An Editorial Farewell.
PMID: 31405406 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Richardson JD Tags: Am Surg Source Type: research

Strengthen Your Core.
PMID: 31405407 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Behrns KE Tags: Am Surg Source Type: research

Trauma Recidivism Postdischarge Mortality: Important Differences Exist between the Adult and Geriatric Populations.
Abstract Trauma recidivists are a high-risk patient population. The effects of recidivism on Geriatric trauma mortality have not been investigated. Our hypothesis is that trauma recidivism is associated with high postdischarge mortality after the initial index admission in both the geriatric and adult trauma populations. The trauma registry of our Level I trauma center was queried for patients evaluated between 2008 and 2012. Patients were stratified adult (18-64) and geriatric (≥65) groups and matched with mortality data from the National Death Index. Unique patients were identified and recidivists flagged. St...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Gerrish AW, Hamill ME, Locklear TM, Bower KL, Lollar DI, Faulks ER, Matos M, Nussbaum MS, Collier BR Tags: Am Surg Source Type: research

Does Neoadjuvant Chemotherapy for Breast Cancer Affect Lymph Node Harvest Rates?
Abstract Some authors report that patients receiving neoadjuvant chemotherapy have fewer lymph nodes harvested during axillary dissection and more dissections with
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: White RL, Palmer PP, Trufan SJ, Sarma D Tags: Am Surg Source Type: research

Novel Technique to Reduce the Incidence of SSI after Colorectal Surgery.
Abstract SSI is a leading cause of morbidity and increases health-care cost after colorectal operations. It is a key hospital-level patient safety indicator. Previous literature has identified perioperative risk factors associated with SSI and interventions to decrease rate of infection. The purpose of this study was to evaluate the impact of blowhole closure on the rate of superficial and deep SSI. The ACS-NSQIP database was queried for patients undergoing colectomy at the University of Kentucky from 2013 to 2016. Retrospective chart review was performed to gather demographic data and perioperative variables. Wou...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Kay D, Bhakta A, Patel JA, Hourigan JS, Kumar S, Davenport D, Beck SJ Tags: Am Surg Source Type: research

National Risk Factors for Child Maltreatment after Trauma: Failure to Prevent.
This study demonstrates that a significant portion of admissions for trauma in children and teenagers could be misrepresented as not involving maltreatment. These index admissions could be the only chance for intervention for child maltreatment. Identifying these at-risk individuals is critical to prevention efforts. PMID: 31405411 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Parreco J, Quiroz HJ, Willobee BA, Sussman M, Buicko JL, Rattan R, Namias N, Thorson CM, Sola JE, Perez EA Tags: Am Surg Source Type: research

Anemia at Discharge in Elderly Trauma Patients Is Not Associated with Six-Month Mortality.
Abstract Few studies have evaluated outcomes in geriatric trauma patients discharged with anemia. Our hypothesis was that anemia at discharge was not associated with six-month mortality. A 22-month retrospective study of trauma patients ≥ 65 years was conducted from 2015 to 2016. The end point was six-month mortality. The degree of anemia at admission (admission hemoglobin [AHb]) and discharge (discharge hemoglobin [DHb]) was categorized as follows based on hemoglobin (Hb) (g/dL): I (>10), II (>9 and ≤10), III (>8 and ≤9), and IV (≤8). Univariate analysis and multivariate analysis were perform...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Ong AW, Muller A, Sigal A, Fernandez F Tags: Am Surg Source Type: research

The Understated Malignancy Potential of Nonoperative Acute Appendicitis.
Abstract Cancer of the appendix is rare and is most commonly found incidentally on pathology after an appendectomy for uncomplicated appendicitis (UA). The medical management alternative with antibiotics and observation remains an ongoing debate. The purpose of our study was to develop modern epidemiological data for adult patients completing an appendectomy for UA secondary to an appendiceal neoplasm (AN). ACS-NSQIP database was queried (2005-2016) to identify patients completing an appendectomy. Cohorts of patients who were diagnosed with UA and an AN were included in the study. Relevant perioperative clinical a...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Seawell J, Sciarretta JD, Pahlkotter M, Muertos K, Onayemi A, Davis JM Tags: Am Surg Source Type: research

Evaluation of Operative Waste in a Military Medical Center: Analysis of Operating Room Cost and Waste during Surgical Cases.
Abstract Operating rooms (ORs) contribute to at least 40 per cent of hospital costs. There is an existing cost waste in ORs for surgical devices that are opened without being used. There is a paucity of data evaluating the hospital cost of opened but unused OR supplies. The goal of this observational study is to examine the cost of opened but unused OR supplies for general surgery cases. We performed a quality improvement project of OR cost waste by observing 30 cases. Surgical cases of a senior surgeon who had been at the institution for more than five years were evaluated for items opened appropriately and wheth...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Rose ED, Modlin DM, Ciampa ML, Mangieri CW, Faler BJ, Bandera BC Tags: Am Surg Source Type: research

Geriatric Patients on Antithrombotic Agents Who Fall: Does Trauma Team Activation Improve Outcomes?
In this study, 4540 patients on ACAP drugs were analyzed, with TTA occurring in 500 (11%). TTA occurred in younger but more severely injured patients with lower Glasgow Coma Score. Logistic regression revealed that TTA was not associated with mortality (odds ratio [95% confidence intervals], 2.04 [0.89-4.25]). The 1:1 propensity score analysis revealed similar mortality for the matched groups (non-TTA, 1.6% vs TTA, 2.2%, P = 0.64). In the elderly patients on ACAP agents, the current triage criteria resulted in the appropriate use of TTA for more severely injured patients. The lack of outcome benefit suggests that ACAP drug...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Hwang P, Ong AW, Muller A, McNicholas A, Martin A, Sigal A, Fernandez FB Tags: Am Surg Source Type: research

Comparing Machine Learning Algorithms for Predicting Acute Kidney Injury.
This study identifies the best performing machine learning algorithms for predicting AKI using trends in laboratory values in ICU patients. Early identification of these patients using readily available data indicates that incorporating machine learning predictive models into electronic medical record systems is an inevitable requisite for improving patient outcomes. PMID: 31405416 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Parreco J, Soe-Lin H, Parks JJ, Byerly S, Chatoor M, Buicko JL, Namias N, Rattan R Tags: Am Surg Source Type: research

Patterns of Nasoorbitalethmoid Fractures in the Pediatric Population.
Abstract There is an absence of literature regarding nasoorbitoethmoid (NOE) facial fractures. Although NOE fractures are uncommon, there are a significant number in the pediatric population. These fractures also often occur in conjunction with other facial fractures because the NOE region adjoins the nose, orbit, maxilla, and cranium. They can also be a harbinger for more serious concerns such as traumatic brain injury and intracranial hemorrhage. For this reason, NOE fractures can be highly complicated and a challenge to manage. We aim to define the etiologies and patterns of NOE fractures to guide hospital and ...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Le TT, Berlin RS, Oleck NC, Dobitsch AA, Halsey JN, Hoppe IC, Lee ES, Granick MS Tags: Am Surg Source Type: research

Developing a Simple Clinical Score for Predicting Mortality and Need for ICU in Trauma Patients.
Abstract Several models exist to predict trauma center need in the prehospital setting; however, there is lack of simple clinical tools to predict the need for ICU admission and mortality in trauma patients. The aim of our study was to develop a simple clinical tool that can be used with ease in the prehospital or emergency setting and can reliably predict the need for ICU admission and mortality in trauma patients. We abstracted one year of National Trauma Data Bank for all patients aged ≥ 18 years. Transferred patients and those dead on arrival were excluded. Patient demographics, injury parameters, vital sig...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Haider A, Con J, Prabhakaran K, Anderson P, Policastro A, Feeney J, Latifi R Tags: Am Surg Source Type: research

Parastomal Hernia Repair Outcomes: A Nine-Year Experience.
Abstract Parastomal hernias (PHs) frequently complicate enterostomy creation. Decision for PH repair (PHR) is driven by patient symptoms due to the frequency of complications and recurrences. The European Hernia Society (EHS) PH classification is based on the PH defect size and the presence/absence of concomitant incisional hernia. The aim of this study was to evaluate PHR outcomes based on EHS classification. An Institutional Review Board-approved retrospective review of a prospective database between 2009 and 2017 was performed. Patient demographics, enterostomy type, EHS classification, operative technique, and...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Lin YW, Keller P, Davenport DL, Plymale MA, Totten CF, Roth JS Tags: Am Surg Source Type: research

Avoiding Pitfalls in Insulinomas by Preoperative Localization with a Dual Imaging Approach.
Abstract Insulinomas are rare endocrine malignancies of the pancreas that require surgical resection but can be difficult to localize preoperatively. We sought to review and improve the accuracy of preoperative localization techniques at our institution. We retrospectively reviewed all insulinomas that underwent resection at our institution between 1998 and 2016. Localization techniques include selective arterial calcium stimulation (CaStim), CT, MRI, angiography, and somatostatin receptor scintigraphy. Thirty-eight patients had pathologically proven insulinomas on surgical resection. Localization accuracies of Ca...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Ramonell KM, Saunders ND, Sarmiento J, Bercu Z, Martin L, Weber CJ, Sharma J, Patel SG Tags: Am Surg Source Type: research

Service-Based Advanced Practice Providers: The Surgeon's Perspective.
Abstract The ACGME work hour restrictions facilitated increased utilization of service-based advanced practice providers (APPs) to offset reduced general surgery resident work hours. Information regarding attending surgeon perceptions of APP impact is limited. The aim of this survey was to gauge these perceptions with respect to workload, length of stay (LOS), safety, best practice, level of function, and clinical judgment. Attending surgeons on surgical teams that employ service-based APPs at an urban tertiary referral center responded to a survey at the completion of academic year 2016. Perceptions regarding APP...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Eaton B, O'Meara L, Herrera AV, Tesoriero R, Diaz J, Bruns B Tags: Am Surg Source Type: research

Farm Injuries: Animal Most Common, Machinery Most Lethal: An NTDB Study.
Abstract To characterize both emergency room (ER) and hospital discharge dispositions of patients presenting with farm-related injuries. The 2012 National Trauma Data Bank was queried in August 2017 for injuries occurring on a farm. Patients were stratified by gender, age group, race, Injury Severity Score (ISS), and injury type. We performed logistic regression analysis to correlate parameters with likelihood of discharge home or death. P values
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Damroth K, Damroth R, Chaudhary A, Erickson A, Heneghan L, Hellenthal N, Monie D, Cooper S, Anderson M, Kaufman T Tags: Am Surg Source Type: research

The "Death Diamond": Death Beyond Trauma.
The "Death Diamond": Death Beyond Trauma. Am Surg. 2019 Jul 01;85(7):757-760 Authors: Farrell M, Marconi T, Getchell J, Green R, Cipolle M, Sixta S Abstract Thromboelastography (TEG) has become a critical tool for the diagnosis, assessment, and management of hyperfibrinolysis and coagulopathy in trauma. In 2015, Chapman et al. of the Denver group coined the term "Death Diamond" (DD) to describe a TEG tracing identified in a unique trauma population. The DD was associated with a 100 per cent positive predictive value for mortality. Given the potential prognostic implications and res...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Farrell M, Marconi T, Getchell J, Green R, Cipolle M, Sixta S Tags: Am Surg Source Type: research

Impact of Laparoscopy on Training: Are Open Appendectomy and Cholecystectomy on the Brink of Extinction?
Abstract The operative experience of present-day surgical residency training has evolved as a result of the contributions of laparoscopic surgery. Some traditional open procedures are now more descriptive and less of a familiarity to many general surgery residents (GSRs). The aim of this study was to investigate how open operative experience compares with laparoscopy for GSRs. A retrospective, multicenter, consecutive cohort study of all patients undergoing surgical intervention involving the appendix and gallbladder identified from the ACS-NSQIP database over a 2.5-year period. All GSR postgraduate year-level ope...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Melmer PD, Chaconas C, Taylor R, Verrico E, Cockcroft A, Pinnola A, Holmes S, Sciarretta JD, Davis JM Tags: Am Surg Source Type: research

Field Triage of Motor Vehicle Crashes: Which Factors Predict High Injury Severity?
Abstract Patient physiology and crash characteristics are essential components of field triage for motor vehicle crashes. We aimed to identify prehospital information that predicted high injury severity or critical patient condition on hospital arrival. The association of demographics, shock index (SI), Glasgow Coma Scale, and 10 crash characteristics of trauma activations for motor vehicle crashes with injury severity score (ISS) ≥ 16 and a composite of hypotension, need for blood transfusions, or immediate operation was determined using univariate and multivariate analyses. A total of 133 of 498 patients (27%...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Leichtle SW, Poulos NG, Whelan J, Aboutanos M Tags: Am Surg Source Type: research

Can I Keep My Nipple? Factors Influencing the Surgical Decision between Skin-Sparing and Nipple-Sparing Mastectomy.
In this study, 196 (26.7%) underwent NSM and 538 (73.3%) underwent SSM. The median age of patients at the time of surgery was 50 years (range, 22-78 years). On multivariate analysis, younger patient age, insurance type, BRCA+ mutation status, smaller breast size (by weight), and those who did not undergo neoadjuvant chemotherapy were more likely to undergo NSM. Surgeon also was an independent predictor of whether patients had NSM or SSM. There may be many factors that play into the decision to pursue NSM versus SSM, but younger patient age, BRCA mutation status, breast size, and whether the patient had neoadjuvant chemothe...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Wang M, Huang J, Chagpar AB Tags: Am Surg Source Type: research

Trauma in Pregnancy: The Relationship of Trauma Activation Level and Obstetric Outcomes.
Abstract Trauma in pregnancy is a leading cause of poor fetal and obstetric outcomes. Trauma team activation (TTA) criteria include injury with ≥ 20 weeks gestational age (GA). A retrospective analysis was performed on pregnant patients evaluated at a Level 1 trauma center. Patients were characterized by TTA: full, partial, or non-TTA, and TTA criteria independent of pregnancy. Index trauma and delayed delivery hospitalization outcomes were examined. Bivariate analysis, t test, and logistic regression were used when appropriate. From 2010 to 2015, 216 full, 50 partial, and 50 non-TTAs presented. Independent of ...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Bryant MK, Roy S, Purcell LN, Porras KL, Spencer A, Udekwu P Tags: Am Surg Source Type: research

Visceral Kaposi Sarcoma Presenting as Small Bowel Intussusception: A Rare Presentation and Call to Action.
In this report, we describe a case of visceral KS causing small bowel intussusception in a young, previously undiagnosed human immunodeficiency virus (HIV)-positive patient. Southern surgeons should be particularly attentive to HIV/AIDS-related disease as a cause of surgical pathology, particularly in the southeast, and can play a significant advocacy role for improved access to HIV/AIDS diagnostic and treatment services. PMID: 31405428 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Lovasik BP, Wang VL, Point du Jour KS, Kim SC, Hashmi SS, Haack CI Tags: Am Surg Source Type: research

Substance Abuse-Related Soft Tissue Infections: A Uniquely Complicated Subset of a Common Problem.
Abstract We hypothesize that soft tissue infections (SSIs) related to intravenous drug usage (IVDU) are associated with a more complicated and costly course than those not associated with IVDU. For the period 2005-2018, ICD 9/ICD 10 billing codes were used to identify patients admitted with SSIs and their causes/complications and associated costs. IVDU-related infections were then compared with non-IVDU-related infections. t test was used to compare treatment costs and length of stay. Logistic regression analysis was used to assess the likelihood/risk of specific events in the IVDU versus non-IVDU populations. Of ...
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Tsai J, Suh L, Annie F, Richmond BK Tags: Am Surg Source Type: research

Facial Fracture-Associated Intracranial Hemorrhage in the Elderly Population.
PMID: 31405430 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Dobitsch AA, Oleck NC, Mansukhani PA, Halsey JN, Le TT, Hoppe IC, Lee ES, Granick MS Tags: Am Surg Source Type: research

Impact of Surgical Care Improvement Project Compliance on Surgical Site Infection in a Trauma Population.
PMID: 31405431 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Elkbuli A, Dowd B, McKenney M, Boneva D Tags: Am Surg Source Type: research

An Unexpected Presentation of Male Breast Cancer in Ectopic Breast Tissue.
PMID: 31405432 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Martin TA, Israel IL, Fillion MM Tags: Am Surg Source Type: research

Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement by an Emergency General Surgery Service: Long-Term Follow-Up Is Lacking.
PMID: 31405433 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: DesPain RW, Parker WJ, Kindvall AT, Elster EA, Jessie EM, Rodriguez CJ, Bradley MJ Tags: Am Surg Source Type: research

Making the Diagnosis-Acute Primary Aortoduodenal Fistula Bleeding Presenting in a Blunt Trauma Patient.
PMID: 31405434 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Kim WC, Ferrada P, Rodas E, Levy M, Aboutanos MA, Anand RJ Tags: Am Surg Source Type: research

Combined Liver and Kidney Transplantation in a Patient with Situs Inversus.
PMID: 31405435 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: King DC, Neill JC, Anderson CD, Earl TM, Koller FL Tags: Am Surg Source Type: research

Laparoscopic Repair of Large Hiatal Hernia and Chemical Fundophrenicopexy in a Frail Elderly Patient with Complex Medical History and Anatomical Challenges.
PMID: 31405436 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Fanous M, Tafoya B, Jaehne A, Lorenson D Tags: Am Surg Source Type: research

Chronic Pneumatosis Intestinalis with Pneumoperitoneum and a Consistently Benign Abdominal Examination.
PMID: 31405437 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Werwie N, Dyer B, Richmond BK Tags: Am Surg Source Type: research

Massive Caudate Lobe in Laparoscopic Hiatal Hernia Repair: Tying and Wrapping outside the Box.
PMID: 31405438 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Fanous M, Jaehne A, Lorenson D, Williams S Tags: Am Surg Source Type: research

Acute Esophageal Necrosis Resulting in Esophageal Perforation.
PMID: 31405439 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Harner A, Mitchell A, Kilbourne M Tags: Am Surg Source Type: research

Occult Renal Cell Carcinoma Presenting as a Palpable Supraclavicular Virchow's Node.
PMID: 31405440 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Perry L, Schwartz J, Slotman G, Al Ustwani O, Kulkarni N Tags: Am Surg Source Type: research

Thoracic Intracavitary Ultrasonographic Localization of a Mediastinal Bronchogenic Cyst.
PMID: 31405441 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Harner A, Schroeder C Tags: Am Surg Source Type: research

Management and Surgical Care of a Female Patient with Complex Pelvic Polytrauma.
PMID: 31405442 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Bjerken E, Jensen A, Costa J, Crandall M, Good MM, Skarupa D Tags: Am Surg Source Type: research

Gastric Outlet Obstruction as an Unusual Presentation for Metastatic Lobular Breast Cancer.
PMID: 31405443 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Elliott E, Smith A, Moe M, Stolier A, Daroca P, Sholl A, Souers A, Swerdloff H, Duchesne J, Hamner JB Tags: Am Surg Source Type: research

Large-Cell Neuroendocrine Carcinoma of the Gallbladder: A Rare Case.
PMID: 31405444 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Nakamoto K, Weaver A, Griswold D, Sanabria J Tags: Am Surg Source Type: research

Sacral Nerve Stimulator for the Treatment of Nocturnal Fecal Incontinence.
PMID: 31405445 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Chavez MR, Chase A, Clark CE, Turner J Tags: Am Surg Source Type: research

Impalement at Zone I of Neck Causing Traumatic Subclavian Arterial Compression Injury.
PMID: 31405446 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Gogna S, Lombardo G, Prabhakaran K, Goyal A, Latifi R Tags: Am Surg Source Type: research

Surgical Resection of Hepatic Epithelioid Hemangioendothelioma.
PMID: 31405447 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Gregory JJ, Patel KJ, Lancaster WP Tags: Am Surg Source Type: research

Hybrid Operating Room Cone-Beam CT-Guided PEG-Tube Placement in a Patient with Large Ventral Hernia.
PMID: 31405448 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Drevets P, Ford A, Schampaert S, Schroeder C Tags: Am Surg Source Type: research

Intramuscular Cavernous Hemangioma of the Breast.
PMID: 31405449 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - July 1, 2019 Category: Surgery Authors: Dugan M, Crandall M, Letter H, Jasra B Tags: Am Surg Source Type: research

Malignant Peripheral Nerve Sheath Tumor in a Patient with Neurofibromatosis and Primary Hyperparathyroidism.
PMID: 31267893 [PubMed - in process] (Source: The American Surgeon)
Source: The American Surgeon - June 1, 2019 Category: Surgery Authors: Herrera A, Kwayisi GM, Reid K Tags: Am Surg Source Type: research

The History of Surgical Staplers: A Combination of Hungarian, Russian, and American Innovation.
Abstract Since their development in 1908, surgical staplers have been used as a method of "mechanical suturing" in efforts to divide hollow viscera and create anastomoses in an efficient and sterile manner. The concept for the surgical stapler was first developed by Humér Hultl, a Hungarian professor and surgeon, and designed by Victor Fischer, a Hungarian businessman and designer of surgical instruments. The design was highly acclaimed; however, it was bulky, cumbersome, and expensive to manufacture. In 1920, Aladár Petz, a student of Hultl, incorporated two innovations to the Fischer-Hult...
Source: The American Surgeon - June 1, 2019 Category: Surgery Authors: Gaidry AD, Tremblay L, Nakayama D, Ignacio RC Tags: Am Surg Source Type: research

Is Opioid Prescribing Driving Trauma Recidivism or Is Trauma Driving Opioid Use?
Abstract In the past 30 years, opioid prescription rates have quadrupled and hospital admissions for overdose are rising. Previous studies have focused on alcohol use and trauma recidivism, however rarely evaluating recidivism and opioid use. We hypothesized there is an association between opioid use and trauma recidivism. This is a retrospective review of patients with multiple admissions for traumatic injury. Demographics, opioid toxicology screen (TS) results, and injury characteristics were collected. Statistical analysis was performed with chi-squared and Poisson regression models. One thousand six hundred fo...
Source: The American Surgeon - June 1, 2019 Category: Surgery Authors: Harmon L, Sukri L, Kufera JA, Nguyen A, Grunnagle M, Ramirez CL, Botwinick I, Cucher D, Feather CB, Scalea TM, Stein DM Tags: Am Surg Source Type: research

Self-Inflicted Stab Wounds: A Single-Center Experience from 2010 to 2016.
This study aimed to characterize demographics, comorbidities, and outcomes seen in self-inflicted stabbings and compare these metrics to those seen in assault stabbings. A Level I trauma center registry was queried for patients with stab injuries between January 2010 and December 2015. Classification was based on whether injuries were SISWs or the result of assault stab wounds (ASWs). Demographic, injury, and outcome measures were recorded. Differences between genders, ethnicities, individuals with and without psychiatric comorbidities, and SISW and ASW patients were assessed. Within the SIWS cohort, no differences were fo...
Source: The American Surgeon - June 1, 2019 Category: Surgery Authors: O'Brien S, Nicolas MD, Bhutiani N, Schucht JE, Stollo B, Miller KR, Benns MV, Nash NA, Franklin GA, Smith JW, Harbrecht BG, Bozeman MC Tags: Am Surg Source Type: research

Trends in Surgeon Wellness (Take a Sad Song and Make It Better): A Comparison of Surgical Residents, Fellows, and Attendings.
Abstract We aim to investigate the prevalence of posttraumatic stress disorder (PTSD), physician burnout (PBO), and work-life balance (WLB) among surgical residents, fellows, and attendings to illustrate the trends in surgeon wellness. A cross-sectional national survey of surgical residents, fellows, and attendings was conducted screening for PTSD, PBO, and WLB. The prevalence of screening positive for PTSD was more than two times that of the general population at all levels of experience, and more than half have an unhealthy WLB. The prevalence of PTSD, PBO, and unhealthy WLB declined with increasing level of experience (P
Source: The American Surgeon - June 1, 2019 Category: Surgery Authors: Jackson T, Morgan J, Jackson D, Cook T, McLean K, Agrawal V, Taubman K, Kumar G, Truitt MS Tags: Am Surg Source Type: research

What Procedures Are Rural General Surgeons Performing and Are They Prepared to Perform Specialty Procedures in Practice?
This study describes specialty procedures performed by general surgeons operating in a rural state and how prepared the surgeons felt starting their rural practice after residency A survey was sent to all exclusively rural surgeons actively practicing in the state, inquiring about their perception of preparedness for rural practice and specialty procedures performed. The survey had a 65.2 per cent response rate. Responders felt well prepared for rural practice after residency (mean response 4.6 ± 0.8 on a Likert scale from 1 to 5; 5 = "well prepared"). Noteworthy, specialty procedures performed by rural su...
Source: The American Surgeon - June 1, 2019 Category: Surgery Authors: Stiles R, Reyes J, Helmer SD, Vincent KB Tags: Am Surg Source Type: research