World journal of surgery
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World journal of surgery · Jan 2015
Global public health impact of recovered supplies from operating rooms: a critical analysis with national implications.
In modern operating rooms, clean and unused medical supplies are routinely discarded and can be effectively recovered and redistributed abroad to alleviate the environmental burden of donor hospitals and to generate substantial health benefits at resource-poor recipient institutions. ⋯ Hospital operating rooms continue to represent a large source of recoverable surgical supplies that have demonstrable health benefits in the recipient communities. Cost-effective recovery and need-based donation programs can significantly alleviate the global burden of surgical diseases.
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World journal of surgery · Jan 2015
Observational StudyLong-term evolution of acute colonic diverticulitis after successful medical treatment.
The evidence is sparse concerning the natural history of acute diverticulitis after successful conservative management. This observational study aimed to evaluate the rate, severity, and need of surgery for recurrence after a first episode of acute diverticulitis successfully managed conservatively. ⋯ The rate of severe recurrence after successful nonoperative management of acute diverticulitis was low, and emergency surgery was rare. Prophylactic surgery, even in cases of recovered severe diverticulitis, should be considered on a case-by-case basis. Strict follow-up assessment during the first year is advised.
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World journal of surgery · Jan 2015
Effect of antiplatelet therapy on patients undergoing gastroenterological surgery: thromboembolic risks versus bleeding risks during its perioperative withdrawal.
Antiplatelet agents given to prevent thromboembolic disease are frequently withdrawn prior to surgical procedures to reduce bleeding complications. This action may expose patients to increased thromboembolic morbidity and mortality. ⋯ Satisfactory outcomes were obtained during gastroenterologic surgery under rigorous perioperative management, including single-agent APT continuation in patients at high thromboembolic risk. Patients treated with multidrug APT still represent a challenging group, however, and need to be carefully managed to prevent perioperative complications.
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World journal of surgery · Jan 2015
Injury, disability and access to care in Rwanda: results of a nationwide cross-sectional population study.
Disparities in access to quality injury care are a growing concern worldwide, with over 90 % of global injury-related morbidity and mortality occurring in low-income countries. We describe the use of a survey tool that evaluates the prevalence of surgical conditions at the population level, with a focus on the burden of traumatic injuries, subsequent disabilities, and barriers to injury care in Rwanda. ⋯ Determining accurate injury and disability burden is crucial to health system planning in low-income countries. SOSAS is a useful survey for determining injury epidemiology at the community level, which can in turn help to plan prevention efforts and optimize provision of care.
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World journal of surgery · Jan 2015
Long-term follow-up after non-operative management of biloma due to blunt liver injury.
Some case series have reported that hepatectomy was used to treat major bile leakage and biloma. However, it is unknown whether non-operative management (NOM) can be used to treat these complications. Our hospital uses NOM primarily for blunt liver injuries. This study describes the incidence and treatment of newly developed biloma in hemodynamically stable patients with blunt liver trauma and investigates NOM as a treatment option. ⋯ Our data suggest that biloma after NOM of blunt liver injury is common (36 %), but infected biloma is rare. All patients with bilomas were treated using NOM. Most bilomas are self-limited, and NOM is feasible.