International journal of surgery
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This retrospective study documented the rate of vaginal cuff dehiscence (VCD) in a large series of gynecologic patients who were treated with an endoscopic (robotic-assisted or laparoscopic) hysterectomy that incorporated either delayed absorbable monofilament barbed or vicryl running sutures. ⋯ Vaginal cuff separation subsequent to laparoscopic closure is a rare occurrence. While our incidence of VCD was low and comparable to other reported rates in the literature, we did not observe any cases of VCD following laparoscopic hysterectomy performed with barbed suture closure.
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Correct placement of the sustentacular screw is an important component during the open reduction and internal fixation of calcaneal fractures. The hypothesis of this study is that certain 3D-CT images would help detect the real placement of the sustentaculum screw. The aims of the study are to investigate the postoperative status of the sustentacular screw and to evaluate the effect of the sustentaculum screw placement on the treatment of intra-articular calcaneal fractures. ⋯ The sustentaculum screw with non-fixation may cause the decrease of Böhler's angle throughout the follow-up. The clinical outcomes were similar whether the screw was accurately placed within the sustentaculum or not.
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There are significant resource challenges to burn surgical care delivery in low and middle-income countries at baseline and only a few burn cost analysis studies from sub-Saharan Africa have been performed. ⋯ Our study has demonstrated that comprehensive burn care is possible at a cost much lower than found in other burn centers in low or middle-income countries and can be sustained with moderate funding.
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Hoffa fracture fixed by only using a single plate or lag screws might be not strong enough to achieve direct stability. The goal of this study is to determine the functional outcome of the surgical treatment and rehabilitation of medial Hoffa fracture by a locking plate combined with cannulated or lag screws. ⋯ Fixation with a locking plate and cannulated or lag screws for medial Hoffa fracture seemed to be effective and reliable for achieving anatomical reduction, and gave satisfactory functional results when coupled with aggressive rehabilitation.
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This study was conducted primarily to determine the prevalence and incidence of intra-abdominal hypertension (IAH) in a mixed ICU (medical & surgical) population and, secondarily, to compare outcomes between patients with and without IAH. ⋯ IAH is a poorly recognized clinical entity with potentially devastating impact on patient outcomes. Since majority of patients had IAH at the time of admission, all ICU patients especially on ventilator should have baseline intra-abdominal pressures measured at the time of admission and subjected to appropriate management to prevent them from developing abdominal compartment syndrome.