Annals of surgery
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We hypothesized that disconcerting lymphedema rates in both sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND) may be because of unrecognized vunerable variations in arm lymphatic drainage within the axilla. Axillary reverse mapping (ARM) facilitates identification and avoidance of arm lymphatics within the axilla and its use may reduce lymphedema. ⋯ ARM allows frequent identification of arm lymphatics in the axilla, which would have been transected during routine surgery. Rates of metastases in noncrossover nodes and axillary recurrences are low. Lymphedema rates are dramatically reduced using ARM when compared with accepted standards.
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Randomized Controlled Trial
Postoperative Showering for Clean and Clean-contaminated Wounds: A Prospective, Randomized, Controlled Trial.
To evaluate wound infection rates, pain scores, satisfaction with wound care, and wound care costs starting 48 hours after surgery. ⋯ Clean and clean-contaminated wounds can be safely showered 48 hours after surgery. Postoperative showering does not increase the risk of surgical site complications. It may increase patients' satisfaction and lower the cost of wound care.
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Comparative Study
The Incremental Risk of Coronary Stents on Postoperative Adverse Events: A Matched Cohort Study.
To determine the incremental risk of coronary stents on adverse events in surgical patients and whether it varies over time from stent placement. ⋯ Surgery after coronary stent placement is associated with an approximate 2% absolute risk for postoperative MI but no difference in mortality compared with nonstented matched controls.
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To describe the components of targeted nanotherapeutics and to review their applications in the treatment of surgical diseases. ⋯ Targeted nanotherapeutics represent a novel therapeutic platform and have great potential to impact the treatment of surgical diseases.
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Incisional hernia (IH) remains a common, highly morbid, and costly complication. Modest progress has been realized in surgical technique and mesh technology; however, few advances have been achieved toward understanding risk and prevention. In light of the increasing emphasis on prevention in today's health care environment and the billions in costs for surgically treated IH, greater focus on predictive risk models is needed. ⋯ This study demonstrates an internally validated preoperative risk model of surgically treated IH after 12,000 elective, intra-abdominal procedures to provide more individualized risk counseling and to better inform evidence-based algorithms for the role of prophylactic mesh.