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https://www.readbyqxmd.com/read/27914764/enhanced-recovery-pathway-in-patients-undergoing-distal-pancreatectomy-a-case-matched-study
#1
Nicolò Pecorelli, Giovanni Capretti, Gianpaolo Balzano, Renato Castoldi, Marianna Maspero, Luigi Beretta, Marco Braga
BACKGROUND: Enhanced recovery (ER) pathways have improved outcomes across multiple surgical specialties, but reports concerning their application in distal pancreatectomy (DP) are lacking. The aim of this study was to assess compliance with an ER protocol and its impact on short-term outcomes in patients undergoing DP. METHODS: Prospectively collected data were reviewed. One hundred consecutive patients undergoing DP were treated within an ER pathway comprising 18 care elements...
November 30, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27913719/surgical-site-infections-in-major-head-and-neck-surgeries-involving-pedicled-flap-reconstruction
#2
Neerav Goyal, Bharat B Yarlagadda, Daniel G Deschler, Kevin S Emerick, Derrick T Lin, Debbie L Rich, James W Rocco, Marlene L Durand
OBJECTIVE: To evaluate surgical site infections (SSI) after pedicled reconstruction in head and neck surgery. METHODS: Records of patients with pedicled flap reconstructions between 2009 and 2014 at Massachusetts Eye and Ear were reviewed. Onset of SSI or fistula ≤30 days postoperatively was noted. A free flap cohort was reviewed for comparison. RESULTS: Two hundred and eight pedicled reconstructions were performed for cancer (83%), osteoradionecrosis (7%), and other reasons (10%)...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27912796/staphylococcal-species-heterogeneity-in-the-nasal-microbiome-following-antibiotic-prophylaxis-revealed-by-tuf-gene-deep-sequencing
#3
Claire L McMurray, Katherine J Hardy, Szymon T Calus, Nicholas J Loman, Peter M Hawkey
BACKGROUND: Staphylococci are a major constituent of the nasal microbiome and a frequent cause of hospital-acquired infection. Antibiotic surgical prophylaxis is administered prior to surgery to reduce a patient's risk of postoperative infection. The impact of surgical prophylaxis on the nasal staphylococcal microbiome is largely unknown. Here, we report the species present in the nasal staphylococcal microbiome and the impact of surgical prophylaxis revealed by a novel culture independent technique...
December 2, 2016: Microbiome
https://www.readbyqxmd.com/read/27912036/failure-to-redose-antibiotic-prophylaxis-in-long-surgery-increases-risk-of-surgical-site-infection
#4
Nongyao Kasatpibal, Joanne D Whitney, E Patchen Dellinger, Bala G Nair, Kenneth C Pike
BACKGROUND: Antibiotic prophylaxis is a key component of the prevention of surgical site infection (SSI). Failure to manage antibiotic prophylaxis effectively may increase the risk of SSI. This study aimed to examine the effects of antibiotic prophylaxis on SSI risk. METHODS: A retrospective cohort study was conducted among patients having general surgery between May 2012 and June 2015 at the University of Washington Medical Center. Peri-operative data extracted from hospital databases included patient and operation characteristics, intra-operative medication and fluid administration, and survival outcome...
December 2, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27906606/influence-of-a-shorter-duration-of-post-operative-antibiotic-prophylaxis-on-infectious-complications-in-patients-undergoing-elective-liver-resection
#5
Masahiko Sakoda, Satoshi Iino, Yuko Mataki, Yota Kawasaki, Hiroshi Kurahara, Kosei Maemura, Shinichi Ueno, Shoji Natsugoe
BACKGROUND: Antibiotic prophylaxis has been recommended to reduce post-operative infectious complications. Discontinuation of post-operative antibiotic administration within 24 hours of operation is currently recommended. Many surgeons, however, conventionally tend to extend the duration of prophylactic antibiotic use. In this study, we performed a retrospective analysis to assess the efficacy of extended post-operative antibiotic use in patients who underwent elective liver resection...
December 1, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27906601/association-between-pre-operative-cefazolin-dose-and-surgical-site-infection-in-obese-patients
#6
William J Peppard, David G Eberle, Nathan W Kugler, Danielle M Mabrey, John A Weigelt
BACKGROUND: A fixed dose of cefazolin results in serum concentrations that decrease as body mass increases. Current national guidelines suggest a pre-operative cefazolin dose of two grams may be insufficient for patients ≥120 kg; thus a three gram dose is recommended. These recommendations, however, are based on pharmacokinetic rather than outcome data. We evaluate the efficacy of pre-operative cefazolin two gram and three gram doses as measured by the rate of surgical site infection (SSI)...
December 1, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27905216/-epidemiology-of-surgical-site-infection-in-a-neurosurgery-department
#7
Patricia López Pereira, Cristina Díaz-Agero Pérez, Nieves López Fresneña, Julio Las Heras Mosteiro, Aurelio Palancar Cabrera, Ángela Lourdes Rincón Carlavilla, Jesús María Aranaz Andrés
OBJECTIVE: To know the rates of infection of the surgical wound in the Department of Neurosurgery between 2011 and 2014. METHODS: An observational, prospective study was conducted of the rates of surgical wound infection among patients admitted for more than 48 h to the Neurosurgery Department of a tertiary-level university hospital between July 2011 and December 2014. RESULTS: The study surveyed a total of 536 surgical procedures performed in 521 patients...
December 1, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27903856/laparoscopic-left-hemicolectomy-for-colon-cancer-in-peritoneal-dialysis-patients-a-valid-and-safe-surgical-technique-to-ensure-peritoneal-dialysis-survival
#8
Sara Auricchio, Giulio Mari, Andrea Galassi, Beatrice Dozio, Marco Pozzi, Dario Maggioni, Renzo Scanziani
A laparoscopic approach represents an effective alternative to open surgery in patients undergoing peritoneal dialysis (PD). In these patients, conventional thinking provides for removal of the peritoneal catheter during left colon resections because of higher risk of patient contamination and peritonitis. The present paper describes 3 cases of laparoscopic left hemicolectomy for colon cancer performed in PD patients without complications and without peritoneal catheter removal, leading to subsequent early PD resumption...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/27900627/extended-duration-versus-short-duration-pharmacological-thromboprophylaxis-in-acutely-ill-hospitalized-medical-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#9
Aaron Y L Liew, Siavash Piran, John W Eikelboom, James D Douketis
Extended-duration pharmacological thromboprophylaxis, for at least 28 days, is effective for the prevention of symptomatic venous thromboembolism (VTE) in high-risk surgical patients but is of uncertain benefit in hospitalized medical patients. We aimed to evaluate the efficacy and safety of extended-duration thromboprophylaxis in hospitalized medical patients. We conducted a systematic PubMed, Medline and EMBASE literature search until June 2016 and a meta-analysis of randomized controlled trials which compared extended-duration with short-duration thromboprophylaxis in hospitalized medical patients...
November 30, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27899248/unexplained-increases-in-serum-vancomycin-concentration-in-a-morbidly-obese-patient
#10
REVIEW
Sean P Kane, Scott D Hanes
INTRODUCTION: To report a case of increases in vancomycin concentrations without additional vancomycin doses being given. CASE STUDY: A 64 year-old morbidly obese female received three total doses of vancomycin for surgical prophylaxis and for ventilator-associated pneumonia. Subsequent vancomycin concentrations from the patient's central venous catheter (CVC) demonstrated increasing drug levels from 27.1 to 45.9mcg/mL despite no additional vancomycin being given and proper line flushing prior to sample collection...
November 26, 2016: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/27899130/antibiotic-prophylaxis-in-reduction-mammaplasty-study-protocol-for-a-randomized-controlled-trial
#11
Edgard Silva Garcia, Daniela Francescato Veiga, Joel Veiga-Filho, Isaías Vieira Cabral, Natália Lana Larcher Pinto, Neil Ferreira Novo, Miguel Sabino Neto, Lydia Masako Ferreira
BACKGROUND: The role of antibiotics in surgical procedures where the risk of surgical site infection (SSI) is low remains uncertain. There is, to date, no evidence to justify the routine use of antibiotics in postoperative reduction mammaplasty. The aim of this study is to evaluate the effect of postoperative antibiotic treatment on the occurrence of SSI after breast reduction surgery. METHODS: This is a double-blind randomized clinical trial with 124 breast hypertrophy patients allocated to two treatment groups: antibiotic (n = 62) and placebo (n = 62)...
November 30, 2016: Trials
https://www.readbyqxmd.com/read/27898350/cronkhite-canada-syndrome-complicated-by-pulmonary-embolism-a-case-report
#12
Neha L Nemade, Urvi B Shukla, Gajanan D Wagholikar
INTRODUCTION: Cronkhite Canada Syndrome (CCS) is a rare syndrome, described in 1955 by Americans, Leonard Wolsey Cronkhite and Wilma Jeanne Canada in the New England Journal of Medicine [1]. About 450 cases have been reported. Complications, like malignant transformation, unprovoked thromboembolism is known. Since there is wide variability in medical presentation, no definitive diagnostic and treatment protocol s have been set. The mortality remains at 55%. CASE PRESENTATION: We report a case of a 50 year old male patient presenting with diarrhea, weight loss, abdominal pain, ectodermal features...
November 17, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27887932/assessing-national-provision-of-care-variability-in-bariatric-clinical-care-pathways
#13
Dana A Telem, Saniea F Majid, Kinga Powers, Eric DeMaria, John Morton, Daniel B Jones
BACKGROUND: The American Society for Metabolic and Bariatric Surgery (ASMBS) Quality Improvement and Patient Safety (QIPS) Committee hypothesized that collecting and sharing clinical pathways could provide a valuable resource to new and existing bariatric programs. OBJECTIVE: To shed light on the variability in practice patterns across the country by analyzing pathways. SETTING: United States Centers of Excellence METHODS: From June 2014 to April 2015, clinical pathways pertaining to preoperative, intraoperative, and postoperative management of bariatric patients were solicited from the ASMBS executive council (EC), QIPS committee members, and state chapter presidents...
August 3, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27884486/epidemiologic-analysis-prophylaxis-and-multidrug-resistance-in-surgery
#14
H Solís-Téllez, E E Mondragón-Pinzón, M Ramírez-Marino, F R Espinoza-López, F Domínguez-Sosa, J F Rubio-Suarez, R D Romero-Morelos
BACKGROUND: Surgical site infection is defined as an infection related to the surgical procedure in the area of manipulation occurring within the first 30 postoperative days. The diagnostic criteria include: purulent drainage, isolation of microorganisms, and signs of infection. AIMS: To describe the epidemiologic characteristics and differences among the types of prophylactic regimens associated with hospital-acquired infections at the general surgery service of a tertiary care hospital...
November 21, 2016: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/27884418/heterotopic-ossification-prophylaxis-after-total-hip-arthroplasty-randomized-trial-of-400-vs-700-cgy
#15
Jane Z Liu, Nicholas B Frisch, Regina M Barden, Aaron G Rosenberg, Craig D Silverton, Jorge O Galante
BACKGROUND: Heterotopic ossification (HO) is a known complication following total hip arthroplasty. Radiation is an effective prophylaxis, but an optimal protocol has yet to be determined. We performed a randomized, double-blinded clinical trial in high-risk patients to determine the efficacy of 400 vs 700 cGy doses of radiation. METHODS: One hundred forty-seven patients undergoing total hip arthroplasty and at high risk for HO at an urban medical center were randomized to receive either a single 400 or 700 cGy dose of radiation postoperatively...
November 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27884335/pneumonia-prevention-in-intubated-patients-given-sucralfate-versus-proton-pump-inhibitors-and-or-histamine-ii-receptor-blockers
#16
Gene A Grindlinger, Sarah B Cairo, Carole B Duperre
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common cause of infectious morbidity and mortality in the intensive care unit (ICU). The type of stress-ulcer prophylaxis (SUP) given to ventilated patients may, in part, be responsible. We observed an increase in VAP as ventilator bundle compliance increased and a decrease in VAP when bundle compliance decreased. We reasoned that SUP which raises gastric pH such as proton-pump inhibitors (PPIs) and histamine II (H2) receptor antagonists as opposed to SUP which does not raise pH such as sucralfate (S) may be responsible and also may alter the causative bacteria...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27883161/-is-it-necessary-to-prescribe-antibiotics-in-impacted-third-molar-surgical-removal-comparative-study-between-prescribing-patterns
#17
I Izuzquiza, K A Jamtøy, N P Fossland, I Martínez-Padilla, F Falahat, L Alou, J Prieto, M L Gómez-Lus
OBJECTIVE: To assess whether there is a significant difference in infection rate after surgery tooth extraction in two different hospitals from Norway and Spain where different surgical antimicrobial prophylaxis protocols are applied. METHODS: An analytical observational study was conducted, retrospective cohorts type, analyzing healthy patients with no risk factors, who were third molar tooth operated in maxillofacial services of two different hospitals: St. Olav in Trondheim (Norway) and Clínico San Carlos in Madrid (Spain)...
November 22, 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/27878663/prevention-and-treatment-of-venous-thromboembolism-in-patients-with-solid-brain-neoplasms-results-of-a-survey-among-italian-physicians
#18
Nicola Mumoli, Stefano Barco, Marco Cei, Matteo Giorgi-Pierfranceschi, Mauro Campanini, Andrea Fontanella, Walter Ageno, Francesco Dentali
The decision concerning the introduction of primary and secondary prophylaxis of venous thromboembolism (VTE) in patients with solid brain neoplasms and brain metastases is often challenging due to the concomitant increased risk of intracranial hemorrhage and to limited evidence from available literature. A standardized questionnaire composed of nine multiple-choice questions regarding primary VTE prevention in non-surgical patients during high-risk conditions and VTE secondary prevention in patients with a solid brain neoplasm or cerebral metastases was sent via electronic mail to all the members (n = 2420) of the Italian Federation of the Internal Medicine Hospital Executives' Associations (FADOI) in June 2015...
November 23, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27873530/pulmonary-embolism-after-abdominoplasty-are-we-really-able-to-avoid-all-complications-case-reports-and-literature-review
#19
M Molitor, O Měšťák, P Popelka, L Vítová, V Hromádková, J Měšťák
Pulmonary embolism is a potentially lethal complication in plastic surgery patients. About 34% of the members of American Society of Plastic Surgery have diagnosed pulmonary embolism in their patients, and 7% had experienced at least 1 death due to this complication. The American Society of Plastic Surgeons Executive Committee approved the Venous Thromboembolism Task Force Report. The members agreed that there was not enough evidence to make all-inclusive recommendations for plastic surgery deep vein thrombosis and pulmonary embolism prophylaxis, but released the 2005 Caprini Scale accompanied by the Task Force recommendations for use in plastic surgery...
2016: Acta Chirurgiae Plasticae
https://www.readbyqxmd.com/read/27870735/combination-of-5-ht3-antagonist-and-dexamethasone-is-superior-to-5-ht3-antagonist-alone-for-ponv-prophylaxis-after-laparoscopic-surgeries-a-meta-analysis
#20
Anirban Som, Sulagna Bhattacharjee, Souvik Maitra, Mahesh K Arora, Dalim Kumar Baidya
INTRODUCTION: 5-Hydroxytryptamine type 3 (5-HT3) receptor antagonists are the most commonly used drugs for postoperative nausea vomiting (PONV) prophylaxis. Dexamethasone is another antiemetic with proven efficacy in reducing PONV. The aim of this study was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the combination of dexamethasone and 5-HT3 antagonist versus a 5-HT3 antagonist alone as prophylaxis of PONV in laparoscopic surgical patients...
December 2016: Anesthesia and Analgesia
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