-free-incisional-hernia-repair-in-the-elderly-our-experience-with-a-tentacle-shaped-implant
#16
Giorgio Romano, Pier Giorgio Calò, Enrico Erdas, Fabio Medas, Luca Gordini, Francesco Podda, Giuseppe Amato
BACKGROUND: Incisional hernia in aged patients represents a challenge even for experienced surgeons. Besides increased risk of complications due to comorbidities, mesh fixation and assuring a sufficient mesh overlap of the defect are the main issues in carrying out the repair. AIMS: In order to assure broader coverage of the abdominal wall and a tension- and fixation-free repair, a specifically designed prosthesis was developed for the surgical treatment of incisional hernias...
November 11, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27836523/-why-and-how-to-perform-an-ultrasound-guided-transversus-abdominis-plane-block-a-step-by-step-approach
#17
E Nohuz, B El Drayi, A Triki, K Grossmannova, B Boudier, K Koffi, M Albaut, C Dualé
Used in clinical practice as part of a multimodal analgesic regimen, the transversus abdominis plane block (TAP block) is a relative novel procedure in which local anaesthetic agents are injected into the anatomic neurofascial space between the internal oblique and the transversus abdominis muscle. It allows a significantly prolonged duration of analgesia during the early postoperative stage in abdominal surgery. This regional anesthesia technique provides analgesia to the skin, muscles of the anterior abdominal wall and parietal peritoneum in order to decrease the incision-related pain...
December 2016: Gynécologie, Obstétrique & Fertilité
https://www.readbyqxmd.com/read/27826779/single-incision-retroperitoneoscopic-adrenalectomy-a-north-american-experience
#18
Shonan Sho, Michael W Yeh, Ning Li, Masha J Livhits
BACKGROUND: Endoscopic adrenalectomy is currently performed using multiple ports placed either transabdominally or retroperitoneally. We report our initial experience with single-incision retroperitoneoscopic adrenalectomy (SIRA). METHODS: A prospective database of patients undergoing adrenalectomy from December 2013 through March 2016 was analyzed. We adopted conventional retroperitoneoscopic adrenalectomy (CORA) in December 2013 and transitioned to SIRA in March 2015...
November 8, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27815740/single-site-laparoscopic-percutaneous-extraperitoneal-closure-of-the-internal-ring-using-an-epidural-and-spinal-needle-excellent-results-in-1464-children-with-inguinal-hernia-hydrocele
#19
Furan Wang, Hongji Zhong, Yi Chen, Junfeng Zhao, Yan Li, Junxian Chen, Sheng Dong
BACKGROUND: Laparoscopic percutaneous extraperitoneal closure (LPEC) of the internal ring is a well-developed procedure for pediatric inguinal hernia and hydrocele. To reduce the skin incisions and improve the cosmesis, single-site LPEC (SLPEC) has been developed with numerous techniques and instruments. In this study, we described our modifications of SLPEC using an epidural and spinal needle in a large pediatric population. METHODS: From February 2013 to February 2016, 1464 pediatric patients who underwent SLPEC in our hospital were retrospectively reviewed...
November 4, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27812057/preventive-role-of-magnesium-sulphate-on-dexamethasone-induced-testicular-injury-in-albino-rats
#20
Hemant Kumar, Aisha Qamar
OBJECTIVE: To evaluate the protection provided by magnesium sulphate on corticosteroid-induced testicular injury in albino rats. METHODS: This experimental study was conducted at Jinnah Postgraduate Medical Centre, Karachi, from August 1 to 20, 2012, and comprised albino rats. About 90-120 days old and weighing 200-230 gm. They were divided into 3 groups. Group A comprised controls, Group B animals were administered dexamethasone 4mg/kg body weight per day intra-peritoneally, and Group C animals were given magnesium sulphate 20mg/kg body weight per day intramuscularly, with dexamethasone at same dose as in Group B...
November 2016: JPMA. the Journal of the Pakistan Medical Association
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