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https://www.readbyqxmd.com/read/29046933/-regional-anesthesia-are-the-standards-changing
#1
REVIEW
T Volk, C Kubulus
Regional anesthesia has undergone many changes over the years and the increasing use of ultrasound has certainly played an important role in this. Apart from individual case reports in the literature of very different blocking options, some new procedures seem to have become established and can be broadly applied. Among these are blockades, by which ultrasound-guided injection of local anesthetics is carried out in fascial or muscular layers rather than around target nerves (e.g. cervical plexus blocks and truncal blocks)...
October 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29043582/triclosan-coated-sutures-and-surgical-site-infection-in-abdominal-surgery-the-tristan-review-meta-analysis-and-trial-sequential-analysis
#2
REVIEW
N A Henriksen, E B Deerenberg, L Venclauskas, R H Fortelny, J M Garcia-Alamino, M Miserez, F E Muysoms
INTRODUCTION: Surgical site infection (SSI) is a frequent complication of abdominal surgery causing increased morbidity. Triclosan-coated sutures are recommended to reduce SSI. The aim of this systematic review and meta-analysis was to evaluate the evidence from randomized controlled trials (RCT) comparing the rate of SSI in abdominal surgery when using triclosan-coated or uncoated sutures for fascial closure. METHODS: A systematic literature search was conducted using Medline, EMBASE, the Cochrane library, CINAHL, Scopus and Web of Science including publications until August 2017...
October 17, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29039226/reconstruction-of-traumatic-dorsal-loss-of-the-thumb-four-different-surgical-approaches
#3
Roberto Adani, Raffaele Mugnai, Giovanna Petrella
BACKGROUND: This article outlines our methods for thumb reconstruction following dorsal skin loss injury located between the metacarpophalangeal joint (MPj) and the entire nail affecting skin, nail, tendon, and bone in different combinations but with intact sensate palmar skin. METHODS: Between 1990 and 2015, 24 patients were treated for dorsal thumb defects using 4 different surgical techniques. Five cases of dorsal compound traumatic loss were reconstructed by custom-made dorsal great toe transfer...
October 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29037653/adolescent-idiopathic-scoliosis-the-tethered-spine-iii-is-fascial-spiral-the-key
#4
Lucy Whyte Ferguson
This article reports on an observational and treatment case series involving 22 adolescents and preadolescents treated over a 15 year period who had or appeared to be developing idiopathic scoliosis (IS). Common patterns of muscle and fascial asymmetry were observed and treated. Most of these individuals had spinal area pain and the trigger points (TrPs) apparently responsible for this pain were located in muscles at some distance from the spine, yet referred pain to locations throughout the thoracolumbar spine...
October 2017: Journal of Bodywork and Movement Therapies
https://www.readbyqxmd.com/read/29033336/open-abdomen-therapy-with-vacuum-and-mesh-mediated-fascial-traction-after-aortic-repair-an-international-multicentre-study
#5
Stefan Acosta, Arne Seternes, Maarit Venermo, Leena Vikatmaa, Karl Sörelius, Anders Wanhainen, Mats Svensson, Khatereh Djavani, Martin Björck
OBJECTIVES: Open abdomen therapy may be necessary to prevent or treat abdominal compartment syndrome (ACS). The aim of the study was to analyse the primary delayed fascial closure (PDFC) rate and complications after open abdomen therapy with vacuum and mesh mediated fascial traction (VACM) after aortic repair and to compare outcomes between those treated with open abdomen after primary versus secondary operation. METHODS: This was a retrospective cohort, multicentre study in Sweden, Finland, and Norway, including consecutive patients treated with open abdomen and VACM after aortic repair at six vascular centres in 2006-2015...
October 12, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29030898/surgical-innovation-for-obstetric-fistula-patients
#6
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/29030779/recurrence-after-operative-treatment-of-adhesive-small-bowel-obstruction
#7
Lea Lorentzen, Mari N Øines, Erling Oma, Kristian K Jensen, Lars N Jorgensen
BACKGROUND: Postoperative adhesions are a common cause of small-bowel obstruction, and up to 53% of patients operated on for adhesive small-bowel obstruction (ASBO) experience recurrence. The primary aim of this study was to identify predictors for recurrence of ASBO. METHODS: We reviewed medical records including operation descriptions from patients who underwent emergency surgery due to ASBO at our institution between 2004 and 2013. Information on the peri- and postoperative periods, including conservatively and surgically treated recurrent ASBO, were obtained from medical records...
October 13, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29023290/fascial-graft-repair-of-wide-bilateral-cleft-lip-deformity
#8
Husam Hosny, Ayman Husein Abdelsattar
Wide bilateral cleft lip deformity reconstruction represents a special difficulty as it affects the lip, nose, and maxillary segments making single-stage reconstruction sometimes unobtainable. Many surgical and nonsurgical techniques have been prescribed to facilitate the definitive repair. Although some of these techniques proved to be useful, they have their inherent limitations and add another treatment step with all its possible complications and costs. The authors present a new method to address muscle layer repair in 1-stage procedure...
October 11, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29016551/pectoral-fascial-pecs-i-and-ii-blocks-as-rescue-analgesia-in-a-patient-undergoing-minimally-invasive-cardiac-surgery
#9
Suraj Yalamuri, Rebecca Y Klinger, W Michael Bullock, Donald D Glower, Brandi A Bottiger, Jeffrey C Gadsden
INTRODUCTION: Patients undergoing minimally invasive cardiac surgery have the potential for significant pain from the thoracotomy site. We report the successful use of pectoral nerve block types I and II (Pecs I and II) as rescue analgesia in a patient undergoing minimally invasive mitral valve repair. CASE REPORT: In this case, a 78-year-old man, with no history of chronic pain, underwent mitral valve repair via right anterior thoracotomy for severe mitral regurgitation...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28986275/quantification-of-resident-work-in-colorectal-surgery
#10
Elizabeth A Bailey, Adam P Johnson, Ira L Leeds, Rachel L Medbery, Vanita Ahuja, Thomas VanderMeer, Elizabeth C Wick, Busayo Irojah, Rachel R Kelz
OBJECTIVE: To examine resident intraoperative participation, perceived autonomy, and communication patterns between residents and attending surgeons using a novel survey tool. DESIGN: This was a prospective multi-institutional study. Operative residents completed the survey tool immediately after each colorectal resection performed during the study period. Resident intraoperative participation was quantified including degree of involvement in the technical aspects of the case, self-perception of autonomy, and communication strategies between the resident and attending...
October 3, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28982622/retroperitoneal-compartment-syndrome-in-renal-transplantation-how-to-salvage-the-graft
#11
Karen Pineda-Solís, Wen Yan Xie, Vivian McAlister, Alp Sener, Patrick P Luke
OBJECTIVE: Early allograft dysfunction may be caused by several technical factors including vascular complications such as thrombosis, kinking, or extrinsic compression. Renal allograft compartment syndrome (RACS) is an unrecognized cause of early allograft dysfunction. This complication is characterized by increased pressure of the iliac fossa that reduces the blood supply to the graft with a potentially devastating consequence. The main objective when recognizing this condition is to create a tension-free muscle closure...
September 2017: Urology
https://www.readbyqxmd.com/read/28969327/influence-of-deep-neuromuscular-block-on-the-surgeon%C3%A5-assessment-of-surgical-conditions-during-laparotomy-a-randomized-controlled-double-blinded-trial-with-rocuronium-and-sugammadex
#12
M V Madsen, S Scheppan, E Mørk, P Kissmeyer, J Rosenberg, M R Gätke
Background: During laparotomy, surgeons may experience difficult surgical conditions if the patient's abdominal wall or diaphragm is tense. Deep neuromuscular block (NMB), defined as a post-tetanic-count (PTC) between 0-1, paralyses the abdominal wall muscles and the diaphragm. We hypothesized that deep NMB (PTC 0-1) would improve subjective ratings of surgical conditions during upper laparotomy as compared with standard NMB. Methods: This was a double blinded, randomized study...
September 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28958281/an-innovative-way-to-separate-gastrointestinal-and-abdominal-wall-reconstruction-after-complex-abdominal-trauma
#13
David H Livingston, David V Feliciano
Despite advances in trauma care, a subset of patients surviving damage control cannot achieve fascial closure and require split-thickness skin grafting (STSG) of their open abdomen. Controversy exists as to whether reconstruction of the gastrointestine (GI) should be staged or performed at the time of abdominal wall reconstruction (AWR). Many surgeons do not believe that operations through the STSG can be completed safely or without loss of graft. This series reviews the outcomes of operations for GI reconstruction performed through the elevated healed STSG...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28956546/aspergillus-myofasciitis-in-a-chronic-granulomatous-disease-patient-first-case-report
#14
Guido Camanni, Alessio Sgrelli, Luigi Ferraro
Aspergillus myofasciitis is a rare infection of the muscles and their fascial sheaths that has been reported in patients with immune deficiencies of various kinds but, until now, not with chronic granulomatous disease (CGD). Patients affected by CGD are at high risk of invasive aspergillus infections. The case described involves a 14-year-old boy with a severe autosomal recessive CGD who was admitted to hospital with an Aspergillus myofasciitis of the left forearm. He was treated with liposomal amphotericin for 14 days and then with oral voriconazole for three months with an excellent clinical outcome...
September 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28953519/the-use-of-bilayered-fascia-lata-with-an-interpositional-omental-flap-for-autologous-repair-of-contaminated-abdominal-fascial-defects
#15
Hui Chai Fong, Bien-Keem Tan, Pierce Kh Chow, Hock Soo Ong
INTRODUCTION: Contaminated abdominal fascial defects, such as those seen in enterocutaneous fistula, or wound dehiscence with mesh exposure, are a significant source of morbidity and present unique reconstructive challenges. We present our technique of using the fascia lata, augmented with an interpositional omental flap, for complete autologous reconstruction of contaminated fascial defects, and the postoperative results of 3 cases. METHODS: Three patients with contaminated abdominal defects underwent wound debridement/fistula resection and immediate reconstruction with fascia lata and omentum flap...
November 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28951014/the-significance-of-organ-prolapse-in-gastroschisis
#16
Shannon M Koehler, Aniko Szabo, Matt Loichinger, Erika Peterson, Melissa Christensen, Amy J Wagner
PURPOSE: The aim of this study was to evaluate the incidence and importance of organ prolapse (stomach, bladder, reproductive organs) in gastroschisis. METHODS: This is a retrospective review of gastroschisis patients from 2000 to 2014 at a single tertiary institution. Statistical analysis was performed using a chi-square test, Student's t test, log-rank test, or Cox regression analysis models. All tests were conducted as two-tailed tests, and p-values <0.05 were considered statistically significant...
September 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28946612/meditative-movement-energetic-and-physical-analyses-of-three-qigong-exercises-unification-of-eastern-and-western-mechanistic-exercise-theory
#17
Penelope Klein, George Picard, Joseph Baumgarden, Roger Schneider
Abstract: Qigong is the meditative movement and therapeutic exercise of Eastern medicine. A growing body of evidence is validating its health benefits leading to mechanistic questions of how it works. The purpose of this article is to explore mechanisms of action related to Qigong, with the intent of unifying Eastern and Western exercise theory and to present a model for Qigong exercise analysis. Three exercises from a standardized Qigong form: 'Plucking the Stars', 'Lotus Leaves Rustle in the Wind', and 'Pacing Forwards and Backwards' were selected for meditative, energetic, and physical analyses...
September 23, 2017: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/28944569/prognostic-factors-and-treatment-outcomes-for-patients-with-fournier-s-gangrene-a-retrospective-study
#18
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
https://www.readbyqxmd.com/read/28942543/suture-to-wound-length-ratio-in-abdominal-wall-closure-how-well-are-we-doing
#19
Z F Williams, P Tenzel, W B Hooks, W W Hope
PURPOSE: Research has established that a ≥4:1 suture to wound (S:W) length ratio decreases incisional hernias. We evaluated our ability to obtain a 4:1 S:W length ratio in a surgery residency program. METHODS: Consecutive abdominal wall closures from 12/1/2013 through 4/9/2015 were reviewed. The length of the incisions and amount of suture used were measured. Patient demographics and operative variables were documented and compared related to inability to obtain a 4:1 ratio...
September 23, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28939333/variants-of-latissimus-dorsi-with-a-perspective-on-tendon-transfer-surgery-an-anatomic-study
#20
Anu V Ranade, Rajalakshmi Rai, Ashwin R Rai, Prameela M Dass, Mangala M Pai, Rajanigandha Vadgaonkar
BACKGROUND: The latissimus dorsi (LD) is often used for tendon transfers to treat massive irreparable posterosuperior rotator cuff tears. The operation requires the LD tendon to be mobilized to reduce tension on the tendon. In that respect, any connection between the LD tendon and contiguous muscles may hamper tendon mobility and affect the surgical outcome. The goal of this study was to document the occurrence of connections between the LD and adjacent muscles and nerves. METHODS: We studied the scapular region on 48 embalmed cadavers...
September 19, 2017: Journal of Shoulder and Elbow Surgery
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