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Surgical prophylaxis

Peter Kranke, Sergio D Bergese, Harold S Minkowitz, Timothy I Melson, David G Leiman, Keith A Candiotti, Ngai Liu, Leopold Eberhart, Ashraf S Habib, Jan Wallenborn, Anthony L Kovac, Pierre Diemunsch, Gabriel Fox, Tong J Gan
BACKGROUND: Postoperative nausea and vomiting causes distress for patients and can prolong care requirements. Consensus guidelines recommend use of multiple antiemetics from different mechanistic classes as prophylaxis in patients at high risk of postoperative nausea and vomiting. The prophylactic efficacy of the dopamine D2/D3 antagonist amisulpride in combination with other antiemetics was investigated. METHODS: This double-blind, randomized, placebo-controlled, international, multicenter trial was conducted in 1,147 adult surgical patients having three or four postoperative nausea and vomiting risk factors...
March 15, 2018: Anesthesiology
Patrick B Murphy, Kelly N Vogt, Brandyn D Lau, Jonathan Aboagye, Neil G Parry, Michael B Streiff, Elliott R Haut
Importance: Venous thromboembolism (VTE) is the most preventable cause of morbidity and mortality in US hospitals, and approximately 2.5% of emergency general surgery (EGS) patients will be diagnosed with a VTE event. Emergency general surgery patients are at increased risk of morbidity and mortality because of the nature of acute surgical conditions and the challenges related to prophylaxis. Observations: MEDLINE, Embase, and the Cochrane Database of Collected Reviews were searched from January 1, 1990, through December 31, 2015...
March 14, 2018: JAMA Surgery
Masoumeh Shohani, Akram Mansouri, Siros Norozi, Naser Parizad, Milad Azami
Background: There is not enough studies to determine the frequency of using the prophylaxis against deep venous thrombosis (DVT) based on the American College of Chest Physician's (ACCP) guidelines in Iran. Thus, providing such statistics is essential to improve thromboprophylaxis in hospital. The present study aimed to determine the frequency of using the prophylaxis against DVT based on ACCP guidelines in patients hospitalized in surgical wards in one of teaching hospital in Ilam, Iran...
2018: International Journal of Preventive Medicine
Mette Louise Andersen, Christina Anne Vinter, Annemette Wildfang Lykkebo
Clitoral phimosis or preputial fusion may occur as a result of atrophic vaginitis among other conditions. A 72-year-old woman presented with atrophic vaginitis, preputial fusion, and a painful periclitorial pseudocyst. We suggest that a minimal surgery approach in a manual retraction of the synarchies without making an incision is a gentle and effective surgical management of preputial fusion. Suturing the ends from each other combined with continuous topical prophylaxis will minimise the risk of recurrence of pseudo-cyst and prevent worsening scar tissue formation...
March 5, 2018: Ugeskrift for Laeger
Pedro C Aravena, Camila P Oyarzún, María F Arias, Héctor Monardes, Alejandro Jerez, Bruna Benso
PURPOSE: The use of antibiotic prophylaxis in dental implant surgery is a routine dental practice to prevent implant failure. Current systematic reviews have yet to confirm the effectiveness of antibiotic treatment at reducing postoperative infection rates in implant procedures. The aim of this study was to quantify amoxicillin plasma levels at the peripheral venous blood and at the surgical implant site in patients undergoing dental treatment. MATERIALS AND METHODS: A prospective study was conducted...
March 2018: International Journal of Oral & Maxillofacial Implants
Felicia Turowski, Ulrich Hügle, Arno Dormann, Matthias Bechtler, Ralf Jakobs, Uwe Gottschalk, Ellen Nötzel, Dirk Hartmann, Albrecht Lorenz, Frank Kolligs, Wilfried Veltzke-Schlieker, Andreas Adler, Olaf Becker, Bertram Wiedenmann, Nataly Bürgel, Hanno Tröger, Michael Schumann, Severin Daum, Britta Siegmund, Christian Bojarski
BACKGROUND AND AIMS: The aim of the study was to evaluate the usefulness and diagnostic and therapeutic outcome of the single-operator cholangiopancreatoscopy (SOC) with SpyGlassDS™. METHODS: In a retrospective multicenter study between November 2015 and January 2017, SpyGlassDS™ procedures were analyzed in participating centers. Indications, accuracy of SOC-guided biopsies, management of large bile duct stones, and complications were analyzed. Follow-up was 4 months...
March 12, 2018: Surgical Endoscopy
Jun Kamei, Satoshi Yazawa, Shingo Yamamoto, Naoto Kaburaki, Satoru Takahashi, Masami Takeyama, Masayasu Koyama, Yukio Homma, Soichi Arakawa, Hiroshi Kiyota
AIMS: We conducted a nationwide survey on perioperative management and antimicrobial prophylaxis of transvaginal mesh surgeries for pelvic organ prolapse in Japan to understand the practice and risk factors for surgical site infection (SSI). METHODS: Health records of women undergoing tension-free vaginal mesh (TVM) surgeries from 2010 to 2012 were obtained from 135 medical centers belonging to the Japanese Society of Pelvic Organ Prolapse Surgery. The questionnaire addressed hospital volume, perioperative management, and SSI...
March 11, 2018: Neurourology and Urodynamics
Robert B Garoon, William E Smiddy, Harry W Flynn
PURPOSE: To report rates and timing of retreatments, new break formation, and vitreoretinal surgical intervention after initial treatment of retinal breaks, and to identify factors associated with increased rates of additional vitreoretinal interventions. METHODS: Retrospective, consecutive case series of all patients who were diagnosed with a retinal break and underwent laser retinopexy for prophylaxis of retinal detachment at the Bascom Palmer Eye Institute, Miami, FL, from 2013 through 2016 were reviewed...
March 9, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
Julius C Mwita, Sajini Souda, Mgaywa Gmd Magafu, Amos Massele, Brian Godman, Michael Mwandri
OBJECTIVES: Antibiotic prophylaxis in surgery is known to reduce the rate of surgical site infections (SSI) as well as shorten hospital stay. However, there is currently a scarcity of data on antibiotic prophylaxis and SSIs among African countries including Botswana. Consequently, this study aimed to address this. METHODS: A prospective study involving 400 patients was carried out at a leading tertiary hospital in Botswana from 2014-2015. Patients' demographic information, type of surgery performed and peri-operative use of antibiotics were documented...
March 9, 2018: Hospital Practice (Minneapolis)
Sheran Seneviratne, Gary Hoffman, Hemalatha Varadhan, Jane Kitcher, Daron Cope
PURPOSE: The study was designed to assess the difference in microbiological colonisation and growth that may occur in drains, in the setting of clean-contaminated compared to clean head and neck surgery. METHODS: A prospective observational cohort study was performed. Surgical drain tips upon removal were sent for bacterial culture and the culture results were compared between clean-contaminated and clean procedures using mixed effects logistic regression. In all statistical analyses, a priori, p < 0...
March 8, 2018: European Archives of Oto-rhino-laryngology
A Pym, E Ben-Menachem
Postoperative nausea and vomiting (PONV) is a common and distressing problem for patients and increases the burden of care in post-anaesthesia care units (PACU). As such it has been a recent focus for quality improvement. Evidence-based guidelines have demonstrated the benefit of PONV risk stratification and prophylaxis, but may be underutilised in clinical practice. This prospective pre-/post-intervention study was conducted at an adult tertiary hospital in non-cardiac adult surgical patients at higher-risk of PONV...
March 2018: Anaesthesia and Intensive Care
Ying-Zi Shen, Ke Peng, Juan Zhang, Xiao-Wen Meng, Fuhai Ji
OBJECTIVE: The aim of this systematic review and meta-analysis was to investigate whether or not the use of haloperidol could reduce the incidence of delirium in adult patients. SUBJECTS AND METHODS: PubMed, Embase, the Cochrane Library, Elsevier, Wiley, and Ovid were searched for randomized controlled trials and prospective interventional cohort studies that compared haloperidol with placebo for delirium prophylaxis or with second generation antipsychotics for delirium treatment...
March 8, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Michael P Veve, Joshua B Greene, Amy M Williams, Susan L Davis, Nina Lu, Yelizaveta Shnayder, David X Li, Salem I Noureldine, Jeremy D Richmon, Lawrence O Lin, Matthew M Hanasono, Patrik Pipkorn, Ryan S Jackson, Joshua D Hornig, Tyler Light, Mark K Wax, Yin Yiu, James Bekeny, Matthew Old, David Hernandez, Urjeet A Patel, Tamer A Ghanem
Objective To characterize and identify risk factors for 30-day surgical site infections (SSIs) in patients with head and neck cancer who underwent microvascular reconstruction. Study Design Cross-sectional study with nested case-control design. Setting Nine American tertiary care centers. Subjects and Methods Hospitalized patients were included if they underwent head and neck cancer microvascular reconstruction from January 2003 to March 2016. Cases were defined as patients who developed 30-day SSI; controls were patients without SSI at 30 days...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Clinton G Lauritsen, Abigail L Chua, Stephanie J Nahas
PURPOSE OF REVIEW: Menopause is a life-changing event in numerous ways. Many women with migraine hold hope that the transition to the climacteric state will coincide with a cessation or improvement of migraine. This assumption is based mainly on common lay perceptions as well as assertions from many in the healthcare community. Unfortunately, evidence suggests this is far from the rule. Many women turn to a general practitioner or a headache specialist for prognosis and management. A natural instinct is to manipulate the offending agent, but in some cases, this approach backfires, or the concern for adverse events outweighs the desire for a therapeutic trial, and other strategies must be pursued...
March 6, 2018: Current Treatment Options in Neurology
Mohammed A Almustafa, Alistair M Ewen, Angela H Deakin, Frederic Picard, Jon V Clarke, Fahd F Mahmood
BACKGROUND: Surgical site infection (SSI) is a debilitating complication of lower limb arthroplasty with significant morbidity and increased costs. Numerous risk factors are associated with SSI. METHODS: In an effort to identify novel risk factors for SSI, we undertook a retrospective cohort study of 1832 primary total hip arthroplasties and 2100 primary total knee arthroplasties performed in our high volume arthroplasty unit over a 2-year period. RESULTS: Two risk factors were identified for SSI following total hip arthroplasty: body mass index ≥30 and peri-operative blood transfusion...
January 31, 2018: Journal of Arthroplasty
Genia Dubrovsky, Nhan Huynh, Joshua D Rouch, John P Koulakis, David P Nicolau, Christina A Sutherland, Seth Putterman, James C Y Dunn
BACKGROUND: Surgical site infections (SSIs) pose a significant health and financial burden. A key aspect of appropriate prophylaxis is the administration of antibiotics intravenously (IV). However, subcutaneous administration of antibiotics is not well described in the literature. During surgery, we hypothesize that subcutaneous injection may provide better protection against SSIs. To better understand the kinetics after subcutaneous injection, we describe the serum concentrations of cefazolin in a porcine model...
April 2018: Journal of Surgical Research
Oisín Conaty, Leah Gaughan, Colum Downey, Noreen Carolan, Megan Joanne Brophy, Ruth Kavanagh, Deborah A A McNamara, Edmond Smyth, Karen Burns, Fidelma Fitzpatrick
Purpose The purpose of this paper is to improve surgical antimicrobial prophylaxis (SAP) prescribing in orthopaedic surgery using the model for improvement framework. Design/methodology/approach Orthopaedic patients receiving joint replacements, hip fracture repairs or open-reduction internal-fixation procedures were included. Antimicrobial(s); dose, time of administration and duration of SAP were evaluated for appropriateness based on the local SAP guidelines. After baseline data collection, a driver diagram was constructed with interventions devised for plan-do-study-act cycles...
March 12, 2018: International Journal of Health Care Quality Assurance
Dario Buccheri, Paola Rosa Chirco, Salvatore Geraci, Giuseppe Caramanno, Bernardo Cortese
Coronary artery fistula (CAF) is a relatively rare anatomic abnormality of the coronary arteries that afflicts 0.002% of the general population and represents 14% of all the anomalies of coronary arteries. Its clinical relevance focusses mainly on the mechanism of "coronary steal phenomenon", causing myocardial functional ischaemia even in the absence of stenosis, hence common symptoms are angina or effort dyspnoea. The suggested diagnostic approach is guided by the patient's symptoms and consists of a number of instrumental examinations like ECG, treadmill test, echocardiography, computed tomography scan, cardiac magnetic resonance and coronary angiography...
February 9, 2018: Heart, Lung & Circulation
Daniel C Thomas, Brian N Arnold, Jessica R Hoag, Michelle C Salazar, Daniel J Boffa, Frank C Detterbeck, Anthony W Kim, Justin D Blasberg
BACKGROUND: Few studies have examined the risk factors and timing of venous thromboembolism (VTE) in patients undergoing surgery for lung cancer, and there is limited data to formulate guidelines for extended VTE prophylaxis after hospital discharge. This study sought to identify risk factors for post-discharge VTE following lung resection. METHODS: Patients undergoing anatomic resection for lung cancer were identified in the National Surgical Quality Improvement Program database from 2005-2015...
March 1, 2018: Annals of Thoracic Surgery
Matthieu Grégoire, Romain Dumont, Ludovic Ronchi, Jean-Baptiste Woillard, Vincent Atthar, Eric Letessier, Raphaël Cinotti, Antoine Roquilly, Guillaume Deslandes, Pascale Jolliet, Karim Asehnoune, Eric Dailly
Morbid obesity is known to increase the risk of surgical site infections. Optimal concentrations of prophylactic antibacterial drugs are required. Using Monte Carlo simulations, the aim of this work was to build a population pharmacokinetics model for a morbidly obese population to assess a 4000-mg dose of cefazolin recommended by the guidelines and to propose new administration schemes. One hundred and seventeen morbidly obese patients (mean body mass index, 46.95 kg/m2 ) received 4000 mg of cefazolin intravenously before sleeve gastrectomy...
March 1, 2018: International Journal of Antimicrobial Agents
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