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Wound dehiscence

Jesús A Morales-Gómez, Everardo Garcia-Estrada, Jorge E Leos-Bortoni, Miriam Delgado-Brito, Luis E Flores-Huerta, Adriana A De La Cruz-Arriaga, Luis J Torres-Díaz, Ángel R Martínez-Ponce de León
OBJECTIVE Cranioplasty implants should be widely available, low in cost, and customized or easy to mold during surgery. Although autologous bone remains the first choice for repair, it cannot always be used due to infection, fragmentation, bone resorption, or other causes, which led to use of synthetic alternatives. The most frequently used allogenic material for cranial reconstructions with long-term results is polymethylmethacrylate (PMMA). Three-dimensional printing technology has allowed the production of increasingly popular customized, prefabricated implants...
June 15, 2018: Journal of Neurosurgery
D A Weiss, C J Long, J R Frazier, A R Shukla, A K Srinivasan, T F Kolon, H DiCarlo, J P Gearhart, D A Canning
INTRODUCTION: Re-operative penile reconstruction is challenging and requires tension-free skin closure. The repair popularized by Cecil and Culp in the 1940s, using the scrotum to provide a temporary vascularized bed for complex hypospadias repairs, fell out of favor due to temporal trends towards single-stage repairs and concern for utilizing hair-bearing skin on the penile shaft. OBJECTIVE: It was hypothesized that a modified Cecil-Culp (CC) concept of penile scrotalization, leaving the penis attached to the scrotum for 1 year rather than 6 weeks as originally described, improves outcomes with this reconstruction for ventral skin deficiency or poor vascular support...
May 30, 2018: Journal of Pediatric Urology
Katy L Townsend, Jen Akeroyd, Duncan S Russell, Jamie J Kruzic, Bria L Robertson, William Lear
Objective: To compare the tolerability and mechanical tensile strength of acute skin wounds closed with nylon suture plus a novel suture bridge device (SBD) with acute skin wounds closed with nylon suture in a porcine model. Approach: Four Yucatan pigs each received 12 4.5 cm full-thickness incisions that were closed with 1 of 4 options: Suture bridge with nylon, suture bridge with nylon and subdermal polyglactin, nylon simple interrupted, and nylon simple interrupted with subdermal polyglactin. Epithelial reaction, inflammation, and scarring were examined histologically at days 10 and 42...
June 1, 2018: Advances in Wound Care
Philipp Franck, Jaime L Bernstein, Leslie E Cohen, Roger Härtl, Ali A Baaj, Jason A Spector
OBJECTIVES: Patients with neoplastic disease involving the spine either from primary or metastatic disease present a unique challenge given these patients' frequent poor nutritional status at the time of surgery, the delivery of early post-operative chemotherapy or radiation, and placement of large amounts of hardware and avascular bone graft into a wound bed that is atrophic, previously operated or irradiated. As a result, wound morbidity has traditionally been high in this cohort of patients...
May 29, 2018: Clinical Neurology and Neurosurgery
David J Kirby, Harry C Dietz, Paul D Sponseller
BACKGROUND: We studied the prevalence and treatment outcomes of spondylolisthesis in patients with Loeys-Dietz syndrome (LDS). METHODS: Clinical data and lumbosacral imaging of 138 patients with LDS were reviewed. Spondylolisthesis (L4-L5 or L5-S1) and spondylolysis were characterized by multimodal imaging and correlated with clinical data. Treatments and outcomes were characterized for patients with spondylolisthesis. Associations were determined using the Fisher exact, Mann-Whitney, and Student t tests (α=0...
June 8, 2018: Journal of Pediatric Orthopedics
Roxane H MacLellan, Jennifer E Rawlinson, Sangeeta Rao, Deanna R Worley
OBJECTIVE To characterize and identify factors associated with intraoperative and postoperative complications of maxillectomy in dogs with oral tumors. DESIGN Retrospective cohort study. ANIMALS 193 dogs that underwent maxillectomy for oral tumor excision from 2000 through 2011. PROCEDURES Data were extracted from the medical records regarding dog signalment, tumor location and size, histologic findings, clinical stage, maxillectomy category, surgical approach, and additional treatments provided. These factors were examined for associations with recorded intraoperative and postoperative outcomes...
June 15, 2018: Journal of the American Veterinary Medical Association
Michael Benson, Moneer K Hanna
INTRODUCTION: Congenital scrotal agenesis (CSA) is an extremely rare condition with fewer than 10 cases reported in the literature. These patients are often further complicated by undescended testicles as well as systemic developmental disorders. Herein, we report our experience and an innovative surgical technique for creation of a neo-scrotum in three children. MATERIALS AND METHODS: We evaluated the records of three children in our database who were labeled as having an absent (1 patient) or severely underdeveloped scrotum (2 patients)...
May 5, 2018: Journal of Pediatric Urology
J Mason DePasse, Wesley Durand, Adam E M Eltorai, Mark A Palumbo, Alan H Daniels
Study design: Retrospective cohort study. Objective: To characterize the timing of complications after posterior cervical fusion. Summary of background data: Understanding the expected timing of postoperative complications facilitates early diagnosis of potential adverse events and is important for optimizing postoperative care. Though studies have examined the incidence of complications after posterior cervical fusion, no study has characterized the timing of these complications...
June 2018: Journal of Orthopaedics
Ho Sik Hwang, Kyong Jin Cho, Gabriel Rand, Roy S Chuck, Ji Won Kwon
BACKGROUND: In our study we describe a method that optimizes size of excision and autografting for primary pterygia along with the use of intraoperative MMC and fibrin glue. Our objective is to propose a simple, optimizedpterygium surgical technique with excellent aesthetic outcomes and low rates of recurrence and otheradverse events. METHODS: Retrospective chart review of 78 consecutive patients with stage III primary pterygia who underwent an optimal excision technique by three experienced surgeons...
June 7, 2018: BMC Ophthalmology
Sarah M Elswick, Christin A Harless, Sarah N Bishop, Cathy D Schleck, Jay Mandrekar, Ryan D Reusche, Robert W Mutter, Judy C Boughey, Steven R Jacobson, Valerie Lemaine
BACKGROUND: Two-stage subpectoral implant-based breast reconstruction (IBBR) is the most common method for breast reconstruction. Recent advances in surgical techniques and technology have made prepectoral IBBR feasible. There is limited data on outcomes after prepectoral IBBR and post-mastectomy radiation therapy (PMRT). METHODS: A retrospective review of consecutive patients undergoing immediate two-stage prepectoral IBBR with PMRT was performed. Outcomes of radiated breasts were compared with non-radiated breasts in bilateral cases...
March 26, 2018: Plastic and Reconstructive Surgery
Alex Gu, Chapman Wei, Camilla M Maybee, Shane A Sobrio, Matthew P Abdel, Peter K Sculco
BACKGROUND: Total knee arthroplasty (TKA) utilization is increasing in older Americans. The incidence of chronic obstructive pulmonary disease (COPD) has been steadily rising over the past few decades. In particular, COPD is being increasingly more common in patients undergoing revision TKA. The aim of this study is to identify the impact of COPD on postoperative complications for patients undergoing revision TKA. METHODS: A retrospective cohort study was conducted using data collected through the American College of Surgeons National Quality Improvement Program Database...
May 14, 2018: Journal of Arthroplasty
Folusakin Ayoade, Pradeep Kumar Mada, Mohammad Alam
Raoultella ornithinolytica is a rare opportunistic aerobic gram-negative bacillus that naturally exists in soil, water and plants. The pathogen has been described in association with diabetic foot infections, biliary infections, bacteraemia and native and prosthetic joint infections. Fat necrosis and wound infection following breast reduction surgery or other plastic surgeries caused by this pathogen have not been previously described. We present a case of bilateral fat necrosis, wound infection and dehiscence in a 24-year-old woman with no significant past medical problems...
June 4, 2018: BMJ Case Reports
Caitlin Cahill, Amanda Fowler, Lara J Williams
Impaired perineal wound healing is a major source of morbidity after abdominoperineal resection. Incisional negative pressure wound therapy can improve healing, prevent infections, and decrease the frequency of dehiscence. Our objective was to summarise existing evidence on the use of incisional negative pressure wound therapy on perineal wounds after abdominoperineal resection and to determine the effect on perineal wound complications. Electronic databases were searched in January 2017. Studies describing the use of incisional negative pressure wound therapy on primarily closed perineal wounds after abdominoperineal resection were included...
June 4, 2018: International Wound Journal
Kazuhiro Yoshida, Michitaka Honda, Hiraku Kumamaru, Yasuhiro Kodera, Yoshihiro Kakeji, Naoki Hiki, Tsuyoshi Etoh, Hiroaki Miyata, Yuichi Yamashita, Yasuyuki Seto, Seigo Kitano, Hiroyuki Konno
To clarify the safety profile of laparoscopic distal gastrectomy (LDG) for gastric cancer patients, the short-term outcome of LDG was compared to that of open distal gastrectomy (ODG) by propensity score matching using data from the Japanese National Clinical Database (NCD). We conducted a retrospective cohort study of patients undergoing distal gastrectomy between January 2012 and December 2013. Using the data for 70 346 patients registered in the NCD, incidences of mortality and morbidities were compared between LDG patients and ODG patients in the propensity score matched stage I patients (ODG: n = 14 386, LDG: n = 14 386) and stage II-IV patients (ODG: n = 3738, LDG: n = 3738), respectively...
January 2018: Annals of gastroenterological surgery
Chun-Dong Zhang, Hiroharu Yamashita, Shun Zhang, Yasuyuki Seto
BACKGROUND: The benefits and risks of laparoscopic distal gastrectomy (LADG) are not yet sufficiently clear for acceptance as a standard treatment of early gastric cancer. Previous meta-analyses were not powered to reach definitive conclusions. MATERIALS AND METHODS: Randomized controlled trials comparing LADG with open distal gastrectomy (ODG) for early gastric cancer in Asia and published between January 1994 and January 2018 were retrieved from PubMed, Embase, the Cochrane Library, and Google Scholar...
May 31, 2018: International Journal of Surgery
Ioannis Tilaveridis, Maria Lazaridou, Lambros Zouloumis, Ioannis Dimitrakopoulos, Vasilis Tilaveridis, Sofia Tilaveridou
OBJECTIVE: The primary aim of our study was to evaluate the efficacy of mineralized bone allograft alone in sinus floor augmentation with simultaneous implant placement in cases with severe atrophy of the residual maxillary bone (bone height < 4 mm). METHODS: Thirty-five dental implants were placed in 29 patients who underwent sinus augmentation via traditional lateral window technique from 2008 to 2013. Patients with residual alveolar height between 1 and 3 mm at the site of implantation were included in the study...
June 1, 2018: Oral and Maxillofacial Surgery
Ken Imaizumi, Yuji Nishizawa, Koji Ikeda, Yuichiro Tsukada, Takeshi Sasaki, Masaaki Ito
PURPOSE: Perineal wound infection (PWI) rates are high after abdominoperineal resection (APR) and total pelvic exenteration (TPE). This study identified risk factors for PWI after surgery for anorectal tumors and examined the relationship between the surgical excision volume with the PWI degree. METHODS: A retrospective review involving 135 patients who underwent surgical excision of anorectal tumors was performed. Superficial PWI included cellulitis and superficial dehiscence; deep PWI included major dehiscence, perineal abscess, and presacral abscess...
June 1, 2018: Surgery Today
Lei Gao, Shuo Wang, Lei Wang, Jiangning Wang
Objective: To evaluate the clinical value of skin stretching device in repair of diabetic foot wound. Methods: A retrospective analysis was made on the clinical data of 48 cases with diabetic foot wound who were treated with skin stretching device (trial group, n =24) and with the vacuum sealing drainage combined with skin graft (control group, n =24) respectively between October 2015 and July 2016. There was no significant difference in gender, age, side, course of disease, TEXAS stage between 2 groups ( P >0...
May 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
D Reichart, C F Brand, A M Bernhardt, S Schmidt, A Schaefer, S Blankenberg, H Reichenspurner, F M Wagner, T Deuse, M J Barten
BACKGROUND:  Minimally invasive left ventricular assist device (LVAD) implantation may reduce peri-/postoperative complications and risks associated with resternotomies. In this study, we describe our first results using a minimally invasive LVAD implantation technique (lateral thoracotomy [LT] group). These results were compared with LVAD implantations done via full median sternotomy (STX group). METHODS:  HVAD (HeartWare, Framingham, Massachusetts, United States) implantations in 70 patients (LT group n  = 22, 52 ± 15 years old; STX group n  = 48, 59 ± 11 years old) were retrospectively analyzed...
May 27, 2018: Thoracic and Cardiovascular Surgeon
Murray Echt, Rafael De la Garza Ramos, Jonathan Nakhla, Yaroslav Gelfand, Phillip Cezayirli, Ryan Holland, Merritt D Kinon, Reza Yassari
PURPOSE: The aim of this study was to evaluate the impact of cigarette smoking on the development of wound complications, including wound dehiscence, superficial infection, deep infection, or organ space infection, within the first 30 postoperative days in patients undergoing surgery for spondylolisthesis. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for the years 2012 - 2014 was used to identify adult patients who underwent single-level posterolateral fusion (PLF) or interbody fusion for spondylolisthesis...
May 23, 2018: World Neurosurgery
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