World journal of surgery
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World journal of surgery · Aug 2009
Randomized Controlled Trial Comparative StudyDiathermy vs. scalpel skin incisions in general surgery: double-blind, randomized, clinical trial.
This prospective, double-blind, randomized, controlled trial was designed to compare the outcome of diathermy incisions versus scalpel incisions in general surgery. ⋯ Diathermy incision has significant advantages compared with the scalpel because of reduced incision time, less blood loss, & reduced early postoperative pain.
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There is currently no validated measurement system available for quality of care assessment in surgery despite all of the inherent benefits of such an approach. A structured quality framework needs to be developed and incorporate measures that are truly reflective of several important dimensions of care within the entire treatment episode. Presently this has been only partially addressed. ⋯ Combining these measures to create an overall composite quality score can be made feasible only if it is supported by the use of robust statistical methodology. It is important to use appropriate display of performance data to facilitate provider engagement in quality improvement initiatives. This article was designed to present such a structured approach of a quality framework, which is required to appraise the quality of care in surgery to enhance future quality improvement programmes.
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World journal of surgery · Aug 2009
Multicenter StudyMultimodal perioperative rehabilitation for colonic surgery in the elderly.
Traditional perioperative care for colonic surgery in elderly patients is associated with increased morbidity and mortality compared to that of younger patients. Although multimodal perioperative rehabilitation has evolved as a valid concept to improve postoperative outcome, its use has not yet been established for colonic surgery in the elderly. ⋯ Although the overall morbidity did increase with age, it was still less when compared to that of historical groups with traditional care. Therefore, multimodal perioperative rehabilitation should be recommended for the elderly.
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World journal of surgery · Aug 2009
Prophylactic thoracic duct mass ligation prevents chylothorax after transthoracic esophagectomy for cancer.
Chylothorax after transthoracic esophagectomy for cancer is an uncommon but potentially life-threatening postoperative complication. It has been reported that preventive thoracic duct ligation can reduce the incidence of postoperative chylothorax after esophagectomy for cancer. In this prospective series, we evaluated the results of preventive intraoperative thoracic duct mass ligation in patients who underwent transthoracic esophagectomy for cancer. ⋯ In this series, the technique of intraoperative thoracic duct mass ligation proved to be safe and effectively prevented postoperative chylothorax in patients who underwent transthoracic esophagectomy for cancer.
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World journal of surgery · Aug 2009
Use of leukoreduced blood does not reduce infection, organ failure, or mortality following trauma.
Leukoreduced (LR) blood has been demonstrated to reduce morbidity and mortality in high-risk surgical patients, but not in trauma patients. The objective of the present study was to determine the effect of LR blood on morbidity and mortality. We hypothesized that the use of LR blood does not improve outcome in trauma patients. ⋯ This study represents the largest series comparing trauma patients who received either LR or standard blood transfusions. The use of LR blood does not improve outcome in trauma patients.