Langenbeck's archives of surgery
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Langenbecks Arch Surg · Nov 2007
Randomized Controlled Trial Multicenter StudyHow to improve satisfaction with hospital stay of severely injured patients.
In the context of medical quality assurance, patient satisfaction with medical and organisational aspects of health care service is considered to be a relevant outcome of patient surveys after a stay in hospital. Within quality research, it is assumed that assessments of patient satisfaction represent a direct measure of the quality of health care received. Furthermore, there is evidence that satisfied patients demonstrate higher levels of compliance for the course of their treatment and that the probability of successful treatment completion thus considerably increases. The present analysis aims to identify determinants of satisfaction of seriously injured patients with regard to their acute hospitalisation. ⋯ In the present study, the perceived quality of psychosocial care proved to have a significant effect on patients' satisfaction with their hospital stay. Results of the current analysis thus indicate that psychosocial aspects of physician-patient interaction are of considerable importance in the medical care of seriously injured patients. Although this study is mainly based on subjective patient reported outcome, there is evidence that the subjective view of a patient is relevant in many aspects of medical treatment and outcome. These results already gave the motivation to develop a prospective interventional study with a training programme of communication skills to improve subjective and objective outcome parameters of severely injured patients.
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Langenbecks Arch Surg · Aug 2006
Randomized Controlled Trial Multicenter StudyEvaluation of the McPeek postoperative outcome score in three trials.
Postoperative outcome of patients is determined by recovery characteristics and self-reported quality of life. The first can be assessed with the McPeek score which values three aspects of recovery: mortality, postoperative critical care and duration of hospitalization. ⋯ The McPeek score values the postoperative outcome on a nonlinear scale. A priori, the average duration of hospitalization and critical care for a specific operation has to be defined. Our validation suggests that it is a reliable, valid, sensitive, and practical instrument for outcome analysis after anesthesia and surgery.
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Langenbecks Arch Surg · Jun 2006
Randomized Controlled Trial Comparative StudyPre-emptive antibiotic treatment vs 'standard' treatment in patients with elevated serum procalcitonin levels after elective colorectal surgery: a prospective randomised pilot study.
Procalcitonin (PCT) is regarded as a specific indicator of bacterial infection. Infectious complications in patients after colorectal surgery are a common cause of morbidity and mortality. The aim of this study was to investigate (a) whether PCT could serve as a negative predictive marker for postoperative complications and (b) whether, in patients with elevated PCT levels, a pre-emptive treatment with the third-generation cephalosporin ceftriaxone is superior to an antibiotic treatment starting later on the appearance of clinical signs and symptoms of infection. ⋯ PCT is an early marker for systemic infectious complications after colorectal surgery with a high negative predictive value. A significant reduction in the rate of postoperative infections in patients with elevated PCT serum concentrations was achieved by means of pre-emptive antibiotic treatment.
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Langenbecks Arch Surg · Apr 2005
Randomized Controlled Trial Multicenter Study Comparative StudyEffectiveness of a new carrier-bound fibrin sealant versus argon beamer as haemostatic agent during liver resection: a randomised prospective trial.
A new carrier-bound fibrin sealant, TachoSil, is expected to be efficacious and safe as a haemostatic treatment in hepatic resection. ⋯ TachoSil is superior to argon beamer in obtaining effective and fast intraoperative haemostasis. The safety data show TachoSil to be tolerable and safe for haemostatic treatment in liver resection.
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Langenbecks Arch Surg · Oct 2004
Randomized Controlled Trial Comparative Study Clinical TrialChronic pain after hernia repair: a randomized trial comparing Shouldice, Lichtenstein and TAPP.
Chronic pain after hernia repair is common, and it is unclear to what extent the different operation techniques influence its incidence. The aim of the present study was to compare the three major standardized techniques of hernia repair with regard to postoperative pain. ⋯ Chronic pain after hernia surgery is significantly more common with the open approach to the groin by Shouldice and Lichtenstein methods. The presence of the prosthetic mesh was not associated with significant postoperative complaints. The TAPP repair represents the most effective approach of the three techniques in the hands of an experienced surgeon.