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Bloodless surgery

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https://www.readbyqxmd.com/read/29752149/tourniquet-pressure-settings-based-on-limb-occlusion-pressure-determination-or-arterial-occlusion-pressure-estimation-in-total-knee-arthroplasty-a-prospective-randomized-double-blind-trial
#1
Bahattin Tuncali, Hakan Boya, Zeynep Kayhan, Sukru Arac
OBJECTIVE: The aim of this study was to compare the limb occlusion pressure (LOP) determination and arterial occlusion pressure (AOP) estimation methods for tourniquet pressure setting in adult patients undergoing knee arthroplasty under combined spinal-epidural anesthesia. METHODS: Ninety-three patients were randomized into two groups. Pneumatic tourniquet inflation pressures were adjusted based either on LOP determination or AOP estimation in Group 1 (46 patients, 38 female and 8 male; mean age: 67...
May 8, 2018: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29671022/-the-minimally-invasive-chevron-and-akin-osteotomy-mica
#2
REVIEW
Sebastian Altenberger, Stefanie Kriegelstein, Oliver Gottschalk, Florian Dreyer, Alexander Mehlhorn, Anke Röser, Markus Walther
OBJECTIVE: Percutaneous correction of a hallux valgus deformity with or without transfer metatarsalgia. INDICATIONS: Hallux valgus deformity up to 20° intermetatarsal angle, without instability of the first tarsometatarsal joint. CONTRAINDICATIONS: Symptomatic arthritis of the first metatarsophalangeal joint, as well as instability of the first tarsometatarsal joint. SURGICAL TECHNIQUE: Percutaneous performed osteotomy of the distal metatarsal 1 in combination with a medial closing wedge osteotomy of the proximal phalanx of the first toe...
April 18, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29660358/a-table-mounted-cardiopulmonary-bypass-system-for-pediatric-cardiac-surgery
#3
Ana Claudia B A Costa, Darren R Parham, Justin E Ashley, Khanh H Nguyen
Systemic inflammatory response and hemodilution are prominent factors associated with cardiopulmonary bypass and result in increased morbidity and mortality in children. Miniaturized systems have evolved in order to decrease such effects and restrict use of blood products, especially in the neonatal population. We have developed a table mounted cardiopulmonary bypass system that allows closer proximity of the system to the patient with consequent decrease in priming volumes, hemodilution, its associated effects and contributes to the development into an ideally bloodless surgical approach...
April 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29616523/short-term-outcome-of-cardiac-surgery-under-cardiopulmonary-bypass-in-patients-who-refuse-transfusion-a-controlled-study
#4
Antonio Reyes Garcia, Gema Vega González, Ricardo Andino Ruiz
BACKGROUND: Although bloodless cardiac surgery has been successfully performed for many years, studies with controls permitting transfusion are few and their results inconclusive. This study compares the outcome of cardiac surgery on Jehovah's Witnesses (JW) refusing transfusion, with that of controls permitting transfusion if required. METHODS: Data from 172 operations in 162 JW were compared with 172 matched controls. Risk factors, preoperative, operative, 48 hour postoperative variables, outcome data and transfusions were recorded...
April 3, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29560297/harmonic-scalpel-assisted-laparoscopic-cholecystectomy-vs-conventional-laparoscopic-cholecystectomy-a-non-randomized-control-trial
#5
Kumar Rajnish, Sathasivam Sureshkumar, Manwar S Ali, Chellappa Vijayakumar, Sundaramurthi Sudharsanan, Chinnakali Palanivel
Introduction Laparoscopic cholecystectomy (LC) is the most commonly done, minimally invasive surgical procedure. Routinely used electrocautery produces more smoke, which masks the operating field, thereby prolongs the surgery and posing an increased risk of gallbladder (GB) perforation. The titanium clips used for clipping the cystic artery and cystic duct have a risk of slippage, which may lead to bleeding, and an increased risk for bile leakage. In addition, it may act as a nidus for stone formation. Advanced energy sources, such as the harmonic scalpel, though expensive, may provide the advantage of shorter operating time by reducing smoke, bloodless dissection in the GB bed, lower risk of bleeding from the cystic artery due to secure vessel sealing, and avoiding the use of a larger number of titanium clips...
January 18, 2018: Curēus
https://www.readbyqxmd.com/read/29504421/-milestones-in-liver-surgery
#6
REVIEW
Ferenc Jakab
Numerous outstanding summarizing publications on the milestones of the rapid development of liver surgery in the twentieth century came to light around the year 2000, therefore in this summary only the newest principles and novelties of liver surgery after the second millennium are presented. Among the new principles, the newest indications, the bloodless surgery and the vascular exclusion of the liver, the "associating liver partition and portal vein occlusion for staged hepatectomy" (ALPPS) - as presently the fastest and most successful method for liver regeneration, and the "downsizing of tumors" treatment for the interest of resection of unresectable tumours are analyzed and evaluated...
March 2018: Orvosi Hetilap
https://www.readbyqxmd.com/read/29379266/surgically-induced-astigmatism-after-phacoemulsification-by-temporal-clear-corneal-and-superior-clear-corneal-approach-a-comparison
#7
Archana Sunil Nikose, Dhrubojyoti Saha, Pradnya Mukesh Laddha, Mayuri Patil
Introduction: Cataract surgery has undergone various advances since it was evolved from ancient couching to the modern phacoemulsification cataract surgery. Surgically induced astigmatism (SIA) remains one of the most common complications. The introduction of sutureless clear corneal incision has gained increasing popularity worldwide because it offers several advantages over the traditional sutured limbal incision and scleral tunnel. A clear corneal incision has the benefit of being bloodless and having an easy approach, but SIA is still a concern...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29302123/bloodless-repair-for-a-3-6-kilogram-transposition-of-the-great-arteries-with-jehovah-s-witness-faith
#8
Jeffery L Burnside, Todd M Ratliff, Ashley B Hodge, Daniel Gomez, Mark Galantowicz, Aymen Naguib
Achieving pediatric cardiac surgery using cardiopulmonary bypass (CPB) without allogeneic blood transfusion is challenging. There are many clinical and economic factors that point to the importance of avoiding blood transfusions. In some instances, honoring patients or parents beliefs may be the reason for avoiding blood transfusions. For example, patients or parents of the Jehovah's Witness faith refuse blood transfusion based on their religious beliefs. Over the last decade, our institution has seen a steady increase in our pediatric Jehovah's Witness patient population...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29284876/dexmedetomidine-versus-magnesium-sulfate-in-anesthesia-for-cochlear-implantation-surgery-in-pediatric-patients
#9
Passaint Fahim Hassan, Amany Hassan Saleh
Context: Cochlear implantation surgery represents a great advance in ENT surgeries. Special anesthetic managements were required to provide bloodless surgical field and monitoring of the facial nerve. Aims: We aimed to compare both dexmedetomidine and magnesium sulfate as regards their efficacy in inducing deliberate hypotension and providing better quality of the surgical field during cochlear implantation in pediatrics. Settings and Design: Prospective, randomized double-blinded study...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29258567/knowledge-of-bloodless-medicine-among-nurses-at-the-medical-surgical-directorate-of-komfo-anokye-teaching-hospital-ghana-a-descriptive-cross-sectional-study
#10
Yaa Obirikorang, Christian Obirikorang, Enoch Odame Anto, Emmanuel Acheampong, Emmanuella Nsenbah Batu, Flora Macaulary, Christopher Kwaku Paavire, Bright Amankwaa
OBJECTIVE: This study assessed the knowledge of bloodless medicine (BM) among nurses at the medical and surgical directorate of Komfo Anokye Teaching Hospital. A paper questionnaire was administered to 322 nurses to obtain information on socio-demographic characteristics and knowledge of BM. RESULTS: More than half (52.1%) of the nurses were aware of BM. The major source of information on BM was from the internet. Out of the study population, 90.1% knew iron therapy as BM strategy...
December 19, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29199481/the-conversational-position-in-endoscopic-pituitary-surgery
#11
Jinendra Ekanayake, Irene Baudracco, Anjum Quereshi, Tom Vercauteren, Neil L Dorward
We describe a novel patient position for endoscopic transphenoidal surgery - the 'conversational position'. This position is a safe and effective alternative to the standard supine position, incorporating a semi-sitting position with the additional innovation of achieving a 'conversational position' by flexing the neck and turning the patient's head turned to face the surgeon. The 'conversational' position offers improvements in the surgical approach to sellar region, addressing specific intraoperative challenges such as maintaining a bloodless operative field, and enabling more intuitive and ergonomic surgical workflow...
December 4, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29147171/recent-progress-of-bypass-surgery-to-the-dialysis-dependent-patients-with-critical-limb-ischemia
#12
Nobuyoshi Azuma, Shinsuke Kikuchi, Hiroko Okuda, Keisuke Miyake, Atsuhiro Koya
According to expansion of dialysis-dependent population, more than half of patients with critical ischemic limbs are dialysis-dependent in Japan. Although patients with end-staged renal disease are well-known as poor life prognosis, well-managed dialysis patients in Japan can survive much longer compared to dialysis patients in the United States and Europe. Therefore, some dialysis patients can enjoy the long-term benefits of bypass surgery. To decide the indication of bypass surgery, patient's general condition, nutrition status, and vein availability are more important rather than arterial disease anatomy...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29141522/perceived-comfort-during-minor-hand-surgeries-with-wide-awake-local-anaesthesia-no-tourniquet-walant-versus-local-anaesthesia-la-tourniquet
#13
Jayaletchumi Gunasagaran, Ee Soon Sean, Sachin Shivdas, Shams Amir, Tunku Sara Ahmad
PURPOSE: Minor hand surgeries can be done under field sterility in procedure rooms. Surgeons are still sceptical about the usage of wide awake local anaesthesia no tourniquet (WALANT) technique. They perceive that patients can tolerate tourniquet for a brief period while they perform minor surgeries under local anaesthesia (LA). We compared the perceived comfort experienced by patients during minor hand surgeries with WALANT and LA/tourniquet. We investigated the difference in preoperative preparation time, operating time and blood loss between the two groups...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28985692/comprehensive-blood-conservation-program-in-a-new-congenital-cardiac-surgical-program-allows-bloodless-surgery-for-the-jehovah-witness-and-a-reduction-for-all-patients
#14
Vincent Olshove, Nicole Berndsen, Veena Sivarajan, Pooja Nawathe, Alistair Phillips
BACKGROUND: Cardiac surgery on Jehovah's Witnesses (JW) can be challenging, given the desire to avoid blood products. Establishment of a blood conservation program involving the pre-, intra- and post-operative stages for all patients may lead to a minimized need for blood transfusion in all patients. METHODS: Pre-operatively, all JW patients were treated with high dose erythropoietin 500 IU/kg twice a week. JW patients were compared to matching non-JW patients from the congenital cardiac database, two per JW to serve as control...
October 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28979046/bloodless-repair-of-aortic-arch-with-dual-aortic-cannulation-in-a-jehovah-s-witness-patient
#15
Melinda S Valleley, Kimberly R Glogowski, Kim F Duncan, Andrea Dutoit, Corinna Hagedorn
Various methods for surgical repair of the aortic arch are described throughout the literature with many focused on cannulation techniques and degree of systemic cooling in an effort to reduce postoperative morbidities. Despite advancements in techniques, this surgery is still often associated with higher levels of blood loss and subsequent allogenic blood transfusions. Although blood products can be safely transfused to the majority of patients undergoing repair of the aortic arch, the complexity and risk is further multiplied when the patient is of Jehovah's Witness faith and refuses blood transfusions...
September 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28970635/basics-of-cardiopulmonary-bypass
#16
REVIEW
Manjula Sarkar, Vishal Prabhu
Cardiopulmonary bypass (CPB) provides a bloodless field for cardiac surgery. It incorporates an extracorporeal circuit to provide physiological support in which venous blood is drained to a reservoir, oxygenated and sent back to the body using a pump. Team effort between surgeon, perfusionist and anaesthesiologist is paramount for the successful use of CPB. However, it also has its share of complications and strategies to reduce these complications are the area of the current research.
September 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28878585/selective-upper-body-perfusion-technique-for-removal-of-renal-cell-carcinoma-extending-into-the-inferior-vena-cava-and-right-atrium
#17
Selim Aydin, Bora Cengiz, Banu Vural Gokay, Anar Mammadov, Remzi Emiroglu, Saadettin Eskicorapci, Ersin Erek
Invasion of a renal cell carcinoma thrombus into the inferior vena cava and right atrium is infrequent. Reaching and completely excising a tumor from the inferior vena cava is particularly challenging because the liver covers the surgical field. We report the case of a 61-year-old man who underwent surgery for a renal cell carcinoma of the right kidney that extended into the inferior vena cava and right atrium. During dissection of the liver to expose the inferior vena cava, transesophageal echocardiograms revealed right atrial mass migration into the tricuspid valve...
August 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28865632/back-to-basics-pneumatic-tourniquet-use
#18
Lisa Spruce
Pneumatic tourniquets are commonly used in surgeries involving the limbs to achieve a nearly bloodless surgery and an optimal operating field or when administering regional anesthesia during surgery on a limb. Complications can arise from the use of tourniquets, including nerve injuries, pain, compartment syndrome, pressure injuries, chemical burns, and tissue necrosis. More serious injuries-including deep vein thrombosis, thermal damage to tissues, severe ischemic injuries, and rhabdomyolysis-also can occur...
September 2017: AORN Journal
https://www.readbyqxmd.com/read/28815690/treatment-of-individuals-who-cannot-receive-blood-products-for-religious-or-other-reasons
#19
REVIEW
Carlton D Scharman, Debora Burger, Joseph J Shatzel, Edward Kim, Thomas G DeLoughery
By virtue of their religious principles, Jehovah's Witnesses (JWs) generally object to receiving blood products, raising numerous ethical, legal, and medical challenges for providers who care for these patients, especially in the emergent setting. In this review, we discuss several areas relevant to the care of JWs, including the current literature on "bloodless" medical care in the setting of perioperative and intraoperative management, acute blood loss, trauma, pregnancy, and malignancy. We have found that medical and administrative efforts in the form of bloodless medicine and surgery programs can be instrumental in helping to reduce risks of morbidity and mortality in these patients...
December 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28789655/efficacy-and-safety-of-a-new-elastic-tourniquet-cuff-in-total-knee-arthroplasty-a-prospective-randomized-controlled-study
#20
O-Sung Lee, Myung Chul Lee, Hyuk-Soo Han
BACKGROUND: The effects of cuff shape, timing of tourniquet application, and automated systems using limb occlusion pressure (LOP) have been reported to minimize the appropriate tourniquet pressure. However, studies on the raw material of the cuff itself to reduce the complications related to the tourniquet have been very rarely reported. The purpose of this study is to report the efficacy and safety of a tourniquet system with a new elastic cuff in which pressure is set with LOP in total knee arthroplasty (TKA)...
August 8, 2017: Biomedical Engineering Online
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