Canadian journal of surgery. Journal canadien de chirurgie
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Medical error is common during trauma resuscitations. Most errors are nontechnical, stemming from ineffective team leadership, nonstandardized communication among team members, lack of global situational awareness, poor use of resources and inappropriate triage and prioritization. We developed an interprofessional, simulation-based trauma team training curriculum for Canadian surgical trainees. Here we discuss its piloting and evaluation.
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More than 320 000 hip fractures occur annually in North America. An estimated 30% of this population have cognitive impairment. We sought to determine the extent to which patients with cognitive impairment or dementia have been included in randomized controlled trials (RCTs) assessing hip fracture management. ⋯ One in 3 patients with hip fractures have concomitant cognitive impairment, yet 8 of 10 hip fracture trials excluded or ignored this population. The ambiguity or exclusion of these patients misses an opportunity to study outcomes and identify factors associated with improved prognosis.
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Review Meta Analysis Comparative Study
Low-intensity pulsed ultrasonography versus electrical stimulation for fracture healing: a systematic review and network meta-analysis.
To best inform evidence-based patient care, it is often desirable to compare competing therapies. We performed a network meta-analysis to indirectly compare low intensity pulsed ultrasonography (LIPUS) with electrical stimulation (ESTIM) for fracture healing. ⋯ To support our findings direct comparative trials with safeguards against bias assessing outcomes important to patients, such as functional recovery, are required.
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Damage control resuscitation (DCR) represents the natural evolution of the initial concept of damage control surgery. It currently includes early blood product transfusion, immediate arrest and/or temporization of ongoing hemorrhage (i.e., temporary intravascular shunts and/or balloon tamponade) as well as restoration of blood volume and physiologic/hematologic stability. ⋯ This concept also applies to severe injuries within anatomical transition zones as well as extremities. This review will discuss each of these concepts in detail.
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Review Meta Analysis
High-concentration oxygen and surgical site infections in abdominal surgery: a meta-analysis.
There has been recent interest in using high-concentration oxygen to prevent surgical site infections (SSIs). Previous meta-analyses in this area have produced conflicting results. With the publication of 2 new randomized controlled trials (RCTs) that were not included in previous meta-analyses, an updated review is warranted. Our objective was to perform a meta-analysis on RCTs comparing high- and low- concentration oxygen in adults undergoing open abdominal surgery. ⋯ There is moderate evidence that high-concentration oxygen does not reduce SSIs in adults undergoing open abdominal surgery.