Articles: postoperative-complications.
-
Review Meta Analysis
Can prophylactic negative pressure wound therapy improve clinical outcomes in spinal fusion surgery? A meta-analysis.
Recently negative pressure wound therapy (NPWT) is increasingly being prophylactically used to prevent wound complications in various types of surgeries, but its role in spinal fusion surgery was less well established. This study aimed to evaluate the efficacy of prophylactic NPWT (PNPWT) usage in spinal fusion surgery. ⋯ The current evidence suggested PNPWT could effectively reduce postoperative surgical site infection, but it had no significant benefit on reducing the incidence of wound dehiscence, overall wound complication, readmission and reoperation.
-
Reg Anesth Pain Med · May 2022
ReviewPruritus, neuraxial morphine and recrudescence of oral herpes simplex and treatment: an educational review in obstetric patients.
Neuraxial opioids are well known to cause itching, which may be challenging to treat. Neuraxial morphine has been demonstrated to cause recrudescent herpes simplex viruses (HSV-1), especially in women during labor and childbirth with neuraxial analgesia, and may be an occult etiology of refractory itching. This educational review summaries the clinical and epidemiological characteristics associated with recrudescent HSV-1 in patients treated with neuraxial opioids, especially morphine.
-
Diabetes mellitus (DM) is frequently encountered in the perioperative period. DM may increase the risk of adverse perioperative outcomes owing to the potential vascular complications of DM. We conducted a scoping review to examine the association between DM and adverse perioperative outcomes. ⋯ Diabetes mellitus is inconsistently defined in the published literature, which limits the potential for pooled analysis. Further research is necessary to determine which cohort of patients with DM are most at risk of adverse postoperative outcomes, and how control influences this association.
-
There has been an observed increase in theprevalence of obesity over the past few decades. The prevalence of anesthesiology related complications is also observed more frequently in obese patients as compared to patients that are not obese. ⋯ Therefore, it is important that anesthesiologists be aware of this development and is equipped to manage these patients effectively and appropriately. As a result, this review highlights the effective management of obese patients undergoing surgery focusing on the preoperative, perioperative and postoperative care of these patients.
-
Eur J Trauma Emerg Surg · Apr 2022
ReviewMitigating the stress response to improve outcomes for older patients undergoing emergency surgery with the addition of beta-adrenergic blockade.
As population age, healthcare systems and providers are likely to experience a substantial increase in the proportion of elderly patients requiring emergency surgery. Emergency surgery, compared with planned surgery, is strongly associated with increased risks of adverse postoperative outcomes due to the short time available for diagnosis, optimization, and intervention in patients presenting with physiological derangement. ⋯ We consider the impact of the adrenergic response and use of beta blockers for these high-risk patients and discuss common risk factors such as frailty and delirium. A proactive multidisciplinary approach to peri-operative care aimed at mitigation of the stress response and proactive management of common conditions in the older emergency surgical patient could yield more favorable outcomes.