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Dehiscence after surgery

Erika Roddy, Mohammad Diab
BACKGROUND CONTEXT: Short-term readmission rates are becoming widely utilized as a quality and performance metrics for hospitals. Data on unplanned short-term readmission after spine fusion for deformity in pædiatric patients is limited. PURPOSE: To characterize the rate and risk factors for short-term readmission after spine fusion for deformity in pædiatric patients. STUDY DESIGN: Retrospective cohort study PATIENT SAMPLE: State In-Patient Databases from NY, UT, NE, FL, NC (years 2006-2010) and CA (years 2006-2011)...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
Shih-Lun Lo, Yu-Hsiu Yen, Pi-Jung Lee, Charles Chih-Ho Liu, Chi-Ming Pu
PURPOSE: The present study aimed to analyze multiple variables and to determine the factors influencing postoperative complications in reconstructive microsurgeries for head and neck cancer. MATERIALS AND METHODS: This was a retrospective review of the medical records of patients with head and neck cancer who underwent free flap reconstruction after ablation surgery at the Cathay General Hospital (Taipei, Taiwan) from January 2010 to December 2014. Clinical and surgical procedure-related factors were retrieved from a database and analyzed...
September 23, 2016: Journal of Oral and Maxillofacial Surgery
Ajm Dingemans, Hjj van der Steeg, R Rassouli-Kirchmeier, M W Linssen, Ialm van Rooij, I de Blaauw
INTRODUCTION: Although surgery is effective in most patients with Hirschsprung's disease (HD), some have persistent obstructive symptoms. Additional medical treatment is generally sufficient, but a small fraction of these patients needs secondary surgery. Series on redo surgery are scarce. Aim of this study is to evaluate complications and clinical outcome of patients in need of redo surgery for HD. MATERIALS AND METHODS: Sixteen patients underwent redo endorectal pull-through surgery in our center between 2007 and 2015...
September 23, 2016: Journal of Pediatric Surgery
Maria A Bocchiotti, Elisabetta A Baglioni, Luca Spaziante, Ambra Frenello, Erind Ruka
: The postoperative dressing in patients undergoing thigh lift is often difficult, not very resistant to movement, and uncomfortable for the patient, and often exposes surgical site to infection, maceration, or delay in wound healing. METHODS: We included 40 patients in a case-control crossover study with no period effects, who were treated both by Aquacel Surgical and a traditional wound dressing. Surveys with a 10-point scale evaluation were used to assess nontraumatic removal level, ease of application, adhesion, and strength of the 2 treatments...
September 2016: Plastic and Reconstructive Surgery. Global Open
Mona Taleb, Lydia Choi, Steve Kim
BACKGROUND: After wide local excision of cutaneous melanoma, large defects not amenable to simple primary closure are often covered with skin grafts. We report our experience using the rhomboid and keystone flaps to immediately close large axial and extremity wounds after potentially curative surgery for non-head and neck melanomas. METHODS: Between January 2011 and September 2016, demographic, operative, pathologic, and outcome data were prospectively collected on 60 patients who underwent wide local excision of melanoma followed by immediate flap reconstruction...
October 19, 2016: World Journal of Surgical Oncology
Raghu L Motaganahalli, Matthew R Smeds, Michael P Harlander-Locke, Peter F Lawrence, Naoki Fujimura, Randall R DeMartino, Giovanni De Caridi, Alberto Munoz, Sherene Shalhub, Susanna H Shin, Kwame S Amankwah, Hugh A Gelabert, David A Rigberg, Jeffrey J Siracuse, Alik Farber, E Sebastian Debus, Christian Behrendt, Jin H Joh, Naveed U Saqib, Kristofer M Charlton-Ouw, Catherine M Wittgen
BACKGROUND: Adventitial cystic disease (ACD) is an unusual arteriopathy; case reports and small series constitute the available literature regarding treatment. We sought to examine the presentation, contemporary management, and long-term outcomes using a multi-institutional database. METHODS: Using a standardized database, 14 institutions retrospectively collected demographics, comorbidities, presentation/symptoms, imaging, treatment, and follow-up data on consecutive patients treated for ACD during a 10-year period, using Society for Vascular Surgery reporting standards for limb ischemia...
October 14, 2016: Journal of Vascular Surgery
Jeremy C K Tan, Melissa X Kuo, Minas T Coroneo
PURPOSE: To report on a case of autoconjunctival graft compromise after pterygium surgery in a patient on long-term anti-vascular endothelial growth factor (anti-VEGF) therapy, due to the deleterious effects of anti-VEGF agents on ocular wound healing. METHODS: A white female in her early eighties presented with large right nasal pterygium, first noted 5 years previously. She also had macular degeneration and had been receiving monthly injections of ranibizumab, which was later switched to aflibercept...
October 5, 2016: Cornea
Chandni Sinha, Bindey Kumar, Umesh Kumar Bhadani, Ajeet Kumar, Amarjeet Kumar, Alok Ranjan
BACKGROUND: Caudal block is a reliable regional analgesic technique for pediatric urogenital surgeries. Various adjuvants have been tried to enhance the duration of action of bupivicaine. Though clonidine is extensively used as an adjuvant in caudal anaesthesia, it can have troublesome adverse effects like bradycardia, hypotension and sedation. Lately dexamethasone has become popular as an adjuvant in paediatric caudals due to its safety profile. AIM: The aim of this study was to compare dexamethasone and clonidine coadministered with bupivicaine caudally in paediatric patients undergoing urogenital surgeries in terms of analgesia and adverse effects...
September 2016: Anesthesia, Essays and Researches
V Maňásek, K Bezděk, A Foltys, K Klos, J Smitka, D Smehlik
BACKGROUND: The primary objective of this study was to investigate the impact of high protein oral nutrition support (ONS) on clinical outcomes in patients with colorectal cancer (CRC). The secondary aim was to compare the cost of treatment and length of stay (LoS) for CRC patients taking high protein ONS vs. patients on conventional nutritional support. MATERIALS AND METHODS: The study was conducted on adult patients with CRC undergoing colorectal surgery. Informed consent was obtained before the study...
2016: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
Kristen Nelson-McMillan, Christoph P Hornik, Xia He, Luca A Vricella, Jeffrey P Jacobs, Kevin D Hill, Sara K Pasquali, Diane E Alejo, Duke E Cameron, Marshall L Jacobs
BACKGROUND: Delayed sternal closure (DSC) is commonly used to optimize hemodynamic stability after neonatal and infant heart surgery. We hypothesized that duration of sternum left open (SLO) was associated with rate of infection complications, and that location of sternal closure may mitigate infection risk. METHODS: Infants (age ≤365 days) undergoing index operations with cardiopulmonary bypass and DSC at STS Congenital Heart Surgery Database centers (from 2007 to 2013) with adequate data quality were included...
October 6, 2016: Annals of Thoracic Surgery
Wei-Liang Chen, Zhao-Hui Yang, Zhi-Quan Huang, Song Fan, Da-Ming Zhang, You-Yuan Wang
PURPOSE: Head and neck tumors that involve the craniomaxillofacial region are classified as stage IVb disease and are clinically challenging. In this study, the outcomes of craniofacial resection and craniofacial reconstruction in patients with recurrent malignant tumors involving the craniomaxillofacial region were evaluated. PATIENTS AND METHODS: This retrospective observational study was conducted from January 2008 to August 2015. Data collected for each patient included age, gender, tumor site, initial treatment, craniofacial resection, reconstruction flaps and complications after craniofacial resection, adjuvant treatment, and reported outcomes of craniofacial resection and craniofacial reconstruction...
September 13, 2016: Journal of Oral and Maxillofacial Surgery
Daniel Deluiz, Luciano Santos Oliveira, Fábio Ramôa Pires, Teresita Reiner, Luciana Armada, Marcus A Nunes, Eduardo Muniz Barretto Tinoco
BACKGROUND: Severe alveolar atrophy often presents a challenge for the implant surgery. The significant lack of bone in the alveolar ridges may compromise the final restorations both from the aesthetic and functional standpoints. OBJECTIVES: To evaluate the behavior of bone block allografts for the maxillary augmentation and to investigate its incorporation, remodeling, and implant survival rates in two different healing time points. MATERIAL AND METHODS: Sixty-six consecutive patients (52 female/14 male, mean age: 57...
September 8, 2016: Clinical Implant Dentistry and related Research
Matthew R Moralle, Nicholas D Stekas, Mark C Reilly, Michael S Sirkin, Mark R Adams
INTRODUCTION: Chronic osteomyelitis is a disease that requires fastidious treatment to eliminate. However, when eradication is unable to be achieved through exhaustive modalities of antibiotic therapy and multiple debridements, significant resection of the infected bone and soft tissue must be considered, including amputation. Here we report of a salvage procedure for chronic osteomyelitis of the left tibia by employing a rotationplasty to avoid an above knee amputation and instead provide the patient with a below knee amputation...
April 2016: Journal of Orthopaedic Case Reports
Stephen King, Elizabeth S Roberts, Jonathan N King
BACKGROUND: Few pharmaceuticals are registered in cats for the management of post-operative pain and inflammation. The objective of this study was to assess the field efficacy and safety of an injectable formulation of the nonsteroidal anti-inflammatory drug robenacoxib in cats undergoing surgery. The study was a multi-center, prospective, randomized, masked, parallel-group, placebo-controlled clinical trial. A total of 349 cats were enrolled and underwent surgery comprising forelimb onychectomy, as an example of orthopedic surgery, plus either ovariohysterectomy or castration...
September 29, 2016: BMC Veterinary Research
N F M Corrêa, M J A de Brito, M M de Carvalho Resende, M F P Duarte, F S Santos, G M Salomé, L M Ferreira
OBJECTIVE: To assess the impact of surgical wound dehiscence on health-related quality of life and mental health. Dehiscence of surgical wounds is a serious postoperative complication associated with high morbidity and mortality. METHOD: Sixty-one adult patients, who had undergone neurological, general, colorectal, orthopaedic, gynaecological, plastic, cardiovascular, urological or neurological surgery in a university hospital in Brazil, were assessed between 30 and 180 days after surgery...
October 2, 2016: Journal of Wound Care
Gilderlene Alves Fernandes, Andréa Conceição Gomes Lima, Isabel Clarisse Albuquerque Gonzaga, Raimundo de Barros Araújo, Rauirys Alencar de Oliveira, Renata Amadei Nicolau
The aim of this study was to analyze the healing effects of low-level laser therapy (LLLT) on the longitudinal sternotomy incisions of patients who underwent coronary artery bypass graft (CABG). The volunteers were randomized into three groups of equal size (n = 30): control, placebo, and laser (λ = 660 nm and spatial average energy fluency [SAEF] = 1.06 J/cm(2)). The patients in the laser group underwent irradiation on postoperative days 2, 4, 6, and 8, and their sternotomy incisions were photographed immediately after the surgery and 8 days later for analysis...
September 20, 2016: Lasers in Medical Science
Luigi Percalli, Renato Pricolo, Luigi Passalia, Paolo Croce, Matteo Ricco', Roberto Berretta, Federico Marchesi
Vaginal cuff dehiscence is a rare complication of hysterectomies which seems to be more frequent after surgery with laparoscopic suture of the cuff. We present a clinical case of evisceration of the small bowel emerging from vaginal cuff dehiscence, successfully repaired by positioning a low profile polypropylene ePTFE mesh*.
September 13, 2016: Acta Bio-medica: Atenei Parmensis
E J Harrison, W E Scherrer, J Fragola, N G Patel, S R Perry, V Janković, A J Staatz
AIMS: To compare the prevalence of minor incisional complications in canine patients undergoing tibial plateau levelling osteotomy (TPLO) surgery that had a hydrogel liquid bandage (HLB) applied to their incision, with patients that had a light adhesive bandage applied. METHODS: Thirty dogs undergoing TPLO surgery were randomly assigned to either application of a light adhesive bandage to the incision, with removal 18-24 hours later, or application of a clear-drying polyethylene glycol HLB to the incision...
September 18, 2016: New Zealand Veterinary Journal
Erica Pettke, Nicole Ilonzo, Martha Ayewah, Sara Tsantes, Alison Estabrook, Aye Moe Thu Ma
BACKGROUND: This study compares early postoperative breast cancer outcomes between patients 80 years and older (older patients) and those younger than 80 years (<80 years). METHODS: The National Surgical Quality Improvement Program database was used to identify patients who had breast surgery between 2005 and 2013 for malignancy. RESULTS: Older patients had a significantly higher percentage of comorbidities and partial mastectomies. Postoperatively, they had higher rates of pneumonia, urinary tract infection, cardiac arrest, and mortality but had lower rates of wound dehiscence, deep wound, and organ space infections...
October 2016: American Journal of Surgery
P Bertholon, A Karkas
This chapter will focus on vertigo/dizziness due to inner-ear malformations, labyrinthine fistula, otosclerosis, infectious processes, and autoimmune inner-ear disorders. Inner-ear malformation due to dehiscence of the superior semicircular canal is the most recently described inner-ear malformation. Vertigo/dizziness is typically induced by sound and pressure stimuli and can be associated with auditory symptoms (conductive or mixed hearing loss). Labyrinthine fistula, except after surgery for otosclerosis, in the context of trauma or chronic otitis media with cholesteatoma, still remains a challenging disorder due to multiple uncertainties regarding diagnostic and management strategies...
2016: Handbook of Clinical Neurology
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