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https://www.readbyqxmd.com/read/28548471/recurrent-mitral-paravalvular-leak-benefits-of-leak-site-repair-compared-to-re-replacement
#1
Jae-Woong Choi, Ho Y Hwang, Kyung H Kim, Ki-Bong Kim, Hyuk Ahn
BACKGROUND: Mitral paravalvular leak (PVL) recurrence after surgical correction has not yet been well demonstrated. The aims of this study were (1) to evaluate the long-term results of surgical mitral PVL correction, including recurrent PVL, and (2) to elucidate the factors including surgical technique that affect the risk of recurrent PVL. METHODS: Eighty-six patients who underwent surgical treatment for mitral PVL were enrolled in this study. Thirty-six patients underwent leak site repair (MVP group), and 50 patients underwent re-replacement (MVR group)...
May 26, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28545173/comparison-of-short-term-complications-of-general-and-spinal-anesthesia-for-primary-unilateral-total-knee-arthroplasty
#2
Yong Bok Park, Won Seok Chae, Sin Hyung Park, Ji Soo Yu, Sun Geun Lee, Soo Jae Yim
Purpose: To compare the occurrences of perioperative complications of two anesthetic techniques (general anesthesia [GA] and spinal anesthesia [SA] in patients undergoing primary unilateral total knee arthroplasty (TKA). Materials and Methods: Patients who underwent unilateral primary TKA due to osteoarthritis from January 2005 to January 2014 were retrospectively reviewed. They were divided into two groups: GA (n=490) and SA (n=746). The operation duration, length of perioperative stay in the operation room and occurrences of adverse events in postoperative 30 days (mean, 29...
June 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28541804/introduction-to-the-centers-for-disease-control-and-prevention-and-the-healthcare-infection-control-practices-advisory-committee-guideline-for-the-prevention-of-surgical-site-infections
#3
Joseph S Solomkin, John Mazuski, Joan C Blanchard, Kamal M F Itani, Philip Ricks, E Patchen Dellinger, George Allen, Rachel Kelz, Caroline E Reinke, Sandra I Berríos-Torres
Surgical site infection (SSI) is a common type of health-care-associated infection (HAI) and adds considerably to the individual, social, and economic costs of surgical treatment. This document serves to introduce the updated Guideline for the Prevention of SSI from the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC). The Core section of the guideline addresses issues relevant to multiple surgical specialties and procedures. The second procedure-specific section focuses on a high-volume, high-burden procedure: Prosthetic joint arthroplasty...
May 2017: Surgical Infections
https://www.readbyqxmd.com/read/28538579/the-split-pectoralis-flap-combining-the-benefits-of-pectoralis-major-advancement-and-turnover-techniques-in-one-flap
#4
Rodger H Brown, Safa E Sharabi, Katarzyna E Kania, Larry H Hollier, Shayan A Izaddoost
BACKGROUND: The pectoralis major is a versatile flap used as an advancement or turnover flap for sternal wound treatment. The advancement flap provides suboptimal inferior sternal coverage and poorly fills mediastinal dead space. The turnover flap covers the inferior sternum and fills dead space but requires disinsertion of the muscle from the humerus, resulting in functional loss and cosmetic deformity. METHODS: The authors describe a new technique of splitting the pectoralis muscle along its fibers, using the superior portion as an advancement flap and the inferior portion as a turnover flap...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28538044/mycobacterium-chimaera-infections-associated-with-heater-cooler-units-in-cardiac-surgery
#5
Peter W Schreiber, Hugo Sax
PURPOSE OF REVIEW: Mycobacterium chimaera infections following cardiac surgery have been reported from an increasing number of countries. These infections are characterized by a poor prognosis with a case fatality rate around 50% despite treatment. Since the first description in 2013, our understanding has grown steadily. Several outbreak investigations, case series, and experiments with heater-cooler units (HCUs) have been published. This review summarizes the current knowledge. RECENT FINDINGS: M...
May 19, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28536044/free-tissue-transfer-for-necrotizing-fasciitis-reconstruction-a-case-series
#6
Justin Peter Gawaziuk, Tianyi Liu, Leif Sigurdson, Edward Buchel, Thomas Edward Jo Hayakawa, Sarah Shiga, Sarvesh Logsetty
BACKGROUND: Necrotizing fasciitis (NF) is a life-threatening infection requiring extensive debridement that may necessitate amputation. Free tissue transfer (FTT) is an option for reconstruction in difficult cases. Currently, only case reports have described FTT in the setting of NF, and comprehensive evidence on flap outcomes is lacking. The present study characterizes outcomes in patients with FTT following NF. METHODS: All patients admitted with NF between January 1, 2005 and December 31, 2011 to our level 1 burns/trauma referral center were retrospectively reviewed...
May 20, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28534258/closed-incision-prophylactic-negative-pressure-wound-therapy-in-patients-undergoing-major-complex-abdominal-wall-repair
#7
F E E de Vries, J J Atema, O Lapid, M C Obdeijn, M A Boermeester
PURPOSE: To evaluate if incisional prophylactic negative pressure wound therapy (pNPWT) reduces wound infections and other wound complications in high-risk patients undergoing major complex ventral abdominal wall repair. METHODS: Retrospective before-after comparison nested in a consecutive series of patients undergoing elective major complex abdominal wall repair. Starting January 2014, pNPWT was applied on the closed incisional wound for a minimum of 5 days. To minimize selection bias, we compared two periods of 14 months before and after January 2014...
May 23, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28532856/implementation-of-a-referral-to-discharge-glycemic-control-initiative-for-reduction-of-surgical-site-infections-in-gynecologic-oncology-patients
#8
Laura Hopkins, Jennifer Brown-Broderick, James Hearn, Janine Malcolm, James Chan, Wendy Hicks-Boucher, Filomena De Sousa, Mark C Walker, Sylvain Gagné
OBJECTIVE(S): To evaluate the frequency of surgical site infections before and after implementation of a comprehensive, multidisciplinary perioperative glycemic control initiative. STUDY METHODS: As part of a CUSP (Comprehensive Unit-based Safety Program) initiative, between January 5 and December 18, 2015, we implemented comprehensive, multidisciplinary glycemic control initiative to reduce SSI rates in patients undergoing major pelvic surgery for a gynecologic malignancy ('Group II')...
May 20, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28532076/sustained-drug-release-from-surface-modified-uhmwpe-for-acetabular-cup-lining-in-total-hip-implant
#9
R Manoj Kumar, Pallavi Gupta, Sandan Kumar Sharma, Akshat Mittal, Manish Shekhar, Vijayesh Kumar, B V Manoj Kumar, Partha Roy, Debrupa Lahiri
Despite sterilization and aseptic procedure, bacterial infection remains a key challenge in total hip arthroplasties. This fact emphasizes the urgent need for development of new implant systems, which should releases the drug in a controlled manner without sparing its mechanical and tribological properties. In this study, the lining material of the acetabular cup, in total hip implant, has been modified for sustained release of drugs, which should be available throughout the site of implantation to fight the post-operation bacterial infection...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28530629/-laparoendoscopic-single-site-less-ureteral-reimplantation
#10
Pedro M Cabrera Castillo, Felipe Cáceres Jiménez
OBJECTIVE: To present in detail our surgical technique and to show our initial experience with ureteral reimplantation using the transumbilical LESS approach to treat patients with ureteral stenosis secondary to various diseases and surgical complications. METHODS: We performed 7 ureteral reimplantations from February 2012, using the multichannel Richard- Wolf (KeyPort) platform placed transumbilical by a small 2-2,5 cm transversal incision. We always use a 3.5 mm minilaparoscopy accessory trocar in the right iliac fossa, that is crucial to perform the laparoscopic suturing safely for the patient and in an optimal time...
May 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28529860/use-of-chlorhexidine-preparations-in-total-joint-arthroplasty
#11
REVIEW
Jaiben George, Alison K Klika, Carlos A Higuera
Prosthetic joint infection (PJI) is a serious complication after total joint arthroplasty (TJA). Chlorhexidine is a widely used antiseptic because of its rapid and persistent action. It is well tolerated and available in different formulations at various concentrations. Chlorhexidine can be used for pre-operative skin cleansing, surgical site preparation, hand antisepsis of the surgical team and intra-articular irrigation of infected joints. The optimal intra-articular concentration of chlorhexidine gluconate in irrigation solution is 2%, to provide a persistent decrease in biofilm formation, though cytotoxicity might be an issue...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28528712/timing-of-antimicrobial-prophylaxis-and-infectious-complications-in-pediatric-patients-undergoing-appendectomy
#12
Cristen N Litz, Jessica B Asuncion, Paul D Danielson, Nicole M Chandler
PURPOSE: Antibiotic administration within one hour prior to incision is a common quality metric; however, antibiotics are typically started at the time of diagnosis in pediatric patients with acute appendicitis. The purpose was to determine if antibiotic administration within one hour prior to incision reduces the incidence of surgical site infections (SSI) in pediatric patients with acute appendicitis started on parenteral antibiotics upon diagnosis. METHODS: A retrospective review was performed of 478 patients aged 0-18years who underwent appendectomy for acute appendicitis from 7/2013 to 4/2015...
May 11, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28527931/predictors-of-surgical-site-infection-after-open-lower-extremity-revascularization
#13
Frank M Davis, Danielle C Sutzko, Scott F Grey, M Ashraf Mansour, Krishna M Jain, Timothy J Nypaver, Greg Gaborek, Peter K Henke
OBJECTIVE: Surgical site infection (SSI) after open lower extremity bypass (LEB) is a serious complication leading to an increased rate of graft failure, hospital readmission, and health care costs. This study sought to identify predictors of SSI after LEB for arterial occlusive disease and also potential modifiable factors to improve outcomes. METHODS: Data from a statewide cardiovascular consortium of 35 hospitals were used to obtain demographic, procedural, and hospital risk factors for patients undergoing elective or urgent open LEB between January 2012 and June 2015...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28527759/selection-of-new-lactic-acid-bacteria-strains-bearing-probiotic-features-from-mucosal-microbiota-of-healthy-calves-looking-for-immunobiotics-through-in-vitro-and-in-vivo-approaches-for-immunoprophylaxis-applications
#14
Sávio Sandes, Luige Alvim, Bruno Silva, Leonardo Acurcio, Cinara Santos, Márcia Campos, Camila Santos, Jacques Nicoli, Elisabeth Neumann, Álvaro Nunes
From the birth, since their mucosal microbiota and immune system are not fully developed, newborn calves are susceptible to several mucosal pathogenic microorganisms. Operating through humoral and non-humoral mechanisms in the host, several lactic acid bacteria strains bearing probiotic features are often employed in livestock as food supplement, improving animal production performance, promoting health and reducing the severity of mucosal infections. Accordingly, we isolated, species-level identified and screened for their probiotic potentials seventy lactic acid bacteria strains from upper airway, vaginal and intestinal mucosa of healthy calves...
July 2017: Microbiological Research
https://www.readbyqxmd.com/read/28527564/prospective-comparison-of-perioperative-antibiotic-management-protocols-in-oncological-head-and-neck-surgery
#15
Alexander K Bartella, Mohammad Kamal, Jan Teichmann, Anita Kloss-Brandstätter, Timm Steiner, Frank Hölzle, Bernd Lethaus
OBJECTIVES: The adequate perioperative antibiotic prophylaxis in head and neck cancer surgery is an important and easy applicable tool to decrease nosocomial morbidity and mortality by reducing the rate of infections. In the study a strictly perioperative antibiosis is compared with an extended postoperative prophylactic antibiosis. We aim to clarify the value of postoperative prophylactic antibiosis for the recovery and clinical course of patients. MATERIAL AND METHODS: In this prospective study 75 consecutive patients, who underwent major oncological head and neck surgery were included and divided in three groups, each containing 25 patients...
April 20, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28526040/catching-a-floating-thrombus-a-case-report-on-the-treatment-of-a-large-thrombus-in-the-ascending-aorta
#16
Gijs Eduard de Maat, Giorgio Vigano, Massimo Alessandro Mariani, Ehsan Natour
BACKGROUND: The ascending aorta is an uncommon site for non-infective thrombus. In non-aneurysmal and non-atherosclerotic vessels this condition becomes extremely rare, while it represents a source of potential cerebral and peripheral embolic events. Currently, there is no consensus in the guidelines on how to treat a free floating thrombus in ascending aorta, therefore we present our decision making process and therapeutic strategy. CASE PRESENTATION: A healthy 48-year-old man was hospital admitted with acute abdominal pain...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28520886/use-of-an-anaesthesia-workstation-barrier-device-to-decrease-contamination-in-a-simulated-operating-room
#17
S Hunter, D Katz, A Goldberg, H-M Lin, R Pasricha, G Benesh, B Le Grand, S DeMaria
Background.: Strategies to achieve reductions in perioperative infections have focused on hand hygiene among anaesthestists but have been of limited efficacy. We performed a study in a simulated operating room to determine whether a barrier covering the anaesthesia workstation during induction and intubation might reduce the risk of contamination of the area and possibly, by extension, the patient. Methods.: Forty-two attending and resident anaesthetists unaware of the study design were enrolled in individual simulation sessions in which they were asked to induce and intubate a human simulator that had been prepared with fluorescent marker in its oropharynx as a marker of potentially pathogenic bacteria...
May 16, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28512613/comparison-of-complications-following-cranioplasty-using-a-sterilized-autologous-bone-flap-or-polymethyl-methacrylate
#18
Sung Hoon Kim, Dong Soo Kang, Jin Hwan Cheong, Jung Hee Kim, Kwan Young Song, Min Ho Kong
OBJECTIVE: The aims of current study are to compare complications following cranioplasty (CP) using either sterilized autologous bone or polymethyl methacrylate (PMMA), and to identify the risk factors for two of the most common complications: bone flap resorption (BFR) and surgical site infection (SSI). METHODS: Between January 2004 and December 2013, 127 patients underwent CP and were followed at least 12 months. Variables, including sex, age, initial diagnosis, time interval between decompressive craniectomy (DC) and CP, operation time, size of bone flap, and presence of ventriculo-peritoneal shunt, were analyzed to identify the risk factors for BFR and SSI...
April 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/28511308/-blood-borne-occupational-exposure-and-protection-in-medical-staff-of-a-traditional-chinese-medicine-hospital
#19
Z G Zhang, Q X Wei, Z P Yang, Q M Wei, X M Wang, X L Wang
Objective: To investigate blood-borne occupational exposure and related protection in the medical staff of a traditional Chinese medicine hospital, and to provide a reference for reducing the risk of blood-borne occupational exposure. Methods: Forty-eight medical workers with blood-borne occupational exposure in 2015 were selected to analyze the incidence of blood-borne occupational exposure, influencing factors, operations that caused blood-borne occupational exposure, pathogens, and occupational protection...
March 20, 2017: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/28508765/a-comparison-of-outcomes-of-treatment-with-resection-prosthesis-of-the-hip-in-revision-and-oncological-surgery
#20
Paweł Kamiński, Jakub Szmyd, Jarosław Ambroży, Jerzy Mirosław Jaworski, Bogusław Frańczuk
INTRODUCTION: The introduction of resection prostheses paved the way for the development of limb-sparing surgery in patients with primary or metastatic bone tumours. After some time, the developing possibilities of treatment of extensive bone defects allowed for the use of resection prostheses as an emergency procedure in patients undergoing revision surgery due to hip implant loosening. The aim of this paper is to compare treatment outcomes in patients receiving the Modular Universal Tumour and Revision System (MUTARS) resection prosthesis during arthroplasty performed for different indications: treatment of a tumour metastasis and revision surgery in cases of implant loosening...
April 12, 2017: Ortopedia, Traumatologia, Rehabilitacja
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