World journal of surgery
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Postoperative fatigue (POF) significantly impacts well-being after major surgery. However, this topic has received little emphasis. ⋯ The role of local inflammation in the development of POF requires further research. Multimodal interventions should be conducted with a focus on addressing various factors that contribute to the development and progression of POF.
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World journal of surgery · Apr 2009
Management of upper extremity vascular injury: outcome related to the Mangled Extremity Severity Score.
The Mangled Extremity Severity Score (MESS) is an objective criterion for amputation prediction after lower extremity injury as well as for amputation prediction after upper extremity injury. A MESS of >or=7 has been utilized as a cutoff point for amputation prediction. In this study, we examined the result of upper extremity vascular injurty (UEVI) management in terms of the amputation rate as related to the MESS. ⋯ MESS, an outcome score used to grade the severity of extremity injuries, correlates well with the risk of amputation. Nevertheless, a MESS of >or=7 does not always mandate amputation. On the other hand, the MESS is a better predictor for patients who do not require amputation when the score is <7. The decisions to amputate in patients should be made individually based on clinical signs and an intraoperative finding of irreversible limb ischemia.
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World journal of surgery · Apr 2009
Neuropathy after herniorrhaphy: indication for surgical treatment and outcome.
Chronic neuropathy after hernia repair is a neglected problem as very few patients are referred for surgical treatment. The aim of the present study was to assess the outcome of standardized surgical revision for neuropathic pain after hernia repair. ⋯ The results of this cohort study suggest that surgical mesh removal with ilioinguinal and iliohypogastric neurectomy is a successful treatment in patients with neuropathic pain after hernia repair.
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World journal of surgery · Mar 2009
Laparoscopic surgical skills assessment: can simulators replace experts?
Global Rating Scales (GRS) quantify and structure subjective expert assessment of skill. Hybrid simulators measure performance during physical laparoscopic tasks through instrument motion analysis. We assessed whether motion analysis metrics were as accurate as structured expert opinion by using GRS. ⋯ Metrics correlate well with GRS assessment, supporting concurrent validity. Metrics predict experience level as accurately as global rating and are construct valid. Hybrid simulators could provide resource-efficient feedback, freeing trainers to concentrate on teaching.