The British journal of surgery
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Randomized Controlled Trial Multicenter Study
Randomized clinical trial of prevention of seroma formation after mastectomy by local methylprednisolone injection.
Seroma formation, the most prevalent postoperative complication after mastectomy, is an inflammatory process that is potentially preventable via local steroid administration. This study investigated the effect of local steroid administration on seroma formation. ⋯ Methylprednisolone administered into the wound cavity on the first day after M + SLNB exerted a highly significant preventive effect against seroma formation during the next 30 days. This effect was not seen in the M + ALND group. Future studies may clarify whether higher or repeated methylprednisolone doses increase the efficacy.
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Randomized Controlled Trial Multicenter Study
Effect of a ward-based pharmacy team on preventable adverse drug events in surgical patients (SUREPILL study).
Surgical patients are at risk of adverse drug events (ADEs) causing morbidity and mortality. Much harm is preventable. Ward-based pharmacy interventions to reduce medication-related harm have not been evaluated in surgical patients. ⋯ The present prospective controlled trial showed no significant reduction in medication-related harm or changes in clinical outcomes when surgical patients received protocolled ward-based pharmacy interventions.
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Randomized Controlled Trial Multicenter Study
Five-year results of a randomized clinical trial of conventional surgery, endovenous laser ablation and ultrasound-guided foam sclerotherapy in patients with great saphenous varicose veins.
A variety of techniques exist for the treatment of patients with great saphenous vein (GSV) varicosities. Few data exist on the long-term outcomes of these interventions. ⋯ NCT00529672 (http://www.clinicaltrials.gov).
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Multicenter Study
Influence of day of surgery on mortality following elective colorectal resections.
The aim of this study was to investigate whether the increased mortality previously identified for surgery performed on Fridays was apparent following major elective colorectal resections and how this might be affected by case mix. ⋯ Patients selected for colorectal resections on Fridays had a higher mortality rate than patients operated on from Monday to Thursday and had different characteristics, suggesting that increased mortality may reflect patient factors rather than hospital variables alone.
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Multicenter Study
Patterns of early resuscitation associated with mortality after penetrating injuries.
Penetrating injuries are rare in European populations so their management represents a particular challenge. The aim was to assess early therapeutic aspects that are associated with favourable outcomes in patients with penetrating trauma. ⋯ Among penetrating traumas, gunshot injuries pose an independent risk of death. Treatment of penetrating trauma in a level I trauma centre was significantly and independently associated with lower hospital mortality.