World journal of surgery
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Abdominal packing (AP) in damage-control laparotomy (DCL) is a lifesaving technique that controls coagulopathic hemorrhage in severely injured trauma patients. However, the impact of the duration of AP on the incidence of re-bleeding and on intra-abdominal infections in penetrating abdominal trauma is not clear. The objective of the present study was to evaluate the complications related to the duration of AP and to determine the optimal time for AP removal. ⋯ The present study suggests that AP used in the setting of DCL for coagulopathic hemorrhage control should not be removed prior to the first postoperative day because of the increased risk of re-bleeding. The ideal length of AP is 2-3 days, and AP left in longer than 3 days is associated with a significantly increased risk of infectious complications.
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World journal of surgery · Dec 2012
Examining a common disease with unknown etiology: trends in epidemiology and surgical management of appendicitis in California, 1995-2009.
The study was designed to examine the epidemiology of appendicitis and risk factors of perforation and appendectomy. ⋯ This is the largest epidemiological study of appendicitis to our knowledge in recent years. Incidence has increased over time and is higher in the summer months. Whites and Hispanics have higher rates of appendicitis, but Hispanics and Asians and patients with non-private insurance, have higher odds of perforation. Surgical management of perforated appendicitis has decreased over time. It is unknown why the incidence has increased, displays seasonality, and varies by race.
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World journal of surgery · Dec 2012
A survey of surgical capacity in rural southern Nigeria: opportunities for change.
Despite growing recognition of the massive surgical burden of disease, unmet need, and disparities in access to care in many African countries, little is known about their capacity to deliver surgical, obstetric, emergency, and anesthetic care, particularly in the rural areas where up to 50% of the population lives. This study aimed to quantify the surgical capacity of select healthcare facilities in rural southern Nigeria in five key areas: Workforce, Infrastructure, Skill, Equipment, and Supplies. ⋯ Severe shortages in key areas should motivate stakeholders to devote more effort and resources to strengthening surgical capacity in rural southern Nigeria.
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World journal of surgery · Dec 2012
The faltering solid organ donor pool in the United States (2001-2010).
Organ shortage is the greatest challenge facing the field of organ transplantation today. Use of more organs of marginal quality has been advocated to address the shortage. ⋯ We detect a significant change in pattern of organ donation and use in the last decade in the United States. The transplant community should consider every precaution to prevent the decay of organ quality and to improve the use of marginal organs.
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World journal of surgery · Nov 2012
Randomized Controlled TrialIntraoperative local insufflation of warmed humidified CO₂ increases open wound and core temperatures: a randomized clinical trial.
The open surgical wound is exposed to cold dry ambient air, resulting in substantial heat loss through radiation, evaporation, and convection. At the same time, anesthesia decreases the patient's core temperature. Despite preventive measures, mild intraoperative hypothermia has been associated with postoperative morbidity. We hypothesized that local insufflation of warmed humidified carbon dioxide (CO(2)) would maintain wound and core temperature. ⋯ Insufflation of warmed, humidified CO(2) in an open surgical wound cavity prevents intraoperative decrease in surgical wound temperature as well as core temperature.