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Dehiscence after surgery

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https://www.readbyqxmd.com/read/28345802/the-association-between-caudal-anesthesia-and-increased-risk-of-postoperative-surgical-complications-in-boys-undergoing-hypospadias-repair
#1
Brad M Taicher, Jonathan C Routh, John B Eck, Sherry S Ross, John S Wiener, Allison K Ross
INTRODUCTION: Recent reports have suggested that caudal anesthesia may be associated with an increased risk of postoperative surgical complications. We examined our experience with caudal anesthesia in hypospadias repair to evaluate for increased risk of urethrocutaneous fistula or glanular dehiscence. METHODS: All hypospadias repairs performed by a single surgeon in 2001-2014 were reviewed. Staged or revision surgeries were excluded. Patient age, weight, hypospadias severity, surgery duration, month and year of surgery, caudal anesthesia use, and postoperative complications were recorded...
March 27, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28322901/urethral-mobilization-as-an-alternative-procedure-for-distal-hypospadias-repair
#2
Hamed M El Darawany, Mahmoud E Al Damhogy
OBJECTIVE: To evaluated the urethral mobilization procedure as the main technique in management of glanular, coronal, subcoronal, and distal penile hypospadias. PATIENTS AND METHODS: Sixty patients with distal hypospadias were included in this prospective study between January 2013 and January 2015. All of them repaired by urethral mobilization. All patients were followed up at 2 weeks, 1, 3, 6 and 12 months post operatively. Duration of the operation, hospital stay, position of meatus and its shape before and after the operation and the postoperative complications were recorded...
March 17, 2017: Urology
https://www.readbyqxmd.com/read/28315282/complications-after-hypospadias-correction-prognostic-factors-and-impact-on-final-clinical-outcome
#3
Elisabeth Maria Dokter, Chantal M Mouës, Iris A L M van Rooij, Jan Jaap van der Biezen
Purpose The purpose of this study was to analyze the influence of patient and treatment characteristics on the occurrence of complications after hypospadias correction and the impact of complications on final clinical outcome. Methods The study cohort consisted of 205 hypospadias patients who had surgery in the Medical Centre Leeuwarden (1996-2011). Patient and treatment characteristics were hypospadias severity (preoperative meatal location and chordee), number of planned surgeries, reconstruction technique, operation year, and patient's age at the time of surgery...
March 17, 2017: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28300677/wound-disruption-after-lower-extremity-bypass-surgery-is-a-predictor-of-subsequent-development-of-wound-infection
#4
Faisal Aziz, Tiffany Bohr, Erik B Lehman
OBJECTIVES: Despite advances in endovascular surgery, lower extremity arterial bypass (LEB) remains the gold standard treatment for severe, symptomatic Peripheral Arterial Disease (PAD). With recent changes in healthcare, there has been an increasing emphasis on reducing the hospital length of stay (LOS). The purpose of this study is to identify the postoperative complications, which occur after discharge from hospital, and to find risk factors for developing such complications. METHODS: The 2013 lower extremity revascularization -targeted American College of Surgeons (ACS-NSQIP) database and generalized 2013 general and vascular surgery ACS-NSQIP PUF were used for this study...
March 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28299265/the-use-of-buccal-fat-pad-free-graft-in-closure-of-soft-tissue-defects-and-dehiscence-in-the-hard-palate
#5
Fares Kablan
INTRODUCTION: The integrity of the palatal mucosa can be lost due to congenital, pathological, and iatrogenic conditions. Various surgical techniques have been suggested for the closure of palatal defects. The aim of the current study is to present the free buccal fat pad graft as a novel technique to repair the soft-tissue defects at the palate. PATIENTS AND METHODS: During a 2-year period, the free fat tissue graft harvested from the buccal fat pad (BFP) (FBFG) and used to reconstruct five soft-tissue defects of the palate in five patients (2 women, 3 men; mean age, 34 years; range, 22-58 years)...
July 2016: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28293002/-dehiscence-of-the-pericardial-patch-after-surgical-treatment-of-active-infective-aortic-valve-endocarditis-with-reconstruction-of-the-aortic-annulus-using-a-glutaraldehyde-treated-autologous-pericardium
#6
Kazufumi Yoshida, Naoto Fukunaga, Shigeki Koizumi, Kenta Nishiya, Yasuhiro Matsuda, Masanosuke Ishigami, Atsushi Nagasawa, Ryuzo Sakata, Tadaaki Koyama
A 50-year-old man was admitted with fever and chill sensation 6 months ago. Transthoracic echocardiography (TTE) showed left and right coronary cusp prolapses and a thickened tissue of the aortic curtain. Congestive heart failure due to active infective aortic valve endocarditis was diagnosed, and he underwent aortic valve replacement. The aortic annulus was reconstructed using a glutaraldehydetreated autologous pericardium. Six months after surgery, TTE showed severe aortic regurgitation and saccular change in the aortic annulus...
March 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28290176/valve-dehiscence-after-bentall-procedure-the-detrimental-traits-of-propionibacterium
#7
Robert A F de Lind van Wijngaarden, Richard van Valen, Jos A Bekkers, Ad J J C Bogers
The present case exemplified the detrimental traits of prosthetic valve endocarditis caused by Propionibacterium acnes. As a baby, the patient had a congenital cardiac defect with truncus arteriosus type I with interrupted aortic arch and open ductus Botalli, and had undergone several operations. However, at 18 months after a Bentall procedure performed 29 years later he presented with major prosthetic dehiscence due to endocarditis. The patient underwent a high-risk reoperation for a re-do Bentall procedure and was treated postoperatively with intravenous antibiotics consisting of vancomycin for five weeks and penicillin and rifampicin each for six weeks...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28272229/occult-lens-subluxation-related-to-laser-peripheral-iridotomy-a-case-report-and-literature-review
#8
REVIEW
Rongrong Hu, Xiaoyu Wang, Yang Wang, Yang Sun
RATIONALE: Laser peripheral iridotomy (LPI) is commonly performed as a primary treatment for acute primary angle closure glaucoma after administration of anti-glaucoma medications or for prevention of this condition. Minor complications may occur following LPI and most of them do not have deleterious consequences. We report a rare case of lens subluxation that has a possible relationship with LPI treatment. PATIENT CONCERNS: A 54-year-old female patient was initially referred for surgical treatment of medication-uncontrollable angle closure glaucoma in her left eye...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28267697/reduced-rate-of-dehiscence-after-implementation-of-a-standardized-fascial-closure-technique-in-patients-undergoing-emergency-laparotomy
#9
Mai-Britt Tolstrup, Sara Kehlet Watt, Ismail Gögenur
OBJECTIVE: In elective surgery, it is well documented that a midline laparotomy should be closed with a slowly absorbable monofilament suture material in a continuous technique, in a ratio of at least 4 : 1. The evidence concerning the suture material or suturing technique in the emergency setting is lacking. We aimed to investigate whether this technique would reduce the rate of dehiscence. METHODS: A standardized procedure of closing the midline laparotomy by using a "small steps" technique of continuous suturing with a slowly absorbable (polydioxanone) suture material in a wound-suture ratio of minimum 1 : 4 was introduced in June 2014...
April 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28262536/challenges-in-salvaging-urinary-continence-following-failed-bladder-exstrophy-repair-in-a-developing-country
#10
Moneer K Hanna, Ibrahim Bassiouny
INTRODUCTION: The management of urinary incontinence following failed bladder exstrophy repairs is not well defined, some surgeons recommend urinary diversion, others would pursue reconstructive surgery. OBJECTIVE: Herein we review our experience with various strategies for management of urinary incontinence and their outcome in 61 patients born with bladder exstrophy who failed their initial repairs. We also examine the impact of diverse factors in making the surgical decision for patients with limited resources in a developing country...
January 29, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28259578/impact-of-body-mass-index-and-gender-on-wound-complications-after-lower-extremity-arterial-surgery
#11
Dean J Arnaoutakis, Rebecca E Scully, Gaurav Sharma, Samir K Shah, C Keith Ozaki, Michael Belkin, Louis L Nguyen
OBJECTIVE: Wound complications (WCs) after lower extremity arterial surgery (LEAS) are common, resulting in readmissions and reinterventions. Whereas diabetes and obesity are known risk factors for WCs, gender-specific variability in body fat distribution (android vs gynoid) may drive differential risks of WCs after LEAS. We analyzed the independent and synergistic effects of gender and body mass index (BMI) on WCs. METHODS: We performed a retrospective review of prospectively collected data from a published, randomized, multicenter trial assessing the incidence of WCs (dehiscence, surgical site infections, seroma, and hematoma) after LEAS...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28256903/mr-imaging-in-patients-with-male-to-female-sex-reassignment-surgery-postoperative-anatomy-and-complications
#12
Michele Bertolotto, Giovanni Liguori, Stefano Bucci, Mariano Iannelli, Francesca Vedovo, Nicola Pavan, Carlo Trombetta, Lorenzo E Derchi
OBJECTIVE: To investigate the role of MRI in the evaluation of both the new female anatomy and complications in male-to-female sex reassignment surgery (MtF-SRS). METHODS: 71 consecutive patients with MtF-SRS had 74 MRI [age range, 21-63 years; mean (±standard deviation) age, 36 ± 10 years; median age, 37 years]. In 47 patients, MRI was performed to rule out early post-operative complications after gender conversion (n = 40), vaginoplasty (n = 6) or remodelling of the labia majora (n = 1)...
April 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28249233/vac-therapy-with-long-term-continuous-saline-infusion-for-secondary-septic-peritonitis-a-new-strategy-for-the-reduction-of-perioperative-risks
#13
Fulvio Nisi, Federico Marturano, Eleonora Natali, Antonio Galzerano, Patrizia Ricci, Vito Aldo Peduto
BACKGROUND: The management of a septic peritonitis open abdomen is a serious problem for clinicians. Open surgery is associated with several complications such as bleeding and perforation of the bowel. CASE PRESENTATION: The authors report a case of a 59-years-old female who underwent a sigmoid resection with an latero-terminal (L-T) anastomosis for the perforation of a diverticulum. After a few days the patients developed a new widespread peritonitis. At the emergency re-laparotomy, surgeons found dehiscence of the posterior wall of the anastomosis with fecal contamination...
February 13, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28237151/outcomes-after-cataract-surgery-in-eyes-with-pseudoexfoliation-results-from-the-veterans-affairs-ophthalmic-surgery-outcomes-data-project
#14
MULTICENTER STUDY
Angela Turalba, Tulay Cakiner-Egilmez, Abhishek R Payal, Luis A Gonzalez-Gonzalez, Amy S Chomsky, David E Vollman, Elizabeth F Baze, Mary G Lawrence, Mary K Daly
OBJECTIVE: To compare clinical outcomes of cataract surgery in eyes with and without pseudoexfoliation (PXF). DESIGN: Retrospective deidentified data analysis. PARTICIPANTS: A total of 123 PXF and 4776 non-PXF eyes of patients who underwent cataract surgery. METHODS: We compared data on visual acuity, Visual Function Questionnaire (VFQ)-based quality of life, and complications in PXF and non-PXF eyes from the Veterans Affairs (VA) Ophthalmic Surgery Outcomes Data Project across 5 VA medical centres...
February 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/28228944/semi-closed-surgical-technique-for-treatment-of-pilonidal-sinus-disease
#15
Georgios Sahsamanis, Stavros Samaras, Georgios Mitsopoulos, Titos Deverakis, Georgios Dimitrakopoulos, Dionysios Pinialidis
INTRODUCTION: Pilonidal sinus disease (PSD) is a highly debatable disorder regarding its surgical management, despite an assortment of surgical techniques described in the medical literature. The aim of this report is to provide an alternate semi-closed surgical method for treatment of PSD, with early recovery and a satisfactory cosmetic result. METHODS: In this retrospective study, 34 patients underwent surgical treatment for primary PSD; 32 male and 2 female. Patients were suffering from primary PSD, with the cyst located in the gluteal midline...
March 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28218552/scandcleft-randomised-trials-of-primary-surgery-for-unilateral-cleft-lip-and-palate-2-surgical-results
#16
Jorma Rautio, Mikael Andersen, Stig Bolund, Jyri Hukki, Hallvard Vindenes, Peter Davenport, Kjartan Arctander, Ola Larson, Anders Berggren, Frank Åbyholm, David Whitby, Alan Leonard, Jan Lilja, Erik Neovius, Anna Elander, Arja Heliövaara, Phil Eyres, Gunvor Semb
BACKGROUND: Longstanding uncertainty surrounds the selection of surgical protocols for unilateral cleft lip and palate, and randomised trials have only rarely been performed. The Scandcleft Project consists of three trials commenced in 1997 involving ten centres in Denmark, Finland, Norway, Sweden, and the UK. Three groups of centres tested a newly-defined common technique for palatal repair (Arm A) against their local protocols (Arms B, C, D). Arm A was familiar to most of the surgeons in Trial 1, but not to the surgeons in the other Trials...
February 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28195891/simple-skin-stretching-device-in-assisted-tension-free-wound-closure
#17
Li-Fu Cheng, Jiunn-Tat Lee, Honda Hsu, Meng-Si Wu
BACKGROUND: Numerous conventional wound reconstruction methods, such as wound undermining with direct suture, skin graft, and flap surgery, can be used to treat large wounds. The adequate undermining of the skin flaps of a wound is a commonly used technique for achieving the closure of large tension wounds; however, the use of tension to approximate and suture the skin flaps can cause ischemic marginal necrosis. The purpose of this study is to use elastic rubber bands to relieve the tension of direct wound closure for simultaneously minimizing the risks of wound dehiscence and wound edge ischemia that lead to necrosis...
March 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28185755/the-james-a-rand-young-investigator-s-award-administrative-claims-vs-surgical-registry-capturing-outcomes-in-total-joint-arthroplasty
#18
Joseph T Patterson, David Sing, Erik N Hansen, Bobby Tay, Alan L Zhang
BACKGROUND: Administrative claims in total joint arthroplasty are used for observational studies and payment adjustments under the Comprehensive Care for Joint Replacement (CJR) legislation. Claims data have not been validated against prospective surgical outcome registries for primary total hip (THA) or knee arthroplasty (TKA). We hypothesized that significant differences in reported comorbidity and adverse event measures exist between administrative claims and prospective registry data relevant to payment adjudication under the CJR reimbursement model...
February 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28182828/scalp-metastasis-from-glioblastoma-multiforme-a-case-report-and-literature-review
#19
Marco Mammi, Roberto Altieri, Alessandro Agnoletti, Paolo Pacca, Federica Franchino, Diego Garbossa, Alessandro Ducati, Antonio Melcarne
Glioblastoma multiforme (GBM) is a common malignant brain tumor that rarely metastasizes extracranially, despite its aggressive clinical course. This report details the case of a young man presenting with a single subcutaneous localization of GBM that arose six months after initial surgery and recurred after excision. Only six other cases of scalp metastasis of GBM following surgery have been described in the literature, each with peculiar features. Whenever feasible, surgery is the most effective way to obtain local control of disease...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28182535/prevention-of-postsurgical-wound-dehiscence-after-abdominal-surgery-with-npwt-a-multicentre-randomised-controlled-trial-protocol
#20
K Sandy-Hodgetts, G D Leslie, R Parsons, N Zeps, K Carville
OBJECTIVE: The effectiveness of negative pressure wound therapy (NPWT) in the prevention of postoperative surgical wound dehiscence (SWD) is the subject of much debate and remains to be determined. This study will identify individuals at risk of postoperative SWD and trial the use of NPWT as a prophylactic measure against the occurrence of SWD, compared with a non-NPWT standard surgical dressing (SSD). METHOD: A prospective multicentre randomised controlled trial comparing NPWT dressing against standard surgical dressings (SSD) will be conducted...
February 2017: Journal of Wound Care
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