Articles

Prevention of lymphedema via axillary reverse mapping for arm lymph-node preservation following breast cancer surgery: a randomized controlled trial

Breast cancer, with an incidence of 32%, is the most frequent cancer among Egyptian women. The frequency of arm lymphedema after axillary surgery for breast cancer ranges from 7 to 77%. Axillary reverse mappin...

Authors: Mohammed Faisal, Mohamed Gamal Sayed, Kerolos Antonious, Ahmmed Abo Bakr and Sherif Hussein Farag

Prevalence and root causes of surgical site infection among women undergoing caesarean section in Ethiopia: a systematic review and meta-analysis

Surgical site infection is a common complication in women undergoing Caesarean section and the second most common cause of maternal mortality in obstetrics. In Ethiopia, prevalence and root causes of surgical ...

Authors: Fentahun Adane, Abay Mulu, Girma Seyoum, Alemu Gebrie and Akilog Lake

Patient safety awareness among 309 surgeons in Enugu, Nigeria: a cross-sectional survey

Adverse healthcare events are major public health problem with the heaviest burden in the low and middle-income countries. Patient safety awareness among healthcare professionals is known to impact this outcom...

Authors: Arinze Duke George Nwosu, Fidelis Anayo Onyekwulu and Elias Chikee Aniwada

Current concepts of perioperative monitoring in high-risk surgical patients: a review

A substantial number of patients are at high-risk of intra- or post-operative complications or both. Most perioperative deaths are represented by patients who present insufficient physiological reserve to meet...

Authors: Paolo Aseni, Stefano Orsenigo, Enrico Storti, Marco Pulici and Sergio Arlati

Safety and efficacy of surgical fixation of fibula fractures using an intramedullary nail: a retrospective observational cohort study in 30 patients

Open reduction and internal fixation remains the standard treatment for displaced unstable ankle fractures. Plate fixation represents the most frequently used instrumentation option in fibula fractures and fav...

Authors: Guilherme Boni, Gustavo T. Sanchez, Gustavo Arliani, Boris A. Zelle, Robinson E. Pires and Fernando B. dos Reis

Clinical outcomes after carbon-plate osteosynthesis in patients with distal radius fractures

Surgical implant material has changed over time, from metal to stainless steel to titanium. In recent decades a new material, carbon-fibre-reinforced polyether ether ketone, has been introduced. The aim of thi...

Authors: Florin Allemann, Sascha Halvachizadeh, Thomas Rauer and Hans-Christoph Pape

Unintended retention of a ruptured radiopaque thread extending from the corner of a gauze during laparoscopy

Small gauze is used in laparoscopy; therefore, retention of gauze can occur. We experienced a case of retention of a radiopaque thread that ruptured from a piece of gauze and moved into the peritoneum during a...

Authors: Yoshiaki Oshima, Osamu Yamamoto, Akihiro Otsuki, Saori Tokunaga, Keiichiro Ueda and Yoshimi Inagaki

Refining the predictive variables in the “Surgical Risk Preoperative Assessment System” (SURPAS): a descriptive analysis

The Surgical Risk Preoperative Assessment System (SURPAS) is a parsimonious set of models providing accurate preoperative prediction of common adverse outcomes for individual patients. However, focus groups wi...

Authors: William G. Henderson, Michael R. Bronsert, Karl E. Hammermeister, Anne Lambert-Kerzner and Robert A. Meguid

Morbidity and mortality meetings to improve patient safety: a survey of 109 consultant surgeons in London, United Kingdom

Morbidity & Mortality (M&M) meetings are a critical component of clinical governance. They have the potential to improve patient outcomes, quality of care, attitudes towards patient safety and they contribute ...

Authors: Daniel M. Sinitsky, Siri B. Gowda, Khaled Dawas and Bimbi S. Fernando

The prevalence and root causes of surgical site infections in public versus private hospitals in Ethiopia: a retrospective observational cohort study

Healthcare-associated illnesses, of which surgical site infection is the most common are significant causes of morbidity and mortality. Therefore, this study aimed to determine the prevalence and root causes o...

Authors: Kidanie Fisha, Muluken Azage, Getasew Mulat and Koku Sisay Tamirat

Technical limitations of REBOA in a patient with exsanguinating pelvic crush trauma: a case report

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an effective adjunct in hemodynamic unstable patients with uncontrolled and non-compressible torso hemorrhage promoting temporary stability ...

Authors: Orkun Özkurtul, Holger Staab, Georg Osterhoff, Benjamin Ondruschka, Andreas Höch, Christoph Josten and Johannes Karl Maria Fakler

Lack of informed consent for surgical procedures by elderly patients with inability to consent: a retrospective chart review from an academic medical center in Norway

Respect for patient autonomy and the requirement of informed consent is an essential basic patient right. It is constituted through international conventions and implemented in health law in Norway and most ot...

Authors: Jorgen Dahlberg, Vegard Dahl, Reidun Forde and Reidar Pedersen

Variability in the timeliness of interventional radiology availability for angioembolization of hemodynamically unstable pelvic fractures: a prospective survey among U.S. level I trauma centers

Patients with hemodynamically unstable pelvic fractures have high mortality due to delayed hemorrhage control. We hypothesized that the availability of interventional radiology (IR) for angioembolization may v...

Authors: Stephanie Jarvis, Alessandro Orlando, Benoit Blondeau, Kaysie Banton, Cassandra Reynolds, Gina M. Berg, Nimesh Patel, Michael Kelly, Matthew Carrick and David Bar-Or

Reducing routine laboratory tests in patients with isolated extremity fractures: a prospective safety and feasibility study in 246 patients

Daily routine laboratory testing is unnecessary in most admitted patients. The opportunity to reduce daily laboratory testing in orthopaedic trauma patients has not been previously investigated.

Authors: Raj. M. Amin, Alexander E. Loeb, Erik A. Hasenboehler, Adam S. Levin, Greg M. Osgood, Robert S. Sterling, Philip F. Stahel and Babar Shafiq

Extravasation of fluid in arthroscopic shoulder surgery requiring prolonged intubation: a case report

Shoulder arthroscopy is a safe and effective procedure with a low complication rate. Although rare, there are potentially life-threatening risks such as fluid extravasation causing airway compromise.

Authors: Brandon R. Vier, Kyle W. Mombell, Erin L. Gagliano, Nicole M. King and Lucas S. McDonald

Impact of the surgical modality for axillary lymph node dissection on postoperative drainage and seroma formation after total mastectomy

The most common complications after total mastectomy with axillary lymph node treatment are prolonged drainage and seroma formation. The aim of this study was to find factors correlated with prolonged fluid di...

Authors: Hiroshi Isozaki, Yasuhisa Yamamoto, Shigeki Murakami, Sasau Matsumoto and Takehiro Takama

The Boston technique for acute point-of-care single-practitioner fracture stabilization of the lower extremity

Closed reduction with long leg casting is a widely practiced method of acute management of lower extremity fractures but may be cumbersome and time consuming. To our knowledge, only one method of single practi...

Authors: Robert L. Parisien and Kenneth J. McAlpine

Preoperative anxiety among adult patients undergoing elective surgery: a prospective survey at a general hospital in Ethiopia

Major life changes are among factors that cause anxiety, and one of these changes is surgery. Hospitalization, regardless of disease, is known to provoke anxiety in the patient admitted for surgery. Anxiety is...

Authors: Asres Bedaso and Mohammed Ayalew

Surgical management of intramuscular hemangioma of the foot: a case report

Hemangiomas are benign tumors usually found in the lower extremity yet their surgical management on the location in the foot is rarely documented.

Authors: K. Lahrach, S. Abdulrazak, A. Marzouki and F. Boutayeb

Outcomes after surgical treatment of acetabular fractures: a review

Acetabular fractures are fractures that extend into the hip joint and pose a challenge for orthopaedic trauma surgeons. The first known descriptions of surgical fixation of acetabular fractures were case repor...

Authors: Navid Ziran, Gillian L. S. Soles and Joel M. Matta

Breast cancer involvement of the nipple-areola complex and implications for nipple-sparing mastectomies: a retrospective observational study in 137 patients

Nipple-sparing mastectomy (NSM) has gained much attention by enhancing the aesthetic outcome in breast carcinoma patients. The aim of this study was to assess the prevalence of malignant affection of the nippl...

Authors: Mohammed Faisal, Hamada Fathy, Ahmed M. M. Gomaa, Haidi Abd-Elzaher, Mohamed A. H. Ahmed and Mohamed Gamal Sayed

Adherence to the WHO surgical safety checklist: an observational study in a Swiss academic center

The World Health Organization (WHO) Surgical Safety Checklist is used globally to ensure patient safety during surgery. Two years after its implementation in the University Hospital Basel’s operating rooms, ad...

Authors: René Schwendimann, Catherine Blatter, Marc Lüthy, Giulia Mohr, Thierry Girard, Siegfried Batzer, Erica Davis and Henry Hoffmann

Correlation of radiographic variables to guide safe implant positioning during acetabular surgery and hip replacement: a retrospective observational study

Knowledge of periacetabular anatomy is crucial for prosthetic cup placement in total hip arthroplasty and for screw placement in anterior fixation with acetabular fractures. It is known that degree of hip dysp...

Authors: Simon Tiziani, Georg Osterhoff, Jan-Farei Campagna and Clément M. L. Werner

Inter-observer reliability of alternative diagnostic methods for proximal humerus fractures: a comparison between attending surgeons and orthopedic residents in training

Proximal humerus fractures are frequent, and several studies show low diagnostic agreement among the observers, as well as an inaccurate classification of these lesions. The divergences are generally correlate...

Authors: Luiz Fernando Cocco, João Alberto Yazzigi Jr, Eduardo Felipe Kin Ito Kawakami, Helio Jorge Fernandes Alvachian, Fernando Baldy dos Reis and Marcus Vinicius Malheiro Luzo

Adherence to preoperative hand hygiene and sterile gowning technique among consultant surgeons, surgical residents, and nurses: a pilot study at an academic medical center in Indonesia

Healthcare-associated infections (HAI) is a major problem for patient safety and surgical site infection (SSI) is a type of HAI and the most common form of infection related to surgical health care. Transmissi...

Authors: Adeodatus Yuda Handaya and Victor Agastya Pramudya Werdana

Incidence, root causes, and outcomes of surgical site infections in a tertiary care hospital in Rwanda: a prospective observational cohort study

Surgical Site Infections (SSI) are the most reported health acquired infection and common surgical complication in both developed and developing countries. In developing countries such as Rwanda, there is a pa...

Authors: Marie Josée Mukagendaneza, Emmanuel Munyaneza, Esperance Muhawenayo, Dancilla Nyirasebura, Egide Abahuje, John Nyirigira, Jean De Dieu Harelimana, Thierry Zawadi Muvunyi, Florence Masaisa, Jean Claude Byiringiro, Théobald Hategekimana and Claude Mambo Muvunyi

Unusual anatomic variant of the axillary nerve challenging the deltopectoral approach to the shoulder: a case report

The deltopectoral approach is a well-described surgical approach to the proximal humerus and glenohumeral joint. One of the structures at risk during this approach is the axillary nerve. Typically, the axillar...

Authors: Richard A. Pizzo, Jeffrey Lynch, Donald M. Adams, Richard S. Yoon and Frank A. Liporace

Does the time of day in orthopedic trauma surgery affect mortality and complication rates?

Orthopedic trauma surgery has multiple, both patient-based and surgeon-based risk factors. Evaluating and modifying certain patient safety factors could mitigate some of these risks. This study investigates th...

Authors: Sascha Halvachizadeh, Henrik Teuber, Paolo Cinelli, Florin Allemann, Hans-Christoph Pape and Valentin Neuhaus

Risk factors for complications and adverse outcomes in polytrauma patients with associated upper extremity injuries

In terms of upper extremity fractures by patients with multiple injuires, a lot of studies have assessed the functional outcome following trauma to have less favorable outcomes in regards to functional recover...

Authors: Florin Allemann, Sandro Heining, Boris Zelle, Christian Probst and Hans-Christoph Pape

Artificial intelligence systems for complex decision-making in acute care medicine: a review

The integration of artificial intelligence (AI) into acute care brings a new source of intellectual thought to the bedside. This offers great potential for synergy between AI systems and the human intellect al...

Authors: Lawrence A. Lynn

Lessons learned for postoperative wound healing: respect the past and embrace the future

Authors: Boris A. Zelle and Philip F. Stahel

Cognition errors in the treatment course of patients with anastomotic failure after colorectal resection

Cognitive errors have a considerable effect on procedural outcome. They play a major role in situational judgement and decision making, especially during cognitively demanding tasks. As such they need to be co...

Authors: P. Vogel and D. H. V. Vogel

Variability in pelvic packing practices for hemodynamically unstable pelvic fractures at US level 1 trauma centers

Mortality from hemodynamically unstable pelvic fractures remains high. Guidelines offer varying care approaches including the use of pelvic packing (PP), which was recently adopted for potential control of ble...

Authors: Benoit Blondeau, Alessandro Orlando, Stephanie Jarvis, Kaysie Banton, Gina M. Berg, Nimesh Patel, Rick Meinig, Allen Tanner II, Matthew Carrick and David Bar-Or

The role of indocyanine green fluoroscopy for intraoperative bile duct visualization during laparoscopic cholecystectomy: an observational cohort study in 70 patients

Bile duct injury is the most feared complication during laparoscopic cholecystectomy. Real-time intraoperative imaging using indocyanine green (ICG) might reduce the risk of bile duct injury by improving visua...

Authors: Peter C. Ambe, Jens Plambeck, Victoria Fernandez-Jesberg and Konstantinos Zarras

Low-grade infections as a possible cause of arthrofibrosis after total knee arthroplasty

Arthrofibrosis after total knee arthroplasty represents a considerable burden for the patient and a therapeutic challenge for the practitioner. One possible cause discussed in the literature is a low-grade inf...

Authors: C. Brückner, E. Straube, I. Petersen, S. Sachse, P. Keller, F. Layher, G. Matziolis, U. Spiegl, D. Zajonz, M. Edel and A. Roth

Does time of surgery influence the rate of false-negative appendectomies? A retrospective observational study of 274 patients

Multiple disciplines have described an “after-hours effect” relating to worsened mortality and morbidity outside regular working hours. This retrospective observational study aimed to evaluate whether diagnost...

Authors: Kirit Singh, Michael S. J. Wilson and Maria Coats

Safety of selective nonoperative management for blunt splenic trauma: the impact of concomitant injuries

Nonoperative management for blunt splenic injury is the preferred treatment. To improve the outcome of selective nonoperative therapy, the current challenge is to identify factors that predict failure. Little ...

Authors: Michel Paul Johan Teuben, Roy Spijkerman, Taco Johan Blokhuis, Roman Pfeifer, Henrik Teuber, Hans-Christoph Pape and Luke Petrus Hendrikus Leenen

Safety and efficacy of a two-screw cephalomedullary nail for intertrochanteric femur fracture fixation: a retrospective case series in 264 patients

Recent advances have led to the design of a new cephalomedullary nail, which aims to decrease the risk of failures in patients with intertrochanteric hip fractures by allowing for insertion of two interdigitat...

Authors: Boris A. Zelle, Antonio J. Webb, Christopher Matson, Michael Morwood, Khang H. Dang, Samuel S. Ornell, Gabrielle Gostigian, Cody M. Ramirez and Hassan Mir

Dexamethasone and postoperative hyperglycemia in diabetics undergoing elective hip or knee arthroplasty: a case control study in 238 patients

Dexamethasone has been routinely used in the pre-operative setting to enhance analgesia and decrease the incidence of nausea and vomiting in patients undergoing primary arthroplasty. However, dexamethasone has...

Authors: Robert S. O’Connell, Bryce N. Clinger, Erin E. Donahue, Francesco S. Celi and Gregory J. Golladay

Predictors of femoral shortening for pediatric developmental hip dysplasia surgery: an observational study in 435 patients

Open reduction of the congenitally dislocated hip may not be possible without femoral shortening. The goal of this study is to develop a prognostic prediction model for the need of femoral shortening in childr...

Authors: Nabil Alassaf

Neuroschistosomiasis mimicking lower back pain: case report of a rare differential diagnosis in a pediatric patient

Spinal myelitis is an infrequent manifestation of spinal cord infection. It is caused by the Schistosoma species, which are endemic in South America, part of the Middle East, and Africa.

Authors: Abdulrahman Hamad Al-Abdulwahhab, Abdulaziz Mohammad Al-Sharydah, Sari Saleh Al-Suhibani, Saeed Ahmad Al-Jubran, Ali Khalaf Al-Haidey, Abdulkhaliq Ibrahim Al-Hifzi and Wissam Al-Issawi

Intraoperative angioedema induced by angiotensin II receptor blocker: a case report

Angiotensin II receptor blockers are a class of antihypertensive agent that is developed to exclude the adverse effects of angiotensin converting enzyme inhibitors. However, as angiotensin II receptor blockers...

Authors: Ala”a Alhowary, Haitham Odat, Obada Alali and Ali Al-Omari

Complications of pelvic and acetabular fractures in 1331 morbidly obese patients (BMI ≥ 40): a retrospective observational study from the National Trauma Data Bank

There have been no large-scale epidemiological studies of outcomes and perioperative complications in morbidly obese trauma patients who have sustained closed pelvic ring or acetabular fractures. We examined t...

Authors: James T. Carson, Sabin G. Shah, Gezzer Ortega, Sorawut Thamyongkit, Erik A. Hasenboehler and Babar Shafiq

Incidence and causes of cancellations of elective operation on the intended day of surgery at a tertiary referral academic medical center in Ethiopia

Elective surgical case cancellation refers to any elective surgical case that is the list on the day prior to surgery but not operated upon as scheduled. Case cancellation has a major cause of psychological tr...

Authors: Melaku Desta, Addissu Manaye, Abiot Tefera, Atalay Worku, Alemitu Wale, Alemlanchi Mebrat and Negesso Gobena

Intraoperative real-time fluorescence angiography with indocyanine green for evaluation of intestinal viability during surgery for an incarcerated obturator hernia: a case report

Bowel incarceration represents a dreaded complication amongst patients with hernias. The intraoperative evaluation of the bowel perfusion following hernia reduction with regard to the need for resection of isc...

Authors: Dimitra Daskalopoulou, Joseph Kankam, Jens Plambeck, Peter C. Ambe and Konstantinos Zarras

Preserving the marginal mandibular branch of the facial nerve during submandibular region surgery: a cadaveric safety study

The marginal mandibular branch of the facial nerve is vulnerable to iatrogenic injuries during surgeries involving the submandibular region. This leads to significant post-operative morbidity. Studies assessin...

Authors: Dimonge Joseph Anthony, Basnayaka Mudiyanselage Oshan Deshanjana Basnayake, Yasith Mathangasinghe and Ajith Peiris Malalasekera

Safety and efficacy of a new thromboprophylaxis regiment for total knee and total hip replacement: a retrospective cohort study in 265 patients

Venous thromboembolism (VTE) remains a significant complication following knee and hip arthroplasty. National and international guidelines recommend pharmacological and mechanical thromboprophylaxis following ...

Authors: Mohammad Amre Fallaha, Sarkhell Radha and Sheena Patel

Transmigration of a retained surgical sponge: a case report

A retained surgical sponge remains a dreaded complication of modern surgery. Despite the increasing focus on patient safety instances of “a sponge being left in the abdomen”, are all too common in popular medi...

Authors: Tushar Patial, Namit Rathore, Angesh Thakur, Digvijay Thakur and Kanika Sharma

Retained surgical sponges: a descriptive study of 319 occurrences and contributing factors from 2012 to 2017

Unintended retention of foreign bodies remain the most frequently reported sentinel events. Surgical sponges account for the majority of these retained items. The purpose of this study was to describe reports ...

Authors: Victoria M. Steelman, Clarissa Shaw, Laurel Shine and Abbey J. Hardy-Fairbanks

Comparison of flow pressures in different 3-way infusion devices: an in-vitro study

The use of multiple infusions through one cannula is an increasingly common practice in anaesthesia. High pressures in the line often lead to occlusion alarms and pump disconnection. In this study, we aim to d...

Authors: Jonathan Chua and Arun Ratnavadivel