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Dehiscence after surgery

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https://www.readbyqxmd.com/read/28441303/surgical-techniques-for-closure-of-a-scalp-defect-after-resection-of-skin-malignancy
#1
Maciej Rysz, Dariusz Grzelecki, Maciej Mazurek, Stanisław Starościak, Romuald Krajewski
BACKGROUND: Surgery for scalp malignancies is aimed at the complete resection and a good aesthetic outcome. The goal was to develop an algorithm for scalp reconstruction based on the authors' surgical experience. METHODS: This is a retrospective analysis of 123 procedures of scalp malignancies in 105 patients. Twenty eight procedures were for resection of squamous cell carcinoma, 54 for basal cell carcinoma, and 41 for suspected melanomas. RESULTS: Primary closure (27 procedures), local flap (LF; 19), split-thickness skin graft (SG; 64), rotated LF and SG (9), and free vascularized flaps (4) were used...
May 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28433042/-alarmins-and-surgical-injury
#2
J Máca, M Peteja
Surgical intervention is an inseparable part of the management of serious surgical disease. However, surgery also presents a potential risk related to the so-called surgical injury causing immune response. When dysregulated the immune activation is able to cause local complications (i.e. wound dehiscence, impaired healing). Systemic decompartmentization of the immunologic disturbance can negatively influence long-term outcomes (i.e. hospital length of stay, mortality). Due to aseptic conditions in the operating room, such an immune activation is almost always of sterile nature...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28429927/endovascular-correction-in-acute-bleeding-after-femoropopliteal-bypass-a-single-centre-experience
#3
Giulia Mazzitelli, Mariagnese Mele, Francesco Setacci, Giuseppe Galzerano, Gianmarco DE Donato, Domenico Benevento, Massimiliano W Guerrieri, Carlo Setacci
INTRODUCTION: The endovascular correction (EC) has emerged in recent years as a possible alternative to surgical revision (SR) in case of bleeding complications after peripheral bypass (PB) . The purpose of this study is to evaluate the efficacy and safety of EC compared to SR in case of bleeding complications of PB. METHODS: From January 2004 to December 2014, we have submitted 32 patients to surgery for acute bleeding in previous PB (25 venous bypass, in situ or reversed, 6 PTFE bypass and 1 composite bypass)...
April 21, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28420521/delayed-postcoital-vaginal-cuff-dehiscence-with-small-bowel-evisceration-after-robotic-assisted-staging-surgery
#4
Yen-Po Lan, Huang-Hui Chen, Wei-Min Liu, Ching-Hui Chen
OBJECTIVE: We report a rare case of vaginal cuff dehiscence with small bowel evisceration at 7 months post robotic-staging surgery. CASE REPORT: A 41-year-old woman was sent to the emergency room with sudden onset of abdominal pain, vaginal bleeding, and vaginal protruding mass after sexual activity. She had a history of synchronous uterine and ovarian cancer treated with robotic-staging surgery 7 months before. Then she received six courses of postoperative adjuvant chemotherapy, and the last chemotherapy ended 1 month ago...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28420022/-severe-bleeding-from-the-middle-ear-cavity-after-myringotomy-review-based-on-a-case-report
#5
Veit M Hofmann, Stefan M Niehues, Andreas E Albers, Annett Pudszuhn
Report of a rare case of severe bleeding from the middle ear cavity after myringotomy. On the basis of the case report, the procedure for such bleeding is discussed in the context of the literature. A 6-year-old boy received a revision myringotomy in an ambulant setting. During the procedure a severe bleeding occurred. The external auditory canal was adequately packed. The patient was extubated and transferred to the clinic as an emergency. Computer tomography of the temporal bone showed the anatomical variant of a dehiscent high jugular bulb, which had been injured...
March 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28391448/type-of-incision-does-not-predict-abdominal-wall-outcome-after-emergency-surgery-for-colonic-anastomotic-leakage
#6
Kristian Kiim Jensen, Erling Oma, Henrik Harling, Peter-Martin Krarup
PURPOSE: Most literature on abdominal incision is based on patients undergoing elective surgery. In a cohort of patients with anastomotic leakage after colonic cancer resection, we analyzed the association between type of incision, fascial dehiscence, and incisional hernia. METHODS: Data were extracted from the Danish Colorectal Cancer Group database and merged with information from the Danish National Patient Register. All patients with anastomotic leakage after colonic resection in Denmark from 2001 until 2008 were included and surgical records on re-operations were retrieved...
April 8, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28379649/grafts-in-glaucoma-surgery-a-review-of-the-literature
#7
Sahil Thakur, Parul Ichhpujani, Suresh Kumar
Patients with bleb leakage, dehiscence, or infection after trabeculectomy need urgent bleb salvaging to prevent vision loss. Patients who have undergone a glaucoma drainage device surgery may have tube erosion, which is yet another devastating and outcome-compromising complication. The bleb or the tube in such cases needs to be patched by a biologic tissue, which is roofed by the conjunctiva and acts as a barrier against external infections. Sclera, pericardium, cornea, and dura mater are the commonly used patch graft materials...
March 29, 2017: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/28370168/major-complications-of-tibial-tuberosity-advancement-in-1613-dogs
#8
Mario Costa, Diane Craig, Tony Cambridge, Peter Sebestyen, Yuhua Su, Maria A Fahie
OBJECTIVES: To report major postoperative complications in 1613 dogs with tibial tuberosity advancement (TTA). STUDY DESIGN: Retrospective case series. SAMPLE POPULATION: Dogs (n = 1613) with cranial cruciate ligament deficiency treated with TTA. METHODS: Medical records of TTAs performed between December 2007-2013 were reviewed for age, sex, weight, contralateral stifle surgery, surgical approach, duration of preoperative lameness, presence of meniscal damage, concurrent patellar luxation and simultaneous bilateral TTA...
March 31, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28345802/the-association-between-caudal-anesthesia-and-increased-risk-of-postoperative-surgical-complications-in-boys-undergoing-hypospadias-repair
#9
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
#10
Hamed M El Darawany, Mahmoud E Al Damhogy
OBJECTIVE: To evaluate 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 had urethral mobilization. All patients were followed up at 2 weeks, and at 1, 3, 6, and 12 months postoperatively. Duration of the operation, hospital stay, position of meatus and its shape before and after the operation, and the postoperative complications were recorded...
March 18, 2017: Urology
https://www.readbyqxmd.com/read/28315282/complications-after-hypospadias-correction-prognostic-factors-and-impact-on-final-clinical-outcome
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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