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https://www.readbyqxmd.com/read/28445352/consensus-review-of-optimal-perioperative-care-in-breast-reconstruction-enhanced-recovery-after-surgery-eras-society-recommendations
#1
Claire Temple-Oberle, Melissa A Shea-Budgell, Mark Tan, John L Semple, Christiaan Schrag, Marcio Barreto, Phillip Blondeel, Jeremy Hamming, Joseph Dayan, Olle Ljungqvist
BACKGROUND: Enhanced recovery following surgery can be achieved through the introduction of evidence-based perioperative maneuvers. This review aims to present a consensus for optimal perioperative management of patients undergoing breast reconstructive surgery and to provide evidence-based recommendations for an enhanced perioperative protocol. METHODS: A systematic review of meta-analyses, randomized controlled trials, and large prospective cohorts was conducted for each protocol element...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28442185/modified-frailty-index-is-an-effective-risk-assessment-tool-in-primary-total-knee-arthroplasty
#2
Robert P Runner, Jaime L Bellamy, CatPhuong Cathy L Vu, Greg A Erens, Mara L Schenker, George N Guild
BACKGROUND: "Frailty" is a marker of physiological decline of multiple organ systems, and the frailty index identifies patients who are more susceptible to postoperative complications. The purpose of this study is to validate the modified frailty index (MFI) as a predictor of postoperative complications, reoperations, and readmissions in patients who underwent primary total knee arthroplasty (TKA). METHODS: The American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2014 was queried by the Current Procedural Terminology code for primary TKA (27447)...
March 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28441385/preoperative-clinical-pathway-of-breast-cancer-patients-determinants-of-compliance-with-eusoma-quality-indicators
#3
Delphine Héquet, Cyrille Huchon, Sandrine Baffert, Séverine Alran, Fabien Reyal, Thuy Nguyen, Alix Combes, Caroline Trichot, Karine Alves, Hélène Berseneff, Roman Rouzier
BACKGROUND: The European Society of Breast Cancer Specialists (EUSOMA) has defined quality indicators for breast cancer (BC). The aim of this study was to describe the preoperative clinical pathway of breast cancer patients and evaluate the determinants of compliance with EUSOMA quality indicators in the Optisoins01 cohort. METHODS: Optisoins01 is a prospective, multicentric study. Data from operable BC patients were collected, including results from before surgery to 1 year follow-up...
April 25, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28441255/european-society-of-gynaecological-oncology-guidelines-for-the-management-of-patients-with-vulvar-cancer
#4
Maaike H M Oonk, François Planchamp, Peter Baldwin, Mariusz Bidzinski, Mats Brännström, Fabio Landoni, Sven Mahner, Umesh Mahantshetty, Mansoor Mirza, Cordula Petersen, Denis Querleu, Sigrid Regauer, Lukas Rob, Roman Rouzier, Elena Ulrikh, Jacobus van der Velden, Ignace Vergote, Linn Woelber, Ate G J van der Zee
OBJECTIVE: The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. METHODS: The European Society of Gynaecological Oncology Council nominated an international development group made of practicing clinicians who provide care to patients with vulvar cancer and have demonstrated leadership and interest in the management of patients with vulvar cancer (18 experts across Europe)...
May 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#5
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28436355/quantification-of-risk-factors-in-500-patients-with-postoperative-urinary-retention
#6
Peter N Tsambarlis, Benjamin A Sherer, Karl F Godlewski, Rebecca M Deal, Jonathan A Myers, Leslie A Deane
INTRODUCTION: An Institutional Quality and Safety Initiative to reduce postoperative urinary retention (POUR) and improve patient safety indicators (PSIs) was undertaken after a nurse driven protocol for catheter removal lead to an increase in POUR. The aim of this study was to identify the number of risk factors present in patients with POUR while examining the prevalence of those risk factors individually. MATERIALS AND METHODS: A retrospective review of our institution's surgical database was performed to identify 500 consecutive cases of POUR between July 1, 2013 and July 1, 2014...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28421875/three-dimensional-printing-and-its-applications-in-otorhinolaryngology-head-and-neck-surgery
#7
Trevor D Crafts, Susan E Ellsperman, Todd J Wannemuehler, Travis D Bellicchi, Taha Z Shipchandler, Avinash V Mantravadi
Objective Three-dimensional (3D)-printing technology is being employed in a variety of medical and surgical specialties to improve patient care and advance resident physician training. As the costs of implementing 3D printing have declined, the use of this technology has expanded, especially within surgical specialties. This article explores the types of 3D printing available, highlights the benefits and drawbacks of each methodology, provides examples of how 3D printing has been applied within the field of otolaryngology-head and neck surgery, discusses future innovations, and explores the financial impact of these advances...
November 1, 2016: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28420664/the-uk-cardiac-and-vascular-surgery-interventional-anaemia-response-caviar-study-protocol-for-an-observational-cohort-study-to-determine-the-impact-and-effect-of-preoperative-anaemia-management-in-cardiac-and-vascular-surgical-patients
#8
Marisa Chau, Toby Richards, Caroline Evans, Anna Butcher, Timothy Collier, Andrew Klein
INTRODUCTION: Preoperative anaemia is linked to poor postsurgical outcome, longer hospital stays, greater risk of complications and mortality. Currently in the UK, some sites have developed anaemia clinics or pathways that use intravenous iron to correct iron deficiency anaemia prior to surgery as their standard of care. Although intravenous iron has been observed to be effective in a variety of patient settings, there is insufficient evidence in its use in cardiac and vascular patients...
April 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28420629/dexamethasone-versus-standard-treatment-for-postoperative-nausea-and-vomiting-in-gastrointestinal-surgery-randomised-controlled-trial-dreams-trial
#9
RANDOMIZED CONTROLLED TRIAL
(no author information available yet)
Objectives To determine whether preoperative dexamethasone reduces postoperative vomiting in patients undergoing elective bowel surgery and whether it is associated with other measurable benefits during recovery from surgery, including quicker return to oral diet and reduced length of stay.Design Pragmatic two arm parallel group randomised trial with blinded postoperative care and outcome assessment.Setting 45 UK hospitals.Participants 1350 patients aged 18 or over undergoing elective open or laparoscopic bowel surgery for malignant or benign pathology...
April 18, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28419812/defining-quality-in-head-and-neck-reconstruction
#10
Peter M Vila, Jason T Rich, Shaun C Desai
Microvascular free flap reconstruction has now become the standard of care in the reconstruction of selected head and neck defects. Although uncommon, flap failure is a catastrophic event that results in significant patient morbidity, extended length of hospitalization, and increased cost. However, there is currently no gold standard for measuring the quality of a reconstructive center. Structure and process outcomes have recently been developed, but outcome measures are still lacking. Areas for future research include preoperative nutrition, preoperative flap planning, intraoperative fluid management, appropriate thromboembolism prophylaxis, consistent perioperative antibiotic regimens, skilled ancillary staff, and clear outcome measures for performance measurement...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28419206/short-term-preoperative-exercise-therapy-does-not-improve-long-term-outcome-after-lung-cancer-surgery-a-randomized-controlled-study%C3%A2
#11
Wolfram Karenovics, Marc Licker, Christoph Ellenberger, Michel Christodoulou, John Diaper, Chetna Bhatia, John Robert, Pierre-Olivier Bridevaux, Frédéric Triponez
OBJECTIVES: Poor aerobic fitness is a potential modifiable risk factor for long-term survival and quality of life in patients with lung cancer. This randomized trial evaluates the impact of adding rehabilitation (Rehab) with high-intensity interval training (HIIT) before lung cancer surgery to enhance cardiorespiratory fitness and improve long-term postoperative outcome. METHODS: Patients with operable lung cancer were randomly assigned to usual care (UC, n  = 77) or to intervention group (Rehab, n  = 74) that entailed HIIT that was implemented only preoperatively...
April 17, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28418577/prospective-assessment-of-sleep-quality-before-and-after-primary-total-joint-replacement
#12
Blaine T Manning, Sean M Kearns, Daniel D Bohl, Tori Edmiston, Scott M Sporer, Brett R Levine
Sleep disruption is a common, yet rarely addressed, complaint among patients who have undergone total joint arthroplasty (TJA). This study assessed sleep quality before and after primary TJA. A total of 105 patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) prospectively completed questionnaires during the preoperative, early postoperative, and late postoperative periods. The survey included the Epworth Sleepiness Scale, current sleeping habits, and patient perspectives of sleep quality and duration...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28414170/importance-of-patient-reported-individualized-goals-when-assessing-outcomes-for-adult-spinal-deformity-asd-initial-experience-with-a-patient-generated-index-pgi
#13
Justin K Scheer, Malla Keefe, Virginie Lafage, Michael P Kelly, Shay Bess, Douglas C Burton, Robert A Hart, Amit Jain, Baron S Lonner, Themistocles S Protopsaltis, Richard Hostin, Christopher I Shaffrey, Justin S Smith, Frank Schwab, Christopher P Ames
BACKGROUND CONTEXT: Current metrics to assess a patient's health-related quality-of-life (HRQOL) may not reflect a true change in a patient's specific perception of what is most important to them. PURPOSE: To describe the initial experience of a Patient Generated Index (PGI) in which patients create their own outcome domains. STUDY DESIGN: Single center prospective study PATIENT SAMPLE: Adult spinal deformity (ASD) patients OUTCOME MEASURES: Oswestry Disability Index (ODI), Short-Form 36 (SF36:PCS/MCS), Scoliosis research society 22r (SRS22r), and PGI METHODS: ODI, SF36, SRS22r, and PGI were administered preoperatively and postoperatively at 6wks, 3mo, 6mo, and 1 and 2yrs...
April 13, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28413629/american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-optimal-analgesia-within-an-enhanced-recovery-pathway-for-colorectal-surgery-part-1-from-the-preoperative-period-to-pacu
#14
Matthew D McEvoy, Michael J Scott, Debra B Gordon, Stuart A Grant, Julie K M Thacker, Christopher L Wu, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver "optimal analgesia," which we define in this paper as a technique that optimizes patient comfort and facilitates functional recovery with the fewest medication side effects. METHODS: With input from a multi-disciplinary, international group of clinicians, and through a structured review of the literature and use of a modified Delphi method, we achieved consensus surrounding the topic of optimal analgesia in the perioperative period for colorectal surgery patients...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28413628/american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-optimal-analgesia-within-an-enhanced-recovery-pathway-for-colorectal-surgery-part-2-from-pacu-to-the-transition-home
#15
Michael J Scott, Matthew D McEvoy, Debra B Gordon, Stuart A Grant, Julie K M Thacker, Christopher L Wu, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver "optimal analgesia", which we define in this paper as a technique that optimizes patient comfort and facilitates functional recovery with the fewest medication side effects. METHODS: With input from a multidisciplinary, international group of experts and through a structured review of the literature and use of a modified Delphi method, we achieved consensus surrounding the topic of optimal analgesia in the perioperative period for colorectal surgery patients...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28412051/-impact-of-postoperative-cognitive-decline-in-quality-of-life-a-prospective-study
#16
Joana Borges, Joana Moreira, Adriano Moreira, Alice Santos, Fernando J Abelha
BACKGROUND: Regardless the progress in perioperative care postoperative cognitive decline (PCD) has been accepted unequivocally as a significant and frequent complication of surgery in older patients. The aim of this study was to evaluate the incidence of postoperative cognitive decline and its influence on quality of life three months after surgery. METHODS: Observational, prospective study in a Post-Anesthesia Care Unit (PACU) in patients aged above 45 years, after elective major surgery...
April 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28408715/postoperative-infection-in-developing-world-congenital-heart-surgery-programs-data-from-the-international-quality-improvement-collaborative
#17
Amitabh Chanchal Sen, Debra Forbes Morrow, Rakhi Balachandran, Xinwei Du, Kimberlee Gauvreau, Byalal R Jagannath, Raman Krishna Kumar, Jennifer Koch Kupiec, Monica L Melgar, Nguyen Tran Chau, Gail Potter-Bynoe, Orlando Tamariz-Cruz, Kathy J Jenkins
BACKGROUND: Postoperative infections contribute substantially to morbidity and mortality after congenital heart disease surgery and are often preventable. We sought to identify risk factors for postoperative infection and the impact on outcomes after congenital heart surgery, using data from the International Quality Improvement Collaborative for Congenital Heart Surgery in Developing World Countries. METHODS AND RESULTS: Pediatric cardiac surgical cases performed between 2010 and 2012 at 27 participating sites in 16 developing countries were included...
April 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28408415/impact-of-international-quality-improvement-collaborative-on-congenital-heart-surgery-in-pakistan
#18
Amina Khan, Ahmed Abdullah, Huzaifa Ahmad, Arjumand Rizvi, Sehrish Batool, Kathy J Jenkins, Kimberlee Gauvreau, Muneer Amanullah, Anwar Haq, Nadeem Aslam, Fauzia Minai, Babar Hasan
BACKGROUND: The International Quality Improvement Collaborative (IQIC) was formed to reduce mortality and morbidity from congenital heart disease (CHD) surgeries in low/middle-income countries. OBJECTIVES: We conducted this study to compare the postoperative outcomes of CHD surgeries at a centre in Pakistan before and after joining IQIC. METHODS: The IQIC provides guidelines targeting key drivers responsible for morbidity and mortality in postoperativepatients with CHD...
April 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28405807/management-and-outcomes-of-acute-surgical-patients-at-a-district-hospital-in-uganda-with-non-physician-emergency-clinicians
#19
Caleb Dresser, Usha Periyanayagam, Brad Dreifuss, Robert Wangoda, Julius Luyimbaazi, Mark Bisanzo
INTRODUCTION: Acute surgical care services in rural Sub-Saharan Africa suffer from human resource and systemic constraints. Developing emergency care systems and task sharing aspects of acute surgical care addresses many of these issues. This paper investigates the degree to which specialized non-physicians practicing in a dedicated Emergency Department contribute to the effective and efficient management of acute surgical patients. METHODS: This is a retrospective review of an electronic quality assurance database of patients presenting to an Emergency Department in rural Uganda staffed by non-physician clinicians trained in emergency care...
April 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28403408/systemic-lidocaine-fails-to-improve-postoperative-morphine-consumption-postoperative-recovery-and-quality-of-life-in-patients-undergoing-posterior-spinal-arthrodesis-a-double-blind-randomized-placebo-controlled-trial
#20
G Dewinter, P Moens, S Fieuws, B Vanaudenaerde, M Van de Velde, S Rex
Background.: It is inconclusive whether the perioperative administration of systemic lidocaine provides effective postoperative analgesia and enhances recovery in major orthopaedic surgery. We hypothesised that in adolescent and adult patients undergoing posterior spinal arthrodesis, a perioperative lidocaine infusion would reduce opioid requirements during the first 24 postoperative h. Methods.: 70 patients undergoing posterior arthrodesis were enrolled in this prospective, randomised, double-blind, placebo-controlled clinical trial...
April 1, 2017: British Journal of Anaesthesia
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