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Surgical wound

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https://www.readbyqxmd.com/read/28543692/the-impact-of-resident-involvement-in-breast-reconstruction-surgery-outcomes-by-modality-an-analysis-of-4-500-cases
#1
Kevin T Jubbal, Anthony Echo, Aldona J Spiegel, Shayan A Izaddoost
BACKGROUND: The goal of this study was to determine the impact of resident involvement on various methods of breast reconstruction via an American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) retrospective analysis. METHODS: We performed a retrospective analysis of the ACS NSQIP database to identify patients undergoing breast reconstruction by free flap, implant, latissimus dorsi (LD), and transverse rectus abdominis myocutaneous (TRAM) flap reconstruction modalities...
May 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28542071/vertical-rectus-abdominis-myocutaneous-versus-alternative-flaps-for-perineal-repair-after-abdominoperineal-excision-of-the-rectum-in-the-era-of-laparoscopic-surgery
#2
Mark Scott Johnstone
AIMS: Plastic surgical reconstruction of the perineum is often required after abdominoperineal excision of the rectum. Options for this reconstruction include a vertical rectus abdominis myocutaneous (VRAM) flap, gluteal fasciocutaneous flap, and gracilis myocutaneous flap. Although the VRAM flap is well established at most centers, less experience exists with the gluteal and gracilis flaps. In the era of laparoscopic colorectal resection, plastic surgeons are being forced to use gluteal and gracilis flaps because the VRAM flap must be tunnelled intra-abdominally requiring laparotomy...
May 25, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28541880/reconstruction-of-a-large-leg-defect-with-a-combined-hatchet-flap-technique
#3
Roberto Cecchi, Laura Bartoli, Luigi Brunetti, Giovanni Troiano
The repair of lower leg defects, not amenable to primary closure, may be challenging, since the skin at this level is scarcely elastic and difficult to mobilize. Local skin flaps are generally utilized only to restore moderately sized losses, whereas grafting becomes a realistic choice in presence of larger wounds. We present the case of a 70-year-old man with a wide defect on his right leg following the surgical excision of a squamous cell carcinoma. The wound was successfully closed with a combination of three hatchet flaps...
April 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28541864/surgical-site-infection-rate-drops-to-0-using-a-vacuum-assisted-closure-in-contaminated-dirty-infected-laparotomy-wounds
#4
Gerardo Lozano-Balderas, Alejandro Ruiz-Velasco-Santacruz, José Antonio Díaz-Elizondo, Juan Antonio Gómez-Navarro, Eduardo Flores-Villalba
Wound site infections increase costs, hospital stay, morbidity, and mortality. Techniques used for wounds management after laparotomy are primary, delayed primary, and vacuum-assisted closures. The objective of this study is to compare infection rates between those techniques in contaminated and dirty/infected wounds. Eighty-one laparotomized patients with Class III or IV surgical wounds were enrolled in a three-arm randomized prospective study. Patients were allocated to each group with the software Research Randomizer® (Urbaniak, G...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28541853/treatment-options-for-pilonidal-disease
#5
Denis Ehrl, Cornelia Choplain, Paul Heidekrueger, Holger C Erne, Horst-Guenter Rau, P Niclas Broer
Pilonidal disease can be treated medically; however, surgical excision remains the gold standard. Nonetheless, all current surgical approaches are still associated with potential for tissue loss, wound healing disorders, and high rates of recurrence. Aim of this study is to assess the long-term outcomes of the minimal-invasive pit-picking operation in comparison to the well-established technique of Karydakis flap-closure. Medical records of all patients undergoing either Karydakis flap-closure or the pit-picking operation for pilonidal disease at our department were reviewed retrospectively...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28541427/percutaneous-cannulation-for-cardiopulmonary-bypass-in-minimally-invasive-surgery-is-associated-with-reduced-groin-complications
#6
Alexandros Moschovas, Paulo A Amorim, Mariana Nold, Gloria Faerber, Mahmoud Diab, Tobias Buenger, Torsten Doenst
OBJECTIVES: Femoral cutdown is standard in most centres if groin cannulation is used for cardiopulmonary bypass in minimally invasive cardiac surgery (MICS). Arterial closure devices (ACDs) allow placement of larger cannulas percutaneously, but its benefit in MICS is unclear. We assessed our results with percutaneous groin cannulation using ACDs in comparison with conventional surgical access in patients undergoing MICS. METHODS: We reviewed 445 consecutive patients having undergone MICS between October 2010 and March 2015...
May 25, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28540806/laparoscopic-hyperthermic-isolated-limb-perfusion-a-new-minimally-invasive-approach-for-hilp
#7
N Solari, F Sucameli, M Gipponi, F De Cian, F Cafiero
BACKGROUND: Hyperthermic isolated limb perfusion (HILP) represents a limb-sparing treatment for unresectable soft tissue sarcoma (STS) of the extremities with substantial complete response rates. HILP often provides good functional limb preservation, hence a significant improvement also in terms of quality of life of the patient. Notwithstanding these clear advantages, the traditional technique is still hindered by relatively high post-operative morbidity. METHOD: We treated a 78-year-old female with unresectable angiosarcoma of the left leg using a new surgical approach: an entirely laparoscopic HILP...
April 24, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28540567/-the-significance-of-biofilm-for-the-treatment-of-infections-in-orthopedic-surgery-2017-update
#8
REVIEW
C Scheuermann-Poley, C Wagner, J Hoffmann, A Moter, C Willy
BACKGROUND: The increase in endoprosthetic and osteosynthetic surgical treatment is associated with a simultaneous increase in implant-associated infections (surgical site infections, SSI). Biofilms appear to play a significant role in the diagnosis and treatment of these infections and heavily contaminated wounds. This article aims to provide a current overview of biofilm and its relevance in orthopedic surgery. MATERIALS AND METHODS: A computer-assisted literature search of MedLine (PubMed) was performed using key word combinations with "biofilm" (as of March 2017)...
May 24, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28540132/more-risks-and-complications-for-elective-spine-surgery-in-morbidly-obese-patients
#9
REVIEW
Nancy E Epstein
BACKGROUND: The vast majority of studies emphasize the greater morbidity/mortality for elective spine surgery in morbidly obese patients. METHODS: This review focuses on the increased morbidity/mortality of performing elective spinal operations in morbidly obese patients. There are two definitions of morbid obesity; a body mass index (BMI) of equal to or greater than 35 plus two major comorbid factors (e.g., hypertension, diabetes, etc.) or a BMI (morbidly obese III) of =≥40 kg/m(2)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28538648/less-is-more-antibiotic-duration-and-outcomes-in-fournier-s-gangrene
#10
Margaret Lauerman, Olga Kolesnik, Kinjal Sethuraman, Ronald Rabinowitz, Manjari Joshi, Emily Clark, Deborah Stein, Thomas Scalea, Sharon Henry
BACKGROUND: Antibiotic management of Fournier's gangrene (FG) is without evidence-based guidelines, and is based on expert opinion. The effect of duration of antibiotic therapy on outcomes in FG is unknown. METHODS: A retrospective review was performed of FG patients from 2012-2015 at a single institution. Patients were managed by our institutional practice of complete primary wound closure as possible, with antibiotic duration according to physician judgement. Patients were stratified into multiple durations of antibiotic administration...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538646/defining-the-ge-junction-in-trauma-epidemiology-and-management-of-a-challenging-injury
#11
Morgan Schellenberg, Kenji Inaba, James M Bardes, Daniel OʼBrien, Lydia Lam, Elizabeth Benjamin, Daniel Grabo, Demetrios Demetriades
INTRODUCTION: Injuries to the gastroesophageal (GE) junction are infrequently encountered because of the high mortality of associated injuries. Consequently, there is a paucity of literature on the patient demographics and treatment options. The aim of this study was to examine the epidemiology, surgical management, and outcomes of these rare injuries. METHODS: Patients presenting to LAC+USC Medical Center (01/2008-08/2016) with traumatic esophageal or gastric injury (ICD-9 and -10 codes) were extracted from the trauma registry...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538525/trajectory-of-postoperative-wound-pain-within-the-first-2-weeks-following-posterior-spinal-fusion-surgery-in-adolescent-idiopathic-scoliosis-patients
#12
Mun Keong Kwan, Chee Kidd Chiu, Teik Seng Chan, Kok Ian Chong, Siti Mariam Mohamad, Mohd Shahnaz Hasan, Chris Yin Wei Chan
STUDY DESIGN: A prospective cohort study. OBJECTIVE: The aim of this study was to determine and evaluate the trajectory of surgical wound pain from day 1 to day 14 after posterior spinal fusion (PSF) surgery in patients with adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: Information regarding how the postoperative pain improves with time offers invaluable information not only to the patients and parents but also to assist the clinician in managing postoperative pain...
June 1, 2017: Spine
https://www.readbyqxmd.com/read/28538451/similar-anatomical-reduction-and-lower-complication-rates-with-the-sinus-tarsi-approach-compared-with-the-extended-lateral-approach-in-displaced-intra-articular-calcaneal-fractures
#13
Tim Schepers, Manouk Backes, Siem A Dingemans, Vincent M de Jong, Jan S K Luitse
OBJECTIVES: To investigate whether the sinus tarsi approach (STA) allows for a similar anatomical reduction of the posterior talocalcaneal facet as the extended lateral approach (ELA) and compare the rate of postoperative wound complications. DESIGN: Retrospective. SETTING: Level 1 trauma center. PATIENTS: All consecutive patients from 2012 to 2015 with a closed displaced intra-articular calcaneal fracture Sanders type II and III surgically treated with the ELA (N = 60) and the STA (N = 65)...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28538418/keystone-designed-buried-de-epithelialized-flap-a-novel-technique-for-obliterating-small-to-moderately-sized-dead-spaces
#14
Hoon Kim, Wan Cheol Ryu, Chi Sun Yoon, Kyu Nam Kim
Effective obliteration of dead space after reconstructive surgery facilitates a good cosmetic outcome and prevention of delayed wound healing and recurrent infection.We evaluated the efficacy of a keystone-designed buried de-epithelialized (KBD) flap for the obliteration of small to moderately sized surgical dead spaces.We reviewed the medical records of patients who received a KBD flap following removal of a mass or debridement of necrotic tissue from September 2015 to February 2016. The diagnosis, site, dead space dimensions, flap width, drain data, complications, and follow-up duration were recorded...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28537569/inguinal-pain-syndrome-the-influence-of-intraoperative-local-administration-of-0-5-bupivacaine-on-postoperative-pain-control-following-lichtenstein-hernioplasty-a-prospective-case-control-study
#15
Bartosz Cybułka
With current technological advancement and availability of synthetic materials used in inguinal hernia repair, a recurrence after first intervention is not a common and important adverse event. On the other hand, however, some patients complain about chronic pain of the operated site after surgeries using a polypropylene mesh. Many patients are constrained to a prolonged use of analgesics and increased frequency of control visits, which may eventually result in loss of trust in the operator. Every surgical intervention is associated with the risk of immediate or delayed complications...
April 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28537349/effects-of-topical-antiseptic-solutions-used-during-total-knee-arthroplasty-on-suture-tensile-strength
#16
Jared M Newman, Jaiben George, Jeffery T Shepherd, Alison K Klika, Carlos A Higuera, Viktor E Krebs
INTRODUCTION: Irrigating a surgical wound with an antiseptic solution is commonly performed while suturing following a total knee arthroplasty (TKA) to help prevent wound complications. The purpose of this study was to: 1) evaluate the mean load to failure of different sutures, and 2) compare the mean load to failure of the sutures after soaking in four different antiseptic solutions. MATERIALS AND METHODS: Load-to-failure tests were conducted on four sets of comparable sutures (eight sutures) from two different companies Ethicon Inc...
May 24, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28536807/prognostic-factors-for-enteroatmospheric-fistula-in-open-abdomen-treated-with-negative-pressure-wound-therapy-a-multicentre-experience
#17
Guillaume Giudicelli, A Rossetti, C Scarpa, N C Buchs, R Hompes, R J Guy, K Ukegjini, P Morel, F Ris, M Adamina
BACKGROUND: Reductions in mortality were reported with negative pressure wound therapy for laparostomy. However, some authors have voiced concern over an increased risk of enteroatmospheric fistulae. In this retrospective study, we hypothesized that surgical and metabolic derangements could increase the incidence of enteroatmospheric fistulae. We aimed to assess our experience and report long-term outcomes. METHODS: A multicentre review of all patients with a laparostomy managed with negative pressure wound therapy between 2005 and 2015 was undertaken...
May 23, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28536687/abdominal-and-pelvic-actinomycosis-due-to-longstanding-intrauterine-device-a-slow-and-devastating-infection
#18
Evelyn Sue Nakahira, Linda Ferreira Maximiano, Fabiana Roberto Lima, Edson Yassushi Ussami
Actinomycosis is a chronic or subacute bacterial infection characterized by large abscess formation, caused mainly by the gram-positive non-acid-fast, anaerobic, or microaerophilic/capnophilic, obligate parasites bacteria from the Actinomyces genus. Although pelvic inflammatory disease is an entity associated with the longstanding use of intrauterine devices (IUDs), actinomycosis is not one of the most frequent infections associated with IUDs. We present the case of a 43-year-old female patient who was referred to the emergency facility because of a 20-day history of abdominal pain with signs of peritoneal irritation...
January 2017: Autopsy & case reports
https://www.readbyqxmd.com/read/28535522/restenosis-in-hemodialytic-fistulas-and-chronic-kidney-disease-associated-vascular-disease-two-pathologies-driven-by-metakaryotic-stem-cells
#19
Gianandrea Pasquinelli, William G Thilly, Elena V Gostjeva, Paola Todeschini, Giuseppe Cianciolo, Claudio Ronco, Gaetano La Manna
Chronic kidney disease (CKD) exacerbating vascular disease poses a major challenge to nephrology. Surgically placed vascular fistulas, as an aid to hemodialysis prior to kidney transplant, have extended many lives, while post-surgical restenosis closure of the fistula by smooth muscle cells affects many lives. When post-surgical restenosis is developed, palliative measures are almost always surgical: there are no effective drug treatments. In this study, we offer a testable hypothesis that effects of CKD on widely distributed vascular diseases and the phenomenon of fistula restenosis are both driven by the pathologic creation of non-dividing smooth muscle cells via asymmetric division of exponentially increasing metakaryotic stem cells...
2017: Contributions to Nephrology
https://www.readbyqxmd.com/read/28534258/closed-incision-prophylactic-negative-pressure-wound-therapy-in-patients-undergoing-major-complex-abdominal-wall-repair
#20
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
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