International journal of surgery
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Randomized Controlled Trial
Safety and efficacy of intra-articular tranexamic acid injection without drainage on blood loss in total knee arthroplasty: A randomized clinical trial.
Major blood loss is unavoidable after primary total knee arthroplasty (TKA). The aim of this study was to determine if tranexamic acid (TXA) can reduce major blood loss following TKA. ⋯ TXA treatment without drainage during TKA reduces the amount of blood transfusions required without increasing the rate of adverse events.
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Randomized Controlled Trial
The late effect of intraoperative wound infiltration with local anaesthetic in surgical patients; is there any? A randomized control trial.
Intraoperative wound infiltration with local anaesthetic is commonly used. Apart from the obvious immediate action it has been supported that a possible down regulation of pain receptors may lead to longer effects. Our aim was to compare the use of local anaesthetic versus placebo in order to assess if indeed there is a late beneficial effect. ⋯ Intraoperative local infiltration of the wound with local anaesthetic offers no further benefit for the general surgery apart from that of the immediate PO period. There is no late effect for pain control. Considering that during the immediate postoperative period stronger systematic painkillers are given the intraoperative, infiltration of the wound with the local anaesthetic under study offers no obvious benefit.
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Correct placement of the sustentacular screw is an important component during the open reduction and internal fixation of calcaneal fractures. The hypothesis of this study is that certain 3D-CT images would help detect the real placement of the sustentaculum screw. The aims of the study are to investigate the postoperative status of the sustentacular screw and to evaluate the effect of the sustentaculum screw placement on the treatment of intra-articular calcaneal fractures. ⋯ The sustentaculum screw with non-fixation may cause the decrease of Böhler's angle throughout the follow-up. The clinical outcomes were similar whether the screw was accurately placed within the sustentaculum or not.
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This study was conducted primarily to determine the prevalence and incidence of intra-abdominal hypertension (IAH) in a mixed ICU (medical & surgical) population and, secondarily, to compare outcomes between patients with and without IAH. ⋯ IAH is a poorly recognized clinical entity with potentially devastating impact on patient outcomes. Since majority of patients had IAH at the time of admission, all ICU patients especially on ventilator should have baseline intra-abdominal pressures measured at the time of admission and subjected to appropriate management to prevent them from developing abdominal compartment syndrome.
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There are significant resource challenges to burn surgical care delivery in low and middle-income countries at baseline and only a few burn cost analysis studies from sub-Saharan Africa have been performed. ⋯ Our study has demonstrated that comprehensive burn care is possible at a cost much lower than found in other burn centers in low or middle-income countries and can be sustained with moderate funding.