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Impact of Incisional Surgical Site Infections on Quality of Life and Patient Satisfaction after General Surgery: A Case Controlled Study.

Surg Infect (Larchmt) 2021 Jun 15. Epub 2021 Jun 15.

Department of Surgical Sciences, Otago Medical School-Dunedin Campus Dunedin, Dunedin, New Zealand.

Most incisional surgical site infections (ISSI) are now diagnosed after discharge from hospital. In this context, it is important to document the impact ISSI has on our patients. Our surgical department sent a validated questionnaire to patients after they had been discharged. Read More

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Ropivacaine continuous wound infusion after mastectomy with immediate autologous breast reconstruction: A retrospective observational study.

Medicine (Baltimore) 2021 Jun;100(24):e26337

Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea.

Abstract: Continuous wound infusion usually provides postoperative analgesia as a multimodal analgesia with systemic opioid use. When continuous wound infusion of local anesthetics (LA) supports successful postoperative analgesia without systemic opioid use, the side effects of opioid can be reduced. Nevertheless, continuous wound infusion after mastectomy with immediate autologous breast reconstruction leads to concerns about wound healing. Read More

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Catastrophisation, chronic pain and sexuality: a cross-sectional investigation in fibromyalgia and rheumatoid arthritis.

Clin Exp Rheumatol 2021 Jun 10. Epub 2021 Jun 10.

Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Italy.

Objectives: In the present study we investigate the putative differences in pain catastrophising (PC), pain perception (PP), sexual functioning (SF), satisfaction (SS), and overall quality of life between fibromyalgia (FM) and rheumatoid arthritis (RA) patients as compared to healthy controls (HC).

Methods: Fifty-seven native Italian-speaking female individuals suffering either from FM or RA and thirty-eight healthy female controls (FM = 40; RA = 17; HC = 38) were submitted to a semi-structured interview aimed at assessing PP intensity (Visual Analog Scale; VAS), general health conditions (36-items Short-Form Health Survey; SF-36), PC (Pain Catastrophising Scale; PCS), SF and SS (Index of Sexual Satisfaction; ISS/ Female Sexual Function Index; FSFI).

Results: FM patients had a significantly higher PP both as compared to RA and HC (p<0. Read More

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Long term outcomes of laparoscopic sacro/colpo-hysteropexy with and without rectopexy for the treatment of prolapse.

Int Urogynecol J 2021 Jun 14. Epub 2021 Jun 14.

Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay Santé, Paris, France.

Introduction And Hypothesis: Laparoscopic sacrohysteropexy (LSH), sacrocolpopexy (LSC) and ventral rectopexy (LVR) with mesh are advocated for surgical treatment of pelvic and rectal prolapse. Our study aims at showing the feasibility of concomitant laparoscopic prolapse repair by comparing perioperative and long-term outcomes of LSH or LSC with and without LVR.

Methods: This is a retrospective study carried out on 348 women operated on between July 2009 and July 2019. Read More

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Aesthetic Outcomes of Perineal Reconstruction with the Lotus Petal Flap.

Plast Reconstr Surg Glob Open 2021 Jun 10;9(6):e3621. Epub 2021 Jun 10.

Department of Plastic Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

The lotus petal flap can be applied for reconstruction of extensive defects in the vulvoperineal area. Studies on aesthetic outcomes are lacking. This study aimed to fill this gap. Read More

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The efficacy of magnesium sulphate as an adjunct to local anaesthetics for perineal pain relief after episiotomy.

Niger J Clin Pract 2021 Jun;24(6):860-865

Department of Obstetrics and Gynaecology, University of Ilorin, Ilorin, Kwara state, Nigeria.

Background: Episiotomy is a deliberate surgical incision of the perineum with the aim of increasing the vulval outlet to facilitate childbirth. However, it could be associated with some complications, such as pain, hemorrhage, and wound infection. It is a surgical procedure that requires adherence to basic surgical principles of providing adequate analgesia. Read More

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Urology residency training in Greece. Results from the first national resident survey.

Actas Urol Esp 2021 Jun 10. Epub 2021 Jun 10.

Department of Urology «Agios Savvas», Anti-Cancer Oncologic Hospital of Athens, Atenas, Grecia.

Background And Objectives: This is the first national survey assessing Greek Urology residency programs. The main objective of this study is to assess the level of confidence and perception of Greek Urology residents regarding their educational program and detect areas of improvement.

Material And Methods: A 51-question survey was developed via an electronic platform and answered by 91 out of 104 Greek residents from March 2019 until May 2019. Read More

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Distal metatarsal osteotomy and dorsal neutralization plate in the treatment of hallux valgus.

Eur J Orthop Surg Traumatol 2021 Jun 13. Epub 2021 Jun 13.

Department of Orthopedic and Traumatology, Prof. Dr. Cemil Tascioglu City Hospital, Darülaceze Street No:27, 34384, Sisli, İstanbul, Turkey.

Purpose: Hallux valgus is a disease that can be treated with many different surgical procedures. In our study, we aimed to compare patients with and without dorsal neutralization plate after distal metatarsal osteotomy and fixation with compression screws.

Methods: The files of 59 patients with 89 feet operated with the diagnosis of moderate degree hallux valgus have been examined retrospectively. Read More

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Revision of failed trapeziometacarpal prothesis by CMI pyrocarbon implant: Retrospective study of 28 patients with a mean follow-up of 7.5 years.

Orthop Traumatol Surg Res 2021 Jun 8:102984. Epub 2021 Jun 8.

Orthopôle, 53, bis avenue Maryse-Bastié, 33520 Bruges, France.

Introduction: There is no consensus on the best salvage option after a failed trapeziometacarpal prothesis. Conserving the trapezium and inserting a pyrocarbon hemiarthroplasty implant will prevent thumb shortening and preserve the thumb's motion. The aim of this study was to evaluate the clinical and radiological outcomes in the medium term of trapeziometacarpal prothesis revisions done using the CMI pyrocarbon implant. Read More

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Postoperative incision scars and cosmetic satisfaction of living liver donors.

Medicine (Baltimore) 2021 Jun;100(23):e26187

Department of General Surgery, Changhua Christian Hospital, Changhua.

Abstract: Cosmetic appearance is a major concern for living donors. However, little is known about the impact of a surgical scar on body image changes in living liver donors. The aim of this study was to identify potential factors that cause displeasing upper midline incision scar, and to evaluate the overall satisfaction regarding body image and scarring after living donor hepatectomy. Read More

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[Application of extracorporeal membrane oxygenation regional treatment pattern in patients with severe cardiopulmonary diseases].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2021 May;33(5):596-599

Department of Public Service Development, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, Henan, China.

Objective: To assess the application of extracorporeal membrane oxygenation (ECMO) regional treatment pattern in patients with severe cardiopulmonary diseases.

Methods: A retrospective analysis was conducted. Patients with severe cardiopulmonary disease who were transferred to Henan Provincial People's Hospital after ECMO treatment in cooperative hospitals were selected. Read More

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A minimally invasive approach to pilonidal disease with endoscopic pilonidal sinus treatment (EPSiT): a single-center case series with long-term results.

Tech Coloproctol 2021 Jun 10. Epub 2021 Jun 10.

General Surgery Unit, San Giovanni Decollato Andosilla Hospital, Civita Castellana, Viterbo, Italy.

Background: Minimally invasive techniques for treating pilonidal disease are safe and effective alternatives to conventional surgery, with improved recovery time, cosmetic results, and pain control. The aim of this study was to evaluate the 5-year surgical outcomes of a single-center case series treated with endoscopic pilonidal sinus treatment (EPSiT).

Methods: We conducted a retrospective single-center analysis of all patients treated with EPSiT, by a single surgical team, from March 2015 to December 2019, for primary or recurrent pilonidal disease. Read More

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Medical expertise as a critical influencing factor on the length of stay in the ED: A retrospective cohort study.

Medicine (Baltimore) 2021 May;100(19):e25911

Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel.

Abstract: Overcrowding in the emergency departments (ED) is a significant issue associated with increased morbidity and mortality rates as well as decreased patient satisfaction. Length of stay (LOS) is both a cause and a result of overcrowding. In Israel, as there are few emergency medicine (EM) physicians, the ED team is supplemented with doctors from specialties including internal medicine, general surgery, orthopedics etc. Read More

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[Preoperative fluid fasting : Establishment of a liberal fluid regimen using fasting cards].

Anaesthesist 2021 Jun 9;70(6):469-475. Epub 2021 Jun 9.

Klinik für Anästhesie, operative Intensivmedizin und Schmerztherapie, Vivantes Klinikum Neukölln, Rudower Str. 48, 12351, Berlin, Deutschland.

Background: Preoperative fasting times for clear liquids surpass by far the recommendations of the specialist societies. The aim of this study was to introduce a liberal regimen for preoperative fasting of clear liquids using fasting cards as a training tool and to evaluate the implementation.

Material And Methods: We developed a liberalized regimen of preoperative clear fluid fasting times, which allows patients to drink water, apple juice, tea and coffee until being called to the operating theatre. Read More

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Therapeutic applications of radioactive sources: from image-guided brachytherapy to radio-guided surgical resection.

Q J Nucl Med Mol Imaging 2021 Jun 9. Epub 2021 Jun 9.

Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.

It is well known nowadays that radioactivity can destroy the living cells it interacts with. It is therefore unsurprising that radioactive sources, such as iodine-125, were historically developed for treatment purposes within radiation oncology with the goal of damaging malignant cells. However, since then, new techniques have been invented that make creative use of the same radioactivity properties of these sources for medical applications. Read More

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Open Appendicectomy under Spinal Anesthesia-A Valuable Alternative during COVID-19.

Surg J (N Y) 2021 Apr 3;7(2):e69-e72. Epub 2021 Jun 3.

Department of Colorectal Surgery, Milton Keynes University Hospital, Standing Way, Milton Keynes, United Kingdom.

 Concerns relating to coronavirus disease 2019 (COVID-19) and general anesthesia (GA) prompted our department to consider that open appendicectomy under spinal anesthesia (SA) avoids aerosolization from intubation and laparoscopy. While common in developing nations, it is unusual in the United Kingdom. We present the first United Kingdom case series and discuss its potential role during and after this pandemic. Read More

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Treatment of Midshaft Humerus Fractures Using Early Functional Bracing: Results and Prognostic Factors.

Cureus 2021 May 5;13(5):e14852. Epub 2021 May 5.

Orthopedic Surgery, East Kent Hospitals University NHS Foundation Trust, Canterbury, GBR.

Purpose Our study tests the hypothesis that a new radiographic measurement, the fracture displacement index (FDI), is associated with the prediction of successful conservative treatment, and investigates factors, that contribute to failure treatment. Methods This was a retrospective case series reporting the results of pragmatic treatment of midshaft humerus fractures using a humeral brace. Details regarding the patient demographics and fracture pattern were recorded. Read More

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A Hybrid Virtual Fracture Clinic is Safe and Efficacious in the COVID-19 Era: Stay at Home and Save Lives.

Cureus 2021 May 5;13(5):e14849. Epub 2021 May 5.

Trauma and Orthopaedics, St. George's University Hospitals NHS Foundation Trust, London, GBR.

Introduction The coronavirus disease 2019 (COVID-19) pandemic necessitated a change in the manner outpatient fracture clinics are conducted due to the need to reduce footfall in hospitals. While studies regarding virtual fracture clinics have shown these to be useful and effective, they focus exclusively on remote consultations. However, our service was bespoke to the patient - either a face-to-face, a telephone consultation or both, depending on patient need - a 'hybrid virtual fracture clinic' (HVFC). Read More

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High-volume, multilevel local anesthetics-Epinephrine infiltration in kyphoscoliosis surgery: Intra and postoperative analgesia.

J Anaesthesiol Clin Pharmacol 2021 Jan-Mar;37(1):73-78. Epub 2021 Apr 10.

Neurosurgery, Faculty of Medicine, Mansoura University, Egypt.

Background And Aims: Local anesthetic (LA) infiltration is one of the analgesic techniques employed during scoliosis correction surgery. However, its efficacy is controversial. In the present study for optimizing analgesia using the infiltration technique, we proposed two modifications; first is the preemptive use of high volume infiltration, second is applying three anatomical multilevel infiltrations involving the sensory, motor, and sympathetic innervations consecutively. Read More

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Comparison of equipotent doses of intrathecal hyperbaric prilocaine 2% and hyperbaric bupivacaine 0.5% for elective caesarean section: A prospective, randomised, controlled, two-centre clinical trial.

Eur J Anaesthesiol 2021 May 18. Epub 2021 May 18.

From the Department of Anaesthesiology and Pain Medicine, University Hospital Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels (PG, RL, YV, YK), Ars Statistica, Nivelles (J-FF) and Department of Anaesthesiology, Clinique Sainte Anne-Saint Remi, CHIREC, Brussels, Belgium (PEG) Philippe Goffard and Renaud Leloup are joint first authors.

Background: Elective caesarean section is performed mainly under spinal anaesthesia using hyperbaric bupivacaine combined with opioids. Despite rapid onset, good quality anaesthesia, bupivacaine provides a long duration of motor block and is related to maternal hypotension. Current policies appeal for implementation of enhanced recovery procedures after caesarean section. Read More

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Minimum 10-Year Outcomes of Primary Arthroscopic Transosseous-Equivalent Double-Row Rotator Cuff Repair.

Am J Sports Med 2021 Jun 8:3635465211015419. Epub 2021 Jun 8.

The Steadman Clinic, Vail, Colorado, USA.

Background: Modern rotator cuff repair techniques demonstrate favorable early and midterm outcomes, but long-term results have yet to be reported.

Purpose: To determine 10-year outcomes and survivorship after arthroscopic double-row transosseous-equivalent (TOE) rotator cuff repair.

Study Design: Case series; Level of evidence 4. Read More

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Telehealth in Pediatric Surgical Subspecialties: Rapid Adoption in the Setting of COVID-19.

Telemed J E Health 2021 Jun 8. Epub 2021 Jun 8.

Division of Plastic Surgery, Connecticut Children's Medical Center, Hartford, Connecticut, USA.

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An eye-tracking based robotic scrub nurse: proof of concept.

Surg Endosc 2021 Jun 8. Epub 2021 Jun 8.

Hamlyn Centre for Robotic Surgery, Imperial College London, London, SW7 2AZ, UK.

Background: Within surgery, assistive robotic devices (ARD) have reported improved patient outcomes. ARD can offer the surgical team a "third hand" to perform wider tasks and more degrees of motion in comparison with conventional laparoscopy. We test an eye-tracking based robotic scrub nurse (RSN) in a simulated operating room based on a novel real-time framework for theatre-wide 3D gaze localization in a mobile fashion. Read More

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An Assessment of Patient Satisfaction and Decisional Regret in Patients Undergoing Staged Free-Flap Breast Reconstruction.

Ann Plast Surg 2021 Jun;86(6S Suppl 5):S538-S544

From the Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, NC.

Background: In the setting of radiation therapy or significant medical comorbidities, free-flap breast reconstruction may be intentionally delayed or staged with tissue expander placement ("delayed-immediate" approach). The effect of a staged approach on patient satisfaction and decisional regret remains unclear.

Methods: All patients undergoing free-flap breast reconstruction (n = 334) between 2014 and 2019 were identified. Read More

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Modified Carpal Tunnel Release: A New Approach to Minimizing Pillar Pain.

Ann Plast Surg 2021 Jun;86(6S Suppl 5):S503-S509

From the Prisma Health/University of South Carolina School of Medicine, Columbia SC.

Introduction: Pillar pain is a frequent postoperative complication of carpal tunnel release (CTR). The precise definition of pillar pain is lacking, but most authors describe it as diffuse aching pain and tenderness in the thenar and hypothenar area. The etiology of pillar pain is unclear. Read More

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Evaluating Factors Associated with the Cancellation and Delay of Elective Surgical Procedures: A Systematic Review.

Int J Qual Health Care 2021 Jun 8. Epub 2021 Jun 8.

Department of Management, Otago Business School, University of Otago, New Zealand.

Background: Elective surgery cancellation is considered a fundamental problem in health care services-it causes considerable disruption to patient flow, further eroding often already stretched operating capacity, and consequentially reduces both hospital performance and patient satisfaction. This research presents a systematic review (SR) of the reasons for surgery cancellation among different hospitals and countries. By highlighting these causes, we identify how to reduce cancellations thereby improving the use of surgical capacity and resources and create a more predicable patient flow. Read More

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Post-traumatic double crush pudendal nerve entrapment syndrome after fracture of the pelvis: A case report.

Acta Orthop Traumatol Turc 2021 May;55(3):277-280

Department of Orthopaedics, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey.

Pudendal syndrome is primarily characterized by stress urinary incontinence, dysuria, sexual arousal syndrome, painful erections, and anal incontinence. The syndrome occurs when the pudendal nerve or one of its branches is compressed, stretched, or injured. Double crush is the compression of a peripheral nerve at two or more separate areas with various signs and symptoms. Read More

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The objective structured clinical examination as an assessment strategy for clinical competence in novice nursing practitioners in Taiwan.

BMC Nurs 2021 Jun 7;20(1):91. Epub 2021 Jun 7.

Division of Hemato-oncology, Department of Internal Medicine, College of Medicine, Chang Gung Memorial Hospital, Keelung & Chang Gung University, 222 Maijin Road, Keelung, Taiwan.

Background: The conventional written tests and professional assessment have limitation in fair judgement of clinical competence. Because the examiners may not have total objectivity and may lack standardization throughout the assessment process. We sought to design a valid method of competence assessment in medical and nursing specialties. Read More

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Association of global sagittal spinal deformity with functional disability two years after total hip arthroplasty.

BMC Musculoskelet Disord 2021 Jun 7;22(1):523. Epub 2021 Jun 7.

Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University (Osaka Medical College), 2-7 Daigaku-machi, Takatsuki, Osaka, 5698686, Japan.

Background: The relationship between spinopelvic alignment and functional disability after total hip arthroplasty (THA) has not been fully elucidated despite the growing recognition of its importance on patient-reported outcome measures. Therefore, our aim was to assess the effect of global sagittal spinal deformity on post-operative disability.

Methods: This analysis was based on 208 cases of THA, with functional disability measured at a follow-up of 2 years. Read More

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