Elective Appendectomy Following Antibiotics for Appendicitis
This Viewpoint considers which may be the better long-term approach to appendicitis —interval elective appendectomy or nonsurgical treatment with antibiotics. (Source: JAMA Surgery)
Source: JAMA Surgery - April 24, 2024 Category: Sports Medicine Source Type: research
Interval Appendectomy After Successful Antibiotic Treatment?
This Viewpoint discusses the pros and cons of performing interval appendectomy in patients who have recovered from successful antibiotic treatment of acute uncomplicated appendicitis. (Source: JAMA Surgery)
Source: JAMA Surgery - April 24, 2024 Category: Sports Medicine Source Type: research
Incisional Wound Irrigation for the Prevention of Surgical Site Infection
This systematic review and network meta-analysis investigates the outcomes of using different types of prophylactic intraoperative incisional wound irrigation solutions for the prevention of surgical site infections. (Source: JAMA Surgery)
Source: JAMA Surgery - April 24, 2024 Category: Sports Medicine Source Type: research
Plastic Wound Protector vs Surgical Gauze for Surgical Site Infection Reduction in Open GI Surgery
This randomized clinical trial examines whether a plastic wound protector lowers surgical site infection rates compared with surgical gauze in open gastrointestinal (GI) surgeries. (Source: JAMA Surgery)
Source: JAMA Surgery - April 24, 2024 Category: Sports Medicine Source Type: research
Total Neoadjuvant Therapy for Pancreatic Cancer —What Is Totality?
This article discusses the meaning of the word total in relation to total neoadjuvant therapy for pancreatic cancer. (Source: JAMA Surgery)
Source: JAMA Surgery - April 24, 2024 Category: Sports Medicine Source Type: research
Solution to Pollution in Surgical Wounds —Not Just Dilution
The systematic review and network meta-analysis by Groenen and colleagues published in a recent issue of JAMA Surgery on incisional wound irrigation for the prevention of surgical site infection (SSI) is a commendable effort in shedding light on a controversial topic in surgery. The key premise is that network meta-analyses can compare the impact of multiple different irrigation solutions on the development of SSI, even when they were not compared in the original studies. Although the study contributes valuable insights, it is essential to scrutinize the inherent challenges in defining and standardizing SSIs, as well as th...
Source: JAMA Surgery - April 24, 2024 Category: Sports Medicine Source Type: research
Professional Societies in Surgical Infection Care
Prevention of surgical site infection (SSI) is a key charge for surgeons. The use of perioperative antibiotics is based on evidence. Still, other elements of the SSI prevention bundle, such as hair clipping, have not demonstrated efficacy in prospective trials. Many surgeons have adopted wound irrigation or wound protector use, as these practices are specifically designed to reduce bacterial load at the surgical wound site, and their decontaminating and barrier effects intuitively seem to make sense as preventive measures. The World Health Organization has endorsed the use of wound protectors for intraoperative SSI prevent...
Source: JAMA Surgery - April 24, 2024 Category: Sports Medicine Source Type: research
Error in the Visual Abstract
In the Original Investigation titled “Morbidity After Mechanical Bowel Preparation and Oral Antibiotics Prior to Rectal Resection: The MOBILE2 Randomized Clinical Trial” published online on March 20, 2024, there was an error in the accompanying visual abstract title. The title should be “Morbidity After Mechanical Bowel Preparati on and Oral Antibiotics Prior to Rectal Resection.” The visual abstract was corrected online. (Source: JAMA Surgery)
Source: JAMA Surgery - April 24, 2024 Category: Sports Medicine Source Type: research
Management of Diverticulitis
This narrative review summarizes left-sided diverticulitis pathophysiology, advances in diagnosis, prevention strategies, and surgical approaches and decision-making. (Source: JAMA Surgery)
Source: JAMA Surgery - April 17, 2024 Category: Sports Medicine Source Type: research
Placebo Control and Blinding in Randomized Trials of Procedural Interventions
This systematic review and meta-regression evaluates the impact of placebo control on various clinical outcomes. (Source: JAMA Surgery)
Source: JAMA Surgery - April 17, 2024 Category: Sports Medicine Source Type: research
Oral Antibiotics vs IV and Oral Antibiotics for Uncomplicated Appendicitis
This secondary analysis of a randomized clinical trial assesses the 3-year clinical outcomes of oral moxifloxacin vs combined intravenous ertapenem plus oral levofloxacin and metronidazole in patients with uncomplicated acute appendicitis. (Source: JAMA Surgery)
Source: JAMA Surgery - April 17, 2024 Category: Sports Medicine Source Type: research
Emergency Department Trauma Activation Fees by Payer Type
This cross-sectional study examines the wide variations in prices of emergency medical services at US hospitals. (Source: JAMA Surgery)
Source: JAMA Surgery - April 17, 2024 Category: Sports Medicine Source Type: research
Blinding, Placebo Effect, and GRADE Methodology
Placebo-controlled trials are commonly performed in medication studies. Due to ethical and practical concerns, this type of double blinding with the use of a “sham” procedure is not often seen or ethical in surgical research. Non–placebo-controlled trials may run the risk of overestimating efficacy of procedural interventions by the nature of their design. In this issue of JAMA Surgery, Rajkumar and colleagues recognized this problem and performed a systematic review and meta-regression to compare all available placebo-controlled trials on procedural interventions with their unblinded (non–placebo-controlled) count...
Source: JAMA Surgery - April 17, 2024 Category: Sports Medicine Source Type: research
Acute Appendicitis —What’s Old Is New Again
The Appendicitis Acuta II (APPAC II) trial was a rigorous noninferiority randomized clinical trial that compared the effectiveness of oral antibiotics alone vs a combination of intravenous and oral antibiotics for the initial management of uncomplicated acute appendicitis. Planned 3-year follow-up data were presented in the secondary analysis by Sel änne et al in this issue of JAMA Surgery. Although we cannot ascertain a pharmacological or pathophysiological reason that the route of initial treatment would affect risk of recurrence 2 to 3 years after resolution of the index episode, these longer-term data do contribute to...
Source: JAMA Surgery - April 17, 2024 Category: Sports Medicine Source Type: research
Operating Room Organization and Methodology of Surgical Activity Regulation
This article discusses the implementation of surgical activity regulation methodology in the operating room to reduce organizational dysfunction, improve quality of work life of the surgical staff, and decrease staff overtime. (Source: JAMA Surgery)
Source: JAMA Surgery - April 10, 2024 Category: Sports Medicine Source Type: research
