American journal of surgery
-
Effective therapeutic agents for the prevention and treatment of acute kidney injury (AKI) after cardiac surgery remain elusive despite the tremendous advances in surgical techniques, technology, and understanding of disease processes. Recent developments and their effect on the incidence of AKI after cardiac surgery are discussed. ⋯ The definition of AKI has changed, and the focus of interventions has shifted from treatment to prevention to recovery from AKI. Antioxidants and biological agents have been added to classic armaments of hydration and diuretics in addition to tighter metabolic control to prevent AKI. Although the treatment options remain unsatisfactory, a lot of progress nevertheless continues to be made in the prevention and treatment of AKI.
-
The purpose of this study was to evaluate the impact of the transition to acute care surgery (ACS) on trauma volumes and outcomes. ⋯ Despite a 60% increase in total patient volume and a 233% increase in operative volume over the study period, the addition of emergency surgery to a trauma service did not compromise trauma patient outcomes.
-
A systematic analysis was conducted of randomized controlled trials (RCTs) comparing lightweight mesh (LWM) with heavyweight mesh in laparoscopic inguinal hernia repair. ⋯ The use of LWM for laparoscopic inguinal hernia repair is not associated with an increased risk for hernia recurrence. LWM reduces the incidence of chronic groin pain, groin stiffness, and foreign body sensations. Therefore, LWM may routinely be used in laparoscopic inguinal hernia repair. However, high-quality RCTs with longer follow-up periods are required to validate these findings.
-
Surgeons must demonstrate leadership to optimize performance and maximize patient safety in the operating room, but no behavior rating tool is available to measure leadership. ⋯ The SLI is empirically grounded in focus group data and both the leadership and surgical literature. The interrater reliability of the system was acceptable. The inventory could be used for rating surgeons' leadership in the operating room for research or as a basis for postoperative feedback on performance.
-
Comparative Study
Prevention of surgical site infections in high-risk patients with laparotomy incisions using negative-pressure therapy.
This study evaluates the efficacy of negative-pressure therapy (NPT) in preventing surgical site infections (SSIs) in high-risk surgical oncology patients. ⋯ Our findings suggest that NPT decreases SSIs in high-risk surgical oncology patients.