Journal of the American College of Surgeons
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Several popular media and Internet-based hospital quality rankings have become increasingly publicized as a method for patients to choose better hospitals. It is unclear whether selecting highly rated hospitals will improve outcomes after cardiovascular surgery procedures. ⋯ Popular hospital rating systems identify high-quality hospitals for cardiovascular operations. However, patients can experience equivalent outcomes by seeking care at high-volume hospitals.
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Management of severe traumatic lower extremity injuries remains a considerable challenge. Free tissue transfer is now a standard part of reconstruction for Gustilo IIIB and IIIC injuries. There is limited information on arterial injury patterns in this population. We undertook a review of our experience to gain insight on vascular injury patterns and surgical outcomes. ⋯ Angiography of severe lower extremity injuries requiring free flap reconstruction usually revealed arterial injury and is generally indicated. In our experience, the anterior tibial artery is most commonly injured and the posterior tibial artery is most likely to be spared and used as a recipient.