Il Giornale di chirurgia
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Il Giornale di chirurgia · Apr 2009
Case ReportsChronic transverse sternal fracture. Role of CT scan and repair by an alternative use of the Synthes-Titanium Sternal Fixation System.
Chest wall fractures, including injuries of the sternum, usually heal spontaneously without specific treatment. However sometimes, they need surgical treatment. ⋯ We describe the case of a 67-year-old man with previous history of chest trauma presenting to our institution with chronic transverse sternal fracture. We describe the pre-operative study, stressing the particular role of the CT scan and a surgical approach by an alternative use of the Synthes.
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Il Giornale di chirurgia · Mar 2009
Misunderstood cardiac involvement with heart impairment in traumatic sternal fracture: an enzyme-guided evaluation.
Isolated sternal fractures occur more and more frequently in traffic road accidents in particular after the introduction of the seat-belt law. This study sets out to assess by laboratory parameters the incidence and consequences of pericardial and myocardial involvement in sternal injury. ⋯ Our results suggest that in traumatic sternal fractures enzymatic activity of CK-MB, echocardiographic investigation and careful monitoring for the first 96 hours are necessary. The cardiac compliance is inadequate in polytrauma patients and can lead to cardiac impairment.
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Il Giornale di chirurgia · Mar 2009
Comparative Study[Advantages and limits of tumescent anesthesia in outpatient surgery].
The Authors report the results of the tumescent anesthesia in 187 patients submitted to various outpatient surgical procedures comparing with those in patients submitted to local anesthesia by direct infiltration.
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Il Giornale di chirurgia · Jan 2009
Case ReportsAcute onset of esophageal duplication cyst in adult. Case report.
Esophageal duplication (ED) cyst is unusual congenital disorder of the foregut, accounting for 10% to 15% of duplications of all foregut cysts. We report a case of esophageal duplication with acute clinical presentation, treated successfully with surgical resection. ⋯ The diagnosis and treatment of esophageal cysts is still evolving. The pathological diagnosis of oesophageal duplication requires the presence of the Ladd and Gross criteria. The infrequent acute onset doesn't modify the management and the surgical resection is the procedure of choice. The future of the treatment of esophageal cysts lies in the advancement of minimally invasive operative techniques.
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Il Giornale di chirurgia · Jan 2009
[Clinical governance and continuous quality improvement in surgical organizations].
Recently the awareness had progressively strengthened that the main interest of health care organizations is effectiveness and appropriateness of clinical performance. They have a statutory duty to seek quality improvement through clinical governance. All health care operators are involved in clinical governance implementation, in respect of their organizational positions toward continuous quality improvement. In this way health care organizations, professionals and patients will benefit of outcomes of the change.