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fascial dehiscence

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https://www.readbyqxmd.com/read/28285012/two-stage-treatment-of-ischial-pressure-ulcers-in-spinal-cord-injury-patients-technique-and-outcomes-over-8-years
#1
Sumanas W Jordan, Mauricio De la Garza, Victor L Lewis
BACKGROUND: Despite newly introduced techniques, reconstruction of ischial pressure ulcers remains a difficult problem with high-reported failure rates. METHODS: A retrospective chart review was performed on all spinal cord injury patients who underwent ischial pressure ulcer reconstruction by the senior author (V.L.) between 2004 and 2012. The two-stage procedure consisted of debridement and bone biopsy, followed by bursectomy, partial ischiectomy, fascial release, and gluteus maximus and hamstring advancement flaps...
January 23, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28267697/reduced-rate-of-dehiscence-after-implementation-of-a-standardized-fascial-closure-technique-in-patients-undergoing-emergency-laparotomy
#2
Mai-Britt Tolstrup, Sara Kehlet Watt, Ismail Gögenur
OBJECTIVE: In elective surgery, it is well documented that a midline laparotomy should be closed with a slowly absorbable monofilament suture material in a continuous technique, in a ratio of at least 4 : 1. The evidence concerning the suture material or suturing technique in the emergency setting is lacking. We aimed to investigate whether this technique would reduce the rate of dehiscence. METHODS: A standardized procedure of closing the midline laparotomy by using a "small steps" technique of continuous suturing with a slowly absorbable (polydioxanone) suture material in a wound-suture ratio of minimum 1 : 4 was introduced in June 2014...
April 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28101722/the-effect-of-antibiotic-coated-sutures-on-the-incidence-of-surgical-site-infections-in-abdominal-closures-a-meta-analysis
#3
Basheer Elsolh, Lisa Zhang, Sunil V Patel
OBJECTIVE: This meta-analysis aims to determine if antibiotic-impregnated sutures for abdominal fascial closure prevent postoperative surgical site infections (SSIs), hernias, and/or dehiscence. METHODS: MEDLINE and EMBASE databases (1946-2016) were searched. Randomized controlled trials comparing antibiotic-impregnated sutures to standard sutures for abdominal closure were eligible. Risk of bias was evaluated using the Cochrane Handbooks definitions. RESULTS: Four-hundred fifty articles were reviewed; five eligible studies (N = 3117) were identified...
January 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28034772/incidence-and-outcomes-of-ventral-hernia-repair-after-robotic-retropubic-prostatectomy-a-retrospective-cohort-of-570-consecutive-cases
#4
A Ashfaq, K Ahmadieh, A A Shah, E M Garvey, A B Chapital, D J Johnson, K L Harold
BACKGROUND: Robotic retropubic prostatectomy (RRP) has become one of the most commonly performed robotic procedures in the United States. Ventral hernia (VH) has been increasingly recognized as an important complication after laparoscopic procedures, in general. However, data related to VH after robotic procedures is relatively scarce, especially after RRP. With increasing popularity of RRP, the purpose of this study was to look at the incidence of VH and outcomes of ventral hernia repair (VHR) after RRP...
February 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/27941315/laparoscopic-versus-open-surgery-for-diverticulitis-a-systematic-review-and-meta-analysis
#5
Kuen-Lin Wu, Ko-Chao Lee, Chia-Cheng Liu, Hong-Hwa Chen, Chien-Chang Lu
BACKGROUND/AIMS: The study aimed to perform a meta-analysis comparing laparoscopic and open surgery for diverticulitis. METHODS: Studies comparing the outcomes of laparoscopic surgery versus open surgery for diverticulitis that reported quantitative data were included. Outcome measures were mortality and morbidity rates and length of hospital stay. RESULTS: Four randomized controlled trials - 3 prospective and 21 retrospective - were included in the analysis...
December 10, 2016: Digestive Surgery
https://www.readbyqxmd.com/read/27810091/primary-fascial-closure-with-biologic-mesh-reinforcement-results-in-lesser-complication-and-recurrence-rates-than-bridged-biologic-mesh-repair-for-abdominal-wall-reconstruction-a-propensity-score-analysis
#6
Salvatore Giordano, Patrick B Garvey, Donald P Baumann, Jun Liu, Charles E Butler
BACKGROUND: Previous studies suggest that bridged mesh repair for abdominal wall reconstruction may result in worse outcomes than mesh-reinforced, primary fascial closure, particularly when acellular dermal matrix is used. We compared our outcomes of bridged versus reinforced repair using ADM in abdominal wall reconstruction procedures. METHODS: This retrospective study included 535 consecutive patients at our cancer center who underwent abdominal wall reconstruction either for an incisional hernia or for abdominal wall defects left after excision of malignancies involving the abdominal wall with underlay mesh...
February 2017: Surgery
https://www.readbyqxmd.com/read/27457861/gluteal-fascial-advancement-for-pilonidal-cyst-disease-a-10-year-review
#7
Benjamin C Powell, Colin B Webb, Joseph A Ewing, Dane E Smith
Elective excision of noninfected pilonidal cysts has historically been plagued by a high rate of complications, such as wound breakdown and recurrence. Debate remains regarding the most effective method of wound closure. We previously reported a small group of patients (n = 17 out of 83 patients) in which a novel technique decreased wound complications and recurrence. The purpose of this article was to build on that prior study by evaluating the utility of the gluteal fascial advancement method to decrease complications over a 10-year period...
July 2016: American Surgeon
https://www.readbyqxmd.com/read/27407965/reconstruction-of-complex-abdominal-wall-defects
#8
A S Bath, P K Patnaik, P S Bhandari
INTRODUCTION: Reconstruction of large abdominal wall defects not amenable to primary closure remains a challenging problem. These defects result from trauma, previous surgery, infection and tumour resection. The primary objectives of abdominal wall reconstructions are to protect abdominal contents and provide functional support. The abdominal wall reconstruction aims at providing basic component parts, i.e. skin, soft tissue and fascia. For large soft tissue defects, pedicled or free flap closure can be used...
April 2007: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27392842/synthetic-meshes-in-the-treatment-of-postoperative-fascial-dehiscence-of-the-spine
#9
Thorsten Jentzsch, James Geiger, Clément M L Werner
BACKGROUND: A fascial dehiscence after spinal instrumentation is usually located at the mechanically stressed interscapular thoracic spine and often causes cosmetic impairment and pain. However, therapy options remain barely discussed. Synthetic meshes have been successfully used in the treatment of abdominal hernias. OBJECTIVE: It was hypothesized that synthetic meshes are a successful treatment option for spinal fascial dehiscence. METHODS: This retrospective study of a prospective database investigated all consecutive patients who received a synthetic mesh for a fascial dehiscence of the spine between 2010 and 2014 after prior spinal instrumentation...
June 30, 2016: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/27079122/immediate-postpartum-glycemic-control-and-risk-of-surgical-site-infection
#10
Robert C Johnston, Lauryn Gabby, Tevy Tith, Kristina Eaton, Melissa Westermann, Deborah A Wing
OBJECTIVE: Nearly one-third of all births in the United States in 2013 were by cesarean delivery, with 6% complicated by diabetes. The purpose of this study was to correlate immediate postoperative hyperglycemia with wound morbidity in diabetic women who underwent cesarean delivery. METHODS: This retrospective case-control study was performed at UC Irvine Health and Miller Women's & Children's Hospital Long Beach between 2009 and 2015. Subjects included women with at least Class B diabetes mellitus who underwent cesarean birth...
February 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/26895908/incisional-hernias-after-open-versus-laparoscopic-surgery-for-colonic-cancer-a-nationwide-cohort-study
#11
Kristian K Jensen, Peter-Martin Krarup, Thomas Scheike, Lars N Jorgensen, Tommie Mynster
BACKGROUND: Laparoscopic surgery for colonic cancer decreases the incidence of postoperative complications and length of hospital stay as compared with open surgery, while the oncologic outcome remains equivalent. It is unknown whether the surgical approach impacts on the long-term rate of incisional hernia. Furthermore, risk factors for incisional hernia formation are not fully elucidated. The aim of this study was to evaluate the long-term effect of elective open versus laparoscopic surgery for colonic cancer on development of incisional hernia...
October 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/26884272/trainee-participation-and-perioperative-complications-in-benign-hysterectomy-the-effect-of-route-of-surgery
#12
Emma L Barber, Benjamin Harris, Paola A Gehrig
BACKGROUND: Intraoperative trainee involvement in hysterectomy is common. However, the effect of intraoperative trainee involvement on perioperative complications depending on surgical approach is unknown. OBJECTIVE: To estimate the effect of intraoperative trainee involvement on perioperative complication after vaginal, laparoscopic, and abdominal hysterectomy for benign disease. METHODS: Patients undergoing laparoscopic, vaginal, or abdominal hysterectomy for benign disease from 2010 to 2012 were identified from the American College of Surgeons National Surgical Quality Improvement Program database...
August 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26850135/abdominal-closure-protocol-in-colorectal-gynecologic-oncology-and-urology-procedures-a%C3%A2-randomized-quality-improvement-trial
#13
RANDOMIZED CONTROLLED TRIAL
Mary R Kwaan, Christopher J Weight, Stacy Jo Carda, Alyssia Mills-Hokanson, Elizabeth Wood, Colleen Rivard-Hunt, Peter A Argenta
BACKGROUND: Prevention of surgical site infections (SSIs) can improve surgical quality through reductions in morbidity and cost. We sought to determine whether the abdominal closure protocol, in isolation, decreases SSI at an academic teaching hospital. METHODS: Adult patients undergoing laparotomy were prospectively randomized to an abdominal closure protocol, which includes unused sterile instruments and equipment at fascial closure, or usual care. A 30-day SSI rates were compared...
June 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/26808023/nontrauma-open-abdomens-a-prospective-observational-study
#14
Brandon R Bruns, Sarwat A Ahmad, Lindsay OʼMeara, Ronald Tesoriero, Margaret Lauerman, Elena Klyushnenkova, Rosemary Kozar, Thomas M Scalea, Jose J Diaz
BACKGROUND: Damage-control surgery with open abdomen (OA) is described for trauma, but little exists regarding use in the emergency general surgery. This study aimed to better define the following: demographics, indications for surgery and OA, fascial and surgical site complications, and in-hospital/long-term mortality. We hypothesize that older patients will have increased mortality, patients will have protracted stays, they will require specialized postdischarge care, and the indications for OA will be varied...
April 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26754456/control-the-damage-morbidity-and-mortality-after-emergent-trauma-laparotomy
#15
COMPARATIVE STUDY
John A Harvin, Curtis J Wray, Joshua Steward, Ryan A Lawless, Michelle K McNutt, Joseph D Love, Laura J Moore, Charles E Wade, Bryan A Cotton, John B Holcomb
BACKGROUND: Damage control laparotomy (DCL) is performed for physiologically deranged patients. Recent studies suggest overutilization of DCL, which may be associated with potentially iatrogenic complications. METHODS: We conducted a retrospective study of trauma patients over a 2-year period that underwent an emergent laparotomy and received preoperative blood products. The group was divided into definitive laparotomy and DCL. RESULTS: A total of 237 received were included: 78 in definitive laparotomy group, 144 in the DCL group, and 15 who died in the operating room...
July 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/26611331/laparoscopic-harvesting-of-omental-pedicle-flap-for-cerebral-revascularization-in-children-with-moyamoya-disease
#16
Matias Bruzoni, Gary K Steinberg, Sanjeev Dutta
INTRODUCTION: An abundance of angiogenic and immunologic factors makes the omentum an ideal tissue for reconstruction and revascularization of a variety of extraperitoneal wounds and defects. Omental harvesting was historically performed through a large laparotomy and subcutaneous tunneling to the site of disease. Several complications of the open procedure including abdominal wound infection, fascial dehiscence, ventral hernia, and postoperative ileus have been described. The use of laparoscopy to harvest the omentum has the potential to reduce such complications...
April 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26520871/outcomes-of-primary-fascial-closure-after-open-abdomen-for-nontrauma-emergency-general-surgery-patients
#17
Lindsay O'Meara, Sarwat B Ahmad, Jacob Glaser, Jose J Diaz, Brandon R Bruns
BACKGROUND: Emergency general surgery patients are increasingly being managed with an open abdomen (OA). Factors associated with complications after primary fascial closure (PFC) are unknown. METHODS: Demographic and operative variables for all emergency general surgery patients managed with OA at an academic medical center were prospectively examined from June to December 2013. Primary outcome was complication requiring reoperation. RESULTS: Of 58 patients, 37 managed with OA achieved PFC...
December 2015: American Journal of Surgery
https://www.readbyqxmd.com/read/26441396/neuromuscular-blockade-for-improvement-of-surgical-conditions-during-laparotomy-protocol-for-a-randomised-study
#18
RANDOMIZED CONTROLLED TRIAL
Matias Vested Madsen, Susanne Scheppan, Peter Kissmeyer, Emilie Mørk, Jacob Rosenberg, Mona Ring Gätke
INTRODUCTION: During laparotomy, surgeons frequently experience difficult surgical conditions if the patient's abdominal wall or diaphragm is tense. This issue is particularly pertinent while closing the fascia and placing the intestines into the abdominal cavity. Establishment of a deep neuromuscular blockade (NMB), defined as a post-tetanic-count (PTC) of 0-1, paralyses the abdominal wall muscles and the diaphragm. We hypothesised that deep NMB (PTC 0-1) would improve surgical conditions during upper laparotomy as compared to standard NMB with bolus administration...
October 2015: Danish Medical Journal
https://www.readbyqxmd.com/read/26424609/improving-wound-healing-and-preventing-surgical-site-complications-of-closed-surgical-incisions-a-possible-role-of-incisional-negative-pressure-wound-therapy-a-systematic-review-of-the-literature
#19
Alessandro Scalise, Roberto Calamita, Caterina Tartaglione, Marina Pierangeli, Elisa Bolletta, Matteo Gioacchini, Rosaria Gesuita, Giovanni Di Benedetto
Advances in preoperative care, surgical techniques and technologies have enabled surgeons to achieve primary closure in a high percentage of surgical procedures. However, often, underlying patient comorbidities in addition to surgical-related factors make the management of surgical wounds primary closure challenging because of the higher risk of developing complications. To date, extensive evidence exists, which demonstrate the benefits of negative pressure dressing in the treatment of open wounds; recently, Incisional Negative Pressure Wound Therapy (INPWT) technology as delivered by Prevena™ (KCI USA, Inc...
December 2016: International Wound Journal
https://www.readbyqxmd.com/read/26375422/component-separation-vs-bridged-repair-for-large-ventral-hernias-a-multi-institutional-risk-adjusted-comparison-systematic-review-and-meta-analysis
#20
REVIEW
Julie L Holihan, Eric P Askenasy, Jacob A Greenberg, Jerrod N Keith, Robert G Martindale, J Scott Roth, Jiandi Mo, Tien C Ko, Lillian S Kao, Mike K Liang
BACKGROUND: Repair of large ventral hernia defects is associated with high rates of surgical site occurrences (SSO), including surgical site infection (SSI), site dehiscence, seroma, hematoma, and site necrosis. Two common operative strategies exist: Component separation (CS) with primary fascial closure and mesh reinforcement (PFC-CS) and bridged repair (mesh spanning the hernia defect). We hypothesized that: (1) ventral hernia repair (VHR) of large defects with bridged repair is associated with more SSOs than is PFC, and (2) anterior CS is associated with more SSOs than is endoscopic, perforator-sparing, or posterior CS...
February 2016: Surgical Infections
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