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https://www.readbyqxmd.com/read/29232685/surgical-management-of-deep-brain-stimulator-scalp-erosion-without-hardware-removal
#1
Michael D Staudt, Navid Pourtaheri, Gregory E Lakin, Hooman T Soltanian, Jonathan P Miller
BACKGROUND: Scalp erosion in patients with deep brain stimulation (DBS) hardware is an uncommon complication that lacks a clearly defined management strategy. Previous studies have described various therapies including conservative treatment with antibiotics and surgical debridement with or without hardware removal. OBJECTIVES: The aim of this study was to review the efficacy of a hardware-sparing management strategy for the treatment of scalp erosion. METHODS: Five patients with previous DBS implantation presented with scalp erosion and visible hardware exposure at the calvarial burr hole site, and underwent tension-free, vascularized, rotational scalp flap, with preservation of the leads under the pericranium...
December 13, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/29232297/long-term-success-with-driveline-exit-site-relocation-for-deep-driveline-infection-in-left-ventricular-assist-device-patients
#2
Leora B Balsam, Adam Jacoby, Eddie Louie, Jamie P Levine
OBJECTIVE: Driveline infection is a common complication of durable left ventricular assist device support. The majority involve the driveline exit site and can be treated with antibiotics and local wound care. Less frequently, these infections extend into deeper tissues and surgical debridement is necessary. Few studies have described the surgical strategy for treatment of deep driveline infection or have reported long-term outcomes. With a growing population of patients being implanted as destination therapy, there is an obvious need to evaluate and optimize treatment for complex driveline infections...
December 7, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29232212/cost-of-major-complications-after-liver-resection-in-the-united-states-are-high-volume-centers-cost-effective
#3
Jay J Idrees, Fabian M Johnston, Joseph K Canner, Mary Dillhoff, Carl Schmidt, Elliott R Haut, Timothy M Pawlik
OBJECTIVE: The aim of the study was to estimate the cost of major complications after liver resection and determine whether high-volume (HV) centers are cost-effective. METHODS: From 2002 to 2011, 96,107 cases of liver resection performed in the United States were identified using Nationwide Inpatient Sample. Hospitals were categorized as HV (150+ cases/yr), medium-volume (51-149 cases/yr), and low-volume (LV) (1-50 cases/yr) centers. Multivariable regression analysis identified predictors of cost...
December 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29229160/postoperative-anti-pd-1-antibody-treatment-to-reduce-recurrence-in-a-cancer-ablation-surgical-wound
#4
Nayeon Choi, Da-Yong Shin, Hye Jin Kim, Uk Yeol Moon, Kwan-Hyuck Baek, Han-Sin Jeong
BACKGROUND: Postoperative radiation and chemotherapy are routinely applied for microscopic residual diseases; however, treatment outcomes are not optimal, and patients frequently suffer from treatment-related toxicities. To search for an effective and less-toxic adjuvant treatment for patients with high risk of recurrence, the preventive effect of anti-programmed cell death protein 1 (PD-1) treatment was evaluated in an in vivo animal model of post-surgical tumor recurrence. MATERIALS AND METHODS: An animal model of postsurgical tumor recurrence (SCCVII tumors in C3H mice) was established by reinoculating tumor cells (105 cells) into surgical wound of primary tumor resection...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29229153/prophylactic-retention-suture-for-surgical-site-infection-a-retrospective-cohort-study
#5
Eisaku Ito, Masashi Yoshida, Norihiko Suzuki, Tomonori Imakita, Nobuhiro Tsutsui, Hironori Ohdaira, Masaki Kitajima, Yutaka Suzuki
BACKGROUND: Surgical site infection (SSI) is a common complication of gastrointestinal surgery. Because retention suture is known to prevent abdominal wound dehiscence, it is only considered indicated in high-risk patients. At present, there are no clear indications for retention suture. The purpose of this study was to analyze the effect of prophylactic retention suture and to determine what situations indicate prophylactic retention suture against SSI. MATERIAL AND METHODS: Between January 2014 and January 2016, 135 patients who underwent midline laparotomy in our hospital were analyzed...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29228673/inhibition-of-pressure-activated-cancer-cell-adhesion-by-fak-derived-peptides
#6
Bixi Zeng, Dinesh Devadoss, Shouye Wang, Emilie E Vomhof-DeKrey, Leslie A Kuhn, Marc D Basson
Forces within the surgical milieu or circulation activate cancer cell adhesion and potentiate metastasis through signaling requiring FAK-Akt1 interaction. Impeding FAK-Akt1 interaction might inhibit perioperative tumor dissemination, facilitating curative cancer surgery without global FAK or AKT inhibitor toxicity. Serial truncation and structurally designed mutants of FAK identified a seven amino acid, short helical structure within FAK that effectively competes with Akt1-FAK interaction. Adenoviral overexpression of this FAK-derived peptide inhibited pressure-induced FAK phosphorylation and AKT-FAK coimmunoprecipitation in human SW620 colon cancer cells briefly exposed to 15mmHg increased pressure, consistent with laparoscopic or post-surgical pressures...
November 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/29228443/postoperative-deep-wound-dehiscence-of-thoracotomy-with-isolation-of-corynebacterium-tuberculostearicum-surgical-site-infection-or-colonization
#7
A Tampakis, E C Tampaki, K Kontzoglou, E Patsouris, G Kouraklis, D Lardinois
OBJECTIVE: Infections with Corynebacterium tuberculostearicum are very rare as in most of the cases its isolation is associated with tissue colonization rather than infection. CASE REPORT: An 80-year old female patient was sent to the consultation hour of thoracic surgery for evaluation of a symptomatic persistent unilateral pleural effusion of her right lung. The differential diagnosis included either the presence of a chronic pleural empyema or the presence of malignancy...
November 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29226477/cell-therapy-for-critical-limb-ischemia-an-integrated-review-of-pre-clinical-and-clinical-studies
#8
REVIEW
Mohammad Qadura, Daniella C Terenzi, Subodh Verma, Mohammed Al-Omran, David A Hess
Critical limb ischemia (CLI), the most severe form of peripheral artery disease, is characterized by pain at rest and non-healing ulcers in the lower extremities. For patients with CLI, where the extent of atherosclerotic artery occlusion is too severe for surgical bypass or percutaneous interventions, limb amputation remains the only treatment option. Thus, cell-based therapy to restore perfusion and promote wound healing in patients with CLI is under intense investigation. Despite promising preclinical studies in animal models, transplantation of bone marrow (BM) derived cell populations in patients with CLI has shown limited benefit preventing limb amputation...
December 11, 2017: Stem Cells
https://www.readbyqxmd.com/read/29225120/retained-bullet-in-the-kidney-imaging-and-conservative-management
#9
Guglielmo Mantica, Stephan Kruger, Hilgard Ackermann, Pieter V Spies, Farzana Cassim, Zamira Keyser, Carlo Terrone, André van der Merwe
Renal gunshot wounds resulting in a grade IV injury (AAST) should be explored only if they involve the hilum or if there are signs of suspected renal pelvis or ureteral laceration, active haemorrhage, peritonitis or hemodynamically unstable patients.1 However, due to the paucity of cases reported in the literature, it is not clear what the best management of patients with a retained bullet is, which have been traditionally treated with surgical retrieval in other organs. We present the radiological findings and a clinical case summary of a patient with Grade IV kidney injury and retained bullet managed conservatively...
December 7, 2017: Urology
https://www.readbyqxmd.com/read/29224829/plasticity-of-oral-mucosal-cell-sheets-for-accelerated-and-scarless-skin-wound-healing
#10
Jong-Lyel Roh, Jaewang Lee, Eun Hye Kim, Daiha Shin
OBJECTIVES: Wound healing is generally faster and associated with less scarring in the oral mucosa than in the skin. Although rarely studied, oral mucosa equivalents may contribute to rapid, scarless cutaneous wound healing. Therefore, we examined the potential utility of our newly developed oral mucosal cell sheet in skin wound healing. MATERIALS AND METHODS: Oral mucosa and skin samples were obtained from surgical patients and Sprague-Dawley rats. Keratinocytes and fibroblasts were primarily cultured for in vitro cell expansion...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29224818/reconstruction-after-salvage-laryngectomy
#11
David H Yeh, Axel Sahovaler, Kevin Fung
Both early and advanced stage laryngeal cancers are treated with organ-preserving strategies including radiation alone or concurrent chemoradiotherapy. While organ-preserving modalities have proven effective in eradicating cancer while also preserving laryngeal function, there remains a proportion of cases where residual or recurrent cancer prevails, or conversely, where radiotherapy renders a larynx dysfunctional. In these circumstances, salvage total laryngectomy is often the surgical treatment. The effects of radiotherapy to the neck, amplified by chemotherapy, can create an inhospitable surgical environment, making the salvage laryngectomy an operation fraught with the potential for major complications such as the dreaded pharyngocutaneous fistula...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29224794/external-validation-of-the-european-hernia-society-classification-for-postoperative-complications-after-incisional-hernia-repair-a-cohort-study-of-2-191-patients
#12
Leonard F Kroese, Gert-Jan Kleinrensink, Johan F Lange, Jean-Francois Gillion
BACKGROUND: Incisional hernia is a frequent complication after midline laparotomy. Surgical hernia repair is associated with complications, but no clear predictive risk factors are identified. The European Hernia Society (EHS) classification offers a structured framework to describe hernias and to analyze postoperative complications. Because of its structured nature, it might prove to be useful for preoperative patient or treatment classification. The objective of this study was to investigate the EHS classification as a predictor for postoperative complications after incisional hernia surgery...
December 7, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29224267/-clinical-outcomes-of-cervical-disc-herniation-treated-by-posterior-percutaneous-endoscopic-cervical-discectomy
#13
B L Chen, Y J Li, Y P Lin, Y X Du, S Zhao, G Y Su
Objective: To evaluate the clinical outcomes of posterior percutaneous endoscopic cervical discectomy (PPECD) for cervical disc herniation. Methods: A total of 23 patients who underwent PPECD for cervical disc herniation at Department of Spine Surgery, Guangdong Provincial Hospital of Chinese Medicine from August 2014 to April 2016 were reviewed. The mean age of the 17 males and 6 females was 49.5 years (range from 31 to 61 years). All patients had unilateral upper limb radiating symptoms, 13 patients with right upper limb radiating pain and 10 patients with left upper limb radiation pain, 17 patients with neck pain symptoms...
December 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29223666/laparoscopic-versus-open-appendectomy-in-children-a-randomized-controlled-trial-from-a-developing-country
#14
Roshan Ali, Muhammad Anwar, Jamshed Akhtar
BACKGROUND: Acute appendicitis is a common surgical emergency. This study was conducted to compare the outcome in terms of duration of surgery, length of hospital stay, and wound infection rate following laparoscopic versus open appendectomy in children with acute appendicitis. METHODS: A prospective randomized controlled trial was conducted. Patients with the diagnosis of acute appendicitis were randomly assigned to Group A: Laparoscopic appendectomy (LA) and Group B: Open appendectomy (OA)...
November 14, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29223633/effectiveness-of-irrigation-with-chlorhexidine-after-removal-of-mandibular-third-molars-a-randomised-controlled-trial
#15
H Cho, M C David, A J Lynham, E Hsu
To evaluate the effect of postoperative irrigation with chlorhexidine on inflammatory complications after the extraction of lower third molars under local anaesthesia, we recruited 100 patients to participate in a controlled, single-blind, randomised clinical trial. They were assigned to one of two groups: the intervention group (postoperative irrigation of the surgical site with chlorhexidine for seven days) or the control group (postoperative chlorhexidine mouth rinse for seven days). The primary outcome variables were pain, swelling, trismus, infection, and alveolar osteitis...
December 6, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29223632/comparative-morbidity-of-cubital-tunnel-surgeries-a-prospective-cohort-study
#16
Robert Staples, Dan London, Agnes Z Dardas, Charles A Goldfarb, Ryan P Calfee
PURPOSE: Randomized controlled trials have not identified a superior surgical approach to cubital tunnel syndrome surgery. This study evaluates the early morbidity of open in situ decompression and transposition. METHODS: This prospective cohort study enrolled 125 adult patients indicated for cubital tunnel surgery at a tertiary institution. Exclusion criteria included preoperative use of narcotics and concurrent elbow procedures. In situ decompressions (n = 47) and ulnar nerve transpositions (n = 78) were performed...
December 6, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29223423/the-requirement-of-sutures-to-close-intercostal-drains-site-wounds-in-thoracic-surgery
#17
Jeremy L C Smelt, Natalie Simon, Lukacs Veres, Karen Harrison-Phipps, Andrea Bille
BACKGROUND: Chest drains are used routinely in thoracic surgery. Often a pursestring or mattress suture is used to facilitate closure of the defect on removal of the drain. This stitch can cause an unsightly scar, increase drain removal pain, and necessitate that the patient attend a community health care center to have this removed. The objective of this study was to assess whether this stitch is necessary in modern thoracic surgical practice. METHODS: Data from a single surgeon's practice were collected over an 18-month period...
December 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29223232/morphologic-features-and-surgically-induced-astigmatism-of-femtosecond-laser-versus-manual-clear-corneal-incisions
#18
Sha Zhu, Naibin Qu, Wei Wang, Yanan Zhu, Xingchao Shentu, Peiqing Chen, Wen Xu, Ke Yao
PURPOSE: To compare the morphologic features and surgically induced astigmatism (SIA) between laser and manual clear corneal incisions (CCIs) after femtosecond laser-assisted cataract surgery. SETTING: Eye Center, 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China. DESIGN: Prospective case series. METHODS: Patients had femtosecond laser-assisted cataract surgery with a CCI created with the laser or manually after random allocation...
November 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/29221299/surgical-site-infections-after-lung-resection-a-prospective-study-of-risk-factors-in-1-091-consecutive-patients
#19
Andrea Imperatori, Elisa Nardecchia, Lorenzo Dominioni, Daniele Sambucci, Sebastiano Spampatti, Giancarlo Feliciotti, Nicola Rotolo
Background: To assess incidence and risk factors of surgical site infections (SSI) (wound infection, pneumonia, empyema) in a monocentric series of patients undergoing lung resection over a decade. Methods: All patients undergoing lung resection at our institution in 2006-2015 [wedge resection, n=579; lobectomy, n=472 (12% after chemo/radiotherapy); pneumonectomy, n=40 (47% after chemo/radiotherapy)], were prospectively enrolled. Perioperative SSI risk factors were recorded: age, gender, blood haemoglobin, lymphocyte count, serum albumin, forced expiratory volume in 1 second percentage (FEV1%) of predicted, antibiotic prophylaxis, length of stay, diabetes, malignancy, steroid therapy, induction chemo/radiotherapy, resection in 2006-2010/2011-2015, urgent/elective procedure, videothoracoscopic/open approach, resection type, operative time...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29220392/safety-and-efficacy-of-the-prepex-device-in-hiv-positive-men-a-single-arm-study-in-zimbabwe
#20
Mufuta Tshimanga, Batsirai Makunike-Chikwinya, Tonderayi Mangwiro, Patricia Tapiwa Gundidza, Pesanai Chatikobo, Vernon Murenje, Amy Herman-Roloff, Peter H Kilmarx, Marrianne Holec, Gerald Gwinji, Owen Mugurungi, Munyaradzi Murwira, Sinokuthemba Xaba, Scott Barnhart, Caryl Feldacker
METHODS: We aimed to determine if the adverse event (AE) rate was non-inferior to an AE rate of 2%, a rate considered the global standard of MC safety. Study procedures, AE definitions, and study staff were unchanged from previous PrePex Zimbabwe trials. After PrePex placement and removal, weekly visits assessed wound healing. Men returned on Day 90. Safety was defined as occurrence of moderate and serious clinical AEs. Efficacy was defined as ability to reach the endpoint of complete circumcision...
2017: PloS One
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