World journal of surgery
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World journal of surgery · Aug 2012
Trauma quality improvement in low and middle income countries of the Asia-Pacific region: a mixed methods study.
Quality Improvement (QI) programs have been shown to be a valuable tool to strengthen care of severely injured patients, but little is known about them in low and middle income countries (LMIC). We sought to explore opportunities to improve trauma QI activities in LMIC, focusing on the Asia-Pacific region. ⋯ Our study provides the first description of trauma QI practices, gaps in existing practices, and barriers to QI in LMIC of the Asia-Pacific region. In this study we identified opportunities for addressing these challenges, and that work will be supported by APTQIN.
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World journal of surgery · Aug 2012
Effects of preoperative oral carbohydrate supplementation on postoperative metabolic stress response of patients undergoing elective abdominal surgery.
The goal of the present study was to evaluate the effects of preoperative oral carbohydrate supplementation (OCH) on the postoperative metabolic stress response of patients undergoing elective abdominal surgery. ⋯ Treatment with OCH was associated with attenuation of the postoperative metabolic stress response. We hypothesize that modulation of the inflammatory response is one of the mechanisms involved.
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World journal of surgery · Aug 2012
Multicenter StudyStapler and nonstapler closure of the pancreatic remnant after distal pancreatectomy: multicenter retrospective analysis of 388 patients.
The pancreatic fistula rate following distal pancreatectomy ranges widely, from 13.3 to 64.0 %. The optimal closure method of the pancreatic remnant remains controversial, especially regarding whether to use a stapler. ⋯ Stapler closure is a safe, efficient alternative to standard suture closure techniques because the clinical fistula rate is significantly lower.
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World journal of surgery · Aug 2012
A tool and index to assess surgical capacity in low income countries: an initial implementation in Sierra Leone.
A first step toward improving surgical care in many low and middle income countries is to document the need. To facilitate the collection and analysis of surgical capacity data and measure changes over time, Surgeons OverSeas (SOS) developed a tool and index based on personnel, infrastructure, procedures, equipment, and supplies (PIPES). ⋯ The PIPES tool was easily administered at hospitals in Sierra Leone and an index was found useful. Surgical capacity in Sierra Leone improved between 2008 and 2011, as demonstrated by an increase in the overall PIPES indices.
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World journal of surgery · Aug 2012
Biochemical profile and outcomes in trauma patients subjected to open cardiopulmonary resuscitation: a prospective observational pilot study.
The predictive factors to regain a heartbeat following emergency department resuscitative thoracotomy (EDT) for trauma are poorly understood. The objective of the present study was to prospectively assess the electrolyte profile, coagulation parameters, and acid-base status from intracardiac blood samples in trauma patients subjected to open cardiopulmonary resuscitation (CPR) in the presence of established cardiac arrest. ⋯ Most patients undergoing open CPR have normal blood gas levels. Severe lactic acidosis, hyperkalemia, and hypernatremia are associated with decreased probability for return of cardiac function. Calcium and magnesium levels were not significantly different between the two groups, making the therapeutic role of these electrolytes very questionable.