Pediatric surgery international
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Pediatr. Surg. Int. · Apr 2012
Near-miss events are really missed! Reflections on incident reporting in a department of pediatric surgery.
The aim of this study was to evaluate the frequency of surgical and organizational events that occurred in the whole Department of Paediatric Surgery at Gaslini Children's Hospital through an incident-reporting system in order to identify the vulnerabilities of this system and improve it. ⋯ An electronic physician-reported event tracking system should be incorporated into all surgery departments to report more accurately adverse events and near misses. In this system, all definitions must be standardized and near misses should be considered as important as the other events, being a rich source of learning.
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Pediatr. Surg. Int. · Feb 2012
Comparative StudyMatriderm® 1 mm versus Integra® Single Layer 1.3 mm for one-step closure of full thickness skin defects: a comparative experimental study in rats.
Dermal templates, such as Matriderm® and Integra®, are widely used in plastic and reconstructive surgery, often as two-step procedures. A recent development is the application of thin dermal templates covered with split thickness skin grafts in one-step procedures. In this experimental study, we compare the two thin matrices Matriderm® 1 mm and Integra® Single Layer in a one-step procedure with particular focus on neodermis formation. ⋯ The two templates demonstrate a comparable biological behavior early after transplantation. The only difference was found regarding neodermal thickness, probably resulting from faster degradation of Matriderm®. These preliminary data suggest that both dermal templates appear similarly suitable for transplantation in a one-step procedure.
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We present the first two cases of acute neonatal appendicitis operated on through the laparoscopic approach. Acute neonatal appendicitis is uncommon and rarely considered by clinicians when assessing the neonatal acute abdomen. Our two cases demonstrate the potential value of diagnostic laparoscopy in the acute neonatal abdomen that poses a diagnostic dilemma. Furthermore, technical modifications of well-established laparoscopic techniques in the older child enable its use in neonates as a therapeutic tool.
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Pediatr. Surg. Int. · Nov 2011
Comparative StudyDiagnosis and outcome of neutropenic enterocolitis: experience in a single tertiary pediatric surgical center in China.
Neutropenic enterocolitis (NE) is clinically defined by the triad of neutropenia, abdominal pain and fever. This retrospective study is to review 24 cases of NE in a single Chinese tertiary center, to elucidate clinical feature, treatments and outcome for this dangerous gastrointestinal complication of neutropenia. ⋯ NE is a life-threatening gastrointestinal complication of neutropenia. Physicians might remain vigilant and consider NE in any neutropenic patient rather than only in oncologic patients. It has typical clinical presentation and CT can provide clear delineation for diagnosis. Early recognition and progressed management have reduced mortality. Most children with NE may be treated without surgery with favorable outcome.
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Pediatr. Surg. Int. · Nov 2011
Comparative StudySevere renal injuries in children following blunt abdominal trauma: selective management and outcome.
Blunt trauma accounts for the majority of pediatric renal injuries. Most injuries are often minor and can be managed without surgical intervention. We have retrospectively reviewed our series of children with severe (grade IV/V) renal injuries, their management and outcome. ⋯ Most children with grade IV/V renal injury following blunt trauma can be managed non-operatively. Management can be properly planned and executed based on clinical features, CT imaging and staging of renal injuries. Surgical intervention is needed for associated abdominal organ injuries and renal vascular injuries.