Comparison of flow pressures in different 3-way infusion devices: an in-vitro study.
In this study, we aim to determine the pressures generated in common 3-way infusion devices, using simple low-cost equipment available and currently in use in the operating theatre environment. Methods: We compared three different common and commercially available 3-way infusion devices that allowed multiple infusions through one cannula in vitro. One with anti-siphon valves, one without valves, and serial extension sets with side ports connected in series. An invasive blood pressure transducer was used to monitor line pressure. Seven different infusion rates were used to simulate different infusions. Results: 3-...
Source: Patient Safety in Surgery - July 12, 2018 Category: Surgery Authors: Chua J, Ratnavadivel A Tags: Patient Saf Surg Source Type: research

Retained surgical sponges: a descriptive study of 319 occurrences and contributing factors from 2012 to 2017.
Conclusions: Because of the complexity of perioperative patient care, the multitude of contributing factors that are difficult to control, and the potential benefit of radiofrequency sponge detection, we recommend that this technology be considered in areas where surgery is performed and in Labor and Delivery. PMID: 29988638 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - July 12, 2018 Category: Surgery Authors: Steelman VM, Shaw C, Shine L, Hardy-Fairbanks AJ Tags: Patient Saf Surg Source Type: research

An improved technical trick for identification of the thoracodorsal nerve during axillary clearance surgery: a cadaveric dissection study.
Conclusions: The lateral thoracic vein is an accurate guide to the thoracodorsal nerve. We recommend exploring for the thoracodorsal nerve from a point 2 cm from the confluence of the lateral thoracic vein and the axillary vein for a distance of 25 ± 5 mm in a posterolateral direction, at a 540 ± 120 angle to the horizontal plane. PMID: 29983745 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - July 10, 2018 Category: Surgery Authors: Anthony DJ, Basnayake BMOD, Ganga NMG, Mathangasinghe Y, Malalasekera AP Tags: Patient Saf Surg Source Type: research

Development of an emergency general surgery process improvement program.
Conclusion: Overall patient volume and PI events post EGS PI program initiation exceeded those prior to implementation. These data suggest that extending trauma PI principles to EGS may be beneficial in maintaining inter-war military and/or lower volume trauma center readiness. PMID: 29977337 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - July 7, 2018 Category: Surgery Authors: Bradley MJ, Kindvall AT, Humphries AE, Jessie EM, Oh JS, Malone DM, Bailey JA, Perdue PW, Elster EA, Rodriguez CJ Tags: Patient Saf Surg Source Type: research

The grass is not always greener: a multi-institutional pilot study of marijuana use and acute pain management following traumatic injury.
Abstract Background: Widespread legislative efforts to legalize marijuana have increased the prevalence of marijuana use and abuse. The effects of marijuana on pain tolerance and analgesic pain management in the acute pain setting have not been reported. Although marijuana has been shown to have antinociceptive effects and is approved for medical use to treat chronic pain, anecdotal evidence suggests marijuana users admitted with traumatic injuries experience poorer pain control than patients who do not use marijuana. We hypothesized that marijuana users would report higher pain scores and require more opioid anal...
Source: Patient Safety in Surgery - June 29, 2018 Category: Surgery Authors: Salottolo K, Peck L, Tanner Ii A, Carrick MM, Madayag R, McGuire E, Bar-Or D Tags: Patient Saf Surg Source Type: research

Incidence of early postoperative complications requiring surgical revision for recurrent lumbar disc herniation after spinal surgery: a retrospective observational study of 9,310 patients from the German Spine Register.
Conclusions: The rate of early recurrent LDH within days of surgery is 1.2%. Age seems to be an important factor in early recurrent LDH while obesity does not. The data of the German Spine Register seems to have a reliable data collection system that can perform multicentre data analysis. The databases from this Register could be used in the future for various purposes, such as the evaluation of multicentre surgical techniques, results in patients with various surgical procedures and basic research in spine surgery. PMID: 29942349 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - June 27, 2018 Category: Surgery Authors: Vinas-Rios JM, Sanchez-Aguilar M, Medina Govea FA, Von Beeg-Moreno V, Meyer F, DWG Registry-group Tags: Patient Saf Surg Source Type: research

Use of reprocessed external fixators in orthopaedic surgery: a survey of 243 orthopaedic trauma surgeons.
Conclusions: Many orthopaedic traumatologists are interested in the reprocessing of EF components but few have reprocessing systems in place at their institutions. A major barrier to implementation is concern about litigation, which is likely unwarranted on the basis of Food and Drug Administration approval and a lack of previous litigation. Reprocessing by the original device manufacturers has yielded substantial savings at our institution and is an example of the cost savings that can be expected when implementing an EF reprocessing system. PMID: 29930708 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - June 23, 2018 Category: Surgery Authors: Thamyongkit S, Bachabi M, Thompson JM, Shafiq B, Hasenboehler EA Tags: Patient Saf Surg Source Type: research

Intra-articular injection of the anti-inflammatory compound LMWF-5A in adults with severe osteoarthritis: a double-blind prospective randomized controlled multi-center safety and efficacy trial.
This study evaluated the safety and efficacy of LMWF-5A for the signs and symptoms of OAK. Methods: This 12-week randomized, double-blind, controlled clinical trial was conducted at thirteen sites across the United States. Patients with symptomatic, severe OAK (Kellgren-Lawrence grade 4 disease) who were fully ambulatory and had no other conditions interfering with the study knee were randomized to a single 4 ml intra-articular injection of LMWF-5A or saline, randomized 6:1. The primary endpoint was Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) responder rate (%), ...
Source: Patient Safety in Surgery - June 20, 2018 Category: Surgery Authors: Salottolo K, Cole B, Bar-Or D Tags: Patient Saf Surg Source Type: research

Assessment of attitudes towards future implementation of the "Surgical Risk Preoperative Assessment System" (SURPAS) tool: a pilot survey among patients, surgeons, and hospital administrators.
Conclusions: Systematically capturing data from the beginning of the implementation process from key stakeholders (patients, surgical providers, clinical staff, and administrators) that includes adaptations to the tool and implementation process will help to inform pragmatic approaches for implementing the SURPAS tool in various settings, scaling-up, and sustaining it. PMID: 29881458 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - June 10, 2018 Category: Surgery Authors: Lambert-Kerzner A, Ford KL, Hammermeister KE, Henderson WG, Bronsert MR, Meguid RA Tags: Patient Saf Surg Source Type: research

Incidence of total knee replacement subsequent to intra-articular injection of the anti-inflammatory compound LMWF-5A versus saline: a long-term follow-up study to a randomized controlled trial.
Conclusion: This study demonstrates significant delays in TKR for patients with severe osteoarthritis treated with LMWF-5A, suggesting that LMWF-5A has the potential to provide structure modifying/preserving therapy in this population. PMID: 29881459 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - June 10, 2018 Category: Surgery Authors: Schwappach J, Schultz J, Salottolo K, Bar-Or D Tags: Patient Saf Surg Source Type: research

The diagnostic value of 99m-Tc GSA scintigraphy for liver function and remnant liver volume in hepatic surgery: a retrospective observational cohort study in 27 patients.
Abstract Background: The aim was to analyze hepatic hypertrophy after portal vein embolization (PVE) and Associating Liver Partition with Portal vein ligation for Staged hepatectomy (ALPPS) to determine whether clinical circumstances associated with major hepatic resections correlated with remnant growth. Methods: Data was abstracted from a retrospectively maintained database on 27 patients undergoing hepatic resection followed by PVE and the ALPPS procedure between October 1, 2007 and December 31, 2016. The increasing rate of liver volume and remnant liver LU15 was defined as the percentage-point difference ...
Source: Patient Safety in Surgery - June 10, 2018 Category: Surgery Authors: Chiba N, Yokozuka K, Ochiai S, Gunji T, Okihara M, Sano T, Tomita K, Tsutsui R, Kawachi S Tags: Patient Saf Surg Source Type: research

A novel technique of harmonic tissue dissection reduces seroma formation after modified radical mastectomy compared to conventional electrocautery: a single-blind randomized controlled trial.
Abstract Background: Seroma is the most frequent postoperative complication following breast cancer surgery. Our aim was to evaluate the effect of the harmonic focus scalpel versus electrocautery in reducing seroma formation post-mastectomy and axillary clearance. Methods: A prospective randomized controlled trial study was conducted at the Department of Surgery of Suez Canal University Hospital from April 26th 2014 to 30th June 2016. Seventy-two women, in whom a mastectomy and axillary clearance for breast cancer were performed, were randomly allocated to either harmonic dissection (n = 36) or el...
Source: Patient Safety in Surgery - May 30, 2018 Category: Surgery Authors: Faisal M, Fathy H, Shaban H, Abuelela ST, Marie A, Khaled I Tags: Patient Saf Surg Source Type: research

Predictors of hydrocephalus as a complication of non-traumatic subarachnoid hemorrhage: a retrospective observational cohort study in 107 patients.
Abstract Background: The predictors of shunt dependency such as amount of subarachnoid blood, acute hydrocephalus (HC), mode of aneurysm repair, clinical grade at admission and cerebro spinal fluid (CSF) drainage in excess of 1500 ml during the 1st week after the subarachnoid hemorrhage (SAH) have been identified as predictors of shunt dependency. Therefore our main objective is to identify predictors of CSF shunt dependency following non-traumatic subarachnoid hemorrhage. Methods: We performed a retrospective study including patients from January 1st 2012 to September 30th 2014 between 16 and 89 ye...
Source: Patient Safety in Surgery - May 30, 2018 Category: Surgery Authors: Vinas Rios JM, Sanchez-Aguilar M, Kretschmer T, Heinen C, Medina Govea FA, Jose Juan SR, Schmidt T Tags: Patient Saf Surg Source Type: research

Mechanical failure of a femoral lengthening nail: a case report.
Conclusion: Post-operative protocol and weight-bearing status should be further researched and standardized after re-evaluating the mechanical stiffness of the intramedullary nail construct. PMID: 29743955 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - May 11, 2018 Category: Surgery Authors: Wu W, Kuhn KM Tags: Patient Saf Surg Source Type: research

Self-assessment of surgical ward crisis management using video replay augmented with stress biofeedback.
Conclusion: Self-assessment using an objective self-assessment tool alongside video replay augmented with stress biofeedback is feasible in a simulated setting and well liked by participants. PMID: 29713382 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - May 3, 2018 Category: Surgery Authors: Normahani P, Makwana N, von Rosenberg W, Syed S, Mandic DP, Goverdovsky V, Standfield NJ, Jaffer U Tags: Patient Saf Surg Source Type: research

Assessment of postoperative complications using E-PASS and APACHE II in patients undergoing oral and maxillofacial surgery.
Abstract Background: The prediction of postoperative complications is important for oral and maxillofacial surgeons. We herein aimed to evaluate the efficacy of the Estimation of Physiologic Ability and Surgical Stress (E-PASS) and Acute Physiology, Age, and Chronic Health Evaluation (APACHE) II scoring systems to predict postoperative complications in patients undergoing oral and maxillofacial surgery. Methods: Thirty patients (22 males, 8 females; mean age: 65.1 ± 12.9 years) who underwent major oral surgeries and stayed in the intensive care unit for postoperative management were ...
Source: Patient Safety in Surgery - April 11, 2018 Category: Surgery Authors: Ishihata K, Kakihana Y, Yoshimura T, Murakami J, Toyodome S, Hijioka H, Nozoe E, Nakamura N Tags: Patient Saf Surg Source Type: research

Non-retrieval of  inferior vena cava filters as a patient safety concern: evaluation of a new process improvement project to increase retrieval rates in a vascular and interventional radiology clinic.
Conclusions: This low-cost intervention significantly increased retrieval rates in a single clinic. However, retrieval rates remain low and can be further improved. Ongoing interventions, including improved patient follow-up and physician education, are being implemented to further improve retrieval and use of inferior vena cava filters. Implanting clinics should implement quality improvement initiatives to improve patient care and follow-up with IVCFs to ensure retrievals occur once clinically relevant in order to minimize long-term complications. PMID: 29560028 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - March 24, 2018 Category: Surgery Authors: Brown J, Talbert J, Pennington R, Han Q, Raissi D Tags: Patient Saf Surg Source Type: research

Quality of life after antegrade intramedullary nail fixation of humeral fractures: a survey in a selected cohort of Brazilian patients.
Conclusions: The WORC Quality of Life Protocol shows good results for evaluating patients submitted to humerus osteosynthesis with antegrade locked intramedullary nailing. The data stratified by domains were good, however, Work and Sport/Recreation domains showed the lowest means compared to the other domains. Trial registration: Research Ethics Commitee (CEP 0676/2016) and Plataforma Brasil 56381216.3.0000.550. CAAE: 56381216.3.0000.5505. PMID: 29563972 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - March 24, 2018 Category: Surgery Authors: Cocco LF, Ejnisman B, Belangero PS, Cohen M, Dos Reis FB Tags: Patient Saf Surg Source Type: research

Incidence and root causes of delays in emergency orthopaedic procedures: a single-centre experience of 36,017 consecutive cases over seven years.
Conclusion: A large number of the clinic's emergency orthopaedic procedures were rescheduled and delayed and the majority of the delays were related to organisational reasons. The results can be interpreted in two ways; first, organisational reasons are avoidable and the potential for improvement is great and, secondly and most importantly, the delays might negatively affect patient outcomes. PMID: 29344088 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - January 20, 2018 Category: Surgery Authors: Caesar U, Karlsson J, Hansson E Tags: Patient Saf Surg Source Type: research

Novel concept of a modular hip implant could contribute to less implant failure in THA: a hypothesis.
l T Abstract Background: The modularity in total hip arthroplasty (THA) allows orthopaedic surgeons for an exact reconstruction of hip biomechanical parameters especially in revision and tumor arthroplasty. Modular structured femoral stems using taper junctions showed increased implant breakage in the recent past. Presentation of the hypothesis: We hypothesize that a novel modular stem-neck-interface leads to less implant breakage compared to conventional femoral stems. Testing of the hypothesis: For this purpose, a novel modular femoral stem for THA was to design and manufacture. Therefore, three differ...
Source: Patient Safety in Surgery - January 13, 2018 Category: Surgery Authors: Grunert R, Schleifenbaum S, Möbius R, Kopper M, Rotsch C, Drossel WG, Hammer N, Prietzel T Tags: Patient Saf Surg Source Type: research

Surgical retrieval of a swallowed denture in a schizophrenic patient: a case report.
Conclusion: Esophagocutaneous fistula represents a rare but serious complication following foreign body ingestion. An interdisciplinary management including an early surgical consultation should be considered in patients with foreign body impaction in the esophagus following failure of endoscopic retrieval. PMID: 29270222 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - December 24, 2017 Category: Surgery Authors: Dörner J, Spelter H, Zirngibl H, Ambe PC Tags: Patient Saf Surg Source Type: research

Predicting hepatic failure with a new diagnostic technique by preoperative liver scintigraphy and computed tomography: a pilot study in 123 patients undergoing liver resection.
Conclusion: Based on the findings form this pilot study, it appears that patients with a remnant liver LU15 value of 13 or less may have a high risk of postoperative hepatic failure. PMID: 29270223 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - December 24, 2017 Category: Surgery Authors: Chiba N, Shimazu M, Takano K, Oshima G, Tomita K, Sano T, Okihara M, Ozawa Y, Hikita K, Gunji T, Abe Y, Koizumi K, Kawachi S Tags: Patient Saf Surg Source Type: research

Exploring unnecessary invasive procedures in the United States: a retrospective mixed-methods analysis of cases from 2008-2016.
Conclusions: Unnecessary procedures usually appear motivated by financial gain and occur in settings that have oversight problems. Preventive efforts should focus on early detection by peers and institutions, and decisive action by medical boards and federal prosecutors. PMID: 29270224 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - December 24, 2017 Category: Surgery Authors: DuBois JM, Chibnall JT, Anderson EE, Walsh HA, Eggers M, Baldwin K, Dineen KK Tags: Patient Saf Surg Source Type: research

The 10th anniversary of patient safety in surgery.
PMID: 29259657 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - December 21, 2017 Category: Surgery Authors: Stahel PF, Smith WR, Moore EE, Mehler PS, Weckbach S, Kim FJ, Butler N, Pape HC, Clarke TJ, Makary MA, Clavien PA Tags: Patient Saf Surg Source Type: research

Length of stay, costs, and complications in lumbar disc herniation surgery by standard PLIF versus a new dynamic interspinous stabilization technique.
Conclusions: Patients who underwent IDSS had a significant decrease of the length of stay and costs in relation to PLIF group. No significant differences were found in 90-day readmission and reintervention rates for both groups. Although differences were not significant, dural tear and urinary tract infection rates were lower in the interspinous group. IDSS or PLIF after discectomy, did not protect against subsequent 90-day re-operation or readmission compared to discectomy alone. PMID: 29201144 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - December 5, 2017 Category: Surgery Authors: Segura-Trepichio M, Candela-Zaplana D, Montoza-Nuñez JM, Martin-Benlloch A, Nolasco A Tags: Patient Saf Surg Source Type: research

Incidence, root cause, and outcomes of unintentionally retained intraabdominal surgical sponges: a retrospective case series from two hospitals in Togo.
CONCLUSIONS: Although rare, the incidence of gossypibomas is still unacceptably high and reveals failures regarding patient safety standards. The associated morbidity and mortality are significant, yet can be reduced by an early diagnosis in the immediate postoperative period. A systematic methodical count of sponges is the cornerstone of prevention, and introducing surgical safety protocols, such as the WHO Safe Surgery Saves Lives checklist, can enhance effectiveness. There is a crucial need for safety-focused policies, which may include a never event reporting system, elaboration of prevention strategies, interventions,...
Source: Patient Safety in Surgery - November 3, 2017 Category: Surgery Authors: Tchangai B, Tchaou M, Kassegne I, Simlawo K Tags: Patient Saf Surg Source Type: research

Risk factors for surgical site infections in obstetrics: a retrospective study in an Ethiopian referral hospital.
CONCLUSIONS: Obstetric ward of Assela teaching referral hospital are encouraged to use properly WHO surgical safety checklist and examine how to sensibly integrate these essential safety steps into their normal operative workflow. Prophylactic antibiotic administration should be provided within one hour before the surgical incision or within two hours if the patient is receiving vancomycin or floroquinolones. PMID: 28932266 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - September 22, 2017 Category: Surgery Authors: Mamo T, Abebe TW, Chichiabellu TY, Anjulo AA Tags: Patient Saf Surg Source Type: research

The role of pre-reduction MRI in the management of complex cervical spine fracture-dislocations: an ongoing controversy?
CONCLUSIONS: The diagnostic evaluation of cervical fracture-dislocations should include advanced imaging by MRI in order to fully understand the injury pattern prior to proceeding with spinal reduction maneuvers which may impose the imminent threat of a devastating iatrogenic injury to the spinal cord. The presented staged management by initial Halo fixation without attempts for spinal reduction, followed by a surgical decompression and multilevel fusion, appears to represent a feasible and safe strategy for patients at risk of a delayed neurological injury. PMID: 28904564 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - September 15, 2017 Category: Surgery Authors: Botolin S, VanderHeiden TF, Moore EE, Fried H, Stahel PF Tags: Patient Saf Surg Source Type: research

Evaluation of a multimodal pain therapy concept for chronic pain after total knee arthroplasty: a pilot study in 21 patients.
CONCLUSIONS: With the presented pilot study on multimodal in-patient therapy of chronic complaints due to TKA, the improvement of pain, function and mobility could be verified, especially during the stationary stay. Even though the results deteriorate during the follow-up period, they did never relapse to their initial level. In order to ensure an effective treatment, a clear diagnostic algorithm is essential, by which treatable causes, such as low-grade infections or loosenings, are safely excluded. Further prospective studies are necessary to obtain precise statements on prospects of success of our therapy plan. PMI...
Source: Patient Safety in Surgery - September 2, 2017 Category: Surgery Authors: Zajonz D, Fakler JKM, Dahse AJ, Zhao FJ, Edel M, Josten C, Roth A Tags: Patient Saf Surg Source Type: research

Musculoskeletal Echinococcus infection as a rare first presentation of hydatid disease: case report.
CONCLUSION: Primary hydatid cysts are sometimes difficult to diagnose preoperatively. It should be considered in the differential diagnosis of subcutaneous cystic lesions in regions where hydatid cysts are endemic. Currently, surgical excision is deemed first choice treatment for solitary cysts and antihelminthic treatment should be initiated preoperatively in the case of risk of rupture or in the event of complications. PMID: 28725269 [PubMed] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - July 21, 2017 Category: Surgery Authors: Marzouki A, Naam A, Abdulrazak S, Soumaré B, Lahrach K, Boutayeb F Tags: Patient Saf Surg Source Type: research

Delayed recognition of an ipsilateral femoral neck and shaft fracture leading to preventable subsequent complications: a case report.
CONCLUSION: This case report exemplifies the need to maintain the highest level of suspiciousness for the concomitant presence of an ipsilateral femoral neck fracture when treating polytraumatized patients who sustained a femoral shaft fracture as a consequence of a high-energy trauma. Furthermore, the pre-operative standardized radiological evaluation (plain x-ray and CT scan) might not always help in ruling out these fractures. It is therefore necessary to adopt additional standardized radiographic protocols not only in the pre-operative but also in the intra-operative and immediate post-operative settings. PMID: 28...
Source: Patient Safety in Surgery - July 14, 2017 Category: Surgery Authors: Labza S, Fassola I, Kunz B, Ertel W, Krasnici S Tags: Patient Saf Surg Source Type: research

Modified technique of transforaminal lumbar interbody fusion for segmental correction of lumbar kyphosis: a safe alternative to osteotomies?
CONCLUSION: The modified transforaminal lumbar fusion technique is a safe method to correct a fixated lumbar kyphosis. The potential of segmental correction is comparable to pedicle subtraction osteotomies but sparing potentially healthy segments. PMID: 28690681 [PubMed - in process] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - July 11, 2017 Category: Surgery Authors: Weckbach S, Reichel H, Kraus M, Kocak T, Lattig F Tags: Patient Saf Surg Source Type: research

Surgical site infection and its associated factors following cesarean section: a cross sectional study from a public hospital in Ethiopia.
Abstract BACKGROUND: A cesarean section is a surgical procedure in which incisions are made through a woman's abdomen and uterus to deliver her baby. Surgical site infections are a common surgical complication among patients delivered with cesarean section. Further it caused to increase maternal morbidity, stay of hospital and the cost of treatment. METHODS: Hospital based cross-sectional study was conducted to assess the magnitude of surgical site infection following cesarean Site Infections and its associated factors at Lemlem Karl hospital July 1, 2013 to June 30, 2016. Retrospective card review was done o...
Source: Patient Safety in Surgery - June 17, 2017 Category: Surgery Authors: Gelaw KA, Aweke AM, Astawesegn FH, Demissie BW, Zeleke LB Tags: Patient Saf Surg Source Type: research

Predisposing factors for recurrence of chronic posttraumatic osteomyelitis: a retrospective observational cohort study from a tertiary referral center in Brazil.
Abstract BACKGROUND: The incidence of posttraumatic osteomyelitis (PTO) is increasing despite new treatment strategies. Assessment of patients' outcomes following PTO is challenging due to multiple variables. The study goals are to determine the frequency of recurrence following PTO treatment and identify factors predisposing patients to treatment failure. METHODS: Between August 01, 2007 to August 30, 2012, a single-center retrospective cohort study was performed among 193 patients diagnosed with PTO following orthopedic surgery for fracture care. Bone and soft tissues were collected for cultures and PTO was...
Source: Patient Safety in Surgery - June 9, 2017 Category: Surgery Authors: Jorge LS, Chueire AG, Fucuta PS, Machado MN, Oliveira MGL, Nakazone MA, Salles MJ Tags: Patient Saf Surg Source Type: research

Induction of immune gene expression and inflammatory mediator release by commonly used surgical suture materials: an experimental in vitro study.
CONCLUSIONS: As prolonged early pro-inflammation is known to produce delayed wound healing responses, the knowledge produced from this study has potential to improve informed surgical decision making and patient safety. This work has the capability to reduce suture-related adverse immune reactions, and therefore positively affect patient outcomes. PMID: 28580016 [PubMed - in process] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - June 7, 2017 Category: Surgery Authors: Lock AM, Gao R, Naot D, Coleman B, Cornish J, Musson DS Tags: Patient Saf Surg Source Type: research

The "Aachen fall prevention App" - a Smartphone application app for the self-assessment of elderly patients at risk for ground level falls.
CONCLUSIONS: The "Aachen Fall Prevention App" (AFPA) is an mHealth app released for iOS and Android. This field study revealed the AFPA as a promising tool to raise older adults' awareness of their individual fall risk by means of a low-threshold patient-driven fall risk assessment tool. PMID: 28503199 [PubMed - in process] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - May 17, 2017 Category: Surgery Authors: Rasche P, Mertens A, Bröhl C, Theis S, Seinsch T, Wille M, Pape HC, Knobe M Tags: Patient Saf Surg Source Type: research

A retrospective cohort study of adverse events in patients undergoing orthopaedic surgery.
CONCLUSIONS: Adverse events are frequent following common orthopaedic procedures. The incidence is greatest for patients with more functional comorbidities. For THA and TKA procedures, being male and being older are also associated with a greater incidence of adverse events. PMID: 28503200 [PubMed - in process] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - May 17, 2017 Category: Surgery Authors: Gagnier JJ, Morgenstern H, Kellam P Tags: Patient Saf Surg Source Type: research

Empty polyetheretherketone (PEEK) cages in anterior cervical diskectomy and fusion (ACDF) show slow radiographic fusion that reduces clinical improvement: results from the prospective multicenter "PIERCE-PEEK" study.
Empty polyetheretherketone (PEEK) cages in anterior cervical diskectomy and fusion (ACDF) show slow radiographic fusion that reduces clinical improvement: results from the prospective multicenter "PIERCE-PEEK" study. Patient Saf Surg. 2017;11:12 Authors: Suess O, Schomaker M, Cabraja M, Danne M, Kombos T, Hanna M Abstract BACKGROUND: Anterior cervical diskectomy and fusion (ACDF) is a well-established surgical treatment for radiculopathy and myelopathy. Previous studies showed that empty PEEK cages have lower radiographic fusion rates, but the clinical relevance remains unclear. This paper's...
Source: Patient Safety in Surgery - May 5, 2017 Category: Surgery Authors: Suess O, Schomaker M, Cabraja M, Danne M, Kombos T, Hanna M Tags: Patient Saf Surg Source Type: research

Does partial coating with titanium improve the radiographic fusion rate of empty PEEK cages in cervical spine surgery? A comparative analysis of clinical data.
CONCLUSIONS: ACDF is effective treatment for cervical myelopathy and radiculopathy. Although this and other studies show that titanium fuses better, partial coating of a PEEK cage does not improve the fusion rate sufficiently or confer other lasting clinical benefit. PEEK cages fully coated with titanium should be tested in prospective randomized comparative trials. TRIAL REGISTRATION: Prospective, multicenter, single-arm clinical observational study without an individual Trial registration number. Study design and post hoc data analysis according to the "PIERCE-PEEK study", ISRCTN42774128, retrospectively r...
Source: Patient Safety in Surgery - May 5, 2017 Category: Surgery Authors: Kotsias A, Mularski S, Kühn B, Hanna M, Suess O Tags: Patient Saf Surg Source Type: research

Safety and efficacy of resistive polymer versus forced air warming in total joint surgery.
CONCLUSIONS: These findings demonstrate that hypothermia is achieved by both forced-air and non-forced air warming devices among total knee and hip arthroplasty patients. The potential for airflow disruption is present with the forced-air warming device and does not exist with the non-forced air device. The disruption of laminar airflow may be associated with surgical site infections. The disposable covers used to protect the device and patient have potential implications for surgical site infection. Quality improvement efforts aimed to enhance patient safety should include the implementation of healthcare equipment with t...
Source: Patient Safety in Surgery - April 19, 2017 Category: Surgery Authors: Sandoval MF, Mongan PD, Dayton MR, Hogan CA Tags: Patient Saf Surg Source Type: research

Surgeons, sign your site!
Abstract Please see related Short report: https://pssjournal.biomedcentral.com/articles/10.1186/s13037-017-0125-1. PMID: 28392833 [PubMed - in process] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - April 12, 2017 Category: Surgery Authors: Clarke TJ Tags: Patient Saf Surg Source Type: research

Should nurses be allowed to perform the pre-operative surgical site marking instead of surgeons? A prospective feasibility study at a Swiss primary care teaching hospital.
CONCLUSION: Surgical site marking can be performed by trained nurses. However, the attending surgeon remains fully responsible of the correct operation on the correct patient. PMID: 28392834 [PubMed - in process] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - April 12, 2017 Category: Surgery Authors: Schäfli-Thurnherr J, Biegger A, Soll C, Melcher GA Tags: Patient Saf Surg Source Type: research

A new patient safety smartphone application for prevention of "forgotten" ureteral stents: results from a clinical pilot study in 194 patients.
CONCLUSIONS: The "Stent Tracker" is a patient safety application that provides a secure and simplified interface, which can significantly reduce the incidence of RUS. Further developments could include automated notifications to patients and staff, color-coding, and integrated information with electronic patient charts. PMID: 28396695 [PubMed - in process] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - April 12, 2017 Category: Surgery Authors: Molina WR, Pessoa R, Donalisio da Silva R, Kenny MC, Gustafson D, Nogueira L, Leo ME, Yu MK, Kim FJ Tags: Patient Saf Surg Source Type: research

Comparing the speed of irrigation between pulsatile lavage versus gravity irrigation: an Ex-vivo experimental investigation.
In this study we set out to determine the differences in irrigation rate between these various treatment methods. METHODS: This was an ex-vivo experimental laboratory study not involving human subjects. Irrigation rates were tested based on the time in seconds required to empty a three-liter bag of normal saline hanging at either 6 or 9 ft. Three forms of irrigation were tested: gravity irrigation (GI6, GI9), low-pressure pulsatile irrigation (LP6, LP9) and high-pressure pulsatile irrigation. One-way ANOVA and Student's t-test were used to compare rates based on height and form of irrigation. RESULTS: Significant...
Source: Patient Safety in Surgery - April 2, 2017 Category: Surgery Authors: Mundy LR, Gage MJ, Yoon RS, Liporace FA Tags: Patient Saf Surg Source Type: research

Introducing the "Bone-Screw-Fastener" for improved screw fixation in orthopedic surgery: a revolutionary paradigm shift?
Introducing the "Bone-Screw-Fastener" for improved screw fixation in orthopedic surgery: a revolutionary paradigm shift? Patient Saf Surg. 2017;11:6 Authors: Stahel PF, Alfonso NA, Henderson C, Baldini T Abstract BACKGROUND: Conventional screws used for fracture fixation in orthopedic surgery continue to rely on the historic buttress thread design. While buttress screws generally provide solid resistance against unidirectional axial loading forces, their design suffers from several limitations, as the buttress thread does not adequately resist multiaxial forces. Furthermore, the buttress scr...
Source: Patient Safety in Surgery - March 23, 2017 Category: Surgery Authors: Stahel PF, Alfonso NA, Henderson C, Baldini T Tags: Patient Saf Surg Source Type: research

Atlantoaxial rotatory fixation as a rare complication from head positioning in otologic surgery: Report of two cases in young children.
CONCLUSION: The correlation between the direction of torticollis and the side of surgery suggests that rotation of the head during surgery has an impact on development of postoperative atlantoaxial rotatory fixation. Thus, children undergoing otologic surgery are thought to be at a risk of postoperative atlantoaxial rotatory fixation. Although rare, the surgical team needs to be aware of this adverse event and pay close attention to this possibility throughout the perioperative period. Perioperative management should include informed consent, preoperative assessment of the range of head and neck motion, proper intraoperati...
Source: Patient Safety in Surgery - February 13, 2017 Category: Surgery Authors: Sakaida H, Akeda K, Sudo A, Takeuchi K Tags: Patient Saf Surg Source Type: research

Changes in safety climate and teamwork in the operating room after implementation of a revised WHO checklist: a prospective interventional study.
CONCLUSIONS: There was no significant change in teamwork climate by use of the revised WHO checklist, which may be due to insufficient implementation, as a lack of adherence to the WHO checklist was detected. We found deficiencies in teamwork and communication. Further studies exploring how to improve safety climate are needed. TRIAL REGISTRATION: NCT02329691. PMID: 28163786 [PubMed - in process] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - February 7, 2017 Category: Surgery Authors: Erestam S, Haglind E, Bock D, Andersson AE, Angenete E Tags: Patient Saf Surg Source Type: research

The impact of economic rationalization, prioritization and rationing on job satisfaction, motivation and team cohesion in hospitals: a survey among retired physician executives in Germany.
CONCLUSIONS: In addition to rationalization, prioritization and rationing measures have now been part of working strategy at the hospitals. On one hand, the conceptual distinction between the terms still seems imprecise; on the other hand, a creeping and imperceptible medico-ethical transgression of the prioritization to rationing seems to have already taken place. PMID: 28115991 [PubMed - in process] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - January 26, 2017 Category: Surgery Authors: Schnoor J, Braehler E, Ghanem M, Heyde CE Tags: Patient Saf Surg Source Type: research

Current practice of antibiotic prophylaxis for surgical fixation of closed long bone fractures: a survey of 297 members of the Orthopaedic Trauma Association.
CONCLUSION: There is heterogeneity in the use of single- versus multiple-dose antibiotic prophylaxis for surgical repair of closed long bone fractures. Many surgeons were unsure of current evidence-based recommendations regarding perioperative antibiotic use. Most respondents indicated they would be receptive to high-level evidence regarding the single- versus multiple-dose perioperative prophylactic antibiotics for the treatment of closed long bone fractures. PMID: 28105080 [PubMed - in process] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - January 21, 2017 Category: Surgery Authors: Gans I, Jain A, Sirisreetreerux N, Haut ER, Hasenboehler EA Tags: Patient Saf Surg Source Type: research

Why do surgeons continue to perform unnecessary surgery?
PMID: 28096899 [PubMed - in process] (Source: Patient Safety in Surgery)
Source: Patient Safety in Surgery - January 19, 2017 Category: Surgery Authors: Stahel PF, VanderHeiden TF, Kim FJ Tags: Patient Saf Surg Source Type: research