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Surgical wound class

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https://www.readbyqxmd.com/read/28635237/-comparison-of-the-short-term-and-long-term-outcomes-of-laparoscopic-surgery-and-open-surgery-for-early-stage-cervical-cancer
#1
H Y He, Z J Yang, D Y Zeng, D S Yao, J T Fan, R F Zhao, J Q Zhang, X X Hu, Z Lin, Y M Jiang, L Li
Objective: To evaluate the short-term and long-term outcomes after laparoscopic surgery compared with traditional laparotomy in cases of stage ⅠA2-ⅡA2 cervical cancer. Methods: We conducted a retrospective study on the clinical data of 1 863 patients diagnosed as FIGO stages ⅠA2-ⅡA2 cervical cancer in 6 third-grade class-A hospitals in Guangxi province between January 2007 and May 2014. One thousand and seventy-one received laparoscopy, and 792 received laparotomy. T-test, U-test and χ(2) test were used to compare the short-term and long-term outcomes...
June 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28619265/comparison-of-surgical-incision-complete-closure-versus-leaving-skin-open-in-wound-class-iv-in-emergent-colon-surgery
#2
Anand Dayama, Catherine A Fontecha, Shahin Foroutan, Jonathan Lu, Sumit Kumar, Nathaniel M Matolo
INTRODUCTION: Our aim was to compare the effect of techniques of wound closure in the emergent colon surgery with wound class IV. METHODS: Using 2014 the colectomy targeted ACS-NSQIP dataset; we identified patients undergoing emergent colectomy with wound class IV. Comparison of surgical incision complete closure versus leaving the skin open and multivariate logistic regression analyses was performed. RESULTS: Of 1792 patients undergoing emergent colectomy with wound class IV, the complete closure cohort had 1376 patients and the incision skin open cohort had 416 patients...
June 3, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28608525/antimicrobials-used-for-surgical-prophylaxis-by-equine-veterinary-practitioners-in-australia
#3
L Y Hardefeldt, G F Browning, K Thursky, J R Gilkerson, H Billman-Jacobe, M A Stevenson, K E Bailey
BACKGROUND: Antimicrobials are widely used in Australian veterinary practices, but no investigation into the classes of antimicrobials used or the appropriateness of use in horses has been conducted. OBJECTIVES: The aim of the study was to describe antimicrobial use for surgical prophylaxis in equine practice in Australia. STUDY DESIGN: Cross-sectional questionnaire survey. METHODS: An online questionnaire was used to document antimicrobial usage patterns...
June 13, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28606597/resident-involvement-in-microsurgery-an-american-college-of-surgeons-national-surgical-quality-improvement-program-analysis
#4
Kevin T Jubbal, Daniel Chang, Shayan A Izaddoost, William Pederson, Dmitry Zavlin, Anthony Echo
OBJECTIVE: In the current healthcare climate, there is increased focus on medical errors, patient outcomes, and the influence of resident participation on these metrics. Other studies have examined the influence of resident involvement on surgical outcomes, but the arena of microsurgery, with added complexity and learning curve, has yet to be investigated. DESIGN: A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database was performed to find patients undergoing procedures with free tissue transfer by screening for Current Procedural Terminology codes...
June 9, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28601329/predictors-of-readmission-in-nonagenarians-analysis-of-the-american-college-of-surgeons-national-surgical-quality-improvement-project-dataset
#5
Zachary Hothem, Dustin Baker, Christina S Jenkins, Jason Douglas, Rose E Callahan, Catherine C Shuell, Graham W Long, Robert J Welsh
BACKGROUND: Increased longevity has led to more nonagenarians undergoing elective surgery. Development of predictive models for hospital readmission may identify patients who benefit from preoperative optimization and postoperative transition of care intervention. Our goal was to identify significant predictors of 30-d readmission in nonagenarians undergoing elective surgery. METHODS: Nonagenarians undergoing elective surgery from January 2011 to December 2012 were identified using the American College of Surgeons National Surgical Quality Improvement Project participant use data files...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28595843/analysis-of-risk-factors-associated-with-unplanned-reoperations-following-pediatric-plastic-surgery
#6
Kevin T Jubbal, Dmitry Zavlin, Edward P Buchanan, Larry H Hollier
BACKGROUND/PURPOSE: Unplanned reoperation (UR) is an outcome measure with multiple advantages that can be used as a standardized tool to assess an institution's quality and safety of medical care. This study aimed to identify parameters associated with an increased likelihood of UR following plastic surgery in patients less than 18 years of age by using a large validated national multicenter database. METHODS/DESCRIPTION: We performed a retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Pediatric database between 2012 and 2014 to identify pediatric patients undergoing primary plastic surgery procedures...
May 18, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28584499/quantifying-intraoperative-laparoscopic-visual-field-opacity
#7
Danielle Abbitt, Bertha Ben Khallouq, Jay Redan
BACKGROUND AND OBJECTIVES: Laparoscopic surgery can be complicated by condensation and debris on the lens obscuring the visual field, increasing the risk of surgical error and injury to the patient. Despite, development of possible solutions, little is known regarding the quantitative measure of time lost during surgery because of an obscured visual field. Without this knowledge, the cost of laparoscopic lens fogging cannot be quantified and compared to the cost of antifogging devices...
April 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28541864/surgical-site-infection-rate-drops-to-0-using-a-vacuum-assisted-closure-in-contaminated-dirty-infected-laparotomy-wounds
#8
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
#9
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
#10
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
#11
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
#12
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...
June 2017: Anaerobe
https://www.readbyqxmd.com/read/28445378/the-impact-of-body-mass-index-on-abdominal-wall-reconstruction-outcomes-a-comparative-study
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
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