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https://www.readbyqxmd.com/read/28804813/a-systematic-review-of-the-clinical-applications-and-complications-of-bone-marrow-aspirate-concentrate-in-management-of-bone-defects-and-nonunions
#1
REVIEW
Mohamed A Imam, James Holton, Lukas Ernstbrunner, Wojciech Pepke, Florian Grubhofer, Ali Narvani, Martyn Snow
PURPOSE: Fracture healing encompasses a succession of dynamic multifactorial metabolic events, which ultimately re-establishes the integrity of the biomechanical properties of the bone. Up to 10% of the fractures occurring annually will need additional surgical procedures because of impaired healing. The aim of this article is to review the current literature regarding the use of bone marrow aspirate concentrate (BMAC) and its effectiveness in the management of bone defects. METHODS: We have included all published clinical literature investigating the development, techniques and applications of BMAC...
August 13, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28802426/comparison-between-antegrade-intramedullary-nailing-imn-open-reduction-plate-osteosynthesis-orpo-and-minimally-invasive-plate-osteosynthesis-mipo-in-treatment-of-humerus-diaphyseal-fractures
#2
Vidisha Sunil Kulkarni, Madhura Sujay Kulkarni, Govind Shivram Kulkarni, Vaibhav Goyal, Milind Govind Kulkarni
INTRODUCTION: The three currently used methods of treatment: namely open reduction plate osteosynthesis (ORPO), Minimally invasive plate osteosynthesis (MIPO), antegrade intramedullary nailing(IMN) are all reported as satisfactory procedures for treatment of humeral shaft fractures. However none of the published reports have a comparison of superiority of one procedure over the other. We evaluated the clinical, radiological and functional outcome of the three procedures. MATERIALS AND METHODS: We studied adult patients with humerus shaft fractures over a period of 2 years from May 2014 to May 2016 in a level 1 trauma center...
August 2017: Injury
https://www.readbyqxmd.com/read/28794007/the-future-of-resuscitative-endovascular-balloon-occlusion-in-combat-operations
#3
Shane A Smith, R Hilsden, A Beckett, V C McAlister
Damage control resuscitation and early thoracotomy have been used to increase survival after severe injury in combat. There has been a renewed interest in resuscitative endovascular balloon occlusion of the aorta (REBOA) in both civilian and military medical practices. REBOA may result in visceral and limb ischaemia that could be harmful if use of REBOA is premature or prolonged. The purpose of this paper is to align our experience of combat injuries with the known capability of REBOA to suggest an implementation strategy for the use of REBOA in combat care...
August 9, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28793951/changes-in-surgical-team-performance-and-safety-climate-attitudes-following-expansion-of-perioperative-services-a-repeated-measures-study
#4
Brigid M Gillespie, Emma Harbeck, Evelyn Kang, Catherine Steel, Nicole Fairweather, Wendy Chaboyer
Objective The aim of the present study was to describe process changes in surgical team performance and team members' attitudes to safety culture following hospital relocation and expansion of perioperative services.Methods The study was a naturalistic study using structured observations and surveys to assess non-technical skills (NTS; i.e. communication, teamwork, situational awareness, decision making and leadership) in surgery. This interrupted time series design used mixed-linear regression models to examine the effect of phase (before and after hospital relocation) on surgical teams' NTS and their processes that may affect performance...
August 10, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28747252/analysis-of-the-tractive-force-pattern-on-a-knot-by-force-measurement-during-laparoscopic-knot-tying
#5
Kenta Takayasu, Kenji Yoshida, Hidefumi Kinoshita, Syunsuke Yoshimoto, Osamu Oshiro, Tadashi Matsuda
BACKGROUND: Quantifying surgical skills assists novice surgeons when learning operative techniques. We measured the interaction force at a ligation point and clarified the features of the force pattern among surgeons with different skill levels during laparoscopic knot tying. METHODS: Forty-four surgeons were divided into three groups based on experience: 13 novice (0-5 years), 16 intermediate (6-15 years), and 15 expert (16-30 years). To assess the tractive force direction and volume during knot tying, we used a sensor that measures six force-torque values (x-axis: Fx, y-axis: Fy, z-axis: Fz, and xy-axis: Fxy) attached to a slit Penrose drain...
July 19, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28741729/influence-of-timing-of-delayed-hard-palate-closure-on-articulation-skills-in-3-year-old-danish-children-with-unilateral-cleft-lip-and-palate
#6
Elisabeth Willadsen, Maria Boers, Antje Schöps, Mia Kisling-Møller, Joan Bogh Nielsen, Line Dahl Jørgensen, Mikael Andersen, Stig Bolund, Helene Søgaard Andersen
BACKGROUND: Differing results regarding articulation skills in young children with cleft palate (CP) have been reported and often interpreted as a consequence of different surgical protocols. AIMS: To assess the influence of different timing of hard palate closure in a two-stage procedure on articulation skills in 3-year-olds born with unilateral cleft lip and palate (UCLP). Secondary aims were to compare results with peers without CP, and to investigate if there are gender differences in articulation skills...
July 25, 2017: International Journal of Language & Communication Disorders
https://www.readbyqxmd.com/read/28734971/robotic-assistance-confers-ambidexterity-to-laparoscopic-surgeons
#7
Souzana Choussein, Serene S Srouji, Leslie V Farland, Ashley Wietsma, Stacey A Missmer, Michael Hollis, Richard N Yu, Charles N Pozner, Antonio R Gargiulo
STUDY OBJECTIVE: To examine whether a robotic surgical platform can complement the fine motor skills of the non-dominant hand, compensating for the innate difference in dexterity between the surgeon's hands, thereby conferring virtual ambidexterity. DESIGN: Crossover intervention study. DESIGN CLASSIFICATION: Level II-1 evidence. SETTING: Centers for medical simulation of two tertiary care hospitals of Harvard Medical School...
July 19, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28728324/the-chicken-thigh-adductor-profundus-free-muscle-flap-a-novel-validated-non-living-microsurgery-simulation-training-model
#8
Georgios Pafitanis, Yasmine Serrar, Maria Raveendran, Ali Ghanem, Simon Myers
BACKGROUND: Simulation training is becoming an increasingly important component of skills acquisition in surgical specialties, including Plastic Surgery. Non-living simulation models have an established place in Plastic Surgical microsurgery training, and support the principles of replacement, reduction and refinement of animal use. A more sophisticated version of the basic chicken thigh microsurgery model has been developed to include dissection of a type 1-muscle flap and is described and validated here...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28707782/exchanging-implements-the-micro-materialities-of-multidisciplinary-work-in-the-operating-theatre
#9
Christian Heath, Paul Luff, Marcus Sanchez-Svensson, Maxim Nicholls
Surgical procedures rely upon an array of commonplace tools, implements and materials that mediate practice and disciplinary collaboration within the operating theatre. Substantial time is dedicated to the issue and provision of these artefacts and their timely exchange is critical to the successful accomplishment of surgical procedures. In this article, we consider the practice, knowledge and agency that informs how particular implements and materials are passed by the scrub nurse to the surgeon that in turn enables their deployment with regard to the particular procedure and the contingencies 'at hand'...
July 14, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28701324/40-4-40-educational-and-economic-outcomes-of-a-free-international-surgical-training-event
#10
James Glasbey, Piriyah Sinclair, Helen Mohan, Rhiannon Harries
PURPOSE OF STUDY: To demonstrate a model for delivery of an international surgical training event, and demonstrate its educational and economic outcomes. STUDY DESIGN: The Association of Surgeons in Training (ASiT) ran a course series on 16 January 2016 across the UK and Ireland. A mandatory, self-reported, online questionnaire collected delegate feedback, using 5-point Likert Scales, and a NetPromoter feedback tool. Precourse and postcourse matched questionnaires were collected for 'Foundation Skills in Surgery' (FSS) courses...
July 12, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28678872/physician-communication-coaching-effects-on-patient-experience
#11
Adrianne Seiler, Alexander Knee, Reham Shaaban, Christine Bryson, Jasmine Paadam, Rohini Harvey, Satoko Igarashi, Christopher LaChance, Evan Benjamin, Tara Lagu
BACKGROUND: Excellent communication is a necessary component of high-quality health care. We aimed to determine whether a training module could improve patients' perceptions of physician communication behaviors, as measured by change over time in domains of patient experience scores related to physician communication. STUDY DESIGN: We designed a comprehensive physician-training module focused on improving specific "etiquette-based" physician communication skills through standardized simulations and physician coaching with structured feedback...
2017: PloS One
https://www.readbyqxmd.com/read/28666793/gaze-based-technology-as-a-tool-for-surgical-skills-assessment-and-training-in-urology
#12
Carolina Diaz-Piedra, Jose M Sanchez-Carrion, Héctor Rieiro, Leandro L Di Stasi
OBJECTIVE: To assess the sensitivity of gaze-based metrics in detecting cognitive demands imposed by surgical procedures. We analyzed urologists' gaze entropy and velocity while performing 2 standardized high-fidelity simulated stone procedures with different levels of complexity. METHODS: Using a wearable eye tracker device (mounted onto an eyeglass frame), we measured gaze entropy and velocity in 15 urologists, members of the Andalusian health-care system, while they performed an extraction of a stone in the bladder (low complexity) and an extraction of a stone in the lumbar ureter (high complexity)...
June 27, 2017: Urology
https://www.readbyqxmd.com/read/28665378/-the-application-of-general-magnetic-therapy-for-the-rehabilitation-of-the-patients-following-the-surgical-treatment-of-herniated-intervertebral-discs
#13
D D Voronina, A G Kulikov, I A Luppova, O V Yarustovskaya
AIM: The objective of the present work was to rehabilitate more efficiently the patients who had undergone the surgical treatment for herniated discs in the lumbosacral spine by applying general magnetic therapy during the combined treatment. MATERIAL AND METHODS: A total of 73 patients underwent the medical examination and treatment. The patients matched for age and sex presenting with similar clinical symptoms were divided into two groups. All of them received initial therapy that included medication, therapeutic physical exercises, and aquatic therapy...
2017: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
https://www.readbyqxmd.com/read/28656672/drilling-into-the-functional-significance-of-stereopsis-the-impact-of-stereoscopic-information-on-surgical-performance
#14
Loulwa M Al-Saud, Faisal Mushtaq, Isra'a Mirghani, Ahmed Balkhoyor, Andrew Keeling, Michael Manogue, Mark A Mon-Williams
PURPOSE: One suggested advantage of human binocular vision is the facilitation of sophisticated motor control behaviours via stereopsis - but little empirical evidence exists to support this suggestion. We examined the functional significance of stereopsis by exploring whether stereopsis is used to perform a highly skilled real-world motor task essential for the occupational practice of dentistry. METHODS: We used a high fidelity virtual reality simulator to study how dentists' performance is affected by the removal of horizontal retinal image disparities under direct and indirect (mirror) observation...
July 2017: Ophthalmic & Physiological Optics: the Journal of the British College of Ophthalmic Opticians (Optometrists)
https://www.readbyqxmd.com/read/28652316/the-modified-jo-burg-technique-for-securing-intercostal-chest-drains
#15
Daniel J Ablett, L Navaratne, D Chua, C G Streets, N R M Tai
Insertion of an intercostal chest drain (ICD) is a common intervention in the management of either blunt or penetrating thoracic trauma. It is frequently performed by junior medical personnel as an emergency procedure during the initial resuscitation period and often within a stressful environment. Approximately one-fifth of all ICD insertions are associated with complications. In a retrospective review of over 1000 ICD insertions, 7% of the complications observed were due to inadequate fixation, resulting in dislodgement...
June 26, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28651976/observational-learning-during-simulation-based-training-in-arthroscopy-is-it-useful-to-novices
#16
Marie-Eve LeBel, John Haverstock, Sayra Cristancho, Lucia van Eimeren, Gavin Buckingham
OBJECTIVE: Observing experts constitutes an important and common learning experience for surgical residents before operating under direct guidance. However, studies suggest that exclusively observing experts may induce suboptimal motor learning, and watching errors from non-experts performing simple motor tasks may generate better performance. We investigated whether observational learning is transferrable to arthroscopy learning using virtual reality (VR) simulation. SETTING/DESIGN: In our surgical simulation laboratory, we compared students learning basic skills on a VR arthroscopy simulator after watching an expert video demonstration of VR arthroscopy tasks or a non-expert video demonstration of the same tasks to a Control group without video demonstration...
June 23, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28647793/training-in-robotic-surgery-an-overview
#17
REVIEW
Ashwin N Sridhar, Tim P Briggs, John D Kelly, Senthil Nathan
PURPOSE OF REVIEW: There has been a rapid and widespread adoption of the robotic surgical system with a lag in the development of a comprehensive training and credentialing framework. A literature search on robotic surgical training techniques and benchmarks was conducted to provide an evidence-based road map for the development of a robotic surgical skills for the novice robotic surgeon. RECENT FINDINGS: A structured training curriculum is suggested incorporating evidence-based training techniques and benchmarks for progress...
August 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28647574/a-rare-uterine-malformation-asymmetric-septate-uterus
#18
Alper Biler, Ali Akdemir, Nuri Peker, Fatih Sendag
STUDY OBJECTIVE: To demonstrate a step by step surgical hysteroscopy technique in a patient with asymmetric uterine septum and transverse uterine septum that was not previously described in the literature. DESIGN: Resection of an asymmetric uterine septum by laparoscopy and ultrasound-guided hysteroscopy (Canadian Task Force classification III). The video was assumed exempt from official review by our institutional review board. SETTING: A septate uterus is defined as the uterus in which the uterine cavity is longitudinally divided by the septum [1]...
June 22, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28643066/solving-the-surgeon-ergonomic-crisis-with-surgical-exosuit
#19
Shanglei Liu, Daniel Hemming, Ran B Luo, Jessica Reynolds, Jonathan C Delong, Bryan J Sandler, Garth R Jacobsen, Santiago Horgan
INTRODUCTION: The widespread adoption of laparoscopic surgery has put new physical demands on the surgeon leading to increased musculoskeletal disorders and injuries. Shoulder, back, and neck pains are among the most common complaints experienced by laparoscopic surgeons. Here, we evaluate the feasibility and efficacy of a non-intrusive progressive arm support exosuit worn by surgeons under the sterile gown to reduce pain and fatigue during surgery. METHODS AND PROCEDURES: This is a prospective randomized crossover study approved by the Internal Review Board (IRB)...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28634630/development-and-validation-of-a-tool-for-non-technical-skills-evaluation-in-robotic-surgery-the-icars-system
#20
Nicholas Raison, Thomas Wood, Oliver Brunckhorst, Takashige Abe, Talisa Ross, Ben Challacombe, Mohammed Shamim Khan, Giacomo Novara, Nicolo Buffi, Henk Van Der Poel, Craig McIlhenny, Prokar Dasgupta, Kamran Ahmed
BACKGROUND: Non-technical skills (NTS) are being increasingly recognised as vital for safe surgical practice. Numerous NTS rating systems have been developed to support effective training and assessment. Yet despite the additional challenges posed by robotic surgery, no NTS rating systems have been developed for this unique surgical environment. This study reports the development and validation of the first NTS behavioural rating system for robotic surgery. METHODS: A comprehensive index of all relevant NTS behaviours in robotic surgery was developed through observation of robotic theatre and interviews with robotic surgeons...
June 20, 2017: Surgical Endoscopy
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