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Wound dehiscence

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https://www.readbyqxmd.com/read/28821472/surgical-findings-and-outcomes-in-premenopausal-breast-cancer-patients-undergoing-oophorectomy-a-multicenter-review-from-the-fellows-pelvic-research-network
#1
Lara F B Harvey, Vandana G Abramson, Jimena Alvarez, Christopher Destephano, Hye-Chun Hur, Katherine Lee, Patricia Mattingly, Beau Park, Carolyn Piszczek, Farinaz Seifi, Mallory Stuparich, Amanda Yunker
STUDY OBJECTIVE: Since publication of the Suppression of Ovarian Function Trial (SOFT) data, some women with premenopausal breast cancer have been recommended to undergo bilateral oophorectomy to facilitate breast cancer treatment with aromatase inhibitors. These women may be at higher risk of occult abdominal pathology than the general population. Our objective is to describe the procedures performed, intra-abdominal findings, and surgical pathology of this population. DESIGN: Multi-center retrospective chart review...
August 15, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28820845/concomitant-panniculectomy-affects-wound-morbidity-but-not-hernia-recurrence-rates-in-abdominal-wall-reconstruction-a-propensity-score-analysis
#2
Salvatore Giordano, Patrick B Garvey, Donald P Baumann, Jun Liu, Charles E Butler
BACKGROUND: Panniculectomy (PAN) is often performed during abdominal wall reconstruction (AWR) to decrease wound healing complications and hernia recurrence rates. However, studies of AWR with concurrent panniculectomy (AWR+PAN) have reported contradictory results. We hypothesized that patients undergoing AWR+PAN experience more wound healing complications but similar rates of hernia recurrence compared to AWR alone. METHODS: In this retrospective study of 548 consecutive patients, 305 (52...
August 8, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28820359/clinical-outcomes-of-direct-oral-anticoagulants-after-lower-extremity-arterial-procedures
#3
Afsha Aurshina, Pavel Kibrik, Justin Eisenberg, Ahmad Alsheekh, Anil Hingorani, Natalie Marks, Enrico Ascher
Objectives The use of postoperative anticoagulation is not uncommon for patients undergoing lower extremity arterial procedures as adjunctive therapy. Longer postoperative length of stay is necessary to achieve adequate therapeutic international normalized ratio with traditional protocols that call for the use of unfractionated heparin and warfarin therapy. We hypothesized the direct oral anticoagulants are an attractive alternative to provide adequate anticoagulation in patients who undergo lower extremity arterial procedures...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28814581/hyperammonaemic-encephalopathy-following-an-uncomplicated-surgery
#4
Stuart McIntosh, Karima Medjoub, Kevin Deans, Sara Sexton
A 59-year-old woman who underwent an uncomplicated exploratory laparotomy, adhesiolysis, small bowel resection and anterolateral thigh flap had a complicated postoperative period characterised by wound dehiscence and poor nutritional intake. 29 days postoperatively, a tremor developed in her upper limbs associated with weakness. Her Glasgow Coma Scale (GCS) fell to 4 and she was transferred to the intensive care unit. The patient was reviewed by multiple specialists and multiple differentials were considered and eliminated...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28807779/syringo-subarachnoid-shunt-for-the-treatment-of-persistent-syringomyelia-following-decompression-for-chiari-type-i-malformation-surgical-results
#5
Jehuda Soleman, Jonathan Roth, Andrea Bartoli, Daniel Rosenthal, Akiva Korn, Shlomi Constantini
BACKGROUND: Approximately 30% of patients treated by foramen magnum decompression (FMD) for Chiari I-associated-syringomyelia will show persistence, recurrence, or progression of the syrinx. OBJECTIVE: This study evaluates the clinical and radiological outcome of syringo-subarachnoid shunt (SSS) as the treatment for persistent syringomyelia after FMD. METHODS: Data was collected retrospectively. The primary outcome measurement was neurological function (assessed with the Modified Japanese Orthopedic Association (mJOA) scale)...
August 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28807399/wound-closure-tension-relieving-techniques-and-local-flaps
#6
REVIEW
Laura C Cuddy
Wounds are often addressed by primary or delayed primary closure. Although many skin wounds could go on to heal by second intention, this results in a less cosmetic outcome, takes longer, and in the long run, is often more expensive. As a general rule, the simplest method of wound closure that is likely to succeed should be chosen. If tension is present at the wound edges, wound dehiscence is likely to occur. Using specific techniques to relieve tension on wound edges and recruiting local flaps from neighboring regions are useful ways to achieve wound closure...
August 11, 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28806210/risk-stratification-for-major-postoperative-complications-in-patients-undergoing-intra-abdominal-general-surgery-using-latent-class-analysis
#7
Minjae Kim, Melanie M Wall, Guohua Li
BACKGROUND: Preoperative risk stratification is a critical element in assessing the risks and benefits of surgery. Prior work has demonstrated that intra-abdominal general surgery patients can be classified based on their comorbidities and risk factors using latent class analysis (LCA), a model-based clustering technique designed to find groups of patients that are similar with respect to characteristics entered into the model. Moreover, the latent risk classes were predictive of 30-day mortality...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28805950/management-of-osteonecrosis-of-the-femoral-head-with-pedicled-iliac-bone-flap-transfer-a-multicenter-study-of-2190-patients
#8
Dewei Zhao, Hui Xie, Yongqing Xu, Yisheng Wang, Aixi Yu, Youwen Liu, Aimin Wang, Wei He, Xiuli Wang, Zirong Li, Wei Sun, Simiao Tian, Benjie Wang, Baoyi Liu
BACKGROUND: Osteonecrosis of the femoral head (ONFH) often affects young active adults and leads to destruction of the hip joint and disabling arthritis. Several procedures have been developed to arrest the progress of osteonecrosis and postpone the procedure of total hip replacement especially in young patients. The aim of this multicenter study was to analyze the results of the use of the vascularized iliac bone flap transfer for management of ONFH. METHODS: From January 1985 to December 2012, a total of 2190 patients (2690 hips) with the mean age of 43...
August 14, 2017: Microsurgery
https://www.readbyqxmd.com/read/28801877/are-barbed-sutures-associated-with-90-day-reoperation-rates-after-primary-tka
#9
Daniel C Austin, Benjamin J Keeney, Brendan E Dempsey, Karl M Koenig
BACKGROUND: Studies have suggested that barbed sutures for wound closure in TKAs are an acceptable alternative to standard methods. However others have observed a higher risk of wound-related complications with barbed sutures. QUESTIONS/PURPOSES: (1) Do 90-day TKA reoperation rates differ between patients undergoing a barbed suture arthrotomy closure compared with a traditional interrupted closure? (2) Do the 90-day reoperation rates of wound-related, deep infection, and arthrotomy failure complications differ between barbed suture and traditional closures? METHODS: A retrospective analysis of a longitudinally maintained institutional primary TKA database was conducted on all TKAs performed between April 2011 and September 2015...
August 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28800928/post-operative-bracing-after-pedicle-screw-fixation-for-thoracolumbar-burst-fractures-a-cost-effectiveness-study
#10
REVIEW
Matthew Piazza, Saurabh Sinha, Prateek Agarwal, Arka Mallela, Nikhil Nayak, James Schuster, Sherman Stein
PURPOSE: While frequently prescribed to patients following fixation for spine trauma, the utility of spinal orthoses during the post-operative period is poorly described in the literature. In this study, we calculated rates of reoperation and performed a decision analysis to determine the utility of bracing following pedicle screw fixation for thoracic and lumbar burst fractures. METHODS: Pubmed was searched for articles published between 2005 and 2015 for terms related to pedicle screw fixation of thoracolumbar fractures...
August 8, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28797517/gynecologic-anatomic-abnormalities-following-anorectal-malformations-repair
#11
Alejandra Vilanova-Sanchez, Carlos A Reck, Kate A McCracken, Victoria A Lane, Alessandra C Gasior, Richard J Wood, Marc A Levitt, Geri D Hewitt
BACKGROUND/AIM: Patients may present with gynecologic concerns after previous posterior sagittal anorectoplasty (PSARP) for repair of an anorectal malformation (ARM). Common findings include an inadequate or shortened perineal body, as well as introital stenosis, retained vaginal septum, and remnant rectovestibular fistula. An inadequate or shortened perineal body may impact fecal continence, sexual function and recommendations regarding obstetrical mode of delivery. We describe our experience with female patients referred to our center for evaluation of their previously repaired ARM, with a specific focus on perineal body anatomy and concomitant gynecologic abnormalities...
July 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28793003/complete-axillary-dissection-without-drainage-for-the-surgical-treatment-of-breast-cancer-a-randomized-clinical-trial
#12
Ruffo Freitas-Junior, Luís Fernando Jubé Ribeiro, Marise Amaral Rebouças Moreira, Geraldo Silva Queiroz, Maurício Duarte Esperidião, Marco Aurélio Costa Silva, Rubens José Pereira, Rossana Araújo Catão Zampronha, Rosemar Macedo Sousa Rahal, Leonardo Ribeiro Soares, Danielle Laperche Dos Santos, Maria Virginia Thomazini, Cassiana Ferreira Silva de Faria, Régis Resende Paulinelli
OBJECTIVE: This randomized clinical trial evaluated the possibility of not draining the axilla following axillary dissection. METHODS: The study included 240 breast cancer patients who underwent axillary dissection as part of conservative treatment. The patients were divided into two groups depending on whether or not they were subjected to axillary drainage. ClinicalTrials.gov: NCT01267552. RESULTS: The median volume of fluid aspirated was significantly lower in the axillary drainage group (0...
July 2017: Clinics
https://www.readbyqxmd.com/read/28790002/reduced-impact-of-smoking-status-on-30-day-complication-and-readmission-rates-after-elective-spinal-fusion-%C3%A2-3-levels-for-adult-spine-deformity-a-single-institutional-study-of-839-patients
#13
Aladine A Elsamadicy, Owoicho Adogwa, Amanda Sergesketter, Victoria D Vuong, Emily Lydon, Shay Behrens, Joseph Cheng, Carlos A Bagley, Isaac O Karikari
BACKGROUND: Smoking status has been shown to affect postoperative outcomes after surgery. The aim of this study is to determine if patients' smoking status impacts 30-day complication and re-admission rates after elective complex spinal fusion (≥3 levels). METHODS: The medical records of 839 adult spinal deformity patients undergoing elective complex spinal fusion (≥3 levels) at a major academic institution from 2005 to 2015 were reviewed. We identified 124(14...
August 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28779808/evans-osteotomy-complications
#14
REVIEW
Marcelo E Jara
In 1975, Evans published an article describing the surgical management of the "calcaneo-valgus deformity," pointing out that the deformity was due to relative shortening of the lateral column of the foot. Correction involved "equalizing" both columns by performing an osteotomy in the neck of the calcaneus 1.5 cm from the calcaneocuboid joint, where a trapezoidal wedge of tricortical bone was placed. Although it was considered a success, there were complications, including sural nerve injury, surgical wound dehiscence, undercorrection, and graft subsidence...
September 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28770482/a-minimally-invasive-approach-for-inguinal-lymphadenectomy-in-melanoma-and-genitourinary-malignancy-long-term-outcomes-in-an-attempted-randomized-control-trial
#15
Lauren M Postlewait, Clara R Farley, Maggie L Diller, Benjamin Martin, M Hart Squires, Maria C Russell, Monica Rizzo, Kenneth Ogan, Viraj Master, Keith Delman
BACKGROUND: Open inguinal lymphadenectomy (OIL) has a high incidence of complications. The authors adapted and reported a minimally invasive technique [videoscopic inguinal lymphadenectomy (VIL)] for use with melanoma, subsequently pursuing a randomized, prospective trial comparing open and minimally invasive approaches in an attempt to confirm retrospective findings illustrating reduced complications with the minimally invasive approach. METHODS: A randomized, prospective trial (NCT01526486) was designed to compare outcomes for patients undergoing VIL versus OIL...
August 2, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28770293/case-series-of-patients-with-pathological-dyaphiseal-fractures-from-metastatic-bone-disease
#16
Dinu Vermesan, Radu Prejbeanu, Horia Haragus, Alis Dema, Manuel D Oprea, Diana Andrei, Dan V Poenaru, Marius Niculescu
INTRODUCTION: Fractures on pathologic bone have major impact on life quality. The appropriate treatment is not standardized, but the current literature delineates that surgery must provide adequate stabilization for the life expectancy. We aimed to review the epidemiology, treatment outcomes and survival in our department. MATERIAL AND METHODS: The electronic database from a major referral centre was searched for patients treated for tumours and fractures by the corresponding ICM-10 codes over five years...
August 2, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28765066/outcomes-of-single-staged-phalloplasty-by-pedicled-anterolateral-thigh-flap-versus-radial-forearm-free-flap-in-gender-confirming-surgery
#17
Mona Ascha, Jonathan P Massie, Shane D Morrison, Curtis N Crane, Mang L Chen
PURPOSE: Phalloplasty is a critical step in female-to-male (transmale) gender-confirming genital surgery. This study examines outcomes between transmales who had phalloplasty with vaginectomy and full-length urethroplasty utilizing the anterolateral thigh pedicled flap (pALT) or radial forearm free flap (RFFF). MATERIALS AND METHODS: A single-center retrospective study of patients undergoing phalloplasty with vaginectomy and full-length urethroplasty using either an pALT or RFFF from April 2013 to July 2016 was performed...
July 29, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28761272/efficacy-of-murva-sansevieria-roxburghiana-schult-and-schult-f-as-a-suture-material-in-closure-of-incisions-in-third-molar-surgeries-a-prospective-study
#18
Pravin Lambade, Ashutosh Thorat
INTRODUCTION: Adequate closure of the surgical wound is one of the most important aspects of surgery; improper suturing techniques or improper suturing materials sometimes compromise the success of surgery. Many synthetic materials have replaced the natural materials, which were once used for suturing in the ancient era, and Murva is one of them. There are references of Murva (Sansevieria roxburghiana Schult. and Schult.f.) at various contexts of "Sushruta Samhita" where it has been used as a suture material...
January 2017: National Journal of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28757401/impact-of-adjuvant-systemic-chemotherapy-on-wound-healing-and-cosmetic-outcome-in-224-women-treated-with-accelerated-partial-breast-irradiation-using-interstitial-brachytherapy
#19
Ashwini Budrukkar, Prakash Pandit, Tabassum Wadasadawala, Ritu Raj Upreti, Rakesh Jalali, Sudeep Gupta, Tanuja Shet, Vani Parmar, Rajendra Badwe, Rajiv Sarin
PURPOSE: To evaluate the impact of timing of adjuvant chemotherapy on wound healing and cosmetic outcome in women treated with accelerated partial breast irradiation (APBI). METHODS AND MATERIALS: Between August 2000 to December 2011, 224 women were treated with APBI using multicatheter interstitial high-dose-rate brachytherapy. Patients were treated to a dose of 34 Gy/10#/5-7 days with bid regimen. Systemic chemotherapy was administered as per the standard guidelines...
July 27, 2017: Brachytherapy
https://www.readbyqxmd.com/read/28751430/persistent-air-leak-after-pulmonary-transplantation
#20
Laurence Pearmain, Piotr Krysiak, John Blaikley, Mohamed Alaloul
A 59-year-old man with bilateral apical emphysema underwent a double lung transplant for end-stagechronic obstructive pulmonary disease leaving remnant right apical native tissue due to pleural adhesions. Initial postoperative course was uneventful until the chest drains were removed. This revealed a small pneumomediastinum, which progressively increased in size causing gross surgical emphysema. Re-insertion of the chest drain stabilised the patient so that the cause could be identified and corrected. Two bronchoscopies excluded anastomotic dehiscence as a cause...
July 27, 2017: BMJ Case Reports
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