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https://www.readbyqxmd.com/read/28807202/do-acute-care-surgeons-follow-best-practices-for-breast-abscess-management-a-single-institution-analysis-of-325-consecutive-cases
#1
Alison Unzeitig Barron, Stephen Luk, Herb A Phelan, Brian H Williams
BACKGROUND: The breast surgery community has adopted needle aspiration as the standard of care for breast abscesses, which have a size less than 5 cm on ultrasound, no skin changes, and fewer than 5 days of symptoms. Our acute-care surgery (ACS) service manages all breast abscess consults at our urban safety-net hospital. We undertook this descriptive study to identify the rate of operative incisions and drainage performed by ACS surgeons which were not compatible with best practices for breast abscess management...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28756821/acute-care-surgery-an-evolving-paradigm
#2
Gregory J Jurkovich, Kimberly A Davis, Clay Cothren Burlew, Christopher J Dente, Joseph M Galante, Joel S Goodwin, Bellal Joseph, Marc de Moya, Robert D Becher, Viraj Pandit
No abstract text is available yet for this article.
July 2017: Current Problems in Surgery
https://www.readbyqxmd.com/read/28738944/predicting-postoperative-complications-for-acute-care-surgery-patients-using-the-acs-nsqip-surgical-risk-calculator
#3
Jessica R Burgess, Benjamin Smith, Rebecca Britt, Leonard Weireter, Travis Polk
The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) risk calculator has been used to assist surgeons in predicting the risk of postoperative complications. This study aims to determine if the risk calculator accurately predicts complications in acute care surgical patients undergoing laparotomy. A retrospective review was performed on all patients on the acute care surgery service at a tertiary hospital who underwent laparotomy between 2011 and 2012. The preoperative risk factors were used to calculate the estimated risks of postoperative complications in both the original ACS NSQIP calculator and updated calculator (June 2016)...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28738931/management-of-appendicitis-with-the-implementation-of-an-acute-care-surgery-service-in-a-community-teaching-hospital
#4
Michael Farrell, Emily Murphy, Richard Caplan, Kevin Bradley, Matthew Rubino, Mark Cipolle
No abstract text is available yet for this article.
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28736059/anti-factor-xa-measurements-in-acute-care-surgery-patients-to-examine-enoxaparin-dose
#5
Vanessa Wall, Kory I Fleming, Joseph E Tonna, Jade Nunez, Nick Lonardo, R Wayne Shipley, Ram Nirula, Christopher J Pannucci
BACKGROUND: The purpose of this study was to determine if fixed dose enoxaparin prophylaxis provided effective anticoagulation for acute care surgery patients and to examine whether a real-time enoxaparin dose adjustment algorithm optimized anticoagulation. METHODS: Acute care surgical patients placed on enoxaparin prophylaxis 30 mg twice daily were recruited prospectively. Peak steady state aFXa levels were drawn with a goal peak aFXa range of 0.2-0.4 IU/ml. A real time dose adjustment algorithm was implemented for patients with out-of-range levels...
July 18, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28662926/defining-the-burden-scope-and-future-of-vascular-acute-care-surgery
#6
Donald G Harris, Anthony Herrera, Charles B Drucker, Richa Kalsi, Nandakumar Menon, Shahab Toursavadkohi, Jose J Diaz, Robert S Crawford
OBJECTIVE: The paradigm of acute care surgery has revolutionized nonelective general surgery. Similarly, nonelective vascular surgery may benefit from specific management and resource capabilities. To establish the burden and scope of vascular acute care surgery, we analyzed the characteristics and outcomes of patients hospitalized for vascular surgical procedures in Maryland. METHODS: A retrospective analysis of a statewide inpatient database was performed to identify patients undergoing noncardiac vascular procedures in Maryland from 2009 to 2013...
June 26, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28640780/challenges-in-acute-care-surgery-shootout-at-the-o-k-corral-history-revisited
#7
Gary A Vercruysse, Zachary M Bauman, Jordan Roman, Peter M Rhee, Ernest E Moore
No abstract text is available yet for this article.
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28465716/acute-care-surgery-a-means-for-providing-cost-effective-quality-care-for-gallstone-pancreatitis
#8
Patrick B Murphy, Dave Paskar, Richard Hilsden, Jennifer Koichopolos, Tina S Mele
BACKGROUND: Modern practice guidelines recommend index cholecystectomy (IC) for patients admitted with gallstone pancreatitis (GSP). However, this benchmark has been difficult to widely achieve. Previous work has demonstrated that dedicated acute care surgery (ACS) services can facilitate IC. However, the associated financial costs and economic effectiveness of this intervention are unknown and represent potential barriers to ACS adoption. We investigated the impact of an ACS service at two hospitals before and after implementation on cost effectiveness, patient quality-adjusted life years (QALY) and impact on rates of IC...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28452889/surgical-management-of-pancreatic-necrosis-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#9
Nathan T Mowery, Brandon R Bruns, Heather G MacNew, Suresh Agarwal, Toby M Enniss, Mansoor Khan, Weidun Alan Guo, Jeremy W Cannon, Matthew E Lissauer, Therese M Duane, Amy N Hildreth, Peter A Pappas, Lynn M Gries, Meghann Kaiser, Bryce R H Robinson
BACKGROUND: Pancreatic or peripancreatic tissue necrosis confers substantial morbidity and mortality. New modalities have created a wide variation in approaches and timing of interventions for necrotizing pancreatitis. As acute care surgery evolves, its practitioners are increasingly being called upon to manage these complex patients. METHODS: A systematic review of the MEDLINE database using PubMed was performed. English language articles regarding pancreatic necrosis from 1980 to 2014 were included...
August 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28450134/variability-in-integrated-cardiothoracic-training-program-curriculum
#10
Elizabeth H Stephens, Dustin M Walters, Amanda L Eilers, Vakhtang Tchantchaleishvili, Andrew B Goldstone, Erin A Gillaspie, Amy Fiedler, Damien J LaPar
BACKGROUND: Development of curricula that appropriately progress a resident from medical school graduate to fully trained cardiothoracic surgeon is a key challenge for integrated cardiothoracic training programs. This study examined variability and perceived challenges in integrated curricula. METHODS: Responses to the 2016 TSDA/TSRA survey that accompanies the annual in-training exam taken by current cardiothoracic surgery residents were analyzed. Standard statistical methods were utilized to examine trends in participant responses...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28444405/focus-on-acute-care-surgery
#11
EDITORIAL
F J Turégano
No abstract text is available yet for this article.
June 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28427944/creating-a-global-acute-care-surgery-fellowship-to-meet-international-need
#12
Amina I Merchant, Camila B Walters, Julie Valenzuela, Kelly A McQueen, Addison K May
INTRODUCTION: Existing Acute Care Surgery (ACS) fellowships are positioned to develop well-trained surgeons with specific skills to facilitate improvements in care delivery in Global ACS. Many resident and fellowship programs offer clinical electives that expose trainees to operative experiences, exposing trainees to the needs in resource-challenged settings. However, most lack a focus on long-term development and research designed to enhance the country's local skills, capability, and capacity...
April 17, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28342097/a-systematic-review-of-propensity-score-methods-in-the-acute-care-surgery-literature-avoiding-the-pitfalls-and-proposing-a-set-of-reporting-guidelines
#13
T L Zakrison, P C Austin, V A McCredie
BACKGROUND: Propensity score methods are techniques commonly employed in observational research to account for confounding when estimating the effects of treatments and exposures. These methods have been increasingly employed in the acute care surgery literature in an attempt to infer causality; however, the adequacy of reporting and the appropriateness of statistical analyses when using propensity score matching remain unclear. OBJECTIVES: The goal of this systematic review is to assess the adequacy of reporting of propensity score methods, with an emphasis on propensity score matching (to assess balance and the use of appropriate statistical tests), in acute care surgery (ACS) studies and to provide suggestions for improvement for junior investigators...
March 24, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28340927/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-control-of-noncompressible-truncal-hemorrhage-in-the-abdomen-and-pelvis
#14
Laura J Moore, Clay D Martin, John A Harvin, Charles E Wade, John B Holcomb
BACKGROUND: Noncompressible truncal hemorrhage is a leading cause of potentially preventable death in trauma and acute care surgery patients. These patients are at high risk of exsanguination before potentially life-saving surgical intervention may be performed. Temporary aortic occlusion is an effective means of augmenting systolic blood pressure and perfusion of the heart and brain in these patients. Aortic occlusion temporarily controls distal bleeding until permanent hemostasis can be achieved...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28328684/eastern-association-for-the-surgery-of-trauma-and-society-of-trauma-nurses-advanced-practitioner-position-paper-optimizing-the-integration-of-advanced-practitioners-in-trauma-and-critical-care
#15
Jonathan Messing, Jasmine Garces-King, Dennis Taylor, Jonathan van Horn, Babak Sarani, A Britton Christmas
Nurse practitioners and physician assistants, collectively known as advanced practitioners (APs), enhance the provision of care for the acutely injured patient. Despite their prevalence, institutions employ, train, and utilize these providers with significant variability. The Eastern Association for the Surgery of Trauma, the Society of Trauma Nurses, and the American Association of Surgical Physician Assistants acknowledge the value of APs and support their utilization in the management of injured and critically ill patients...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28258628/intracorporeal-anastomoses-in-emergency-laparoscopic-colorectal-surgery-from-a-series-of-59-cases-where-and-how-to-do-it-a-technical-note
#16
Salomone Di Saverio, Arianna Birindelli, Matteo Mandrioli, Mauro Podda, Gian Andrea Binda
BACKGROUND: Laparoscopy offers the benefits of minimally invasive surgery and faster recovery. Acute surgical patients may potentially benefit from the greatest advantages of emergency laparoscopy, even more clinically relevant in acute rather than elective patients. Fashioning a laparoscopic intra-corporeal anastomosis (ICA) after emergent colorectal resection, whenever technically feasible and non-contraindicated for the patients' general and hemodynamic condition, represents the most challenging technical skill to be learned...
March 4, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28121678/greater-mortality-after-emergency-laparotomy-in-the-united-kingdom-compared-with-united-states-a-window-into-the-quality-of-acute-care-surgery-in-the-united-states
#17
John R Bergquist, Cornelius A Thiels, Joseph A Hyder, Martin D Zielinski
No abstract text is available yet for this article.
January 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28045742/management-of-anticoagulation-with-rivaroxaban-in-trauma-and-acute-care-surgery-complications-and-reversal-strategies-as-compared-to-warfarin-therapy
#18
COMPARATIVE STUDY
Sara P Myers, Esmaeel R Dadashzadeh, Jessica Cheung, Louis Alarcon, Matthew Kutcher, Joshua B Brown, Matthew D Neal
BACKGROUND: Rivaroxaban has gained popularity as an anticoagulant (AC) for stroke prevention in nonvalvular atrial fibrillation (afib) and venous thromboembolism (VTE). Although adverse bleeding events are associated with all AC, lack of point-of-care testing to measure the effect of rivaroxaban in emergent situations has contributed to perceived increased risk among physicians. METHODS: This study aims to describe a single-center experience with trauma and emergency general surgery (EGS) patients taking rivaroxaban and evaluate outcomes compared with patients taking warfarin using a propensity score analysis...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28045741/is-your-graduating-general-surgery-resident-qualified-to-take-trauma-call-a-15-year-appraisal-of-the-changes-in-general-surgery-education-for-trauma
#19
Aaron Strumwasser, Daniel Grabo, Kenji Inaba, Kazuhide Matsushima, Damon Clark, Elizabeth Benjamin, Lydia Lam, Demetrios Demetriades
BACKGROUND: Trauma training in general surgery residency is undergoing an evolution. Hour restrictions, the growth of subspecialty care, and the trend toward nonoperative management have altered resident exposure to operative trauma. We sought to identify trends in resident trauma training since the inception of the 80-hour workweek. METHODS: The Accreditation Council for General Medical Education Case Log Statistical Reports for Surgery was abstracted for general surgery resident trauma operative volume for the years 1999-2014...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28009772/acute-kidney-injury-following-exploratory-laparotomy-and-temporary-abdominal-closure
#20
Tyler J Loftus, Azra Bihorac, Tezcan Ozrazgat-Baslanti, Janeen R Jordan, Chasen A Croft, Robert Stephen Smith, Philip A Efron, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: Acute kidney injury (AKI) following exploratory laparotomy and temporary abdominal closure (TAC) is poorly understood but clinically significant. We hypothesized that the prevalence of AKI would be highest 96 h following TAC, early hypoxemia would predict AKI, and that AKI would be an independent predictor of mortality. METHODS: We performed a retrospective analysis of 251 acute care surgery patients managed with TAC by negative pressure wound therapy (NPWT)...
July 2017: Shock
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