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https://www.readbyqxmd.com/read/29234966/efficacy-and-feasibility-of-a-collaborative-multidisciplinary-program-for-antibiotic-prophylaxis-in-clean-wound-surgery
#1
Xinyu Li, Hong Chen, Shenyin Zhu, Yu Liu, Jiadan Yang, Zhe Yuan, Gaoqun Yao, Feng Qiu
Background Despite national and international guidelines and recommendations, inappropriate prophylactic antibiotic use for clean wound surgery remains a common phenomenon in many Chinese hospitals, causing higher medical costs and bacterial resistance. Objective To improve the prescribing behavior for antibiotic prophylaxis and decrease antibiotic abuse and/or misuse in clean wound surgery. Setting The teaching hospital of a medical university in Southwest China. Methods A collaborative multidisciplinary program involving educational, technical, and administrative strategies was undertaken...
December 12, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29229656/informing-future-research-for-carriage-of-multiresistant-gram-negative-bacteria-problems-with-recruiting-to-an-english-stool-sample-community-prevalence-study
#2
Donna M Lecky, Deborah Nakiboneka-Ssenabulya, Tom Nichols, Peter Hawkey, Kim Turner, Keun-Taik Chung, Mike Thomas, Helen Lucy Thomas, Li Xu McCrae, Sahida Shabir, Susan Manzoor, Adela Alvarez-Buylla, Steve Smith, Cliodna McNulty
OBJECTIVES: This study aims to highlight problems with recruiting to an English stool sample community prevalence study. It was part of a larger cross-sectional research to determine the risk factors for the presence of extended-spectrum beta-lactamase and carbapenemase-producing coliforms in stool samples of the asymptomatic general English population. SETTING: Four National Health Service primary care trusts (PCTs) of England representing a different section of the population of England: Newham PCT; Heart of Birmingham Teaching PCT; Shropshire County PCT; and Southampton City PCT...
December 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/29229578/left-lateral-endosurgical-extraperitoneal-total-hysterectomy-with-para-aortic-and-pelvic-lymphadenectomy-a-novel-approach-for-the-obese-patient-with-endometrial-cancer
#3
Gwenael Ferron, Javier De Santiago, Denis Querleu, Alejandra Martinez, Martina Aida Angeles, Berenice Boulet, Frederic Guyon, Ignacio Zapardiel
STUDY OBJECTIVE: To describe the left lateral extraperitoneal approach to perform complete para-aortic and pelvic lymphadenectomy and transverse total hysterectomy from left to right as a novel approach to treat obese patients with endometrial cancer. Laparoscopic management of obese patients represents a challenge for the gynecological surgeon. The extraperitoneal approach is technically easier in the obese patient as it naturally creates a bowel-free operative field. DESIGN: A prospective pilot bicentric and descriptive study (Canadian Task Force III) evaluating the feasibility and reproducibility of the transverse total hysterectomy and complete lymphadenectomy through left endoscopic extraperitoneal approach in obese patients with endometrial cancer...
December 8, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29229134/animal-models-in-plastic-and-reconstructive-surgery-simulation-a-review
#4
REVIEW
Charles Yuen Yung Loh, Aline Yen Ling Wang, Vincent Tze Yang Tiong, Thanassi Athanassopoulos, Meiling Loh, Philip Lim, Huang-Kai Kao
BACKGROUND: The use of live and cadaveric animal models in surgical training is well established as a means of teaching and improving surgical skill in a controlled setting. We aim to review, evaluate, and summarize the models published in the literature that are applicable to Plastic Surgery training. MATERIALS AND METHODS: A PubMed search for keywords relating to animal models in Plastic Surgery and the associated procedures was conducted. Animal models that had cross over between specialties such as microsurgery with Neurosurgery and pinnaplasty with ear, nose, and throat surgery were included as they were deemed to be relevant to our training curriculum...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29226957/pilot-multi-centre-randomised-trial-of-the-impact-of-pre-operative-focused-cardiac-ultrasound-on-mortality-and-morbidity-in-patients-having-surgery-for-femoral-neck-fractures-echonof-2-pilot
#5
D J Canty, J Heiberg, Y Yang, A G Royse, S Margale, N Nanjappa, D Scott, A Maier, D I Sessler, A Chuan, A Palmer, A Bucknill, C French, C F Royse
Hip fracture surgery is common, usually occurs in elderly patients who have multiple comorbidities, and is associated with high morbidity and mortality. Pre-operative focused cardiac ultrasound can alter diagnosis and management, but its impact on outcome remains uncertain. This pilot study assessed feasibility and group separation for a proposed large randomised clinical trial of the impact of pre-operative focused cardiac ultrasound on patient outcome after hip fracture surgery. Adult patients requiring hip fracture surgery in four teaching hospitals in Australia were randomly allocated to receive focused cardiac ultrasound before surgery or not...
December 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29224789/pediatric-surgical-capacity-building-a-pathway-to-improving-access-to-pediatric-surgical-care-in-haiti
#6
Neema Kaseje, Hillary Jenny, Andre Patrick Jeudy, Jean Louis MacLee, John G Meara, Henri R Ford
PURPOSE: Lack of human resources is a major barrier to accessing pediatric surgical care globally. Our aim was to establish a model for pediatric surgical training of general surgery residents in a resource constrained region. MATERIALS/METHODS: A pediatric surgical program with a pediatric surgical rotation for general surgery residents in a tertiary hospital in Haiti in 2015 was established. We conducted twice daily patient rounds, ran an outpatient clinic, and provided emergent and elective pediatric surgical care, with tasks progressively given to residents until they could run clinic and perform the most common elective and emergent procedures...
November 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29222631/an-advanced-simulator-for-orthopedic-surgical-training
#7
J Cecil, Avinash Gupta, Miguel Pirela-Cruz
PURPOSE: The purpose of creating the virtual reality (VR) simulator is to facilitate and supplement the training opportunities provided to orthopedic residents. The use of VR simulators has increased rapidly in the field of medical surgery for training purposes. This paper discusses the creation of the virtual surgical environment (VSE) for training residents in an orthopedic surgical process called less invasive stabilization system (LISS) surgery which is used to address fractures of the femur...
December 8, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/29221742/early-experience-with-robotic-mitral-valve-repair-with-intra-aortic-occlusion
#8
Risto Kesävuori, Peter Raivio, Janne J Jokinen, Antero Sahlman, Kari Teittinen, Antti Vento
OBJECTIVE: To report the learning curve and early results of robotic mitral valve repairs in comparison with propensity score-matched sternotomy controls after the adoption of a robotic mitral valve surgery program in a university teaching hospital. METHODS: A total of 142 patients underwent robotic mitral valve repair due to degenerative mitral regurgitation between May 2011 and December 2015. Control patients operated on via the conventional sternotomy approach were selected by the use of propensity score analysis resulting in 2 well-matched study groups...
December 5, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29219135/waiting-time-of-inpatients-before-elective-surgical-procedures-at-a-state-government-teaching-hospital-in-india
#9
Shreyasi Ray, Jyotirmay Kirtania
BACKGROUND: Abundant published literature exists addressing the issues of outpatient waiting lists before surgery. However, there is no published literature on inpatient waiting time before elective surgical procedures. OBJECTIVES: This study aims to measure the inpatient waiting time, identify the factors that affect the inpatient waiting time, and recommend the ways of reducing the waiting time of inpatients before elective surgical procedures, at a state government teaching hospital in India...
October 2017: Indian Journal of Public Health
https://www.readbyqxmd.com/read/29217927/magnitude-and-factors-associated-with-post-cesarean-surgical-site-infection-at-hawassa-university-teaching-and-referral-hospital-southern-ethiopia-a-cross-sectional-study
#10
Samuel Wodajo, Mehretu Belayneh, Samson Gebremedhin
Background: Surgical site infection (SSI) after cesarean section (CS) increases maternal morbidity, hospital stay and medical cost. However, in Ethiopia, limited evidence exists regarding the magnitude and risk factors of post-CS wound infection. The purpose of this study was to determine the prevalence of - and factors associated with the problem among mothers who gave birth in Hawassa University Teaching and Referral Hospital, Southern Ethiopia. Methods: Hospital based cross-sectional study was conducted based on the medical records of 592 women who underwent CS from June 2012 to May 2013...
May 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/29217236/accuracy-precision-and-trending-of-4-pulse-wave-analysis-techniques-in-the-postoperative-period
#11
Martin Geisen, Michael T Ganter, Sonja Hartnack, Omer Dzemali, Christoph K Hofer, Andreas Zollinger
OBJECTIVE: The aim of this study was to analyze the accuracy, precision, and trending ability of the following 4 pulse wave analysis devices to measure continuous cardiac output: PiCCO2 ([PCCO]; Pulsion Medical System, Munich, Germany); LiDCORapid ([LCCO]; LiDCO Ltd, London, UK); FloTrac/Vigileo ([FCCO]; Edwards Lifesciences, Irvine, CA); and Nexfin ([NCCO]; BMEYE, Amsterdam, The Netherlands). DESIGN: Prospective, observational clinical study. SETTING: Intensive care unit of a single-center, teaching hospital...
September 7, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29214316/association-between-hospital-financial-distress-and-immediate-breast-reconstruction-surgery-after-mastectomy-among-women-with-ductal-carcinoma-in-situ
#12
Catherine A Richards, Andrew G Rundle, Jason D Wright, Dawn L Hershman
Importance: Hospital financial distress (HFD) is a state in which a hospital is at risk of closure because of its financial condition. Hospital financial distress may reduce the services a hospital can offer, particularly unprofitable ones. Few studies have assessed the association of HFD with quality of care. Objective: To examine the association between HFD and receipt of immediate breast reconstruction surgery after mastectomy among women diagnosed with ductal carcinoma in situ (DCIS)...
December 6, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29212686/practice-patterns-in-the-care-of-acute-achilles-tendon-ruptures-is-there-an-association-with-level-i-evidence
#13
U Sheth, D Wasserstein, R Jenkinson, R Moineddin, H Kreder, S Jaglal
AIMS: To determine whether the findings from a landmark Canadian trial assessing the optimal management of acute rupture of the Achilles tendon influenced the practice patterns of orthopaedic surgeons in Ontario, Canada. MATERIALS AND METHODS: Health administrative databases were used to identify Ontario residents ≥ 18 years of age with an Achilles tendon rupture from April 2002 to March 2014. The rate of surgical repair (per 100 cases) was calculated for each calendar quarter...
December 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29208308/serum-intestinal-fatty-acid-binding-protein-predictor-of-bowel-necrosis-in-pediatric-intussusception
#14
A Ademuyiwa, F Alakaloko, O Elebute, C Bode, I Udenze
BACKGROUND/PURPOSE: Serum Intestinal Fatty-Acid Binding Protein (I-FABP) is a useful marker of bowel necrosis in pediatric intussusception. The aim of this study is to determine the sensitivity of this marker and correlate it with length of necrosed small bowel. METHODS: A single-centre prospective study of 50 children presenting to Lagos University Teaching Hospital, Nigeria, in whom a diagnosis of intussusception was made over 1 year was completed. Additionally, 25 age- and sex-matched controls (day case surgery) were recruited...
November 14, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29206799/simulation-based-educational-module-improves-intern-and-medical-student-performance-of-closed-reduction-and-percutaneous-pinning-of-pediatric-supracondylar-humeral-fractures
#15
Bennet A Butler, Cort D Lawton, Jamie Burgess, Earvin S Balderama, Katherine A Barsness, John F Sarwark
BACKGROUND: Simulation-based education has been integrated into many orthopaedic residency programs to augment traditional teaching models. Here we describe the development and implementation of a combined didactic and simulation-based course for teaching medical students and interns how to properly perform a closed reduction and percutaneous pinning of a pediatric supracondylar humeral fracture. METHODS: Subjects included in the study were either orthopaedic surgery interns or subinterns at our institution...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29205404/a-quilting-subcutaneous-suture-pattern-to-reduce-seroma-formation-and-pain-24-hours-after-midline-celiotomy-in-dogs-a-randomized-controlled-trial
#16
Blake M Travis, Galina M Hayes, K Vissio, H J Harvey, James A Flanders, Julia P Sumner
OBJECTIVE: To determine the influence of a quilting suture pattern tacking the subcutaneous tissues to the deep fascia on complications after midline celiotomy in dogs. STUDY DESIGN: Single-center, randomized, blinded, controlled trial conducted in a veterinary teaching hospital. ANIMALS: Four hundred thirty-two dogs undergoing midline celiotomy for ovariohysterectomy (n = 249) or other abdominal procedures (n = 183). METHODS: Dogs were randomly assigned to (1) a quilting group, subcutaneous tissue with apposition plus tacking to the rectus fascia or (2) a nonquilting group, with apposition of subcutaneous tissue without tacking...
December 3, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29204021/cranioplasty-using-autoclaved-autologous-skull-bone-flaps-preserved-at-ambient-temperature
#17
Dominic Anto, Raju Paul Manjooran, Rajeev Aravindakshan, Kumar Lakshman, Raymond Morris
Context: Decompressive craniectomy followed by cranioplasty (CP) uses autologous craniectomy flaps or synthetic materials like titanium. Sterilization and preservation methods for the autologous bone flaps continue to be the surgeon's choice. Aim: This study aimed to assess the short-term as well as long-term clinical outcomes of CP using autoclaved autologous bone grafts. Settings and Design: This retrospective observational study was performed on patients admitted in a tertiary care teaching neurosurgery department...
October 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29202838/development-of-a-saw-bones-model-for-training-pedicle-screw-placement-in-scoliosis
#18
Gregory Tanner, Saman Vojdani, David E Komatsu, James M Barsi
OBJECTIVE: The purpose of this study was to determine if a Sawbones Scoliosis Model could be used as a simulator to train residents in placing pedicle screws-a complex procedure with a steep learning curve. Surgical simulation, a common tool teaching residents complex procedures in a safe environment, was staged using a Sawbones Scoliosis Model. Ten junior and ten senior residents out of 25 total possible residents (80%) were instructed how to place pedicle screws using the free-hand technique...
December 4, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29195738/a-perioperative-care-map-improves-outcomes-in-patients-with-morbid-obesity-undergoing-major-surgery
#19
Benjamin D Boodaie, Anthony H Bui, David L Feldman, Michael Brodman, Peter Shamamian, Ronald Kaleya, Meg Rosenblatt, Donna Somerville, Patricia Kischak, I Michael Leitman
BACKGROUND: The surgical management of patients with morbid obesity (BMI ≥ 40) is notable for a relatively high risk of complications. To address this problem, a perioperative care map was developed using precautions and best practices commonly employed in bariatric surgery. It requires additional medical assessments, sleep apnea surveillance, more stringent guidelines for anesthetic management, and readily available bariatric operating room equipment, among other items. This care map was implemented in 2013 at four major urban teaching hospitals for use in patients undergoing all types of non-ambulatory surgery with a BMI greater than 40 kg/m2...
November 28, 2017: Surgery
https://www.readbyqxmd.com/read/29192866/frontoethmoidal-meningoencephalocele-appraisal-of-a-craniofacial-surgical-teaching-program-in-cambodia
#20
Franck-Emmanuel Roux, Cheng Ngiep Ou, Ratha Soum, James Gollogly, Imène Djidjeli, Frédéric Lauwers
OBJECTIVE The treatment of frontoethmoidal meningoencephaloceles (fMECs) in Cambodia was not possible before the development of a program that taught some Khmer surgeons (working at the Children's Surgical Centre in Phnom Penh) how to surgically correct these deformities without any foreign help. The results of that teaching program are discussed in this paper. METHODS Between 2004 and 2009, both local and visiting foreign neurosurgical and craniofacial surgeons (the visitors coming twice a year) worked together to operate on 200 patients, and a report on those cases was published in 2010...
December 1, 2017: Journal of Neurosurgery. Pediatrics
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