American journal of surgery
-
The perioperative management of clopidogrel remains an area of controversy. ⋯ Laparoscopic cholecystectomy performed on patients maintained on clopidogrel during the perioperative period did not produce an increase in blood loss, operative time, 30-day morbidity, or length of stay.
-
Multimodality monitoring and goal-directed therapy may not prevent blood flow and brain oxygen (Flow/BrOx) crisis. We sought to determine the impact of these events on outcome in patients with severe traumatic brain injury (sTBI). ⋯ A multimodality monitoring and goal-directed therapy may decrease mortality in sTBI. However, Flow/BrOx crisis events still occur and predict a poor outcome.
-
We hypothesized that patients with acute mild gallstone pancreatitis (GSP) admitted to surgery (SUR; vs medicine [MED]) had a shorter time to surgery, shorter hospital length of stay (HLOS), and lower costs. ⋯ Admitting acute mild GSP patients directly to SUR shortened the time to surgery, shortened HLOS, and lowered hospital costs.
-
Randomized Controlled Trial
High-concentration supplemental perioperative oxygen and surgical site infection following elective colorectal surgery for rectal cancer: a prospective, randomized, double-blind, controlled, single-site trial.
Perioperative supplemental oxygen has been proposed to decrease the incidence of surgical site infection (SSI) in colorectal surgery with controversial results. We have assessed the influence of hyperoxygenation on SSI by using the most homogeneous study population. ⋯ Supplemental 80% FiO2 reduced postoperative SSI with few risks to the patient and little associated cost.
-
The objective of this study was to evaluate implementation of an innovative intervention designed to prevent complications and stimulate early rehabilitation among frail elderly inpatients. ⋯ The CareWell in Hospital program was implemented satisfactorily. Although the low baseline delirium incidence (11%), higher comorbidity, and an increasing learning curve during a restricted implementation period potentially influenced the overall effects, this integrated care program may have beneficial effects on outcomes among frail elderly surgical patients.