More Harm Than Good: It is Time to Reconsider Prophylactic Fasciotomy in Lower-Extremity Vascular Injury
CONCLUSIONS: In trauma patients with lower-extremity vascular injury undergoing vascular repair, selective use of fasciotomy can spare almost half of patients the need for fasciotomy without an increase in limb complications.PMID:38590003 | DOI:10.1177/00031348241244629 (Source: The American Surgeon)
Source: The American Surgeon - April 9, 2024 Category: Surgery Authors: Appajosula S Rao Thomas M Scalea David V Feliciano Melike N Harfouche Source Type: research
Cost Savings of Whole Blood Versus Component Therapy at a Community Level 1 Trauma Center
This study is a retrospective single-center review of adult trauma patients admitted to a community trauma center who received WB or CORe as part of their massive transfusion protocol (MTP) resuscitation from 2017 to 2021. The WB group received a minimum of one unit WB while CORe received no WB. Univariate and multivariate analyses were completed. Statistical analysis was conducted using a 95% confidence level. Non-normally distributed, continuous data were analyzed using the Wilcoxon rank sum test.RESULTS: 576 patients were included (201 in WB and 375 in CORe). Whole blood conveyed a survival benefit vs CORe (OR 1.49 P &l...
Source: The American Surgeon - April 9, 2024 Category: Surgery Authors: Rachel C Murphy Tyler W Johnson Thomas J Mack Rachel E Burke Nicholas P Damiano Laura Heger Nicholas Minner Emily German Angela Wilson Michael G Mount Brian C Thurston Caleb J Mentzer Source Type: research
iPad-Based Neurocognitive Testing (ImPACT-QT) in Acute Adult Mild Traumatic Brain Injury/Concussion: Study on Practicality and Bedside Cognitive Scores in a Level-1 Trauma Center
DISCUSSION: Immediate Post-Concussion Assessment & Cognitive Testing-Quick Test is feasible in trauma patients. Preliminary findings suggest acute mTBIs have lower memory but not attention/motor scores vs non-TBI trauma controls.PMID:38592191 | DOI:10.1177/00031348241246168 (Source: The American Surgeon)
Source: The American Surgeon - April 9, 2024 Category: Surgery Authors: Patrick M Chen Sean Lee Lillian D Cruz Michael Lopez Aaron Thomas Jefferson W Chen Areg Grigorian Jeffry Nahmias Michael Lekawa Source Type: research
More Harm Than Good: It is Time to Reconsider Prophylactic Fasciotomy in Lower-Extremity Vascular Injury
CONCLUSIONS: In trauma patients with lower-extremity vascular injury undergoing vascular repair, selective use of fasciotomy can spare almost half of patients the need for fasciotomy without an increase in limb complications.PMID:38590003 | DOI:10.1177/00031348241244629 (Source: The American Surgeon)
Source: The American Surgeon - April 9, 2024 Category: Surgery Authors: Appajosula S Rao Thomas M Scalea David V Feliciano Melike N Harfouche Source Type: research
Cost Savings of Whole Blood Versus Component Therapy at a Community Level 1 Trauma Center
This study is a retrospective single-center review of adult trauma patients admitted to a community trauma center who received WB or CORe as part of their massive transfusion protocol (MTP) resuscitation from 2017 to 2021. The WB group received a minimum of one unit WB while CORe received no WB. Univariate and multivariate analyses were completed. Statistical analysis was conducted using a 95% confidence level. Non-normally distributed, continuous data were analyzed using the Wilcoxon rank sum test.RESULTS: 576 patients were included (201 in WB and 375 in CORe). Whole blood conveyed a survival benefit vs CORe (OR 1.49 P &l...
Source: The American Surgeon - April 9, 2024 Category: Surgery Authors: Rachel C Murphy Tyler W Johnson Thomas J Mack Rachel E Burke Nicholas P Damiano Laura Heger Nicholas Minner Emily German Angela Wilson Michael G Mount Brian C Thurston Caleb J Mentzer Source Type: research
iPad-Based Neurocognitive Testing (ImPACT-QT) in Acute Adult Mild Traumatic Brain Injury/Concussion: Study on Practicality and Bedside Cognitive Scores in a Level-1 Trauma Center
DISCUSSION: Immediate Post-Concussion Assessment & Cognitive Testing-Quick Test is feasible in trauma patients. Preliminary findings suggest acute mTBIs have lower memory but not attention/motor scores vs non-TBI trauma controls.PMID:38592191 | DOI:10.1177/00031348241246168 (Source: The American Surgeon)
Source: The American Surgeon - April 9, 2024 Category: Surgery Authors: Patrick M Chen Sean Lee Lillian D Cruz Michael Lopez Aaron Thomas Jefferson W Chen Areg Grigorian Jeffry Nahmias Michael Lekawa Source Type: research
Implementation of a Trauma Bay Checklist Improves Antibiotic Prophylaxis Compliance in Open Extremity Fractures
DISCUSSION: Our study estimates improved compliance of antibiotic administration after implementation of MARTY after adjusting for encounter characteristics. Findings from this study demonstrate improved compliance, but this compliance is often still lacking in those with higher injury severity scores. Findings from this study may be used to inform approaches to further improve trauma care.PMID:38584500 | DOI:10.1177/00031348241244648 (Source: The American Surgeon)
Source: The American Surgeon - April 8, 2024 Category: Surgery Authors: Robert D Luke Casey P Balio Claire K Foley Alexa P Soult Source Type: research
A Ventral Hernia Management Pathway; A "Getting It Right First Time" approach to Complex Abdominal Wall Reconstruction
CONCLUSION: In this emerging specialty, there is limited guidance on the management of these patients. Our pathway, the "Complex Hernia Bundle," currently provides guidance for our abdominal wall team and may well be one that could be adopted/adapted by other centers where challenging hernia cases are undertaken.PMID:38584505 | DOI:10.1177/00031348241241650 (Source: The American Surgeon)
Source: The American Surgeon - April 8, 2024 Category: Surgery Authors: Samuel G Parker James Joyner Rhys Thomas Jonathan Van Dellen Said Mohamed Ravishankar Jakkalasaibaba Helena Blake Arun Shanmuganandan Waleed Albadry Julia Panascia William Gray Stella Vig Source Type: research
Is Minimally Invasive Resection of Large Thymoma Appropriate?
DISCUSSION: MIS has equivalent oncologic benefit to open resection for large thymomas, but is associated with shorter LOS. When clinically appropriate, MIS thymectomy may be considered a safe alternative to open resection for large thymomas.PMID:38584508 | DOI:10.1177/00031348241246180 (Source: The American Surgeon)
Source: The American Surgeon - April 8, 2024 Category: Surgery Authors: Grigory A Manyak Aria Bassiri Christine E Alvarado Kunaal S Sarnaik Jilian Sinopoli Leonidas Tapias Philip A Linden Christopher W Towe Source Type: research
Prophylactic Cholecystectomy is Safe in Patients Undergoing Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy
CONCLUSION: Prophylactic cholecystectomy in patients undergoing CRS-HIPEC is not associated with increased morbidity or increased bile leak risk compared to historical data. While the benefits of prophylactic cholecystectomy are not yet elucidated, it may be considered to avoid potential future morbid operations for biliary disease.PMID:38587264 | DOI:10.1177/00031348241246171 (Source: The American Surgeon)
Source: The American Surgeon - April 8, 2024 Category: Surgery Authors: David N Hanna Nazanin Khajoueinejad Muhammad O Ghani Andrew Hermina Alexander Mina Christina E Bailey Noah Cohen Daniel Labow Benjamin Golas Umut Sarpel Kamran Idrees Deepa Magge Source Type: research
Learning Curve of a Laparoscopic Pancreaticoduodenectomy Program at a Second Institution
CONCLUSIONS: The learning curve and average operative time of an SI laparoscopic PD program was shorter than the initial learning curve for a single surgeon with comparable outcomes. This suggests that complex minimally invasive surgical programs can be safely transferred to another high-volume institution without significant loss of progress.PMID:38587270 | DOI:10.1177/00031348241246163 (Source: The American Surgeon)
Source: The American Surgeon - April 8, 2024 Category: Surgery Authors: W Taylor Martin Morgan Bonds Laura Fischer Katherine T Morris Zoona Sarwar Kenneth Stewart Tabitha Garwe Alessandro Paniccia Richard D Schulick Ajay Jain Barish H Edil Source Type: research
Technical Considerations in Laparoscopic-Assisted Endoscopic Retrograde Cholangiography
Am Surg. 2024 Apr 8:31348241244651. doi: 10.1177/00031348241244651. Online ahead of print.ABSTRACTThe use of endoscopic retrograde cholangiography (ERCP) for diagnostic and therapeutic interventions on the pancreaticobiliary system has steadily increased, but the standard approach through the oropharynx is prohibited after Roux-en-Y (RYGB) gastric bypass surgery. Laparoscopic access to the gastric remnant allows for the completion of ERCP using the standard side-viewing duodenoscope to facilitate the completion of standard and advanced endoscopic maneuvers. Here, we describe our experience with the technical aspects of saf...
Source: The American Surgeon - April 8, 2024 Category: Surgery Authors: Eric H Mace Patrick S Yachimski Marcus C Tan Michael C Smith Source Type: research
Race/Ethnicity and Social Determinants of Health and Their Impact on Receiving Appropriate Chemotherapy for Colon Cancer
CONCLUSION: Age, living in a Metro area, and government insurance status at diagnosis are negatively correlated with the likelihood of receiving chemotherapy. Race was not associated with differences in receiving chemotherapy.PMID:38587435 | DOI:10.1177/00031348241244646 (Source: The American Surgeon)
Source: The American Surgeon - April 8, 2024 Category: Surgery Authors: Erica Dobbs Edward C Tobin Staci Deslich Bryan K Richmond Source Type: research
Implementation of a Trauma Bay Checklist Improves Antibiotic Prophylaxis Compliance in Open Extremity Fractures
DISCUSSION: Our study estimates improved compliance of antibiotic administration after implementation of MARTY after adjusting for encounter characteristics. Findings from this study demonstrate improved compliance, but this compliance is often still lacking in those with higher injury severity scores. Findings from this study may be used to inform approaches to further improve trauma care.PMID:38584500 | DOI:10.1177/00031348241244648 (Source: The American Surgeon)
Source: The American Surgeon - April 8, 2024 Category: Surgery Authors: Robert D Luke Casey P Balio Claire K Foley Alexa P Soult Source Type: research
A Ventral Hernia Management Pathway; A "Getting It Right First Time" approach to Complex Abdominal Wall Reconstruction
CONCLUSION: In this emerging specialty, there is limited guidance on the management of these patients. Our pathway, the "Complex Hernia Bundle," currently provides guidance for our abdominal wall team and may well be one that could be adopted/adapted by other centers where challenging hernia cases are undertaken.PMID:38584505 | DOI:10.1177/00031348241241650 (Source: The American Surgeon)
Source: The American Surgeon - April 8, 2024 Category: Surgery Authors: Samuel G Parker James Joyner Rhys Thomas Jonathan Van Dellen Said Mohamed Ravishankar Jakkalasaibaba Helena Blake Arun Shanmuganandan Waleed Albadry Julia Panascia William Gray Stella Vig Source Type: research
