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Dehiscence after surgery

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https://www.readbyqxmd.com/read/28917602/comparing-inpatient-versus-outpatient-bowel-preparation-in-children-and-adolescents-undergoing-appendicovesicostomy
#1
David L Weatherly, Konrad M Szymanski, Benjamin M Whittam, William E Bennett, Shelly King, Rosalia Misseri, Martin Kaefer, Richard C Rink, Mark P Cain
PURPOSE: The need for mechanical inpatient bowel preparation (IBP) in reconstructive pediatric urology has come under scrutiny, secondary to literature demonstrating little benefit regarding outcomes. Starting in 2013, a majority of patients undergoing reconstructive procedures at our institution no longer underwent IBP. We hypothesized that outpatient bowel preparation (OBP) would reduce length of stay (LOS) without increasing postoperative complications after appendicovesicostomy surgery...
August 26, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28910784/fetal-surgery-for-myelomeningocele-a-systematic-review-and-meta-analysis-of-outcomes-in-fetoscopic-versus-open-repair
#2
Sandra K Kabagambe, Guy W Jensen, Yue Julia Chen, Melissa A Vanover, Diana L Farmer
BACKGROUND/OBJECTIVES: The Management of Myelomeningocele (MMC) Study (MOMS) showed that prenatal repair of MMC resulted in improved neurological outcomes but was associated with high rates of obstetrical complications. This study compares outcomes of open and fetoscopic MMC repair. DATA SOURCES: PubMed and Embase studies reporting outcomes of fetal MMC repair published since the completion of the MOMS. RESULTS: We analyzed 11 studies and found no difference in mortality or the rate of shunt placement for hydrocephalus...
September 15, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28903524/pediatric-dental-clinic-associated-outbreak-of-mycobacterium-abscessus-infection
#3
Lindsay A Hatzenbuehler, Melissa Tobin-D'Angelo, Cherie Drenzek, Gianna Peralta, Lisa C Cranmer, Evan J Anderson, Sarah S Milla, Shelly Abramowicz, Jumi Yi, Joseph Hilinski, Roy Rajan, Matthew K Whitley, Verlia Gower, Frank Berkowitz, Craig A Shapiro, Joseph K Williams, Paula Harmon, Andi L Shane
Background: Mycobacterium abscessus is an uncommon cause of invasive odontogenic infection. Methods: M abscessus-associated odontogenic infections occurred in a group of children after they each underwent a pulpotomy. A probable case-child was defined as a child with facial or neck swelling and biopsy-confirmed granulomatous inflammation after a pulpotomy between October 1, 2013, and September 30, 2015. M abscessus was isolated by culture in confirmed case-children...
September 1, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28902804/long-term-patient-reported-outcomes-after-surgery-for-superior-canal-dehiscence-syndrome
#4
Mohammed S Alkhafaji, Sanskriti Varma, Seth E Pross, Jeffrey D Sharon, Jason C Nellis, Charles C Della Santina, Lloyd B Minor, John P Carey
OBJECTIVE: Evaluate the long-term patient-reported outcomes of surgery for superior canal dehiscence syndrome (SCDS). STUDY DESIGN: Cross-sectional survey. SETTING: Tertiary referral center. PATIENTS: Adults who have undergone surgery for SCDS with at least 1 year since surgery. MAIN OUTCOME MEASURE(S): Primary outcome: change in symptoms that led to surgery. SECONDARY OUTCOMES: change in 11 SCDS-associated symptoms, change in psychosocial metrics, and willingness to recommend surgery to friends with SCDS...
October 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28895500/anesthetic-management-of-a-patient-with-tracheal-dehiscence-post-tracheal-resection-surgery
#5
Sang Kim, Maryna Khromava, Jeron Zerillo, George Silvay, Adam I Levine
We present a case of a patient with complete tracheal dehiscence and multiple false passages after recent tracheal resection and anastomosis. Loss of tracheal continuity after disruption of anastomosis with distal stump retraction presents a unique anesthetic challenge given lack of access to the trachea and the need for adequate anesthesia and analgesia for surgical neck dissection. Traditional airway management, including awake fiberoptic intubation, intubation via direct laryngoscopy, needle cricothyrotomy, and awake tracheostomy are not viable options...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28893435/gradual-bone-transfer-for-the-correction-of-the-pubic-diastasis-using-the-ilizarov-technique-in-closure-of-bladder-and-cloacal-exstrophy
#6
Hiroshi Kusakabe, Katsuhiko Ueoka, Shinichiro Takayama, Atsuhito Seki
BACKGROUND: In the patient of the cloacal exstrophy, cloaca with local abdominal wall is disrupted and exposed inner surface of the bladder needs early closure. Pelvic osteotomies are required for severe cases whose bladder cannot be closed by the suture of soft tissue only. We developed a technique involving the gradual positioning of bone fragments using a light, Ilizarov external fixator. The usefulness of the technique was assessed. METHODS: We enrolled 3 patients with cloacal exstrophy and 1 with bladder exstrophy as a gradual transfer group and 6 patients who were treated by other osteotomies as a control group...
September 8, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28883736/omentum-flap-as-a-salvage-procedure-in-deep-sternal-wound-infection
#7
Nick Spindler, Christian D Etz, Martin Misfeld, Christoph Josten, Friedrich-Wilhelm Mohr, Stefan Langer
INTRODUCTION: Deep sternal wound infections (DSWIs) are rare but devastating complication after median sternotomy following cardiac surgery. Especially in the presence of artificial material or inadequate preliminary muscle flaps, the pedicled omentum flap is due to its immunological properties, the predetermined flap in salvage procedures. METHODS: We treated 14 patients suffering a mediastinitis and open thorax using a pedicled omentoplasty as a salvage procedure because of persisting DSWIs...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28880987/association-of-mohs-reconstructive-surgery-timing-with-postoperative-complications
#8
Matthew Q Miller, Abel P David, James E McLean, Stephen S Park, Jared Christophel
Importance: Same-day Mohs reconstructive surgery is not always possible; moreover, a delay can offer benefits such as improved surgical planning and increased blood supply to the cauterized wound bed. However, recent work found that delaying reconstruction by more than 2 days increases the postoperative complication rate. Objective: To review the outcomes of Mohs micrographic surgery (MMS) reconstruction with respect to patient- and surgery-specific variables, especially timing of repair...
September 7, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28880048/histopathological-changes-associated-to-an-absorbable-fibrin-patch-tachosil%C3%A2-covering-in-an-experimental-model-of-high-risk-colonic-anastomoses
#9
C García-Vásquez, S Gómez García de Las Heras, C Pastor Idoate, D De Pablo, M J Fernández-Aceñero
BACKGROUND: TachoSil® is a fibrin sponge that contains fibrinogen and thrombin and is a useful adjuvant to enhance control of air leaks in thoracic surgery and to control bleeding in vascular and general surgery. Its use in intestinal surgery to prevent suture dehiscence is currently under investigation. MATERIAL AND METHODS: We report the results of a prospective randomized experimental study on 33 large white pigs in which a high-risk suture was created by induction of ischemia...
September 7, 2017: Histology and Histopathology
https://www.readbyqxmd.com/read/28876659/abdominoperineal-resection-in-the-prone-position-early-outcomes-at-a-tertiary-institution-in-the-western-cape-south-africa
#10
N Stevenson, A V V Lambrechts
BACKGROUND: Abdominoperineal resection (APR) in the prone position is a new technique in the developing world, where colorectal cancer incidence is rising fast and the patient population is different from those in the developed world. Literature is lacking on the outcomes of this technique under these conditions. METHOD: All patients who underwent APR in the prone position for rectal adenocarcinoma from February 2011 to February 2017 were reviewed. Main endpoints were stage at presentation, neoadjuvant treatment, circumferential resection margin involvement, perineal wound complications, length of intensive care unit (ICU) stay and days discharged after surgery...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28873411/preoperative-asymptomatic-leukocytosis-and-postoperative-outcome-in-cardiac-surgery-patients
#11
Eitezaz Mahmood, Ziyad O Knio, Feroze Mahmood, Rabia Amir, Sajid Shahul, Bilal Mahmood, Yanick Baribeau, Ariel Mueller, Robina Matyal
BACKGROUND: Despite showing a prognostic value in general surgical patients, preoperative asymptomatic elevated white blood cell (WBC) count is not considered a risk factor for cardiac surgery. Whereas there is sporadic evidence of its value as a preoperative risk marker, it has not been looked at methodically as a specific index of outcome during cardiac surgery. Using a national database we sought to determine the relationship between preoperative WBC count and postoperative outcome in cardiac surgical patients...
2017: PloS One
https://www.readbyqxmd.com/read/28872500/simple-septocutaneous-free-flap-design-for-one-stage-reconstruction-of-pharyngocutaneous-and-orocutaneous-fistulae
#12
Soo Hyun Woo, Tae Hui Bae, Woo Seob Kim, Han Koo Kim
Reconstruction of pharyngocutaneous fistula (PCF) or orocutaneous fistula is always a challenging task. It has many causes and is especially related to radiation therapy after resection of head and neck cancers. There are many reports of surgical procedures for fistula repair. For example, 2-stage methods, methods of combining multiple flaps, and methods of using chimeric flaps have been reported. However, there is no established simple method as a treatment of choice. The authors describe 5 patients of head and neck fistulas and recommend a useful 1-stage reconstruction method using a double skin paddle free flap...
September 1, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28857982/is-horizontal-mattress-suturing-more-effective-than-simple-interrupted-suturing-on-postoperative-complications-and-primary-wound-healing-after-impacted-mandibular-third-molar-surgery
#13
Ahmet Hüseyin Acar, Hakki Oğuz Kazancioğlu, Necip Fazil Erdem, Fatih Asutay
The aim of this clinical study was to compare the influence of 2 different suturing techniques on postoperative complications and wound healing after surgical extractions of impacted mandibular third molars. In this randomized split mouth study, 30 patients were examined in whom 60 consecutive surgical extractions of symmetrically positioned impacted mandibular third molars were performed. After the extractions, the surgical flaps were sutured with either the simple interrupted or horizontal mattress suturing technique...
August 28, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28856354/severity-weighting-of-postoperative-adverse-events-in-orthopedic-surgery
#14
Daniel D Bohl, Junyoung Ahn, Adam M Lukasiewicz, Andre M Samuel, Matthew L Webb, Bryce A Basques, Nicholas S Golinvaux, Kern Singh, Jonathan N Grauer
Studies of adverse events (AEs) after orthopedic surgery commonly use composite AE outcomes. An example of such an outcome is any AE. These types of outcomes treat AEs with different clinical significance (eg, death, urinary tract infection) similarly. We conducted a study to address this shortcoming in research methodology by creating a single severity-weighted outcome that can be used to characterize the overall severity of a given patient's postoperative course. All orthopedic faculty members at 2 academic institutions were invited to complete a severity-weighting exercise in which AEs were assigned a percentage severity of death...
July 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28856325/ilioprofunda-endobypass-can-successfully-treat-a-post-operative-femoral-pseudo-aneurysm
#15
T Mehta, R Dey, A Chaudhuri
INTRODUCTION: A 75-year-old male patient with significant cardiopulmonary comorbidity presented with a 70-mm left femoral pseudoaneurysm 6 years after aortobifemoral bypass (and prior femoral endarterectomy). REPORT: As the left superficial femoral artery was occluded, an ilioprofunda endobypass was undertaken following extraperitoneal exposure of the left limb of the bypass graft with subsequent deployment of four Viabahn endoprostheses via the left limb into the proximal left deep femoral artery with successful exclusion of the pseudoaneurysm...
2017: EJVES Short Rep
https://www.readbyqxmd.com/read/28844754/the-role-of-preoperative-intra-muscular-testosterone-in-improving-functional-and-cosmetic-outcomes-following-hypospadias-repair-a-prospective-randomized-study
#16
Ramesh Babu, Sibi Chakravarthi
BACKGROUND: There are very few well-designed studies on the role of preoperative testosterone in hypospadias repair. The aims of the current study are to ascertain the efficacy of intramuscular testosterone in increasing the glans width, reducing the complications and improving the functional and cosmetic outcomes. MATERIALS AND METHODS: Between January 2013 and December 2016, a total of 200 patients with distal hypospadias were recruited to this prospective randomized study...
August 12, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28829760/outcomes-of-laparoscopic-treatment-in-women-with-cesarean-scar-syndrome
#17
Erik Dosedla, Pavel Calda
BACKGROUND The aim of this study was to evaluate the outcomes of laparoscopic treatment of women with severe defect of a Cesarean section (CS) scar and Cesarean scar syndrome. MATERIAL AND METHODS A prospective longitudinal study was conducted in 11 women who were treated for Cesarean scar syndrome. Ultrasound examinations were performed transvaginally 1 day before surgery and 6 months after laparoscopy in all women. Clinical data were registered 1 day before laparoscopy and 6 months after laparoscopy. RESULTS Of these 11 women, total dehiscence of the CS scar was present in 72...
August 22, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28807779/syringo-subarachnoid-shunt-for-the-treatment-of-persistent-syringomyelia-following-decompression-for-chiari-type-i-malformation-surgical-results
#18
Jehuda Soleman, Jonathan Roth, Andrea Bartoli, Daniel Rosenthal, Akiva Korn, Shlomi Constantini
BACKGROUND: Approximately 30% of patients treated by foramen magnum decompression (FMD) for Chiari I-associated-syringomyelia will show persistence, recurrence, or progression of the syrinx. OBJECTIVE: This study evaluates the clinical and radiological outcome of syringo-subarachnoid shunt (SSS) as the treatment for persistent syringomyelia after FMD. METHODS: Data was collected retrospectively. The primary outcome measurement was neurological function (assessed with the Modified Japanese Orthopedic Association (mJOA) scale)...
August 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28806210/risk-stratification-for-major-postoperative-complications-in-patients-undergoing-intra-abdominal-general-surgery-using-latent-class-analysis
#19
Minjae Kim, Melanie M Wall, Guohua Li
BACKGROUND: Preoperative risk stratification is a critical element in assessing the risks and benefits of surgery. Prior work has demonstrated that intra-abdominal general surgery patients can be classified based on their comorbidities and risk factors using latent class analysis (LCA), a model-based clustering technique designed to find groups of patients that are similar with respect to characteristics entered into the model. Moreover, the latent risk classes were predictive of 30-day mortality...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28799112/the-dgav-risk-calculator-development-and-validation-of-statistical-models-for-a-web-based-instrument-predicting-complications-of-colorectal-cancer-surgery
#20
Alexander Crispin, Carsten Klinger, Anna Rieger, Brigitte Strahwald, Kai Lehmann, Heinz-Johannes Buhr, Ulrich Mansmann
PURPOSE: The purpose of this study is to provide a web-based calculator predicting complication probabilities of patients undergoing colorectal cancer (CRC) surgery in Germany. METHODS: Analyses were based on records of first-time CRC surgery between 2010 and February 2017, documented in the database of the Study, Documentation, and Quality Center (StuDoQ) of the Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV), a registry of CRC surgery in hospitals throughout Germany, covering demography, medical history, tumor features, comorbidity, behavioral risk factors, surgical procedures, and outcomes...
August 10, 2017: International Journal of Colorectal Disease
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