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Wound dehiscence

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https://www.readbyqxmd.com/read/29686547/comparison-of-a-standardized-negative-pressure-wound-therapy-protocol-after-midline-celiotomy-to-primary-skin-closure-and-traditional-open-wound-vacuum-assisted-closure-management
#1
Justin L Regner, Matthew J Forestiere, Yolanda Munoz-Maldonado, Richard Frazee, Travis S Isbell, Claire L Isbell, Randall W Smith, Stephen W Abernathy
A negative pressure wound therapy (NPWT) protocol using Hydrofera Blue® bacteriostatic foam wicks and silver-impregnated foam overlay to close midline skin incisions after emergency celiotomy was compared to primary skin closure only and traditional open wound vacuum-assisted closure management as part of a quality improvement initiative. This single-institution retrospective cohort study assessed all consecutive emergency celiotomies from July 2013 to June 2014 excluding clean wounds. Included variables were demographics, wound classification, NPWT days, and surgical site occurrences (SSOs)...
January 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29685567/minimally-invasive-treatment-of-ankle-fractures-in-patients-at-high-risk-of-soft-tissue-wound-healing-complications
#2
REVIEW
Sherif Mohamed Abdelgaid, Ahmed Fawaz Moursy, Eyad Abd Allah Elgebaly, Aly Mohamed Aboelenien
The complex nature of ankle fractures is magnified when seen in patients at high risk of soft tissue wound healing complications. The major categories include associated soft tissue injury, diabetes, tobacco use, peripheral vascular disease, malnutrition, alcoholism, and corticosteroid use. Because of the potential for wound dehiscence and infection with open reduction and internal fixation of ankle fractures in these patients, minimally invasive procedures have been described. The aims of the present study were to assess the possibility for, and evaluate the results and complications of, minimally invasive techniques for different types of malleolar fractures in high-risk patients...
May 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29683248/computer-guided-chin-harvest-a-novel-approach-for-autogenous-block-harvest-from-the-mandibular-symphesis
#3
Ahmed H Osman, Mohammed Atef
BACKGROUND: The introduction of CAD/CAM technology allowed clinicians to carry out complex procedures with a high level of precision and reproducibility and minimize the risk of injury during the procedure. PURPOSE: The aim of the present study is to evaluate the efficacy of the CAD/CAM surgical guide during chin harvesting procedures in reducing the risk of neurosensory damage and patient morbidity compared with the standard technique. MATERIALS AND METHODS: About 20 cases of autogenous block chin harvest were randomly into two groups...
April 23, 2018: Clinical Implant Dentistry and related Research
https://www.readbyqxmd.com/read/29682010/craniofacial-trauma-in-pediatric-patients-following-winnowing-blade-injury-review-of-literature
#4
REVIEW
Harsha Huliyappa, Balakrishna Ojha, Anil Chandra, Sunil Kumar Singh, Chhitij Srivastava
In developing countries, during the harvest season, winnower blade injuries occur very frequently in children and results in lifelong disability. Nine children were managed during 1 month, all resulting due to winnower blade induced craniofacial trauma. PubMed search for "fan blade injury" showed two case series and three case reports. In our study, 88% had compound depressed fracture; brain matter leak in 56%, cerebrospinal fluid (CSF) leak alone in 22%. 66.7% had injury involving the frontal bone...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29681693/anorectal-malformations-in-adolescent-females-a-retrospective-study
#5
Jiledar Rawat, Sudhir Singh, Nitin Pant
Context: While most of the females with anorectal malformations (ARMs) present in either neonatal period or early infancy, a small percentage presents in their adolescence. Aim: The aim is to study the causes of delay in presentation, management, and postoperative outcome in these cases. Settings and Design: This is a retrospective observational study conducted in the Department of Paediatric Surgery, King George's Medical University, Lucknow...
April 2018: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/29681629/incidence-of-complications-in-dermatological-surgery-of-melanoma-and-non-melanoma-skin-cancer-in-patients-with-multiple-comorbidity-and-or-antiplatelet-anticoagulants-five-year-experience-in-our-hospital
#6
Lilia Arguello-Guerra, Estefanía Vargas-Chandomid, Jose Manuel Díaz-González, Silvia Méndez-Flores, Ana Ruelas-Villavicencio, Judith Domínguez-Cherit
Introduction: Surgery is performed more frequently now at days, due to the increasing incidence of melanoma and no-melanoma skin cancer. There are different opinions among dermatologic surgeons between to continue or discontinue antithrombotic therapy prior to the procedure, which increases the risk of thromboembolic events. Prophylaxis with oral antibiotics in the postsurgical period is controversial. Objective: To report the safety of surgery without suspending antithrombotic therapy and without oral antibiotic prophylaxis in dermatology surgery of patients with multiple comorbidities and polypharmacy...
2018: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/29679726/late-presenting-dural-tear-incidence-risk-factors-and-associated-complications
#7
Wesley M Durand, J Mason DePasse, Eren O Kuris, JaeWon Yang, Alan H Daniels
BACKGROUND CONTEXT: Unrecognized and inadequately repaired intraoperative durotomies may lead to cerebrospinal fluid leak, pseudomeningocele, and other complications. Few studies have investigated durotomy that is unrecognized intraoperatively and requires additional postoperative management (hereafter, late-presenting dural tear [LPDT]), though estimates of LPDT range from 0.6 - 8.3 per 1,000 spinal surgeries. These single-center studies are based on relatively small sample sizes for an event of this rarity, all with <10 patients experiencing LPDT...
April 18, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29678699/acute-communicating-hydrocephalus-as-spinal-cord-surgery-complication-in-a-patient-with-lumbar-lipomyelocele-case-report
#8
Alessandro Prior, Mariasavina Severino, Andrea Rossi, Marco Pavanello, Gianluca Piatelli, Alessandro Consales
BACKGROUND: A lumbar lipomyelocele is a closed spinal dysraphism that can cause tethered cord syndrome. Between 5-15% of spinal dysraphism surgery cases are burdened with complications, the most common being wound infections or dehiscence and cerebrospinal fluid leak. Acute communicating hydrocephalus has never been described as a complication of this type of surgery. CASE DESCRIPTION: A 6-year-old girl, who had undergone several surgeries in another Institution for lumbar lipomyeloschisis, came to our attention for a second opinion about the management of her spinal dysraphism...
April 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29675345/comparison-of-endoscopic-and-external-dacryocystorhinostomy-for-treatment-of-primary-acquired-nasolacrimal-duct-obstruction
#9
Pei-Yuan Su
PURPOSE: The purpose of this study is to compare the success rates of endoscopic endonasal dacryocystorhinostomy (EN-DCR) and external DCR (EX-DCR) for the treatment of primary acquired nasolacrimal duct obstruction (PANLDO). DESIGN: This was a retrospective, comparative, nonrandomized clinical study. METHODS: Reviewed medical records of PANLDO underwent DCR at Far-Eastern Memorial Hospital from May 2011 to June 2017. Data regarding the lacrimal passage system, comorbidities, surgical outcomes, and postoperative complications were analyzed...
January 2018: Taiwan Journal of Ophthalmology
https://www.readbyqxmd.com/read/29667926/proximal-tibia-stress-fracture-with-osteoarthritis-of-knee-radiological-and-functional-analysis-of-one-stage-tka-with-long-stem
#10
Dhanasekaran Soundarrajan, Natesan Rajkumar, Palanisamy Dhanasekararaja, Shanmuganathan Rajasekaran
INTRODUCTION: Proximal tibia stress fractures with knee osteoarthritis pose a challenging situation. We evaluated the radiological and functional outcome of one-stage total knee arthroplasty (TKA) and long stem for patients with varied grades of knee arthritis and proximal tibia stress fractures.  Methods: We analysed 20 patients from April 2012 to March 2017 with proximal tibia stress fractures associated with knee osteoarthritis of varied grades. Out of 20 patients, five were acute fresh fractures...
2018: SICOT-J
https://www.readbyqxmd.com/read/29660388/outcomes-of-gracilis-muscle-flaps-in-the-management-of-groin-complications-after-arterial-bypass-with-prosthetic-graft
#11
Anahita Dua, Vy T Ho, Christina Rao, Sapan S Desai
INTRODUCTION: This study details two-year outcomes of a modified gracilis muscle flap (GMF) technique in providing tissue coverage for groin complications after arterial bypass surgery with synthetic graft. METHODS: All patients who developed groin infections after lower extremity arterial bypass with synthetic graft that underwent a GMF were included from June 2014 to March 2017 from a prospectively collected, purpose-built institutional database. Modifications to the standard technique included identification of the muscle using ultrasound to ensure precise skip incisions, preservation of the segmental blood supply, widening of the tunnel through which the muscle is retroflexed, placement of a wound VAC for healing, and lifelong antibiotics...
April 13, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29656973/how-fast-should-a-total-knee-arthroplasty-be-performed-an-analysis-of-140-199-surgeries
#12
Jaiben George, Bilal Mahmood, Assem A Sultan, Nipun Sodhi, Michael A Mont, Carlos A Higuera, Kim L Stearns
BACKGROUND: Although previous studies have shown that prolonged operative times can lead to an increased risk of complications after total knee arthroplasty (TKA), they only evaluated a few complications. It is also unclear whether a distinctive operative time exists after which complications increase. Therefore, this study was performed to (1) assess whether higher operative time increases the risk of complications within 30 days of TKA and (2) explore the relationship between operative time and various complications to identify possible operative times where complication rates increase...
March 13, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29655664/a-retrospective-investigation-of-abdominal-visceral-fat-body-mass-index-bmi-and-active-smoking-as-risk-factors-for-donor-site-wound-healing-complications-after-free-diep-flap-breast-reconstructions
#13
Floyd W Timmermans, Pèdrou B Westland, Stefan Hummelink, Joep Schreurs, Marijn Hameeteman, Dietmar J O Ulrich, Nicholas J Slater
BACKGROUND: The deep inferior epigastric artery perforator (DIEP) flap is one of the most common techniques for breast reconstruction. Body mass index (BMI) is considered as an important predictor of donor site healing complications such as wound dehiscence. The use of computed tomography (CT) proved to be a precise and objective method to assess visceral adipose tissue. It remains unclear whether quantification of visceral fat provides more accurate predictions of abdominal wound healing complications than BMI...
March 28, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29652536/computed-tomography-assisted-auricular-cartilage-graft-for-depression-of-the-alar-base-in-secondary-unilateral-cleft-lip-repair-a-preliminary-report
#14
Hong Chen, Chun-Ye Chen, Qing-Qing Fang, Min-Xia Zhang, Wan-Yi Zhao, Xiao-Feng Wang, Wei-Qiang Tan, Li-Yun Zhang
OBJECTIVES: To evaluate the feasibility, effectiveness, and safety of computed tomography-assisted auricular cartilage grafting for treating alar base depression secondary to unilateral cleft lip. DESIGN AND SETTING: For patients with obvious depression of the alar base, the difference in heights of the alar base and the piriform margin between the cleft side and the noncleft side were measured with computed tomography. If both were >3.0 mm, the cartilage was harvested postauricularly and subdivided into 2 to 4 pieces...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29650355/a-prospective-study-examining-the-effects-of-treatment-timing-in-the-management-of-mandible-fractures
#15
M J L Hurrell, M C David, M D Batstone
The ideal timing for treatment of mandible fractures has not been well established. The objective of this study was to analyse the effects of treatment timing in the surgical management of mandible fractures. A prospective evaluation of 215 continuous patients with a total of 359 mandible fractures was undertaken. Nine outcome variables were analysed in relation to treatment delay by logistic regression modelling: wound dehiscence, hardware exposure, local postoperative infection, malocclusion, trismus, nerve damage, fracture non-union, return to theatre, and radiographic outcome...
April 10, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29644884/prospective-analysis-of-surgical-bone-margins-after-partial-foot-amputation-in-diabetic-patients-admitted-with-moderate-to-severe-foot-infections
#16
Brian M Schmidt, Jonathan B McHugh, Rajiv M Patel, James S Wrobel
BACKGROUND: Osteomyelitis is common in diabetic foot infections and medical management can lead to poor outcomes. Surgical management involves sending histopathologic and microbiologic specimens which guides future intervention. We examined the effect of obtainment of surgical margins in patients undergoing forefoot amputations to identify patient characteristics associated with outcomes. Secondary aims included evaluating interobserver reliability of histopathologic data at both the distal-to and proximal-to surgical bone margin...
April 1, 2018: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29629896/the-v-y-flap-technique-in-complicated-and-recurrent-pilonidal-sinus-disease
#17
Yavuz Savas Koca, Ihsan Yıldız, Mustafa Ugur, Ibrahim Barut
OBJECT VES: This study presents early and long term (5 years) outcome of 61 complicated pilonidal sinus disease cases undergoing V-Y advancement flap method together with the literature data. METHOD: Data of 336 patients undergoing surgery for pilonidal sinus disease between 2008 and 2012 were retrospectively analyzed. Patients with defect size ≥ 10 cm, and more than one subcutaneous sinus tunnels were assumed to have complicated pilonidal sinus disease. A total of 61 patients were included in the study...
2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29627154/how-to-close-classic-bladder-exstrophy-are-subspecialty-training-and-technique-important
#18
Brian M Inouye, J Todd Purves, Jonathan C Routh, Mahir Maruf, Daniel Friedlander, John Jayman, John P Gearhart
INTRODUCTION: Successful primary closure is one of the main factors for achieving continence in a classic bladder exstrophy (CBE) patient. Even with contemporary management, patients still have failed primary closures. We sought to understand the role of training, surgical technique, and their impacts on outcomes of CBE closure. MATERIALS AND METHODS: A retrospective cohort study from the largest single-institution database of primary and re-closure CBE patients in the world was performed...
March 29, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29627149/combined-bilobed-trapezius-myocutaneous-and-scapula-osteomyocutaneous-flaps-for-the-restoration-of-through-and-through-defects-of-the-mandible-following-salvage-surgery-for-recurrent-head-and-neck-tumours
#19
W-L Chen, Z-Q Huang, B Zhou, Y Wang, R Chen
This study was performed to evaluate the outcomes of combined bilobed trapezius myocutaneous and scapula osteomyocutaneous flaps for the restoration of through-and-through defects of the mandible. The subjects were six patients with recurrent malignant tumours who underwent salvage surgeries and reconstruction with combined flaps based on the transverse cervical vessels (TCVs). All patients had combined bone (four type H, one type LCL, and one type C) and extensive soft tissue defects (through-and-through defects) following salvage surgery...
April 4, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29626245/a-new-method-for-surgical-abdominal-mass-closure-after-abdominal-fascial-dehiscence-using-nasogastric-tube-and-hemovac-perforator-a-case-series-study
#20
Jalal Vahedian, Sepideh Jahanian, Behrouz Banivaheb, Nima Hemmati, Mehrnaz Ghavamipour, Majid Chegini, Mahdi Alemrajabi
BACKGROUND: As the challenge for finding the best abdominal incision closure technique continues, surgeons are aiming to minimize postoperative wound complications such as wound dehiscence and hernia as an acute or late manifestation. In order to achieve this goal, several abdominal opening and closure techniques have been tried. In this article, we describe a method in which we used a nasogastric tube (NGT) in mass closure for patients with fascial dehiscence. METHODS: In this case-series study, a total number of 25 patients participated...
April 6, 2018: World Journal of Surgery
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