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https://www.readbyqxmd.com/read/28748563/intra-hospital-transfers-and-adverse-patient-outcomes-an-analysis-of-administrative-health-data
#1
Nicole Blay, Michael Roche, Christine Duffield, Xiaoyue Xu
AIMS AND OBJECTIVES: To determine whether there was an association between intra-hospital transfers and adverse outcomes. BACKGROUND: Transfers between clinical units and between beds on the same unit are routine aspects of an episode of care in acute hospitals. The rate of these transfers per episode has increased in response to high occupancy levels, a decline in bed numbers, and increased demand for hospital services. The impact of the number of transfers between both wards and beds on patient outcomes is not widely explored...
July 26, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28747091/district-nurses-experiences-of-caring-for-leg-ulcers-in-accordance-with-clinical-guidelines-a-grounded-theory-study
#2
Annica Lagerin, Ingrid Hylander, Lena Törnkvist
This qualitative study used the grounded theory method to investigate district nurses' experiences of caring for leg ulcers in accordance with clinical guidelines at seven primary health care centres in Stockholm, Sweden. Group interviews were conducted with 30 nurses. The results describe how district nurses strive to stay on track in order to follow clinical guidelines and remain motivated despite prolonged wound treatment and feelings of hopelessness. Three main obstacles to following the guidelines were found...
December 2017: International Journal of Qualitative Studies on Health and Well-being
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
#3
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/28746267/the-baltodano-breast-reduction-score-a-nationwide-multi-institutional-validated-approach-to-reducing-surgical-site-morbidity
#4
Pablo A Baltodano, Myrna Eliann Reinhardt, Ashar Ata, Usamah F Simjee, Malcolm Z Roth, Ashit Patel
BACKGROUND: Breast reduction remains associated with significantly higher rates of overall morbidity, superficial surgical-site infections, and wound disruptions. The authors developed a validated risk model to identify patients at higher risk for postoperative surgical-site morbidity after breast reduction. METHODS: A retrospective review was performed of all women undergoing breast reduction from the American College of Surgeons National Surgical Quality Improvement Program 2005 to 2012 data...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28746237/abdominoplasty-with-lymphatic-microsurgery-for-patients-with-secondary-lower-extremity-lymphedema
#5
Shinsuke Akita, Yoshihisa Yamaji, Hideki Tokumoto, Naoki Adachi, Yoshitaro Sasahara, Yoshitaka Kubota, Motone Kuriyama, Nobuyuki Mitsukawa
BACKGROUND: Patients with secondary lower extremity lymphedema (LEL) often develop suprapubic lymphedema. We developed a novel surgical method of shaping the lower abdomen and debulking suprapubic lymphedema with simultaneous reconstruction of lymphatic flow in case of LEL. METHODS: A skin incision in a fleur-de-lis pattern was performed for horizontal and vertical abdominal skin and fat resection. A caudal-based isosceles triangular flap was created on the central suprapubic region to reduce wound tension at the intersection of the horizontal and vertical incisions...
July 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28746169/traditional-long-term-central-venous-catheters-versus-transhepatic-venous-catheters-in-infants-and-young-children
#6
Amanda Marie Marshall, David A Danford, Christopher L Curzon, Venus Anderson, Jeffrey W Delaney
OBJECTIVES: Children with congenital heart disease may require long-term central venous access for intensive care management; however, central venous access must also be preserved for future surgical and catheterization procedures. Transhepatic venous catheters may be an useful alternative. The objective of this study was to compare transhepatic venous catheters with traditional central venous catheters regarding complication rate and duration of catheter service. DESIGN: Retrospective review of 12 congenital heart disease patients from September 2013 to July 2015 who underwent placement of one or more transhepatic venous catheters...
July 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28742434/use-of-regional-anesthesia-techniques-analysis-of-institutional-enhanced-recovery-after-surgery-protocols-for-colorectal-surgery
#7
Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Principles of enhanced recovery after surgery (ERAS(®)) protocols are well established, with the primary goal of optimizing perioperative care and recovery. The use of multimodal analgesia is a key component of these protocols, including regional analgesia techniques such as thoracic epidural analgesia (TEA), transversus abdominis plane (TAP), rectus sheath blocks or continuous wound infiltration (CWI)/catheters, and spinal anesthesia. We compare and contrast regional anesthesia approaches in different institutional colorectal surgery ERAS protocols...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28740785/coronary-artery-disease-in-patients-with-critical-limb-ischemia-undergoing-major-amputation-or-not
#8
Akio Nishijima, Naoto Yamamoto, Ryuichi Yoshida, Koji Hozawa, Satoshi Yanagibayashi, Megumi Takikawa, Rie Hayasaka, Junko Nishijima, Masahiko Gosho, Haruo Nishijima
BACKGROUND: Due to the increase of elderly and diabetes patients, surgeons encounter patients requiring treatment of critical limb ischemia (CLI) in the presence of systemic arteriosclerotic diseases. In this study, we retrospectively investigated the prevalence of coronary artery disease (CAD) in patients with CLI who underwent major (above-the-ankle) amputation or nonmajor amputation (below-the-ankle amputation or debridement of wound). METHODS: We retrospectively investigated 129 consecutive patients surgically managed for CLI in our institution between January 2013 and December 2015...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28739123/effects-of-modifiable-non-modifiable-and-clinical-process-factors-in-ventral-hernia-repair-surgical-site-infections-a-retrospective-study
#9
John Chipko, Anthony DeSantis, Erik Quinn, Vic Velanovich
BACKGROUND: The hypothesis of this study is that non-modifiable factors are more important in ventral hernia repair (VHR) surgical site infection (SSI) than care process factors. METHODS: All VHR's which were reviewed retrospectively for both NSQIP-recorded data, and also: preoperative hospitalization, existing mesh, enterocutaneous fistula, open wound, case month, case day, case length, prophylactic antibiotics, skin preparation, other procedure performed, re-do operation, estimate blood loss, hernia size, repair approach, repair type, mesh used, skin closure, suture type, use of drains, and dressing...
July 19, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28738588/maldi-matrix-assisted-laser-desorption-ionization-imaging-mass-spectrometry-ims-of-skin-aspects-of-sample-preparation
#10
Cristiana Santos de Macedo, David M Anderson, Kevin L Schey
MALDI (matrix assisted laser desorption ionization) Imaging Mass Spectrometry (IMS) allows molecular analysis of biological materials making possible the identification and localization of molecules in tissues, and has been applied to address many questions on skin pathophysiology, as well as on studies about drug absorption and metabolism. Sample preparation for MALDI IMS is the most important part of the workflow, comprising specimen collection and preservation, tissue embedding, cryosectioning, washing, and matrix application...
November 1, 2017: Talanta
https://www.readbyqxmd.com/read/28734103/levels-of-wound-calprotectin-and-other-inflammatory-biomarkers-aid-in-deciding-which-patients-with-a-diabetic-foot-ulcer-need-antibiotic-therapy-induce-study
#11
J R Ingram, S Cawley, E Coulman, C Gregory, E Thomas-Jones, T Pickles, R Cannings-John, N A Francis, K Harding, K Hood, V Piguet
AIMS: Deciding if a diabetic foot ulcer is infected in a community setting is challenging without validated point-of-care tests. Four inflammatory biomarkers were investigated to develop a composite algorithm for mildly infected diabetic foot ulcers: venous white cell count, C-reactive protein (CRP) and procalcitonin, and a novel wound exudate calprotectin assay. Calprotectin is a marker of neutrophilic inflammation. METHODS: In a prospective study, people with uninfected or mildly infected diabetic foot ulcers who had not received oral antibiotics in the preceding 2 weeks were recruited from community podiatry clinics for measurement of inflammatory biomarkers...
July 22, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28733982/postoperative-complications-in-individuals-aged-70-and-over-undergoing-elective-surgery-for-colorectal-cancer
#12
Katleen Fagard, Julie Casaer, Albert Wolthuis, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers, Cindy Kenis
AIM: This study aims to describe the nature, incidence, severity and outcomes of in-hospital postoperative complications (POCs) in older patients undergoing elective surgery for colorectal cancer (CRC).. METHOD: Patients were identified from a prospectively collected database (2009-2015) focusing on the implementation of geriatric screening and assessment in patients with cancer. Medical and surgical POCs were retrieved retrospectively from the medical records, and the severity of the POCs was graded by the Clavien-Dindo (CD) grading system...
July 22, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28732886/chitosan-hyaluronic-acid-composite-sponge-scaffold-enriched-with-andrographolide-loaded-lipid-nanoparticles-for-enhanced-wound-healing
#13
Rania Abdel-Basset Sanad, Hend Mohamed Abdel-Bar
In this work chitosan-hyaluronic acid composite sponge scaffold enriched with Andrographolide (AND) lipid nanocarriers was developed. Nanocarriers were prepared using solvent diffusion method by applying 2(3) factorial design. NLC4 had the highest desirability value (0.882) and therefore, it was chosen as an optimal nanocarrier. Itexhibited spherical shape with 253nm, 83.04% entrapment efficiency and a prolonged release of AND up to 48-h. Consecutively, NLC4 was incorporated in a chitosan-hyaluronic acid gel and lyophilized for 24h to obtain chitosan-hyaluronic acid/NLC4 nanocomposite sponge to enhance AND delivery to wound sites...
October 1, 2017: Carbohydrate Polymers
https://www.readbyqxmd.com/read/28731404/jackson-pratt-drainage-in-pediatric-craniofacial-reconstructive-surgery-is-it-helping-or-hurting
#14
Kumar Vasudevan, Ahyuda Oh, R Shane Tubbs, David Garcia, Andrew Reisner, Joshua J Chern
OBJECTIVE Jackson-Pratt drains (JPDs) are commonly employed in pediatric craniofacial reconstructive surgery (CRFS) to reduce postoperative wound complications, but their risk profile remains unknown. Perioperative blood loss and volume shifts are major risks of CFRS. The goal of this study was to evaluate the risks of JPD usage in CFRS, particularly with regard to perioperative blood loss, hyponatremia, intensive care unit (ICU) length of stay, and postoperative wound complications. METHODS The authors performed a retrospective review of data obtained in pediatric patients who underwent CFRS at a single institution, as performed by multiple surgeons between January 2010 and December 2014...
July 21, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28729228/tangled-history-of-the-european-uses-of-sphagnum-moss-and-sphagnol
#15
REVIEW
Jacek Drobnik, Adam Stebel
ETHNOPHARMACOLOGICAL RELEVANCE: Sphagnum mosses and peat could have been utilized as wound dressings for centuries, however reliable data on this subject are ambiguous; sometimes even no distinction between peat moss (Sphagnum spp.) and peat is made or these terms become confused. The first scientific account on surgical use of peat comes from 1882: a peat digger who successfully, by himself and in the way unknown to the then medicine, cured an open fracture of his forearm with peat. The peat, and very soon the peat moss itself (which is the major constituent of peat) drew attention of the 19(th)-century surgeons...
July 17, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28727593/understanding-moisture-associated-skin-damage-medical-adhesive-related-skin-injuries-and-skin-tears
#16
Karen Zulkowski
GENERAL PURPOSE: To provide information on superficial skin issues related to moisture-associated skin damage, medical adhesive-related skin injury, and skin tears. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1...
August 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28727591/the-effectiveness-of-emla-as-a-primary-dressing-on-painful-chronic-leg-ulcers-a-pilot-randomized-controlled-trial
#17
Anne Purcell, Thomas Buckley, Judith Fethney, Jennie King, Wendy Moyle, Andrea P Marshall
OBJECTIVE: To evaluate the effectiveness of the eutectic mixture of local anesthetics (EMLA; Aspen Pharmacare, St. Leonards, New South Wales, Australia) as a primary dressing on painful chronic leg ulcers. DESIGN: A pilot randomized controlled trial. SETTING: The study was conducted across 6 community nursing procedure clinics located in a community nursing service in New South Wales, Australia. PARTICIPANTS: Sixty participants with painful chronic leg ulcers of varied etiology were recruited into the study...
August 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28727481/leucocyte-and-platelet-rich-fibrin-l-prf-as-a-regenerative-medicine-strategy-for-the-treatment-of-refractory-leg-ulcers-a-prospective-cohort-study
#18
Nelson R Pinto, Matias Ubilla, Yelka Zamora, Verónica Del Rio, David M Dohan Ehrenfest, Marc Quirynen
Chronic wounds (VLU: venous leg ulcer, DFU: diabetic foot ulcer, PU: pressure ulcer, or complex wounds) affect a significant proportion of the population. Despite appropriate standard wound care, such ulcers unfortunately may remain open for months or even years. The use of leukocyte- and platelet-rich fibrin (L-PRF) to cure skin ulcers is a simple and inexpensive method, widely used in some countries but unknown or neglected in most others. This auto-controlled prospective cohort study explored and quantified accurately for the first time the adjunctive benefits of topical applications of L-PRF in the management of such refractory ulcers in a diverse group of patients...
July 20, 2017: Platelets
https://www.readbyqxmd.com/read/28727170/entire-papilla-preservation-technique-in-the-regenerative-treatment-of-deep-intrabony-defects-1-year-results
#19
Serhat Aslan, Nurcan Buduneli, Pierpaolo Cortellini
AIM: This study evaluates the clinical performance of a novel tunnel-like surgical technique in the treatment of isolated deep intrabony defects. MATERIAL AND METHODS: Twelve patients presenting with at least one isolated deep intrabony defect received regenerative periodontal treatment with "entire papilla preservation" technique. Access to the intrabony defect for debridement was provided by a bevelled vertical releasing incision positioned in the buccal gingiva of the neighbouring interdental space...
July 20, 2017: Journal of Clinical Periodontology
https://www.readbyqxmd.com/read/28725521/naso-or-orbitocutaneous-fistulas-after-free-flap-reconstruction-of-orbital-exenteration-defects-retrospective-study-systematic-review-and-meta-analysis
#20
Patrick Tassone, Kurren S Gill, David Hsu, Gurston Nyquist, Howard Krein, Jurij R Bilyk, Anna P Murchison, James J Evans, Ryan N Heffelfinger, Joseph M Curry
Objective  Naso- or orbitocutaneous fistula (NOF) is a challenging complication of orbital exenteration, and it often requires surgical repair. We sought to identify the incidence and risk factors for NOF after orbital exenteration. Study Design  Retrospective chart review, systematic review, meta-analysis. Setting  Tertiary care center. Participants  Patients undergoing free flap reconstruction following orbital exenteration. Records were reviewed for clinicopathologic data, operative details, and outcomes...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
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