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Surgical wound class

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https://www.readbyqxmd.com/read/28541864/surgical-site-infection-rate-drops-to-0-using-a-vacuum-assisted-closure-in-contaminated-dirty-infected-laparotomy-wounds
#1
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/28493162/single-setting-endoscopic-retrograde-cholangiopancreatography-ercp-and-cholecystectomy-improve-the-rate-of-surgical-site-infection
#2
Michele M Loor, Jean Dominique Morancy, James K Glover, Gregory J Beilman, Catherine L Statz
INTRODUCTION: Cholecystectomy is a common surgical procedure. The presence of common bile duct stones complicates treatment, often requiring a second procedure for stone retrieval. For such patients, endoscopic retrograde cholangiopancreatography (ERCP) provides adequate therapy, and can be performed before, after, or at the same time as cholecystectomy. In 2013, duodenoscopes were implicated by the Centers for Disease Control and Prevention in transmission of carbapenem-resistant Enterobacteriaceae...
May 10, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28470562/outcomes-are-local-patient-disease-and-procedure-specific-risk-factors-for-colorectal-surgical-site-infections-from-a-single-institution
#3
Robert R Cima, John R Bergquist, Kristine T Hanson, Cornelius A Thiels, Elizabeth B Habermann
BACKGROUND: Colorectal surgical site infections (SSIs) contribute to postoperative morbidity, mortality, and resource utilization. Risk factors associated with colorectal SSI are well-documented. However, quality improvement efforts are informed by national data, which may not identify institution-specific risk factors. METHOD: Retrospective cohort study of colorectal surgery patients uses institutional ACS-NSQIP data from 2006 through 2014. ACS-NSQIP data were enhanced with additional variables from medical records...
May 3, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28455181/discharge-to-inpatient-facilities-after-total-hip-arthroplasty-is-associated-with-increased-postdischarge-morbidity
#4
Michael C Fu, Andre M Samuel, Peter K Sculco, Catherine H MacLean, Douglas E Padgett, Alexander S McLawhorn
BACKGROUND: Discharge disposition accounts for significant variability in costs after elective total hip arthroplasty (THA). Therefore, institutions must evaluate the short-term clinical outcomes associated with postdischarge care options. The present study intends to characterize the associations between short-term morbidity after primary THA and discharge destination. METHODS: Primary elective unilateral THA cases performed for osteoarthritis were identified in the American College of Surgeons National Surgical Quality Improvement Program registry from 2011 to 2014...
March 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28450145/are-anaerobes-a-major-underappreciated-cause-of-necrotizing-infections
#5
Hannah Zhao-Fleming, Sharmila Dissanaike, Kendra Rumbaugh
Necrotizing soft tissue infections (NSTIs) are the most severe and rapidly progressing class of skin and soft tissue infections (SSTIs). They are a surgical emergency and are associated with high mortality and morbidity. While NSTIs remain relatively rare, their incidence is steadily rising. Earlier diagnosis and more focused antibiotic treatments can potentially improve patient outcome, but both of these solutions require a more accurate understanding of the microbial component of these infections. While molecular detection methods, namely 16S sequencing, have not been traditionally used to identify the causative microorganisms in NSTIs, they are becoming more commonplace for other types of SSTIs, especially for chronic wound infections...
April 24, 2017: Anaerobe
https://www.readbyqxmd.com/read/28445378/the-impact-of-body-mass-index-on-abdominal-wall-reconstruction-outcomes-a-comparative-study
#6
Salvatore A Giordano, Patrick B Garvey, Donald P Baumann, Jun Liu, Charles E Butler
BACKGROUND: Obesity and higher body mass index may be associated with higher rates of wound healing complications and hernia recurrence rates following complex abdominal wall reconstruction. The authors hypothesized that higher body mass indexes result in higher rates of postoperative wound healing complications but similar rates of hernia recurrence in abdominal wall reconstruction patients. METHODS: The authors included 511 consecutive patients who underwent abdominal wall reconstruction with underlay mesh...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28357687/efficacy-and-safety-of-non-suture-dural-closure-using-a-novel-dural-substitute-consisting-of-polyglycolic-acid-felt-and-fibrin-glue-to-prevent-cerebrospinal-fluid-leakage-a-non-controlled-open-label-multicenter-clinical-trial
#7
Shunsuke Terasaka, Toshiaki Taoka, Satoshi Kuroda, Nobutaka Mikuni, Toru Nishi, Hiroyuki Nakase, Yukihiko Fujii, Yasuhiko Hayashi, Jun-Ichi Murata, Ken-Ichiro Kikuta, Toshihiko Kuroiwa, Sachie Shimokawa, Kiyohiro Houkin
The objective of this study is to evaluate the efficacy and safety of non-suture dural closure using a novel dural substitute (GM111) consisting of polyglycolic acid felt with a fibrin-glue-coated area commensurate in size with the dural defect. This was a non-controlled, open-label, multicenter clinical trial. The efficacy evaluation endpoints were (1) GM111's intra-operative capability to close dural defects and (2) prevention of cerebrospinal fluid (CSF) leakage and subcutaneous CSF retention throughout the postoperative period (evaluated by diagnostic imaging)...
May 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28353606/prophylactic-vacuum-sealing-drainage-vsd-in-the-prevention-of-postoperative-surgical-site-infections-in-pediatric-patients-with-contaminated-laparotomy-incisions
#8
Bailin Chen, Fabao Hao, Yang Yang, Qingjuan Shang, Chunbao Guo
Surgical site infection (SSI) continues to be an issue in abdominal surgery, especially for contaminated (class III) and dirty-infected (class IV) wounds. Vacuum sealing drainage (VSD) was reported effective in the management of various types of wounds or skin grafts. Our goal was to investigate the efficacy of prophylactic VSD to better orient their medicosurgical care of high-risk incisions following laparotomy in a pediatric population.A total of 331 pediatric patients with contaminated (class III) and dirty-infected (class IV) wounds following emergency laparotomy were retrospectively reviewed between January 2005 and January 2013...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28349533/subtotal-petrosectomy-surgical-technique-indications-outcomes-and-comprehensive-review-of-literature
#9
Sampath Chandra Prasad, Valeria Roustan, Gianluca Piras, Antonio Caruso, Lorenzo Lauda, Mario Sanna
OBJECTIVES/HYPOTHESIS: To describe the technique of subtotal petrosectomy (STP), to analyze the outcomes, and to review the literature STUDY DESIGN: A retrospective review. METHODS: Four hundred sixty cases of STP performed for various indications were included in the study, which was conducted at a quaternary referral center for otology and skull base surgery. Surgical and audiological parameters, and complications were evaluated. Our results were compared with the existing literature on the subject...
March 27, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28341868/risk-factors-of-reoperation-after-pancreatic-resection
#10
Heather G Lyu, Gaurav Sharma, Ethan Brovman, Julius Ejiofor, Aparna Repaka, Richard D Urman, Jason S Gold, Edward E Whang
BACKGROUND: Pancreatic resection is associated with a high incidence of postoperative complications, some of which require reoperation. AIMS: To analyze the incidence of and risk factors for reoperation following pancreatectomy. METHODS: Pre- and postoperative information and procedure characteristics of 15,549 patients having undergone pancreatectomy in 435 hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program from 2011 to 2014 were analyzed...
March 24, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28332921/leaving-the-skin-incision-open-may-not-be-as-beneficial-as-we-have-been-taught
#11
Jack C He, Brenda M Zosa, David Schechtman, Brian Brajcich, Jonathan C Savakus, Amanda L Wojahn, Derek Z Wang, Jeffrey A Claridge
BACKGROUND: Currently, various methods of skin closures are used in contaminated and dirty abdominal wounds without solid, evidence-based guidance. This study investigates whether closure methods affect surgical site infection (SSI) and other incisional complications. We hypothesize that open management of the skin would have the lowest complications, including SSI. PATIENTS AND METHODS: Patients age ≥18 who underwent trauma laparotomy (TL) or damage control laparotomy (DCL) from 2008-2013 and had class III/IV wounds were included...
May 2017: Surgical Infections
https://www.readbyqxmd.com/read/28285902/continued-inpatient-care-after-primary-total-knee-arthroplasty-increases-30-day-post-discharge-complications-a-propensity-score-adjusted-analysis
#12
Alexander S McLawhorn, Michael C Fu, William W Schairer, Peter K Sculco, Catherine H MacLean, Douglas E Padgett
BACKGROUND: Discharge destination, either home or skilled care facility, after total knee arthroplasty (TKA) may be associated with significant variation in postacute care outcomes. The purpose of this study was to characterize the 30-day postdischarge outcomes after primary TKA relative to discharge destination. METHODS: All primary unilateral TKAs performed for osteoarthritis from 2011-2014 were identified in the National Surgical Quality Improvement Program database...
February 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28285473/a-modern-case-series-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-an-out-of-hospital-combat-casualty-care-setting
#13
Justin D Manley, Benjamin J Mitchell, Joseph J DuBose, Todd E Rasmussen
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to mitigate bleeding and sustain central aortic pressure in the setting of shock. The ER-REBOA™ catheter is a new REBOA technology, previously reported only in the setting of civilian trauma and injury care. The use of REBOA in an out-of-hospital setting has not been reported, to our knowledge. METHODS: We present a case series of wartime injured patients cared for by a US Air Force Special Operations Surgical Team at an austere location fewer than 3km (5-10 minutes' transport) from point of injury and 2 hours from the next highest environment of care-a Role 2 equivalent...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28282003/complex-ventral-hernia-repair-with-acellular-dermal-matrices-clinical-and-quality-of-life-outcomes
#14
John Scott Roth, Amanda Zachem, Margaret A Plymale, Daniel L Davenport
Acellular dermal matrices (ADMs) are used in conjunction with complex hernia repair, but their efficacy is often debated. This study assesses clinical and quality of life (QOL) outcomes in multiply comorbid patients undergoing complex ventral hernia repair using ADMs. After obtaining institutional review board approval, a prospective study was conducted evaluating patients undergoing complex ventral incisional hernia repair with abdominal wall reconstruction (AWR) using either human (Flex HD) or porcine ADM (Strattice)...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28267128/medical-adhesive-related-skin-injury-following-emergent-appendectomy-a-case-study-of-marsi-and-missed-opportunities-in-nursing-care
#15
Sylvia E Britt, Karen M Coles, Shannon S Polson
BACKGROUND: The potential for skin damage from adhesive products is documented in the literature. Nevertheless, health care providers continue to lack understanding of the impact and seriousness of skin injury associated with use of tapes or other adhesive devices when applied to a patient with a history or hypersensitivity or allergy to adhesives. CASE: A 67-year-old woman with a history of tape allergy underwent emergency appendectomy. Initial removal of an adhesive bandage placed over the surgical incision revealed medical adhesive-related skin injury (MARSI)...
March 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28228200/complex-ventral-hernia-repair-with-acellular-dermal-matrices-clinical-and-quality-of-life-outcomes
#16
John Scott Roth, Amanda Zachem, Margaret A Plymale, Daniel L Davenport
Acellular dermal matrices (ADMs) are used in conjunction with complex hernia repair, but their efficacy is often debated. This study assesses clinical and quality of life (QOL) outcomes in multiply comorbid patients undergoing complex ventral hernia repair using ADMs. After obtaining institutional review board approval, a prospective study was conducted evaluating patients undergoing complex ventral incisional hernia repair with abdominal wall reconstruction (AWR) using either human (Flex HD) or porcine ADM (Strattice)...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28168619/pure-endoscopic-management-of-epileptogenic-hypothalamic-hamartomas
#17
S Chibbaro, H Cebula, J Scholly, J Todeschi, I Ollivier, A Timofeev, M Ganau, P Di Emidio, M P Valenti, A M Staack, T Bast, B J Steinhoff, E Hirsch, P Kehrli, F Proust
Hypothalamic hamartomas (HH) are rare congenital malformations located in the region of the tuber cinereum and third ventricle. Their usual clinical presentation is characterized by gelastic/dacrystic seizures which often become pharmaco-resistant and progress to secondary focal/generalized intractable epilepsy causing mostly in children cognitive and behavioral problems (particularly in cases of progressive epileptic encephalopathy) and precocious puberty. Whereas gelastic seizures can be surgically controlled either by resection of the lesion or disconnection (tissue-destructive) procedures, aimed at functionally prevent the spreading of the epileptic burst; generalized seizures tend to respond better to HH excision rather than isolated neocortical resections, which generally fail to control them...
February 7, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28168215/incidence-and-etiology-of-surgical-site-infections-among-emergency-postoperative-patients-in-mbarara-regional-referral-hospital-south-western-uganda
#18
Abubaker Lubega, Bazira Joel, Najjuka Justina Lucy
Background. This prospective hospital based study was conducted to determine the incidence, risk factors, and causative agents of surgical site infection their susceptibility to among 114 emergency postoperative patients at the Mbarara Regional Referral Hospital between September 2014 and January 2015. Methods. Consented patients were consecutively enrolled and their preoperative, intraoperative, and postoperative data were collected. Follow-ups were done in the surgical outpatient clinics. Wound specimens were collected and processed as per Sops; susceptibility testing was done using the Kirby-Bauer disc diffusion technique...
2017: Surgery Research and Practice
https://www.readbyqxmd.com/read/28167877/hypoalbuminemia-is-a-better-predictor-than-obesity-of-complications-after-total-knee-arthroplasty-a-propensity-score-adjusted-observational-analysis
#19
Michael C Fu, Alexander S McLawhorn, Douglas E Padgett, Michael B Cross
BACKGROUND: Obesity is an established risk factor for complications after total knee arthroplasty (TKA) and is often associated with malnutrition. QUESTIONS/PURPOSES: 1. What is the prevalence of hypoalbuminemia in obese patients undergoing TKA? 2. What is the independent morbidity risk of malnutrition relative to obesity? METHODS: TKA cases were identified from the National Surgical Quality Improvement Program from 2005 to 2013. Propensity scores for having preoperative albumin measurements were calculated using demographics, BMI, and modified Charlson Comorbidity Index (CCI)...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28166064/incidence-and-risk-factors-of-surgical-site-infections-in-kathmandu-university-hospital-kavre-nepal
#20
S Shrestha, P Wenju, R Shrestha, R M Karmacharya
Background Surgical site infections (SSI) are the common nosocomial infection in surgical patients, and are a significant source of postoperative morbidity resulting in increased hospital stay, morbidity and cost. Objective The objective of this study was to obtain the incidence of SSI and determine various risks factors influencing the SSI rate with special reference to the National Nosocomial Infections Surveillance System risk index in Kathmandu University Hospital, Kavre, Nepal. Method Six hundred and thirty eight patients who underwent various surgeries in Dhulikhel Hospital, Kathmandu University Hospital during a three-month period were included...
April 2016: Kathmandu University Medical Journal (KUMJ)
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