American journal of surgery
-
Randomized Controlled Trial
A randomized trial of antibiotic prophylaxis for the prevention of surgical site infection after open mesh-plug hernia repair.
The efficacy of antibiotic prophylaxis for the prevention of surgical-site infection (SSI) after open tension-free inguinal hernia repair remains controversial. ⋯ This study indicates that antibiotic prophylaxis is effective for the prevention of SSI after open mesh-plug hernia repair.
-
Comparative Study
Interhospital transfer of blunt multiply injured patients to a level 1 trauma center does not adversely affect outcome.
Stops at nontrauma centers for severely injured patients are thought to increase deaths and costs, potentially because of unnecessary imaging and indecisive/delayed care of traumatic brain injuries (TBIs). ⋯ Interhospital transfer does not affect the outcome of blunt trauma patients. However, the unnecessarily prolonged stay of low GCS patients in hospitals lacking neurosurgical care is inappropriate.
-
The aim of this study was to characterize patients readmitted following inpatient general surgery procedures. We hypothesized that a decreased length of stay would increase risk for readmission. ⋯ Contributors to postoperative readmissions are multifactorial. Perioperative factors predict risk for readmission and may help determine a target length of stay. Prevention of postoperative complications may reduce readmission rates.
-
The Model for End-Stage Liver Disease Sodium Model (MELD-Na) is a validated scoring system that uses bilirubin, international normalized ratio, serum creatinine, and sodium to predict mortality in cirrhotic patients awaiting liver transplantation. The aim of this study was to identify the utility of MELD-Na to predict patient outcomes, with and without liver disease, after elective colon cancer surgery. ⋯ Elevated preoperative MELD-Na score is significantly associated with worse outcomes after elective resection for colon cancer.