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Surgical skin closure

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https://www.readbyqxmd.com/read/29122621/simple-operating-room-bundle-reduces-superficial-surgical-site-infections-after-major-urologic-surgery
#1
Sarah C Vij, Ganesh Kartha, Venkatesh Krishnamurthi, Michelle Ponziano, Howard B Goldman
OBJECTIVE: To reduce our superficial surgical site infection rate (sSSI) following major urologic surgery by implementing a simple operating room bundle. METHODS: A simple operating room bundle was applied to all major urologic cases (cystectomy, nephrectomy and prostatectomy) at a single tertiary referral center. The bundle included allowing skin prep to dry appropriately, changing gloves prior to skin closure, irrigating the wound prior to skin closure and using a new separate sterile closing instrument set for skin closure...
November 6, 2017: Urology
https://www.readbyqxmd.com/read/29118534/pure-retroperitoneoscopic-donor-nephrectomy-in-duplication-of-inferior-vena-cava-a-series-of-four-cases
#2
Bipin Chandra Pal, Pranjal R Modi, Syed Jamal Rizvi, Rohit Chauhan, Suresh Kumar, Shruti P Gandhi, Vivek B Kute, Hargovind L Trivedi
Aim: Complex vascular anatomy poses a major challenge to the donor surgeon. Here, we have described the technical nuances in retroperitoneoscopic living donor nephrectomy for the left kidney in the situations of a rare vascular anomaly of duplication of inferior vena. Materials and Methods: Between September 2005 and June 2016, 1460 retroperitoneoscopic living donor nephrectomy were carried out in single surgical unit of our institution. Out of these four donors were found to have duplication of inferior vena cava (IVC)...
October 2017: Urology Annals
https://www.readbyqxmd.com/read/29077498/split-thickness-skin-grafts-to-the-foot-and-ankle-of-diabetic-patients
#3
Kyle Sanniec, Tea Nguyen, Suzanne van Asten, Javier La Fontaine, Lawrence A Lavery
BACKGROUND: There is an increased prevalence of foot ulceration in patients with diabetes, leading to hospitalization. Early wound closure is necessary to prevent further infections and, ultimately, lower-limb amputations. There is no current evidence stating that an elevated preoperative hemoglobin A1c (HbA1c) level is a contraindication to skin grafting. The purpose of this review was to determine whether elevated HbA1c levels are a contraindication to the application of skin grafts in diabetic patients...
September 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/29076318/polydeoxyribonucleotide-improves-peripheral-tissue-oxygenation-and-accelerates-angiogenesis-in-diabetic-foot-ulcers
#4
Seoyoung Kim, Jun Hyung Kim, Jaehoon Choi, Woonhyeok Jeong, Sunyoung Kwon
Background: Polydeoxyribonucleotide (PDRN) is known to have anti-inflammatory and angiogenic effects and to accelerate wound healing. The aim of this study was to investigate whether PDRN could improve peripheral tissue oxygenation and angiogenesis in diabetic foot ulcers. Methods: This was a prospective randomized controlled clinical trial. Twenty patients with a non-healing diabetic foot ulcer were randomly distributed into a control group (n=10) and a PDRN group (n=10)...
October 26, 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29076239/use-of-epidermal-skin-grafts-in-chronic-wounds-a-case-series
#5
Peter Am Everts, Marco Warbout, Diana de Veth, Merel Cirkel, Nicole E Spruijt, Jaap Buth
In stalled, chronic wounds, more aggressive and proactive wound closure efforts are needed. We describe adjunctive use of epidermal grafting in patients with chronic wounds. Wound bed preparation consisted of surgical necrotectomy or sharp debridement, hyperbaric oxygen therapy, negative pressure wound therapy, compression therapy, platelet-rich plasma therapy and/or heparan sulphate agents. Epidermal grafts were harvested from the patient's thigh and applied to the wound. Wound and donor site healing was monitored...
October 27, 2017: International Wound Journal
https://www.readbyqxmd.com/read/29075160/osseointegrated-implants-and-prosthetic-reconstruction-following-skull-base-surgery
#6
REVIEW
Shirley Hu, Demetri Arnaoutakis, Sameep Kadakia, Allison Vest, Raja Sawhney, Yadranko Ducic
Rehabilitation following ablative skull base surgery remains a challenging task, given the complexity of the anatomical region, despite the recent advances in reconstructive surgery. Remnant defects following resection of skull base tumors are often not amenable to primary closure. As such, numerous techniques have been described for reconstruction, including local rotational muscle flaps, pedicled flaps with skin paddle, or even free tissue transfer. However, not all patients are appropriate surgical candidates and therefore may instead benefit from nonsurgical options for functional and aesthetic restoration...
November 2017: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29073726/reconstruction-of-extensive-thoracic-wall-defect-using-the-external-oblique-myocutaneous-flap-an-analysis-on-20-chinese-patients-with-locally-advanced-soft-tissue-sarcoma
#7
Chun-Meng Wang, Ruming Zhang, Peng Luo, Zhiqiang Wu, Biqiang Zheng, Yong Chen, Yingqiang Shi
BACKGROUND: Soft tissue sarcomas are rare neoplasms that can occur in the thoracic wall, abdominal wall, extremities, and inguinal region. Wide local resection, with precise histological margin control, results in large skin defects that are challenging to close. Various repair procedures, such as vertical rectus abdominis flaps (VRAM), latissimus dorsi flaps, and tensor fascia lata (TFL) flaps are used to cover broad thoracic wall defects. Although the cosmetic reconstruction results of using these flaps are often excellent, each has significant drawbacks...
October 26, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29069047/amputation-of-the-first-metatarsophalangeal-joint-due-to-a-giant-gouty-tophi-a-case-report
#8
Chenchen Zhou, Cheng Xue, Bo Yang, Wutao Wang, Yanqiu Xu, Fang Huang, Yi Wang
RATIONALE: The first metatarsophalangeal joint (MTP1) is the most frequent site of gouty tophi. We report an unusual case with a giant skin-perforating tophi. This is the first case of gouty tophi at MTP1 which accepts surgical debulking and amputation. PATIENT CONCERNS: A 42-year-old man presented with a seven-year history of gout and a giant tophi at MTP1. The patient was referred to hospital due to persistent pain and ulcerations on the surface of the left MTP1...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29049675/combined-perventricular-septal-defect-closure-and-patent-ductus-arteriosus-ligation-via-the-lower-ministernotomy-approach
#9
Alexey Voitov, Alexander Omelchenko, Yuriy Gorbatykh, Alexander Bogachev-Prokophiev, Alexander Karaskov
Over the past decade, minimally invasive approaches have been advocated for surgical correction of congenital defects to reduce costs related to hospitalization and for improved cosmesis. Minimal skin incisions and partial sternotomy reduce surgical trauma, however these techniques might not be successful in treating a number of congenital pathological conditions, particularly for combined congenital defects. We focused on cases with a combined presentation of ventricular septal defect and patent ductus arteriosus...
September 25, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29039127/dermotaxis-v-s-loop-suture-technique-for-closure-of-fasciotomy-wounds-a-study-of-50-cases
#10
Naveen Mittal, Robin Bohat, Jagandeep Singh Virk, Payal Mittal
Fasciotomy incisions lead to large, unsightly, chronic wounds after surgical intervention. Classic management was to use split-thickness skin grafts, but this leads to insensate skin with reports that as many as 23% of patients are dissatisfied by the appearance of the wound. Since no skin loss has occurred with the fasciotomy incision, utilizing the dermal properties of creep, stress relaxation and load cycling, closure can be achieved in a better way. We describe using dermotaxis for skin edge approximation that is done using inexpensive equipment available readily in any standard operating room...
October 16, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/29033046/eschar-removal-by-bromelain-based-enzymatic-debridement-nexobrid-%C3%A2-in-burns-an-european-consensus
#11
Christoph Hirche, Antonella Citterio, Henk Hoeksema, Ján Koller, Martina Lehner, José Ramón Martinez, Stan Monstrey, Alexandra Murray, Jan A Plock, Frank Sander, Alexandra Schulz, Benjamin Ziegler, Ulrich Kneser
Early debridement and/or eschar removal is regarded as a significant step in the treatment of deep partial and full thickness burns. It aims to control wound bioburden and allows early wound closure by conservative treatment or skin grafting. Preservation of viable dermis accompanied by early wound closure, is regarded as a necessary step to reduce scar related complication, e.g. functional limitations and/or unaesthetic scar formation. Aside from the classical techniques of surgical excision as tangential excision for eschar removal, hydro-surgery, maggot therapy, laser, enzymatic debridement have been described as additional techniques in the burn surgeon's armamentarium...
October 12, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29030898/surgical-innovation-for-obstetric-fistula-patients
#12
Rachel Pope, Jeffrey Wilkinson
Browning et al describe procedures for prevention of incontinence in women undergoing obstetric fistula (OF) repair or treatment of women who have residual incontinence after successful fistula closure. Their premise is that scarring and decreased elasticity of the anterior vagina results in opposing forces on the urethra thereby causing incontinence-the so called Integral Theory. By employing a rotational skin flap from the adjacent thigh, the vaginal wall elasticity is restored. Their technique does not include the fascial portion of the flap which is widely considered to be important for preservation of the blood supply...
October 14, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29029780/risk-factors-for-surgical-site-infection-after-stoma-closure-comparison-between-pursestring-wound-closure-and-conventional-linear-wound-closure-propensity-score-matching-analysis
#13
Masashi Yamamoto, Keitaro Tanaka, Shinsuke Masubuchi, Masatsugu Ishii, Hiroki Hamamoto, Shigenori Suzuki, Yasuhiko Ueda, Junji Okuda, Kazuhisa Uchiyama
PURPOSE: Stoma closure has been associated with a high rate of surgical site infection (SSI) and the optimal skin closure method is still controversial. The aim of this study was to compare the short-term and long-term outcomes between the conventional linear closure (CC) and the persestring closure (PC) using propensity score matching analysis. METHODS: We analysed the data of 360 patients who underwent stoma closure with CC or PC between January 2000 and December 2014...
October 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29024420/skin-flap-vaginal-augmentation-helps-prevent-and-cure-post-obstetric-fistula-repair-urine-leakage-a-critical-anatomical-analysis
#14
Andrew Browning, Gordon Williams, Peter Petros
Our aim was to describe a new surgical method for prophylaxis/cure of post -obstetric fistula repair leakage based on restoring vaginal elasticity with Singapore skin flap. The rationale for this operation was based on the Integral Theory: scarring removes elasticity required for independent function of oppositely-acting urethral closure forces so they become 'tethered, forcibly opening the urethra when give the signal to close. Skin graft restores elasticity and closure. Used prophylactically with Goh type 4 fistula (n=45) 46% were dry against expected 19%...
October 11, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29022793/intralesional-excision-with-topical-intralesional-cryotherapy-improves-the-treatment-of-keloid-scarring-in-a-paediatric-patient
#15
D Reissis, T Tickunas, R A Agha, Avh Greig
Recurrent keloid scarring has a significant impact on quality of life. Management is complex, particularly for scars resistant to conventional treatments and in paediatric cases where radiotherapy is not a suitable adjunct to surgical excision. We present the case of a nine-year-old African Caribbean girl with multiple large and recurrent keloid scars on both ears and bilateral sensorineural deafness. Following repeated intralesional excisions, corticosteroid and botulinum toxin injections, she continued to experience rapid recurrence of her keloids, worsening pain and pruritus...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28990694/suprafascial-versus-traditional-harvesting-technique-for-free-antero-lateral-thigh-flap-a-case-control-study-to-assess-the-best-functional-and-aesthetic-result-in-extremity-reconstruction
#16
Michele Maruccia, Nefer Fallico, Emanuele Cigna, Pedro Ciudad, Fabio Nicoli, Emilio Trignano, Eleonora Nacchiero, Giuseppe Giudice, Diego Ribuffo, Hung-Chi Chen
Clinical applications of ALT flap have currently extended to extremity (hand and foot) as well as oral cavity reconstruction. In these anatomical areas, the traditional harvesting technique presents a few disadvantages such as bulkiness of the recipient site and potential donor site morbidity including damage to the deep fascia and skin graft adhesions. The purpose of the present study was to compare the functional and aesthetic outcomes of upper and lower extremity reconstruction with either suprafascial or subfascial harvested anterolateral (ALT) flaps...
October 9, 2017: Microsurgery
https://www.readbyqxmd.com/read/28985927/association-between-targeted-her-2-therapy-and-breast-reconstruction-outcomes-a%C3%A2-propensity-score-matched-analysis
#17
Ronnie L Shammas, Eugenia H Cho, Adam D Glener, Luke P Poveromo, Lily R Mundy, Rachel A Greenup, Kimberly L Blackwell, Scott T Hollenbeck
BACKGROUND: Current treatment for HER-2+ breast cancer includes chemotherapy and targeted HER-2 therapy with trastuzumab and/or pertuzumab. Evidence is lacking on the safety of breast reconstructive operations in these patients. We hypothesized that targeted HER-2 therapy was not associated with post-mastectomy reconstructive outcomes. STUDY DESIGN: Women receiving chemotherapy and post-mastectomy reconstruction at Duke University Medical Center from 2006 to 2016 were retrospectively identified...
September 26, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28983890/skin-closure-following-fractured-neck-of-femur-surgery-a-survey-of-orthopaedic-surgeons-practices
#18
Daniel S Hill, Matthew Freudmann, Jamie C Sergeant, Tim N Board
INTRODUCTION: Surgical intervention for patients presenting with a fractured neck of femur is common, however the best method of skin closure remains unclear. It has been suggested that the use of metallic skin clips in the closure of hip wounds may increase the rate of surgical site infections, however there are few high quality studies evaluating this. METHODS: We designed a survey to assess surgeons preferred skin closure method and their reasons for choosing it...
October 4, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28959931/use-of-poliglecaprone-25-for-perineal-urethrostomy-in-cats-61-cases-2007-2013
#19
Daniel L Frem, Heidi A Hottinger, Suzanne L Hunter, Nicholas J Trout
OBJECTIVE To determine frequency of postoperative complications in cats undergoing perineal urethrostomy (PU) in which poliglecaprone 25 was used for closure and identify possible predisposing factors for development of complications. DESIGN Retrospective case series. ANIMALS 61 cats that underwent PU. PROCEDURES Medical records for cats that underwent PU at Gulf Coast Veterinary Specialists between 2007 and 2012 were reviewed. Information regarding signalment, perioperative conditions, surgical procedures, treatments, and postoperative complications were obtained from medical records and by telephone follow-up...
October 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28944569/prognostic-factors-and-treatment-outcomes-for-patients-with-fournier-s-gangrene-a-retrospective-study
#20
Kyung Sook Hong, Hee Jung Yi, Ryung-Ah Lee, Kwang Ho Kim, Soon Sup Chung
Fournier's gangrene is a gas-forming, necrotising soft tissue infection affecting the perineum. It spreads rapidly along the deep fascial planes and is associated with a high mortality rate. With a growing elderly population with comorbidities, the frequency of severe cases of Fournier's gangrene is expected to increase. We retrospectively reviewed 20 patients diagnosed with Fournier's gangrene at our institution from 2003 to 2014 and analysed data. Thirteen patients had diabetes mellitus, two had been diagnosed with liver cirrhosis, and four were chronic alcoholics...
September 25, 2017: International Wound Journal
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