Articles: cations.
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Neurosurgical complications are unfortunately unavoidable events in our field. Notwithstanding the potentially devastating effect they can have on patients' lives, young neurosurgeons may equally feel devastated by their occurrence and find themselves poorly equipped emotionally to handle them. ⋯ This special article, written in essay format, is simply a brief overview of the seasoned author's personal approach to complication avoidance and management, with an emphasis on the behavioral aspects and humane dimensions of our profession. The younger trainee may find value in the ideas and emotions expressed here, and the seasoned neurosurgeon may well identify with the author's thoughts.
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Current clinical dogma favors universal inpatient admission after colorectal resection particularly in the presence of an anastomosis. ⋯ With careful patient selection, preoperative education, perioperative management, and postoperative follow-up, ambulatory surgery is feasible in up to a third of patients undergoing colorectal resection/anastomosis and can be performed with comparable safety to the time-honored practice of routine inpatient hospitalization. Refinements in inclusion/exclusion criteria and postoperative outpatient follow-up will allow a paradigm shift in how such patients are managed, which has huge implications for patient experience, care-giver workload and health care finances.
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Case Reports
Dehiscence and Deep Wound Infection After Spinal Cord Stimulator Implant Managed Without Explantation: A Case Report.
Deep infections of spinal cord stimulator devices usually result in explantation, as recommended by some professional societies. However, alternative options should be explored to avoid potential complications that are associated with explantation, and possibly additional procedures required in consideration of reimplantation. ⋯ There was suspicion for deep wound infection based on a wound culture that was positive for Staphylococcus aureus, but no purulent material was noted on further inspection. The patient was treated with standard wound-care management and oral antibiotics without removing the device, and recovered while preserving the original system.