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Surgical wound class

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https://www.readbyqxmd.com/read/28341868/risk-factors-of-reoperation-after-pancreatic-resection
#1
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
#2
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...
March 23, 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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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)
https://www.readbyqxmd.com/read/28111178/risk-factors-for-and-timing-of-adverse-events-after-total-shoulder-arthroplasty
#12
Andrew J Lovy, Aakash Keswani, Christina Beck, James E Dowdell, Bradford O Parsons
BACKGROUND: Total shoulder arthroplasty (TSA) is a likely target for future bundled payment initiatives, necessitating accurate preoperative risk stratification. The purpose of this study was to identify risk factors for unplanned readmission and severe adverse events, to risk stratify TSA patients based on these risk factors, and to assess timing of complications after TSA. METHODS: Data were collected from patients undergoing TSA from 2009 to 2014 in the American College of Surgeons National Surgical Quality Improvement Program...
January 19, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28103161/nurses-practice-in-preventing-postoperative-wound-infections-an-observational-study
#13
S Ding, F Lin, A P Marshall, B M Gillespie
OBJECTIVE: Surgical site infections (SSIs) are serious postoperative complications that may lead to undesired patient outcomes. Previous research has used survey and chart audit methods to describe wound care practices. However, little research has been published using contemporaneous observations to describe the surgical wound management practices of nurses. The aim of this study was to prospectively describe surgical nurses' postoperative wound care practices and the extent to which observed surgical wound practices aligned with evidence-based guideline recommendations...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28066954/ultrashort-self-assembling-fmoc-peptide-gelators-for-anti-infective-biomaterial-applications
#14
Alice P McCloskey, Emily R Draper, Brendan F Gilmore, Garry Laverty
Biomaterial-related infections have a significant impact on society and are a major contributor to the growing threat of antimicrobial resistance. Current licensed antibiotic classes struggle to breakdown or penetrate the exopolysaccharide biofilm barrier, resulting in sub-therapeutic concentrations of antibiotic at the surface of the biomaterial, treatment failure and increased spread of resistant isolates. This paper focuses for the first time on the ability of ultrashort Fmoc-peptide gelators to eradicate established bacterial biofilms implicated in a variety of medical device infections (Gram-positive: Staphylococcus aureus, Staphylococcus epidermidis and Gram-negative Escherichia coli, Pseudomonas aeruginosa)...
February 2017: Journal of Peptide Science: An Official Publication of the European Peptide Society
https://www.readbyqxmd.com/read/28034901/body-mass-index-and-mortality-among-adults-undergoing-cardiac-surgery-a-nationwide-study-with-a-systematic-review-and-meta-analysis
#15
Giovanni Mariscalco, Marcin J Wozniak, Alan G Dawson, Giuseppe F Serraino, Richard Porter, Mintu Nath, Catherine Klersy, Tracy Kumar, Gavin J Murphy
BACKGROUND: In an apparent paradox, morbidity and mortality are lower in obese patients undergoing cardiac surgery, although the nature of this association is unclear. We sought to determine whether the obesity paradox observed in cardiac surgery is attributable to reverse epidemiology, bias, or confounding. METHODS: Data from the National Adult Cardiac Surgery registry for all cardiac surgical procedures performed between April 2002 and March 2013 were extracted...
February 28, 2017: Circulation
https://www.readbyqxmd.com/read/28009747/multicenter-prospective-longitudinal-study-of-the-recurrence-surgical-site-infection-and-quality-of-life-after-contaminated-ventral-hernia-repair-using-biosynthetic-absorbable-mesh-the-cobra-study
#16
Michael J Rosen, Joel J Bauer, Marco Harmaty, Alfredo M Carbonell, William S Cobb, Brent Matthews, Matthew I Goldblatt, Don J Selzer, Benjamin K Poulose, Bibi M E Hansson, Camiel Rosman, James J Chao, Garth R Jacobsen
OBJECTIVE: The aim of the study was to evaluate biosynthetic absorbable mesh in single-staged contaminated (Centers for Disease Control class II and III) ventral hernia (CVH) repair over 24 months. BACKGROUND: CVH has an increased risk of postoperative infection. CVH repair with synthetic or biologic meshes has reported chronic biomaterial infections and high hernia recurrence rates. METHODS: Patients with a contaminated or clean-contaminated operative field and a hernia defect at least 9 cm had a biosynthetic mesh (open, sublay, retrorectus, or intraperitoneal) repair with fascial closure (n = 104)...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/27990572/creation-of-a-novel-risk-score-for-surgical-site-infection-and-occurrence-after-ventral-hernia-repair
#17
K E Poruk, C W Hicks, J Trent Magruder, N Rodriguez-Unda, K K Burce, S C Azoury, P Cornell, C M Cooney, F E Eckhauser
BACKGROUND: Complex ventral hernia repair (VHR) is a common surgical operation but carries a risk of complications from surgical site infections (SSI) and occurrences (SSO). We aimed to create a predictive risk score to identify patients at increased risk for SSO or SSI within 30 days of surgery. METHODS: Data were prospectively collected on all patients undergoing VHR between January 2008 and February 2015 by a single surgeon. Multivariable logistic regression was used to identify independent factors predictive of SSO and SSI...
April 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/27988412/breast-reconstruction-after-mastectomy-a-ten-year-analysis-of-trends-and-immediate-postoperative-outcomes
#18
Nicole Ilonzo, Ashley Tsang, Sara Tsantes, Alison Estabrook, Aye Moe Thu Ma
The landscape of breast reconstruction has changed significantly. This study assesses trends in type of reconstruction performed after mastectomy and impact on immediate postoperative complications. METHODS: Data for 67,450 patients undergoing mastectomy for breast cancer were analyzed using the National Surgical Quality Improvement Program (NSQIP) database for years 2005-2014. Primary outcomes were wound, nonwound related infections, and bleeding complications. Data were analyzed by univariate and multivariate analysis...
April 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/27956070/rates-and-risk-factors-of-unplanned-30-day-readmission-following-general-and-thoracic-pediatric-surgical-procedures
#19
Stephanie F Polites, Donald D Potter, Amy E Glasgow, Denise B Klinkner, Christopher R Moir, Michael B Ishitani, Elizabeth B Habermann
BACKGROUND/PURPOSE: Postoperative unplanned readmissions are costly and decrease patient satisfaction; however, little is known about this complication in pediatric surgery. The purpose of this study was to determine rates and predictors of unplanned readmission in a multi-institutional cohort of pediatric surgical patients. METHODS: Unplanned 30-day readmissions following general and thoracic surgical procedures in children <18 were identified from the 2012-2014 National Surgical Quality Improvement Program- Pediatric...
December 7, 2016: Journal of Pediatric Surgery
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
#20
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
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