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Surgical wound class

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https://www.readbyqxmd.com/read/28228200/complex-ventral-hernia-repair-with-acellular-dermal-matrices-clinical-and-quality-of-life-outcomes
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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)...
January 9, 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
#9
Giovanni Mariscalco, Marcin J Woźniak, 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...
December 28, 2016: 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
#10
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
#11
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...
December 18, 2016: 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
#12
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...
December 15, 2016: 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
#13
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
#14
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
https://www.readbyqxmd.com/read/27906759/development-of-a-disease-based-hernia-program-and-the-impact-on-cost-for-a-hospital-system
#15
David M Krpata, Ivy N Haskins, Steven Rosenblatt, Sharon Grundfest, Ajita Prabhu, Michael J Rosen
OBJECTIVE: The aim of this study was to assess the impact of developing a hernia program on mesh utilization. BACKGROUND: With the ongoing changes in healthcare, the value of all interventions will see increased scrutiny. Hernia mesh can be one of the most costly components of hernia repairs. A disease-based institutional hernia program that defines roles for mesh utilization and measures outcomes has the potential to add significant value to hospital systems. METHODS: In August 2014, a disease-based hernia program was initiated across a hospital system...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27890683/the-effect-of-obesity-on-perioperative-outcomes-for-open-and-minimally-invasive-prostatectomy
#16
Scott C Johnson, Vignesh T Packiam, Shay Golan, Andrew J Cohen, Charles U Nottingham, Norm D Smith
OBJECTIVE: To compare the impact of obesity on perioperative outcomes between open radical prostatectomy (ORP) and minimally invasive prostatectomy (MIP). METHODS: Using the National Surgical Quality Improvement Program public use files for 2008-2013, we identified patients undergoing prostatectomy using Current Procedural Terminology codes. Those without body mass index (BMI) or comorbidity information were excluded. BMI was treated as a categorical variable according to the World Health Organization classification...
November 24, 2016: Urology
https://www.readbyqxmd.com/read/27879589/abdominal-contouring-can-the-american-society-of-anesthesiologists-classification-system-help-determine-when-to-say-no
#17
Olatomide T Familusi, Matthew Doscher, Oscar J Manrique, Joseph Shin, Teresa Benacquista
BACKGROUND: The purpose of this study was to determine whether the American Society of Anesthesiologists classification system could be used preoperatively to identify patients at high risk for complications after abdominal contouring. METHODS: Using the National Surgical Quality Improvement Program database from 2007 to 2012, patients undergoing abdominal contouring procedures were identified and stratified by American Society of Anesthesiologists class. The primary outcome was any complication within 30 days...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27853659/incidence-predictors-and-postoperative-complications-of-blood-transfusion-in-thoracic-and-lumbar-fusion-surgery-an-analysis-of-13-695-patients-from-the-american-college-of-surgeons-national-surgical-quality-improvement-program-database
#18
Ahmed Aoude, Anas Nooh, Maryse Fortin, Sultan Aldebeyan, Peter Jarzem, Jean Ouellet, Michael H Weber
Study Design Retrospective cohort study. Objective To identify predictive factors for blood transfusion and associated complications in lumbar and thoracic fusion surgeries. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was used to identify patients who underwent lumbar or thoracic fusion from 2010 to 2013. Multivariate analysis was used to determine predictive factors and postoperative complications associated with transfusion. Results Out of 13,695 patients, 13,170 had lumbar fusion and 525 had thoracic fusion...
December 2016: Global Spine Journal
https://www.readbyqxmd.com/read/27825917/intraoperative-hypothermia-and-surgical-site-infections-in-patients-with-class-1-clean-wounds-a-case-control-study
#19
Michael J Brown, Timothy B Curry, Joseph A Hyder, Elie F Berbari, Mark J Truty, Darrell R Schroeder, Andrew C Hanson, Daryl J Kor
BACKGROUND: Numerous surgical quality metrics focus on prevention of unintentional perioperative hypothermia due, in part, to the association between hypothermia and surgical site infections (SSI). However, few studies have comprehensively evaluated the relationship between these metrics and SSI. In this study, we evaluated individual components of one set of hypothermia metrics to determine their association with SSI. METHODS: Patients with clean (Type 1) wounds who developed a SSI within thirty days after surgery from January 2003-December 2012 in one of five surgical specialties were matched to specialty specific controls without SSI...
November 4, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27825916/does-preoperative-bowel-preparation-reduce-surgical-site-infections-during-elective-ventral-hernia-repair
#20
David M Krpata, Ivy N Haskins, Sharon Phillips, Ajita S Prabhu, Steven Rosenblatt, Benjamin K Poulose, Michael J Rosen
BACKGROUND: To date, little is known about the benefits of preoperative bowel preparation in patients undergoing elective ventral hernia repair (VHR). The purpose of this study was to determine the effect of preoperative bowel preparation on 30-day wound events in patients undergoing elective VHR using the Americas Hernia Society Quality Collaborative (AHSQC). STUDY DESIGN: All patients undergoing elective VHR from January 2013 through January 2016 were identified within the AHSQC...
November 4, 2016: Journal of the American College of Surgeons
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