American journal of surgery
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Randomized Controlled Trial
Is double-gloving really protective? A comparison between the glove perforation rate among perioperative nurses with single and double gloves during surgery.
Surgical teams rely on surgical gloves as a barrier to protect themselves against blood-borne pathogenic infections during surgery. Double-gloving is adopted by surgeons to tackle the problem of glove perforation. Nevertheless, double-gloving is not practiced commonly by operating room nurses and there are only limited studies about double-gloving that targets only perioperative nurses. The aim of this research was to assess the effectiveness of double-gloving in protecting perioperative nurses by comparing the frequency of glove perforation between single-gloving and double-gloving groups. ⋯ Based on the findings of the study, double-gloving is indeed effective in protecting operating room nurses against blood-borne pathogen exposure. It should be introduced as a routine practice.
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Few studies have assessed the impact of pre-existing medical comorbidities on long-term survival after major trauma. This study investigated the influence of comorbidities as measured by the Charlson Comorbidity Index (CCI) on the 1-year mortality after major traumatic injury. ⋯ Comorbid illnesses have an important influence on long-term outcomes after major trauma. Whether this represents an inherent risk for adverse outcome or an opportunity for enhanced medical co-management remains to be defined.
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The national incidence of postoperative urinary retention (POUR), its risk factors, and associated outcomes are not well understood. ⋯ Patients at risk for POUR can be identified, and they may benefit from interventions to prevent POUR.
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The standard paradigm for acutely injured patients involves evaluation in an emergency department (ED). Our center has employed a policy for bypassing the ED and proceeding directly to the operating room (OR) based on prehospital criteria. ⋯ Our DOR protocol identified a severely injured cohort at high risk for requiring surgery with improved observed survival. High-yield triage criteria for DOR admission include a penetrating truncal injury, hypotension, and a severely altered mental status.