Annals of surgery
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Randomized Controlled Trial Comparative Study
Total extraperitoneal inguinal hernia repair compared with Lichtenstein (the LEVEL-Trial): a randomized controlled trial.
This randomized controlled trial was designed to compare the most common technique for open mesh repair (Lichtenstein) with the currently preferred minimally invasive technique (total extra peritoneal, TEP) for the surgical correction of inguinal hernia. ⋯ TEP procedure was associated with more adverse events during surgery but less postoperative pain, faster recovery of daily activities, quicker return to work, and less impairment of sensibility after 1 year. Recurrence rates and chronic pain were comparable. TEP is recommended in experienced hands.
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To develop a method of evaluating trauma center mortality that addresses the limitations of currently available methodology-Standardized Mortality Ratios (SMRs) based on the Trauma and Injury Severity Score. ⋯ The proposed method of trauma center profiling offers comprehensive adjustment for patient-level risk factors and consideration of transfer status, is based on comparisons to an internal standard, accounts for inter- and intrahospital variation, and replaces SMRs with estimates of regression-adjusted mortality that are comparable across hospitals. TRAM-adjusted mortality estimates can be used to describe institutional outcome performance and to identify institutional outliers. Such information is the key to identifying ways to improve the quality of modern trauma care.
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Meta Analysis Comparative Study
Vypro II mesh for inguinal hernia repair: a meta analysis of randomized controlled trials.
The aim of this meta-analysis was to compare the effectiveness of Vypro II mesh and polypropylene mesh after inguinal hernia repair. ⋯ Current evidence suggests that there is no significant difference between Vypro II and polypropylene mesh in short-term effectiveness. However, use of Vypro II mesh was associated with reduced feeling of a foreign body. Further high-quality, long follow-up period RCTs should be carried out to provide more reliable evidence.
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Multicenter Study
Effect of a 19-item surgical safety checklist during urgent operations in a global patient population.
To assess whether implementation of a 19-item World Health Organization (WHO) Surgical Safety Checklist in urgent surgical cases would improve compliance with basic standards of care and reduce rates of deaths and complications. ⋯ Implementation of the checklist was associated with a greater than one-third reduction in complications among adult patients undergoing urgent noncardiac surgery in a diverse group of hospitals. Use of the WHO Surgical Safety Checklist in urgent operations is feasible and should be considered.
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Randomized Controlled Trial Comparative Study
Platelet-rich fibrin versus albumin in surgical wound repair: a randomized trial with paired design.
To study the effects of autologous platelet-rich fibrin (PRF) versus human albumin on incisional wound breaking strength and subcutaneous collagen deposition in patients undergoing laparoscopic cholecystectomy in a randomized trial. ⋯ PRF did not improve wound strength significantly compared with albumin but suppressed subcutaneous collagen synthesis and deposition during early repair of surgical wounds in humans. Furthermore, deposition of reparative collagen in the subcutaneous ePTFE tube model partly predicted the breaking strength of an incisional skin wound.