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https://www.readbyqxmd.com/read/29773240/perioperative-risk-factors-that-predict-complications-of-radial-forearm-free-flaps-in-oral-and-maxillofacial-reconstruction
#1
C Wang, G Fu, F Liu, L Liu, M Cao
The aim of the study was to find out what perioperative risk factors predicted complications in patients having reconstructions with radial forearm free flaps (RFFF). We organised a retrospective study of 169 patients (mean (range) age 54 (22-86) years, 100 of whom were female) who had oral and maxillofacial tumours resected, and reconstructed with RFFF, from January 2011-December 2016. We recorded predictive variables, subdivided into: personal and clinical (sex, age, weight, coexisting conditions, history of smoking, radiotherapy, and primary lesions); haemodynamic (perioperative concentrations of haemoglobin and albumin, blood loss, blood transfusion, urinary output (ml), and rate (ml/kg/hour), and infusion rates for crystalloids and colloids (ml/kg/hour, and volumes given intraoperatively and postoperatively for 24hours); and anaesthetic and surgical (American Society of Anesthesiologists(ASA) grade, visual analogue pain score (VAS), and duration of tourniquet and operation)...
May 14, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29767734/electrical-burns-and-late-spontaneous-artery-ruptures-about-three-cases
#2
C Reinbold, K Serror, M Mimoun, M Chaouat, O Marco, D Boccara
Electrical burns are responsible for arterial and venous thrombosis, as well as weakening of the arteries. Immediate or delayed arterial occlusions, secondary to the aggression of the intima, or aneurysms, secondary to the aggression of the media, sometimes lead to artery ruptures without any warning signs. Such ruptures may trigger a hemorrhagic shock whose period of onset is variable and unpredictable. We are presenting here three cases treated in our department for electrical burns, whose complications were marked by hemorrhagic shock, secondary to late artery ruptures, sometimes occurring several months following the event...
May 15, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29754478/methicillin-resistant-staphylococcus-aureus-contamination-of-phlebotomy-tourniquets-and-faucets
#3
T Abeywickrama, K Amarasinghe, S Wijerathne, C Dharmaratne, D Fernando, B C Senaratna, H A K M Gunasekera
Introduction: Methicillin resistant Staphylococcus aureus (MRSA) is transmitted through direct contact or fomites. The most important means of nosocomial spread is by hospital personnel. However, fomites are being increasingly recognized as sources of nosocomial infection. Objectives: Our aim was to describe the MRSA contamination rate of phlebotomy tourniquets and faucets in a tertiary care hospital and to compare the contamination of plastic tourniquets with that of fabric tourniquets...
March 31, 2018: Ceylon Medical Journal
https://www.readbyqxmd.com/read/29752218/elevated-international-normalized-ratio-is-not-associated-with-increased-perioperative-morbidity-in-podiatric-limb-salvage-surgery-a-retrospective-analysis
#4
Nalini Vadivelu, Alice M Kai, Feng Dai, Hosni Mikhael, Rima Aouad, Peter Blume
The risk of hemorrhage always exists in anticoagulated patients with an elevated international normalized ratio (INR), a risk that must be measured against the necessity for surgical procedures. The objective of the present retrospective medical record study was to assess the safety with which limb salvage procedures can be conducted in patients with an INR >1.4. The medical records of 231 patients who had undergone limb salvage procedures by 1 surgeon at the Yale New Haven Health System from November 2008 through July 2014 were reviewed...
May 8, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29752149/tourniquet-pressure-settings-based-on-limb-occlusion-pressure-determination-or-arterial-occlusion-pressure-estimation-in-total-knee-arthroplasty-a-prospective-randomized-double-blind-trial
#5
Bahattin Tuncali, Hakan Boya, Zeynep Kayhan, Sukru Arac
OBJECTIVE: The aim of this study was to compare the limb occlusion pressure (LOP) determination and arterial occlusion pressure (AOP) estimation methods for tourniquet pressure setting in adult patients undergoing knee arthroplasty under combined spinal-epidural anesthesia. METHODS: Ninety-three patients were randomized into two groups. Pneumatic tourniquet inflation pressures were adjusted based either on LOP determination or AOP estimation in Group 1 (46 patients, 38 female and 8 male; mean age: 67...
May 8, 2018: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29736337/influence-and-reliability-of-lower-limb-arterial-occlusion-pressure-at-different-body-positions
#6
Luke Hughes, Owen Jeffries, Mark Waldron, Ben Rosenblatt, Conor Gissane, Bruce Paton, Stephen D Patterson
Background: Total arterial occlusive pressure (AOP) is used to prescribe pressures for surgery, blood flow restriction exercise (BFRE) and ischemic preconditioning (IPC). AOP is often measured in a supine position; however, the influence of body position on AOP measurement is unknown and may influence level of occlusion in different positions during BFR and IPC. The aim of this study was therefore to investigate the influence of body position on AOP. Methods: Fifty healthy individuals (age = 29 ± 6 y) underwent AOP measurements on the dominant lower-limb in supine, seated and standing positions in a randomised order...
2018: PeerJ
https://www.readbyqxmd.com/read/29715136/calcium-phosphate-cement-in-the-surgical-management-of-benign-bone-tumors
#7
Takashi Higuchi, Norio Yamamoto, Katsuhiro Hayashi, Akihiko Takeuchi, Hiroaki Kimura, Shinji Miwa, Kentaro Igarashi, Kensaku Abe, Yuta Taniguchi, Hisaki Aiba, Hiroyuki Tsuchiya
BACKGROUND/AIM: This study assessed the mid- to long-term outcomes of calcium phosphate cement (CPC) implantation in benign bone tumor surgery. PATIENTS AND METHODS: Between 2000 and 2015, 130 patients underwent CPC implantation in benign bone tumor surgery. Radiographic findings and clinical outcomes were retrospectively evaluated. RESULTS: The mean follow-up period was 52 months. CPC filling immediately after surgery was sufficient, regardless of the amount of CPC used and the usage of adjuvant substances, which resulted in 92% of the patients' radiological results being classified as good or excellent...
May 2018: Anticancer Research
https://www.readbyqxmd.com/read/29710685/beneficial-effects-of-remote-organ-ischemic-preconditioning-on-micro-rheological-parameters-during-liver-ischemia-reperfusion-in-the-rat
#8
Zsuzsanna Magyar, Anita Mester, Gabor Nadubinszky, Gabor Varga, Souleiman Ghanem, Viktoria Somogyi, Bence Tanczos, Adam Deak, Laszlo Bidiga, Mihai Oltean, Katalin Peto, Norbert Nemeth
BACKGROUND: Remote ischemic preconditioning (RIPC) can be protective against the damage. However, there is no consensus on the optimal amount of tissue, the number and duration of the ischemic cycles, and the timing of the preconditioning. The hemorheological background of the process is also unknown. OBJECTIVE: To investigate the effects of remote organ ischemic preconditioning on micro-rheological parameters during liver ischemia-reperfusion in rats. METHODS: In anesthetized rats 60-minute partial liver ischemia was induced with 120-minute reperfusion (Control, n = 7)...
April 14, 2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29701410/digital-artery-aneurysm-case-report
#9
José Vidoedo, José Teixeira
INTRODUCTION AND METHODS: A 71-year-old patient, housewife, with a history of hypertension, elevated cholesterol and hypotyroidism was referred to the outpatient clinic for tumefaction of the right hand 5th finger noticed 3-4 months earlier. She denied past or recent history of trauma, cardiac or infectious disease and had no familial history of aneurysmatic disease. She was asymptomatic except for local slight discomfort when she had to press or push something with her hand. She had no sensitivity or mobility impairment...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29699882/radical-robot-assisted-laparoscopic-nephrectomy-with-thrombectomy-in-the-vena-cava
#10
J Estébanez Zarranz, J Belloso Loidi, M A Gutierrez García, V Rubio Calaveras, G Morales Higelmo, P Melendo Tercilla, L Busto Leis, J P Sanz Jaka
BACKGROUND: Renal cell carcinoma has a natural tendency to extend through the renal vein. When the thrombus reaches the vena cava, thrombectomy and the necessary reconstruction of the vena cava are typically performed by open pathway. Robot-assisted technology provides advantages for performing this complex technique, using a minimally invasive access. MATERIAL AND METHODS: We present the technique we employed in the first case performed in our department. After performing renal artery embolisation, we conducted the surgery with the Vinci S robotic system...
April 23, 2018: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/29695912/tranexamic-acid-reduces-intraoperative-occult-blood-loss-and-tourniquet-time-in-obese-knee-osteoarthritis-patients-undergoing-total-knee-arthroplasty-a-prospective-cohort-study
#11
Yutong Meng, Zhirui Li, Ke Gong, Xiao An, Jiyuan Dong, Peifu Tang
Purpose: Obesity can result in increased blood loss, which is correlated with poor prognosis in total knee arthroplasty (TKA). Clinical application of tranexamic acid is effective in reducing blood loss in TKA. However, most previous studies focused on the effect of tranexamic acid in the whole population, neglecting patients with specific health conditions, such as obesity. We hypothesized that tranexamic acid would reduce blood loss to a greater extent in obese patients than in those of normal weight...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29693490/fatal-wounding-pattern-and-causes-of-potentially-preventable-death-following-the-pulse-night-club-shooting-event
#12
E Reed Smith, Geoff Shapiro, Babak Sarani
BACKGROUND: Mortality following shooting is related to time to provision of initial and definitive care. An understanding of the wounding pattern, opportunities for rescue, and incidence of possibly preventable death is needed to achieve the goal of zero preventable deaths following trauma. METHODS: A retrospective study of autopsy reports for all victims involved in the Pulse Nightclub Shooting was performed. The site of injury, probable site of fatal injury, and presence of potentially survivable injury (defined as survival if prehospital care is provided within 10 minutes and trauma center care within 60 minutes of injury) was determined independently by each author...
April 25, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29693237/intravenous-tranexamic-acid-only-versus-combined-intravenous-and-intra-articular-tranexamic-acid-for-perioperative-blood-loss-in-patients-undergoing-total-knee-arthroplasty
#13
Takuya Iseki, Sachiyuki Tsukada, Motohiro Wakui, Shinichi Yoshiya
PURPOSE: This study was performed to assess the effectiveness of the combined intravenous and intra-articular tranexamic acid (TXA) regimen in total knee arthroplasty (TKA). METHODS: The perioperative blood loss in 75 consecutive patients undergoing unilateral TKA that received both 1000 mg of TXA intravenously and 1000 mg of intra-articular TXA (combined TXA group) was compared with a consecutive series of 77 patients that received 1000 mg of TXA intravenously (intravenous TXA group)...
April 24, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29690533/snakebite-when-the-human-touch-becomes-a-bad-touch
#14
REVIEW
Bryan G Fry
Many issues and complications in treating snakebite are a result of poor human social, economic and clinical intervention and management. As such, there is scope for significant improvements for reducing incidence and increasing patient outcomes. Snakes do not target humans as prey, but as our dwellings and farms expand ever farther and climate change increases snake activity periods, accidental encounters with snakes seeking water and prey increase drastically. Despite its long history, the snakebite crisis is neglected, ignored, underestimated and fundamentally misunderstood...
April 21, 2018: Toxins
https://www.readbyqxmd.com/read/29679123/-wide-awake-hand-surgery-based-on-application-examples
#15
P Kaiser, M Keller, J Dörler, G Schmidle
OBJECTIVE: Anesthesiologic method with low bleeding level, risk level, and complication rate for surgical procedures on the hand without a tourniquet on an unsedated patient with the possibility for functional testing during surgery. INDICATIONS: Surgical procedures of the hand can be carried out using the wide awake technique depending on the patient's suitability and preference considering individual risk factors. CONTRAINDICATIONS: Absolute contraindications are allergies to the local anesthetic or its components...
April 20, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29673673/the-application-of-uterine-wall-local-resection-and-reconstruction-to-preserve-the-uterus-for-the-management-of-morbidly-adherent-placenta-case-series
#16
Xianlan Zhao, Ya Tao, Yingying Du, Lei Zhao, Cai Liu, Yan Zhou, Peng Wei
OBJECTIVE: We aimed to evaluate our experience with the application of uterine wall local resection and reconstruction to preserve the uterus in patients with morbidly adherent placenta. MATERIALS AND METHODS: In a retrospective study, data from patients with morbidly adherent placenta who delivered by cesarean section between January 1, 2013 and May 31, 2016 were analyzed. Prophylactic abdominal aorta balloon occlusion and tourniquet were used to prevent massive hemorrhage in all 62 cases, followed by uterine wall local resection and reconstruction to preserve the uterus...
April 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29672392/the-effect-of-hyperoxygenated-fatty-acids-in-preventing-skin-lesions-caused-by-surgical-pneumatic-tourniquets
#17
Beatriz Castillo Martín, Juan Ignacio Castillo Martín, Jesús Lago Oliver, Jorge Diz Gómez
OBJECTIVES: To determine whether hyperoxygenated fatty acids (HOFAs) provide safe and effective protection against lesions caused by surgical pneumatic tourniquets (SPTs). METHODS: This was a nonrandomized, single-blind, 2-arm, prospective, comparative study. The study was approved by the Ethics and Clinical Research Commission of the Hospital Universitario Gregorio Marañón, in Madrid, Spain. Subjects in the intervention group were treated topically with HOFAs (Linovera; B...
May 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29672324/lidocaine-patch-to-treat-postoperative-tourniquet-pain-after-total-knee-replacement-a-case-report
#18
Brittney M Clark, Gabriel L Pagani-Estevez, Rebecca L Johnson
Intraoperative tourniquet-related pain is well recognized by anesthesiologists, but postoperative tourniquet-related pain has received little attention. We present a patient who underwent a total knee arthroplasty under general anesthesia and an adductor canal nerve block. She complained of intractable thigh pain postoperatively. Lidocaine 5% patches completely resolved her postoperative tourniquet-related pain.
April 17, 2018: A&A practice
https://www.readbyqxmd.com/read/29664057/remote-ischemic-postconditioning-for-ischemic-stroke-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#19
Jing-Jing Zhao, Hui Xiao, Wen-Bo Zhao, Xiao-Pei Zhang, Yu Xiang, Zeng-Jie Ye, Miao-Miao Mo, Xue-Ting Peng, Lin Wei
Background: Remote ischemic postconditioning (RIPostC) appears to protect distant organs from ischemia-reperfusion injury (IRI). However, cerebral protection results have remained inconclusive. In the present study, a meta-analysis was performed to compare stroke patients with and without RIPostC. Methods: CNKI, WanFang, VIP, CBM, PubMed, and Cochrane Library databases were searched up to July 2016. Data were analyzed using both fixed-effects and random-effects models by Review Manager...
April 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29661286/comparison-of-zone-3-resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-the-abdominal-aortic-and-junctional-tourniquet-in-a-model-of-junctional-hemorrhage-in-swine
#20
Jason M Rall, Theodore T Redman, Elliot M Ross, Jonathan J Morrison, Joseph K Maddry
BACKGROUND: Traumatic injuries to the pelvis and high junctional injuries are difficult to treat in the field; however, Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) and the Abdominal Aortic and Junctional Tourniquet (AAJT) constitute two promising treatment modalities. The aim of this study is to use a large animal model of pelvic hemorrhage to compare the survival, hemostatic, hemodynamic, and metabolic profile of both techniques. METHODS: Yorkshire swine (n = 10, 70-90 kg) underwent general anesthesia, instrumentation, and surgical isolation of the femoral artery...
June 2018: Journal of Surgical Research
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