Journal of vascular surgery
-
Within the vascular patient population there is increased risk of developing wound complications especially in infra-inguinal incisions. There has been increasing interest in using closed incisional negative pressure dressings to decrease the risk of wound complications. To assess the efficacy of these incisional wound dressings we studied surgical site infections and seroma rates of infrainguinal incisions in our vascular patient population. ⋯ The use of an incisional negative pressure dressing decreases the rate of surgical site infections in infrainguinal incisions. Regarding the use of these wound systems for seromas; our study did not show a statistical significance in decreasing seroma rates.
-
Multicenter Study Observational Study
Association and interplay of surgeon and hospital volume with mortality after open abdominal aortic aneurysm repair in the modern era.
Operative volume has been used as a marker of quality. Research from previous decades has suggested minimum open abdominal aortic aneurysm (AAA) repair volume requirements for surgeons of 9 to 13 open AAA repairs annually and for hospitals of 18 open AAA repairs annually to purportedly achieve acceptable results. Given concerns regarding the decreased frequency of open repairs in the endovascular era, we examined the association of surgeon and hospital volume with the 30- and 90-day mortality in the Vascular Quality Initiative (VQI) registry. ⋯ Surgeons and hospitals in the VQI registry achieved mortality outcomes of <5% (Society for Vascular Surgery guidelines), with an average surgeon volume that was substantially lower compared with previous reports. Furthermore, when considering the development of minimal surgeon volume guidelines, it is important to contextualize the outcomes within the hospital volumes.