World journal of surgery
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World journal of surgery · Nov 2007
Early management of gunshot injuries to the face in civilian practice.
Gunshot injuries to the face in civilian practice are rarely reported. Potential complications in the Emergency Department can have catastrophic consequences, and inappropriate operative management of the facial soft and skeletal tissues are related to outcome. ⋯ Gunshot injury to the face in civilian violence is a "benign" condition as long as the Patient's airway is kept patent and hemorrhage is controlled. Early operative intervention for repair of the soft and skeletal facial structures leads to satisfactory results. Mortality directly related to the facial trauma is uncommon.
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World journal of surgery · Nov 2007
Vacuum-assisted wound closure and mesh-mediated fascial traction--a novel technique for late closure of the open abdomen.
Open abdomen (OA) treatment often results in difficulties in closing the abdomen. Highest closure rates are seen with the vacuum-assisted wound closure (VAWC) technique. However, we have experienced occasional failures with this technique in cases with severe visceral swelling needing longer treatment periods with open abdomen. Feasibility and short-term outcome of a novel combination of techniques for managing the open abdomen are presented. ⋯ Delayed primary closure in cases with severe visceral swelling and long periods of OA seems feasible with this technique.
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World journal of surgery · Nov 2007
Predictors and outcome of readmission after laparoscopic intestinal surgery.
Previous studies have failed to identify predictors of early readmission after major intestinal operations. The objectives of this study were to determine readmission rates, outcomes, and predictors of readmission for patients undergoing laparoscopic colon and rectal operations. ⋯ Early readmission after laparoscopic colon and rectal operations is not associated with early discharge. Identification of specific patient characteristics indicating risk for early readmission may allow for selective changes in perioperative care or discharge criteria to avoid unexpected readmission.
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The practice of surgical trainees operating in developing countries is gaining interest in the medical community. Although there has been little analysis about the ethical impact of these electives, there has been some concerns raised over the possible exploitation of trainees and their patients. ⋯ Advanced surgical trainees who have already achieved surgical competence are best qualified to satisfy these ethical issues. All training programs need to develop a structured ethical review for international electives to protect their trainees and their patients from harm.
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World journal of surgery · Nov 2007
Emergency left colon resection for acute perforation: primary anastomosis or Hartmann's procedure? A case-matched control study.
The optimal treatment remains controversial for acute left-sided colon perforation. Therefore, the effectiveness and safety of primary anastomosis versus Hartmann's operation (HP) was compared in a case-matched control study. ⋯ Primary anastomosis and protective ileostomy is a superior treatment to HP in acute left-sided colon perforation. In the absence of feculent peritonitis an ileostomy appears unnecessary.