International journal of surgery
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Comparative Study
Refusal of cervical spine immobilization after blunt trauma: Implications for initial evaluation and management: A retrospective cohort study.
Rigid cervical collars are routinely placed in the pre-hospital setting after significant blunt trauma. Patients who are deemed competent by field personnel (Glasgow Coma Scale (GCS) ≥13, no major distracting injury and not grossly intoxicated) may refuse cervical collar placement. ⋯ The incidence of cervical spine injuries in patients refusing cervical collar immobilization is higher than in compliant patients. Patients arriving for initial evaluation having refused cervical collar immobilization should be treated with caution.
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This retrospective study evaluates the effectiveness and safety of the Angio-Seal closure device in superficial femoral artery (SFA) antegrade punctures compared to common femoral artery (CFA) antegrade punctures. ⋯ Angio-Seal closure device is safe and effective method of haemostasis both in antegrade SFA and CFA punctures with no significant complications or delayed discharge.
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Surgical site infection, particularly intra-abdominal infection (IAI), remains a clinically important event after gastrectomy for gastric cancer. The aim of this retrospective study was to clarify the incidence, pathogens, risk factors and outcomes of IAI following gastrectomy for gastric cancer. ⋯ IAI is a major complication after radical gastrectomy for gastric cancer, and associated with combined multi-organ resection and a BMI ≥ 25 kg/m2; thus, meticulous surgical procedures need to be performed in patients with these specific risk factors.
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Optimal perfusion of the gastric conduit during esophagectomy is elementary for the anastomotic healing since poor perfusion has been associated with increased morbidity due to anastomotic leaks. Until recently surgical experience was the main tool to assess the perfusion of the anastomosis. We hypothesized that anastomoses located in the zone of optimal ICG perfusion of the gastric conduit ("optizone") have a reduced anastomotic leakage rate after esophagectomy. ⋯ ICG tissue angiography represents a feasible and reliable technical support in the evaluation of the anastomotic perfusion after esophagectomy. In this retrospective analysis we observed a significant decrease in anastomotic leakage rate when the anastomosis could be placed in the zone of good perfusion defined by ICG fluorescence. A prospective trial is needed in order to provide higher level evidence for the use of ICG fluorescence in reducing leakage rates after esophagectomy.
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Multicenter Study
Surgical site infection following open reduction and internal fixation of a closed ankle fractures: A retrospective multicenter cohort study.
Identification of risk factors for surgical site infection (SSI) after surgical ankle fractures was important, but related evidence was inadequate. This study was conducted to investigate the incidence and risk factors for SSI after open reduction and internal fixation (ORIF) of a closed ankle fractures. ⋯ After comprehensive evaluation of patients medical conditions, immediate operation by a surgeon with more expertise could effectively reduce SSI occurrence.