American journal of surgery
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The bispectral index (BIS) is a processed electroencephalographic value (awake = 100, isoelectric = 0). The relationship of BIS and brain death (BD) is assessed. ⋯ Distinguishing brain death and near brain death in severely comatose trauma patients is complex. By indicating the likelihood of brain death, BIS is an adjunct for efficient evaluation.
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Comparative Study
Using antimicrobial solution for irrigation in appendicitis to lower surgical site infection rates.
The use of antimicrobial solutions for irrigation in appendicitis is controversial. Numerous antiseptic and antibiotic solutions have been suggested for use as an intraoperative irrigant. We sought to determine whether there was a difference in postoperative surgical site infections (SSIs) comparing normal saline (.9%), antiseptic solution (Dakin's, .25%), and an antibiotic solution (imipenem 1 mg/mL). ⋯ These results suggest that abdominal irrigation with an antibiotic solution (imipenem 1 mg/mL) is superior to both normal saline and Dakin's solution.
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Multicenter Study
Predictors of successful implementation of preoperative briefings and postoperative debriefings after medical team training.
The purpose of this study was to examine which factors at a medical team training learning session predict future success in the implementation of preoperative briefings and postoperative debriefings at health care facilities. ⋯ Full implementation of the patient safety tool preoperative briefings and postoperative debriefings is dependent on facility leadership support.
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Randomized Controlled Trial
Prospective randomized trial of paravertebral block for patients undergoing breast cancer surgery.
The goal of the current study was to evaluate the effect of regional anesthesia using paravertebral block (PVB) on postoperative pain after breast surgery. ⋯ PVB significantly decreases postoperative pain up to 3 hours after breast cancer surgery.
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From the legacy of Shukri Khuri, we have successfully implemented a regional quality collaborative in Michigan, the Michigan Surgical Quality Collaborative (MSQC). ⋯ The improved quality was likely the result of diverse process measures, many not yet recognized in the literature, which came together effectively in specific hospitals.