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https://www.readbyqxmd.com/read/27915373/risk-factors-associated-with-postoperative-morbidity-in-over-500-colovesical-fistula-patients-undergoing-colorectal-surgery-a-retrospective-cohort-study-from-acs-nsqip-database
#1
H Hande Aydinli, Cigdem Benlice, Gokhan Ozuner, Emre Gorgun, Maher A Abbas
PURPOSE: The aim of this study was to evaluate the impact of various factors on 30-day postoperative morbidity in patients who underwent colorectal surgery (CRS) for colovesical fistula (CVF) in the elective and emergency settings. METHODS: Patients who underwent CRS for CVF between 2005 and 2013 were identified from the American College of Surgeons National Surgical Quality Improvement Program database by using current procedural terminology codes. Demographics, perioperative, and operative factors were assessed and compared between two groups classified according to the presence or absence of postoperative complications...
December 3, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27915096/universal-contact-precautions-do-not-change-the-prevalence-of-antibiotic-resistant-organisms-in-a-tertiary-burn-unit
#2
Adelyn L Ho, Reid Chambers, Claudia Malic, Anthony Papp
OBJECTIVE: The prevalence of antibiotic-resistant organisms (ARO) in burn units is increasing worldwide and contributes significantly to morbidity and mortality. Study aims are to describe the burden of AROs in burn patients admitted to a tertiary burn unit, to evaluate the impact of contact precautions implemented after an outbreak of antibiotic-resistant Acinetobacter baumannii, and to identify possible predictors of ARO acquisition. METHODS: Data of burn inpatients between 2006 and 2010 were retrospectively reviewed...
November 30, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27914662/surgical-site-infection-in-tibial-plateau-fractures-with-ipsilateral-compartment-syndrome
#3
Andrew G Dubina, Ebrahim Paryavi, Theodore T Manson, Christopher Allmon, Robert V O'Toole
AIM: The aim of this study was to investigate the effects of compartment syndrome and timing of fasciotomy wound closure on surgical site infection (SSI) after surgical fixation of tibial plateau fractures. Our primary hypothesis was that SSI rate is increased for fractures with compartment syndrome versus those without, even accounting for confounders associated with infection. Our secondary hypothesis was that infection rates are unrelated to timing of fasciotomy closure or fixation...
October 18, 2016: Injury
https://www.readbyqxmd.com/read/27914243/efficacy-and-safety-of-bevacizumab-containing-neoadjuvant-therapy-followed-by-interval-debulking-surgery-in-advanced-ovarian-cancer-results-from-the-anthalya-trial
#4
Roman Rouzier, Sébastien Gouy, Frédéric Selle, Eric Lambaudie, Anne Floquet, Virginie Fourchotte, Christophe Pomel, Pierre-Emmanuel Colombo, Elsa Kalbacher, Sandrine Martin-Francoise, Raffaele Fauvet, Philippe Follana, Anne Lesoin, Fabrice Lecuru, Youssef Ghazi, Julien Dupin, Elisabeth Chereau, Sarah Zohar, Paul Cottu, Florence Joly
AIM: To investigate whether adding bevacizumab to neoadjuvant carboplatin-paclitaxel (CP) helps achieve optimal debulking, measured by complete resection rate (CRR) at interval debulking surgery (IDS), in patients with initially unresectable International Federation of Gynecology and Obstetrics stage IIIC/IV ovarian, tubal or peritoneal adenocarcinoma. METHODS: Multicentre, open-label, non-comparative phase II study. Ninety-five patients randomised (2:1) to receive four cycles of neoadjuvant CP ±3 concomitant cycles of bevacizumab 15 mg/kg (BCP) followed by IDS...
November 30, 2016: European Journal of Cancer
https://www.readbyqxmd.com/read/27913719/surgical-site-infections-in-major-head-and-neck-surgeries-involving-pedicled-flap-reconstruction
#5
Neerav Goyal, Bharat B Yarlagadda, Daniel G Deschler, Kevin S Emerick, Derrick T Lin, Debbie L Rich, James W Rocco, Marlene L Durand
OBJECTIVE: To evaluate surgical site infections (SSI) after pedicled reconstruction in head and neck surgery. METHODS: Records of patients with pedicled flap reconstructions between 2009 and 2014 at Massachusetts Eye and Ear were reviewed. Onset of SSI or fistula ≤30 days postoperatively was noted. A free flap cohort was reviewed for comparison. RESULTS: Two hundred and eight pedicled reconstructions were performed for cancer (83%), osteoradionecrosis (7%), and other reasons (10%)...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27912820/modern-endodontic-microsurgery-concepts-a-clinical-update
#6
REVIEW
Spyros Floratos, Syngcuk Kim
Increased use of the surgical operating microscope in endodontic surgery has elucidated many shortcomings of previous techniques and along with microsurgical instruments and new more biologically acceptable root-end filling materials has started the new microsurgical era in surgical endodontics. Endodontic microsurgery is a minimally invasive technique that results in less postoperative pain and edema and faster wound healing. It offers a significantly higher success rate than traditional apical surgery technique...
January 2017: Dental Clinics of North America
https://www.readbyqxmd.com/read/27911904/dressing-wear-time-after-breast-reconstruction-a-randomized-clinical-trial
#7
Daniela Francescato Veiga, Carlos Américo Veiga Damasceno, Joel Veiga-Filho, Luiz Francisley Paiva, Fernando Elias Martins Fonseca, Isaías Vieira Cabral, Natália Lana Larcher Pinto, Yara Juliano, Lydia Masako Ferreira
BACKGROUND: The evidence to support dressing standards for breast surgery wounds is empiric and scarce. OBJECTIVE: This two-arm randomized clinical trial was designed to assess the effect of dressing wear time on surgical site infection (SSI) rates, skin colonization and patient perceptions. METHODS: A total of 200 breast cancer patients undergoing breast reconstruction were prospectively enrolled. Patients were randomly allocated to group I (dressing removed on the first postoperative day, n = 100) or group II (dressing removed on the sixth postoperative day, n = 100)...
2016: PloS One
https://www.readbyqxmd.com/read/27911412/reproducible-arterial-denudation-injury-by-infrarenal-abdominal-aortic-clamping-in-a-murine-model
#8
Aditya S Shirali, Austin I McDonald, Julia J Mack, M Luisa Iruela-Arispe
Percutaneous vascular interventions uniformly result in arterial denudation injuries that subsequently lead to thrombosis and restenosis. These complications can be attributed to impairments in re-endothelialization within the wound margins. Yet, the cellular and molecular mechanisms of re-endothelialization remain to be defined. While several animal models to study re-endothelialization after arterial denudation are available, few are performed in the mouse because of surgical limitations. This undermines the opportunity to exploit transgenic mouse lines and investigate the contribution of specific genes to the process of re-endothelialization...
November 24, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27910210/microbiological-evaluation-of-the-extension-wire-and-percutaneous-epidural-lead-anchor-site-following-a-2-stage-cut-down-spinal-cord-stimulator-procedure
#9
Abdul Ghaaliq Lalkhen, Mahindra Chincholkar, Jiten Patel
OBJECTIVES: There are concerns regarding bacterial colonization of the temporary extension leads and subsequent infection risk using the 2-stage cut-down approach in spinal cord stimulation (SCS). We sought to quantify the extent of bacterial colonization of the temporary extension wire and percutaneous epidural lead anchor site. MATERIALS AND METHODS: We conducted a cross-sectional observational study recruiting a pragmatic sample of 25 consecutive patients listed for a cut-down trial of SCS...
December 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27909643/source-control-and-graft-preservation-using-negative-pressure-wound-therapy-with-antibiotic-instillation-a-case-report
#10
Victoria Gilbert, Timothy Kelly, Robert Grossi
Negative pressure wound therapy (NPWT) is widely used to treat many types of complex wounds, and the advent of the instillation and dwell time (NPWTi-d) technique has enhanced this system with the addition of automated treatment with topical solutions. In the field of vascular surgery, NPWT is utilized to help close wounds over underlying grafts; however keeping these wounds free of infection and avoiding large reoperation when infection occurs remains a challenge. In this case report we present a patient who required acute intervention for limb ischemia, with a large wound created in the groin for anastomosis of a prosthetic graft bypass...
October 31, 2016: Curēus
https://www.readbyqxmd.com/read/27909641/a-case-series-of-complex-recalcitrant-wounds-treated-with-epidermal-grafts-harvested-from-an-automated-device
#11
Stephen S Cai, Arvind U Gowda, Karan Chopra, Rachel Waldman, Ronald P Silverman, Yvonne M Rasko
INTRODUCTION: Epidermal grafting has several advantages over full-thickness or split-thickness grafts in the treatment of complex non-healing wounds. These include the low risk of donor site complications, minimal patient discomfort, and abstention from the operating room. Traditionally, the lack of reliable epidermal harvesting techniques has limited its clinical utilization. The development of an automated suction blister epidermal graft (SBEG) harvesting device may facilitate clinical utilization of this technique...
October 30, 2016: Curēus
https://www.readbyqxmd.com/read/27909640/treating-fasciotomy-wounds-with-negative-pressure-wound-therapy-with-instillation-and-dwell-time-npwti-d
#12
Priscilla Lee
Acute compartment syndrome (ACS) is a serious complication of lower-extremity trauma caused by accidents or post-procedure complications. ACS is characterized by increased pressure within the compartment, resulting in reduced blood flow, tissue hypoxia, and tissue necrosis. Fasciotomies to relieve pressure and debridement of necrotic tissue comprise primary treatment. My purpose is to present initial experience using negative pressure wound therapy with instillation and dwell time (NPWTi-d)* to treat fasciotomy wounds in two patients...
October 28, 2016: Curēus
https://www.readbyqxmd.com/read/27909035/randomised-controlled-pilot-study-to-investigate-the-effectiveness-of-thoracic-epidural-and-paravertebral-blockade-in-reducing-chronic-post-thoracotomy-pain-topic-feasibility-study-protocol
#13
Joyce Yeung, Teresa Melody, Amy Kerr, Babu Naidu, Lee Middleton, Kostas Tryposkiadis, Jane Daniels, Fang Gao
INTRODUCTION: Open chest surgery (thoracotomy) is considered the most painful of surgical procedures. Forceful wound retraction, costochondral dislocation, posterior costovertebral ligament disruption, intercostal nerve trauma and wound movement during respiration combine to produce an acute, severe postoperative pain insult and persistent chronic pain many months after surgery is common. Three recent systematic reviews conclude that unilateral continuous paravertebral blockade (PVB) provides analgesia at least equivalent to thoracic epidural blockade (TEB) in the postoperative period, has a lower failure rate, and symptom relief that lasted months...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27908808/emergency-hybrid-approach-to-ruptured-femoral-pseudoaneurysm-in-hiv-positive-intravenous-drug-abusers
#14
Maurizio Domanin, Giovanni Romagnoni, Silvia Romagnoli, Antonio Rolli, Livio Gabrielli
PURPOSE: Chronic traumatism of the common femoral artery due to intravenous injection in drug abusers, in association with local infections and arterial wall weakening caused by HIV, can lead to the development of pseudoaneurysms. Rupture of pseudoaneurysm is a dramatic event in such patients and its correction is difficult and controversial. Most of the cases reported describe open surgical elective options, that consist in ligation, repair or substitution of the damaged arterial segment, employing when possible biological grafts...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27906851/silk-ligation-delay-for-the-random-pattern-flap
#15
Lei Liu, Chen Zhang, Haizhou Tong, Tao Song, Ningbei Yin, Haidong Li, Zhenmin Zhao
OBJECTIVE: The purpose of this study is to explore a silk ligation delay for the expanded and unexpanded random flaps to improve the vascularization and survival length of the flap. METHODS: Marked incision points 2 to 3 cm at every interval along the design line with methylene blue, each incision was about 3 mm long. A subepidermal tunnel was formed on the superfacial layer of dermis between every adjacent incision; another gap was done on the surface of the expander...
November 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27906759/development-of-a-disease-based-hernia-program-and-the-impact-on-cost-for-a-hospital-system
#16
David M Krpata, Ivy N Haskins, Steven Rosenblatt, Sharon Grundfest, Ajita Prabhu, Michael J Rosen
OBJECTIVE: The aim of this study was to assess the impact of developing a hernia program on mesh utilization. BACKGROUND: With the ongoing changes in healthcare, the value of all interventions will see increased scrutiny. Hernia mesh can be one of the most costly components of hernia repairs. A disease-based institutional hernia program that defines roles for mesh utilization and measures outcomes has the potential to add significant value to hospital systems. METHODS: In August 2014, a disease-based hernia program was initiated across a hospital system...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27905650/-aseptic-techniques-for-minor-surgical-procedures
#17
Marcela Concha-Rogazy, Catalina Andrighetti-Ferrada, Maximiliano Curi-Tuma
Aseptic techniques are those practices designed to reduce the risk of surgical site infection (SSI), defined as such, all those that occur within the first 30 days of the procedure. While the patient’s risk of developing an SSI in dermatologic surgery is low since many of the procedures are considered sterile, there are different factors associated with an increased or decreased risk of developing SSI. The characteristics of the surgical wound (such as involving infected or inflamed tissue or when breaks in the aseptic technique occur), patient characteristics (such as age, comorbidities, medication use and smoking) and procedure factors (such as setting, surgical technique, type of procedure, duration and body region involved)...
August 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/27905216/-epidemiology-of-surgical-site-infection-in-a-neurosurgery-department
#18
Patricia López Pereira, Cristina Díaz-Agero Pérez, Nieves López Fresneña, Julio Las Heras Mosteiro, Aurelio Palancar Cabrera, Ángela Lourdes Rincón Carlavilla, Jesús María Aranaz Andrés
OBJECTIVE: To know the rates of infection of the surgical wound in the Department of Neurosurgery between 2011 and 2014. METHODS: An observational, prospective study was conducted of the rates of surgical wound infection among patients admitted for more than 48 h to the Neurosurgery Department of a tertiary-level university hospital between July 2011 and December 2014. RESULTS: The study surveyed a total of 536 surgical procedures performed in 521 patients...
December 1, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27905018/minimal-excision-and-primary-suture-is-a-cost-efficient-definitive-treatment-for-pilonidal-disease-with-low-morbidity-a-population-based-interventional-and-a-cross-sectional-cohort-study
#19
Kaveh Khodakaram, Joachim Stark, Ida Höglund, Roland E Andersson
BACKGROUND: Conventional treatment of pilonidal disease with wide excision is associated with high morbidity. We describe the short- and long-term results and the impact on the health care system of a simple operation performed in the office under local anaesthesia, consisting of minimal excision of pilonidal sinuses with primary suture-the modified Lord-Millar operation (mLM). METHODS: All patients operated with mLM from February 2008 till November 2012 were prospectively followed for recurrence by telephone interviews and examination of symptomatic patients till July 2015...
November 30, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27903444/design-of-an-elastin-layered-dermal-regeneration-template
#20
Suzanne M Mithieux, Anthony S Weiss
: We demonstrate a novel approach for the production of tunable quantities of elastic fibers. We also show that exogenous tropoelastin is rate-limiting for elastin synthesis regardless of the age of the dermal fibroblast donor. Additionally, we provide a strategy to further enhance synthesis by older cells through the application of conditioned media. We show that this approach delivers an elastin layer on one side of the leading dermal repair template for contact with the deep dermis in order to deliver prefabricated elastic fibers to a physiologically appropriate site during subsequent surgery...
November 26, 2016: Acta Biomaterialia
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