American journal of surgery
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Observational Study
Beyond surgical care improvement program compliance: antibiotic prophylaxis implementation gaps.
Despite increased compliance with Surgical Care Improvement Project infection measures, surgical-site infections are not decreasing. The aim of this study was to test the hypothesis that documented compliance with antibiotic prophylaxis guidelines on a pediatric surgery service does not reflect implementation fidelity or adherence to guidelines as intended. ⋯ Lack of implementation fidelity in antibiotic prophylaxis guidelines may partly explain the lack of expected reduction in surgical-site infections. Future studies of Surgical Care Improvement Project effectiveness should measure adherence and implementation fidelity rather than just documented compliance.
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Functional outcomes can improve with early intensive care unit (ICU) mobilization programs but require additional resources. Details regarding resource allotment and methods to deliver therapy are lacking. We describe an effective team-based, resource-efficient mobility program (REMP). ⋯ A team-based, resource-efficient approach to early mobilization is feasible and effective in the ICU.
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There is limited knowledge on how diabetes and other comorbidities influence the survival of patients undergoing curative esophageal cancer surgery. ⋯ This study revealed no strongly increased risk for mortality in patients with diabetes or other comorbidities selected for esophageal cancer surgery.
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Observational Study
Improving postoperative handover: a prospective observational study.
The information provided during the postoperative handover influences the delivery of care of patients in the postoperative recovery unit through their care on the ward. There is a need for a structured and systematic approach to postoperative handover. The aim of this study was to improve postoperative handover through the implementation of a new handover protocol, which involved a handover proforma and standardization of the handover process. ⋯ The study demonstrates that standardization of postoperative handover improved communication and teamwork and reduced information omissions and task errors. There was an improvement in the quality of the handover after the introduction of the new handover protocol, which was easy and simple to use.
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Comparative Study
Single incision vs conventional laparoscopic anterior resection for sigmoid colon cancer: a case-matched study.
The purpose of the study was to evaluate the safety and effects of single-incision laparoscopic anterior resection (SILAR) for sigmoid colon cancer by comparing it with conventional laparoscopic anterior resection (CLAR). ⋯ On the basis of the early outcomes, we conclude that SILAR is feasible and safe. Moreover, the adequate lymph node harvest and free margins support the use of this procedure.