Articles

The value of Morbidity & Mortality (M&M) conferences in residency training: a proposed model from an academic medical center in Iran

Authors: Kiana Hassanpour, Nazanin Behnaz, Maryam Fakhri and Mohammad Pakravan

Inter- and intraobserver agreement of three classification systems for lateral clavicle fractures – reliability comparison between two specialist groups

Although of great value in the management of lateral clavicle fractures, substantial variation in their classification exists. We performed a retrospective study to address the inter- and intraobserver reliabi...

Authors: Thomas Rauer, Matthias Boos, Valentin Neuhaus, Prasad Ellanti, Robert Alexander Kaufmann, Hans-Christoph Pape and Florin Allemann

Prevalence and root causes of surgical site infections at an academic trauma and burn center in Ethiopia: a cross-sectional study

Despite modern surgical techniques and the use of antibiotic prophylaxis, surgical site infection remains a burden for the patient and health system. It is a major cause of morbidity, prolonged hospital stay, ...

Authors: Rahel Mezemir, Awole Seid, Teshome Gishu, Tangut Demas and Addisu Gize

The effect of discharge destination and primary insurance provider on hospital discharge delays among patients with traumatic brain injury: a multicenter study of 1,543 patients

Hospital length of stay (HLOS) is a commonly used measure of hospital quality and is influenced by clinical and non-clinical factors. To reduce HLOS, it is key to identify factors placing patients at increased...

Authors: Melissa Sorensen, Erica Sercy, Kristin Salottolo, Michael Waxman, Thomas A. West, Allen Tanner II and David Bar-Or

Splenic injury severity, not admission hemodynamics, predicts need for surgery in pediatric blunt splenic trauma

Authors: Michel Teuben, Roy Spijkerman, Henrik Teuber, Roman Pfeifer, Hans-Christoph Pape, William Kramer and Luke Leenen

Improving blood product utilization at an ambulatory surgery center: a retrospective cohort study on 50 patients with lumbar disc replacement

There is minimal literature discussing anterior lumbar spine surgery in ambulatory surgery centers (ASCs). The main concern with the anterior approach to the lumbar spine is the potential for injury to great v...

Authors: Benjamin C. Dorenkamp, Madisen K. Janssen and Michael E. Janssen

Surgical site infection leading to gangrene and amputation after ambulatory surgical care of an ingrown toenail: a case report

Currently, the management of ingrown toenail (onychocryptosis) ranges from conservative medical management to surgical treatment. Surgical management is typically performed as an outpatient procedure due to it...

Authors: Aimé Gilbert Mbonda Noula, Joel Noutakdie Tochie, Landry W. Tchuenkam, Desmond Aji Abang and René Essomba

A descriptive survey on the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for pelvic fractures at US level I trauma centers

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is not widely adopted for pelvic fracture management. Western Trauma Association recommends REBOA for hemodynamically unstable pelvic fractures...

Authors: Stephanie Jarvis, Michael Kelly, Charles Mains, Chad Corrigan, Nimesh Patel, Matthew Carrick, Mark Lieser, Kaysie Banton and David Bar-Or

Knowledge, attitude and practice of surgical staff towards preoperative surgical antibiotic prophylaxis at an academic tertiary hospital in Sudan

Surgical site infections (SSIs) are among the most common serious complications after surgery and associated with preventable morbidity, mortality, and increased health care costs. The use of surgical antimicr...

Authors: Ali Mohammed Ahmed, Sara Nasr, Almegdad Mohamed Ahmed and Osama Elkhidir

Prophylactic antibiotic bundle compliance and surgical site infections: an artificial neural network analysis

Best practice “bundles” have been developed to lower the occurrence rate of surgical site infections (SSI’s). We developed artificial neural network (ANN) models to predict SSI occurrence based on prophylactic...

Authors: Steven Walczak, Marbelly Davila and Vic Velanovich

Root causes and outcomes of postoperative pulmonary complications after abdominal surgery: a retrospective observational cohort study

Postoperative pulmonary complications (PPCs) contribute significantly to overall postoperative morbidity and mortality. In abdominal surgery, PPCs remain frequent. The study aimed to analyze the profile and ou...

Authors: Antero Fernandes, Jéssica Rodrigues, Patrícia Lages, Sara Lança, Paula Mendes, Luís Antunes, Carla Salomé Santos, Clara Castro, Rafael S. Costa, Carlos Silva Lopes, Paulo Matos da Costa and Lúcio Lara Santos

Intramedullary reaming modality for management of postoperative long bone infection: a prospective randomized controlled trial in 44 patients

Studies addressing the management of intramedullary infection are mainly retrospective and with a limited number of cases. Reaming can be performed using either conventional reaming or using the reamer/irrigat...

Authors: Carlos Augusto Finelli, Fernando Baldy dos Reis, Helio Alvachian Fernandes, Adriana Dell’Aquila, Rogério Carvalho, Natalia Miki, Carlos Franciozi, Rene Abdalla and Mauro José Costa Salles

Standardization of early drain removal following pancreatic resection: proposal of the “Ottawa pancreatic drain algorithm”

Early drain removal after pancreatic resection is encouraged for individuals with low postoperative day 1 drain amylase levels (POD1 DA) to mitigate associated morbidity. Although various protocols for drain m...

Authors: Heather Smith, Fady K. Balaa, Guillaume Martel, Jad Abou Khalil and Kimberly A. Bertens

Chronic abdominal pain after laparoscopic hernia repair due to mesh graft migration to the cecum: a case report

Hernia repair with mesh graft is one of the most common procedures in general surgery. Mesh graft repair is the treatment of choice for umbilical and periumbilical hernias to minimize recurrence. One of the ra...

Authors: Abdullah AlShammari, Fatima Alyousef, Amal Alyousif, Zainab Alsulabi, Fatimah AlJishi, Isra Siraj, Hissah Alotaibi and Mohammad Aburahmah

Summary of the International Patient Safety Conference, June 28—29, 2019, Kathmandu, Nepal

Globally, medical errors are associated with an estimated $42 billion in costs to healthcare systems. A variety of errors in the delivery of healthcare have been identified by the World Health Organization and...

Authors: Deepak C. Bajracharya, Kshitij Karki, Chhiring Yangjen Lama, Rajesh Dhoj Joshi, Shankar Man Rai, Sudhakar Jayaram, Amit Tomer, John Zervos, Mohammad Imran Khan, Arjun Sapkota, Madan Kumar Upadhyaya and Paul E. Kilgore

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