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J Gastrointest Surg 2021 May 4. Epub 2021 May 4.

Gastrointestinal Associates, PC, 1311 Dowell Springs Blvd, Suite 300, Knoxville, TN, 37909, USA.

J Infus Nurs 2021 May-Jun 01;44(3):137-146

Infusion Services, Seattle Cancer Care Alliance, Seattle, Washington (Mr Eisenberg); Cancer Treatment Centers of America, Philadelphia, and Community College of Philadelphia, Philadelphia, Pennsylvania (Ms Klein).

Chemotherapy agents used for cancer treatment are considered hazardous drugs (HDs). Guidelines and standards for handling HDs have been in place for several decades to protect oncology nurses working in hospitals and outpatient infusion areas. However, chemotherapy is frequently being administered in home settings, often by infusion nurses who do not necessarily have the requisite knowledge and training. Read More

Spine Deform 2021 Apr 9. Epub 2021 Apr 9.

Division of Orthopaedic Surgery, Department of Surgery, IWK Health Center, 5850 University Avenue, PO Box 9700, Halifax, NS, B3K-6R8, Canada.

Purpose: The purpose of this study was to determine peri-operative morbidity associated with anterior vertebral body tethering (aVBT) for idiopathic scoliosis.

Method: Of 175 patients treated with aVBT, 120 patients had 2 year follow up and were included in this study. Prospectively collected clinical and radiographic data was analyzed retrospectively. Read More

Trauma Case Rep 2021 Apr 26;32:100446. Epub 2021 Feb 26.

Prince Court Medical Centre, 39, Jalan Kia Peng, 50450 Kuala Lumpur, Malaysia.

A feature of the flexor pollicis longus tendon injury is the frequency of palmar retraction so that a wrist approach is needed for retrieval of the proximal stump. We are reporting on our first outpatient zone T2 flexor pollicis longus tendon repair under WALANT with ultrasound guidance. In the event of zone T2 flexor pollicis rupture, ultrasound location of tendon extremities is used to plan surgical WALANT strategy and to guide the injection of lidocaine with epinephrine whilst limiting the injected volume to what is strictly necessary. Read More

J Otolaryngol Head Neck Surg 2021 Feb 12;50(1):10. Epub 2021 Feb 12.

Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, ON, Canada.

Background: Superficial parotidectomy has a potential to be performed as an outpatient procedure. The objective of the study is to evaluate the safety and selection profile of outpatient superficial parotidectomy compared to inpatient parotidectomy.

Methods: A retrospective review of individuals who underwent superficial parotidectomy between 2006 and 2016 at a tertiary care center was conducted. Read More

Ann Vasc Surg 2021 May 22;73:97-106. Epub 2021 Jan 22.

Vascular Surgery Department, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisboa, Portugal; Cardiovascular Center of the University of Lisbon (CCUL), Lisboa, Portugal; Faculty of Medicine, University of Lisbon, Lisboa, Portugal.

Objectives: This study aims to report the changes and adaptations of a vascular tertiary center during a global pandemic and the impact on its activity and patients.

Methods: We conducted a retrospective cohort study within the Vascular Surgery ward in Centro Hospitalar Universitário Lisboa Norte, Portugal. All data from surgical, inpatient and outpatient activity were collected from February to June 2020 and compared to the same 5-month period in 2018 and 2019. Read More

Arch Dermatol Res 2021 Jan 12. Epub 2021 Jan 12.

Departments of Dermatology, Otolaryngology and Surgery, Feinberg School of Medicine, Northwestern University, 676 N St Clair Suite 1600, Chicago, IL, 60611, USA.

Since dermatologists routinely perform surgery in an outpatient setting, ensuring that dermatology trainees are provided with opportunities to develop sufficient proficiency in excisional surgery and suture technique is paramount. The objectives of this study are to assess trainee preference for silicone-based synthetic skin compared with porcine skin as a surgical training medium and to assess the ability of trainees to successfully demonstrate basic surgical skills using the simulated skin model. Participants were a convenience sample of dermatology residents from the greater Chicago area, who were asked to perform an elliptical excision and bilayered repair on a silicone-based synthetic skin model. Read More

BMC Musculoskelet Disord 2021 Jan 8;22(1):51. Epub 2021 Jan 8.

Houston Methodist Orthopedics & Sports Medicine, 6445 Main Street, Outpatient Center, Suite 2500, Houston, TX, 77030, USA.

Background: Transthyretin and immunoglobulin light-chain amyloidoses cause amyloid deposition throughout various organ systems. Recent evidence suggests that soft tissue amyloid deposits may lead to orthopedic conditions before cardiac manifestations occur. Pharmacologic treatments reduce further amyloid deposits in these patients. Read More

HSS J 2020 Dec 22;16(Suppl 2):349-357. Epub 2020 Jan 22.

Caldwell Sports Medicine, 2307 West Broward Blvd., Suite 200, Fort Lauderdale, FL 33312 USA.

Background: The use of opioid analgesia is common in both the acute and extended post-operative periods after rotator cuff repair. The current opioid crisis has prompted surgeons to seek alternatives that minimize or even eliminate the need for oral opioids after surgery.

Questions/purposes: We sought to investigate the effects on post-operative opioid use of a surgeon-administered block of the suprascapular and axillary nerves in arthroscopic rotator cuff repair (ARCR), in particular to quantify outpatient opioid consumption and duration. Read More

Can J Anaesth 2021 Mar 2;68(3):367-375. Epub 2020 Dec 2.

Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA.

Background: A perioperative surgical home, the Anesthesia Perioperative Care Service (APCS), was created to execute enhanced recovery after surgery pathways for total knee and total hip arthroplasty patients at the Tennessee Valley Health System Nashville VA Medical Center. We hypothesized that the APCS would be associated with reduced length of stay, in-hospital and post-discharge opioid exposure, costs, and hospital readmissions.

Methods: Data were collected for all patients admitted to the Nashville VA Medical Center following their respective surgery, for 400 days after the initiation of the APCS and for a 400-day period prior. Read More

Nurs Stand 2020 Dec 30;35(12):72-76. Epub 2020 Nov 30.

education, Glasgow Caledonian University, Glasgow, Scotland.

Preoperative care refers to the physical and psychosocial care that prepares a patient to undergo surgery safely. The preoperative period begins when the patient is booked for surgery and ends with their transfer to the theatre or surgical suite. As well as the preoperative care that takes place in hospital, various preoperative tests and clinical assessments can be undertaken during a preoperative outpatient appointment, one week or more before surgery takes place. Read More

Plast Reconstr Surg 2020 12;146(6):819e-820e

Department of Plastic Surgery, Ohio State University, 915 Olentangy River Road, Suite 2100, Columbus, Ohio 43212,

Contracept X 2020 18;2:100044. Epub 2020 Oct 18.

University of Hawaii, Department of Obstetrics, Gynecology, and Women's Health, 1319 Punahou St., Suite 824, Honolulu, HI 96826, USA.

Objective: The objective was to evaluate if buffered lidocaine decreases injection pain as compared to plain lidocaine for paracervical blocks during first-trimester outpatient surgical abortions.

Study Design: We conducted a randomized, double-blind, placebo-controlled trial among women undergoing outpatient uterine aspiration of a first-trimester pregnancy or an early pregnancy loss. Subjects received a paracervical block with either lidocaine 1% 20 mL or lidocaine 1% 18 mL plus sodium bicarbonate 8. Read More

Int J Colorectal Dis 2021 Mar 22;36(3):501-508. Epub 2020 Oct 22.

Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, 1550 N. Northwest Highway, Suite 107, Park Ridge, IL, 60068, USA.

Purpose: Enhanced Recovery After Surgery (ERAS) protocols, particularly when paired with advanced laparoscopy, have reduced recovery time following colorectal procedures. The aim of this study was to determine if length of stay (LOS) could be reduced to an overnight observation stay (< 24 h) with comparable perioperative morbidity. The secondary aim was to establish predictive factors contributing to early discharge. Read More

J Orthop Surg Res 2020 Jul 31;15(1):292. Epub 2020 Jul 31.

Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, 676 N. Saint Clair St., Suite 1350, Chicago, Cook County, IL, 60611, USA.

Background: Given the trend toward value-based care, there has been increased interest in minimizing hospital length of stay (LOS) after orthopedic procedures. Outpatient total ankle arthroplasty (TAA) has become more popular in recent years; however, research on surgical outcomes of this procedure has been limited. This study sought to employ large sample, propensity score-matched analyses to assess the safety of outpatient and short-stay discharge pathways following TAA. Read More

Dig Dis Sci 2021 Jun 20;66(6):2059-2068. Epub 2020 Jul 20.

Department of Internal Medicine, Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.

Background: Inadequate bowel preparation (IBP) is associated with reduced adenoma detection. However, limited research has examined the impact of different commercial bowel preparations (CBPs) on IBP and adenoma detection. We aim to determine whether type of CBP used is associated with IBP or adenoma detection. Read More

Otolaryngol Clin North Am 2020 Oct 1;53(5):819-830. Epub 2020 Jul 1.

Department of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, TN, USA; Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, 910 Madison Avenue, Suite 400, Memphis, TN 38163-2242, USA; Department of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, TN, USA. Electronic address:

This article reviews the evidence regarding current perioperative pain management strategies in pediatric patients undergoing otolaryngologic surgery. Pediatric otolaryngology is a broad field with a wide variety of surgical procedures that each requires careful consideration for optimal perioperative pain management. Adequate pain control is vital to ensuring patient safety and achieving successful postoperative care, but many young children are limited in their capacity to communicate their pain experience. Read More

Hand Clin 2020 08;36(3):313-321

Division of Hand Surgery, Department of Orthopaedic Surgery, Massachusetts General Hospital, MGH Orthopaedic Hand Surgery, Yawkey Center for Outpatient Care, 55 Fruit Street, Suite 2C, Boston, MA 02114-2696, USA. Electronic address:

The fingertip is the most common site of infections in the hand, which frequently are encountered by surgeons, dermatologists, and emergency and primary providers. Their mismanagement may have serious consequences. This review discusses the unique anatomy of the volar fingertip pulp and perionychium and reviews pathophysiology and treatment of acute and chronic paronychia, including the decision for surgical versus medical management, choice of antibiotics, incisional techniques, and postincisional care. Read More

Gynecol Surg 2020 16;17(1). Epub 2020 Jun 16.

The Center for Innovative GYN Care, 3206 Tower Oaks Blvd., Suite 200, Rockville, MD 20852 USA.

Background: Non-hysteroscopic myomectomy is infrequently performed in a freestanding ambulatory setting, in part due to risks of intraoperative hemorrhage. There are also concerns about increased surgical risks for morbidly obese patients in this setting. The purpose of this study is to report the surgical outcomes of a series of laparoscopic-assisted myomectomy (LAM) cases at a freestanding ambulatory surgery center (ASC), including a comparative analysis of outcomes in morbidly obese patients (BMI > 40 kg/m). Read More

Clin Nutr 2020 09 11;39(9):2872-2880. Epub 2020 Jun 11.

Medicine and Nutrition, The Larner College of Medicine, University of Vermont, Burlington, VT, USA. Electronic address:

Background: The Global Leadership Initiative on Malnutrition (GLIM) created a consensus-based framework consisting of phenotypic and etiologic criteria to record the occurrence of malnutrition in adults. This is a minimum set of practicable indicators for use in characterizing a patient/client as malnourished, considering the global variations in screening and nutrition assessment, and to be used across different health care settings. As with other consensus-based frameworks for diagnosing disease states, these operational criteria require validation and reliability testing as they are currently based solely on expert opinion. Read More

Acad Radiol 2020 Jun 8. Epub 2020 Jun 8.

Emory University Department of Radiology, Emory University Hospital, 1364 Clifton Road NE, Suite D112, Atlanta, GA 30322.

Rationale And Objectives: Historically, patients undergoing image-guided percutaneous gastrostomy tube placement have been admitted overnight with feeds commencing 12-24 hours postprocedure. With new expedited feeding protocols starting 3-4 hours postprocedure, same-day discharge is now possible. The purpose of this study was to evaluate the safety and cost of image-guided percutaneous gastrostomy tube placement as an outpatient procedure. Read More

Am J Otolaryngol 2020 Sep - Oct;41(5):102570. Epub 2020 Jun 1.

Department of Otolaryngology - Head and Neck Surgery, Thomas Jefferson University Hospital, 925 Chestnut St., 6th Floor, Philadelphia, PA 19146, USA.

The novel coronavirus (SARS-CoV-2 or COVID-19) pandemic has impacted nearly every aspect of otolaryngologic practice. The transition from office-based evaluation to telemedicine and the number of postponed elective surgical cases is unprecedented. There is a significant need to resume elective surgical care for these patients at the appropriate time. Read More

Contraception 2020 08 29;102(2):104-108. Epub 2020 May 29.

Department of Reproductive Health, Secretariat of Health of Mexico City, Calle Altadena #23, Col. Nápoles, Del. Benito Juárez, 03810 Mexico City, Mexico.

Objective: To compare the effectiveness of outpatient medical abortion with mifepristone 200 mg and two misoprostol 800 mcg doses at 64-70 and 71-77 days of gestation.

Study Design: We conducted a retrospective chart review of medical abortion outcomes among clients with 64-77 day gestations at a Mexico City public clinic between February 2014 and November 2016 who took mifepristone 200 mg followed 24-48 h later by two doses of misoprostol 800 mcg four hours apart (first dose buccally, second dose sublingually). The primary outcome was successful medical abortion, defined as pregnancy expulsion without surgical intervention. Read More

J Hip Preserv Surg 2020 Jan 22;7(1):103-108. Epub 2020 Jan 22.

Rush University Medical Center, Midwest Orthopaedics, 1611 W. Harrison Ave. Suite 300, Chicago, IL 60612, USA.

To determine the outcomes of a limited surgical intervention, consisting of neurolysis, inguinal wall repair and/or adductor debridement of adhesions based on intraoperative findings. Retrospective case series. Outpatient orthopedic/general surgery clinic. Read More

Prev Med Rep 2020 Jun 8;18:101085. Epub 2020 Apr 8.

Department of Anesthesiology, Yale School of Medicine, TMP-3, 333 Cedar Street, P.O. Box 208051, New Haven, CT 06520-8051, United States.

Although statins are highly effective for reducing cardiovascular disease events, prior studies demonstrate their significant underuse in the US population, including among those with known atherosclerotic disease. It is unknown whether this finding applies to the subset of patients who present for outpatient surgery, as such patients would be expected to have recent exposures to healthcare providers during the preoperative referral period. The primary aim of this manuscript was to ascertain the prevalence of statin underuse and associated risk-factors for such underuse among ambulatory surgical patients with documented atherosclerotic cardiovascular disease. Read More

J Orthop 2020 Sep-Oct;21:203-206. Epub 2020 Mar 28.

University of Texas Medical Branch, 301 University Blvd, Galveston, TX, 77550, USA.

Background: This study evaluates the safety of foot and ankle outpatient surgeries at a freestanding ambulatory surgery centers.

Methods: A total of 1352 cases were evaluated for adverse events in a retrospective review of all foot and ankle cases performed over a 5-year period at a single center.

Results: The rate of adverse events was 2. Read More

Am J Surg 2020 05 10;219(5):741-745. Epub 2020 Mar 10.

Legacy Cancer Institute, Legacy Medical Group Surgical Oncology, 1040 NW 22nd Ave, Suite 560, Portland, 97227, OR, USA. Electronic address:

Background: Neoadjuvant chemotherapy (NAC) is increasingly used in the treatment of breast cancer. The time interval from last dose of cytotoxic chemotherapy to surgery (TTS) can vary widely. We aimed to evaluate the effect of TTS on postoperative complications. Read More

Otolaryngol Clin North Am 2020 04;53(2):xiii-xiv

Otolaryngology Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology Head and Neck Surgery, The Johns Hopkins University School of Medicine, Johns Hopkins Outpatient Center, 601 N. Caroline St, 6th Floor, Baltimore, MD 21287, USA. Electronic address:

Spine Deform 2020 06 24;8(3):405-411. Epub 2020 Feb 24.

Shriners Hospitals for Children-Houston, 6977 Main St., Houston, TX, 77030, USA.

Study Design: Quality improvement evaluation with retrospective analysis.

Objectives: To compare a technique to place pedicle screws (PS) using a novel detachable pedicle marker and probe (DPMP) and pulsed fluoroscopy (PF) vs. conventional technique utilizing PF with standard instruments (SI) and O-arm. Read More

Contraception 2020 05 1;101(5):302-308. Epub 2020 Feb 1.

Gynuity Health Projects, 220 E. 42nd Street, Suite 710, New York, NY 10017, USA. Electronic address:

Objectives: This open-label non-inferiority study assessed efficacy of a common outpatient medical abortion regimen among people with pregnancies 64-70 days and 71-77 days of gestation.

Study Design: We defined non-inferiority by a 6% margin of method success. People with intrauterine pregnancies 64-77 days' gestational age by abdominal ultrasound seeking medical abortion at one of eight clinics and met eligibility criteria were offered participation. Read More