American journal of surgery
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Randomized Controlled Trial
The effect of mupirocin dressings on postoperative surgical site infections in elective colorectal surgery: A prospective, randomized controlled trial.
Surgical site infections (SSIs) are the most common nosocomial infection among surgical patients. We hypothesized that mupirocin ointment would decrease SSI rates compared to standard surgical dressings in patients undergoing colorectal surgery. ⋯ Mupirocin (2%) ointment failed to show a benefit compared to standard dressings for postoperative SSI.
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Randomized Controlled Trial
A randomized double blinded study to determine the effectiveness of utilizing intraperitoneal bupivacaine: Does it reduce postoperative opioid use following laparoscopic appendectomy?
Improving postoperative pain control may lead to improved outcomes including decreased opioid use, shorter hospital stays, and improved patient satisfaction. This study examined the effects of instilling intraperitoneal bupivacaine following laparoscopic appendectomy. ⋯ This prospective, randomized, double-blinded, placebo-controlled study enrolled subjects with acute appendicitis undergoing laparoscopic appendectomy. Subjects were randomized to receive either bupivacaine or normal saline intraperitoneally at the close of surgery. In the bupivacaine group, pain scores at 1 h were improved and inpatient postoperative opioid use was less.
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Randomized Controlled Trial Comparative Study
Pain control with continuous infusion preperitoneal wound catheters versus continuous epidural analgesia in colon and rectal surgery: A randomized controlled trial.
To compare continuous infusion preperitoneal wound catheters (CPA) versus continuous epidural analgesia (CEA) after elective colorectal surgery. ⋯ Continuous epidural analgesia provided superior pain control following colorectal surgery in the PACU and on the day of surgery. The secondary endpoints of return of bowel function, length of stay, and adjusted SF-36 were not affected by choice of peri-operative pain control.
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Randomized Controlled Trial
Patient Hand-Off iNitiation and Evaluation (PHONE) study: A randomized trial of patient handoff methods.
As residency work hour restrictions have tightened, transitions of care have become more frequent. Many institutions dedicate significant time and resources to patient handoffs despite the fact that the ideal method is relatively unknown. We sought to compare the effect of a rigorous formal handoff approach to a minimized but focused handoff process on patient outcomes. ⋯ This large randomized trial comparing two contrasting handoff techniques demonstrated no clinically significant differences in patient outcomes. A minimalistic handoff process may save time and resources without negatively affecting patient outcomes.
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Randomized Controlled Trial Comparative Study
The evaluation of clopidogrel use in perioperative general surgery patients: a prospective randomized controlled trial.
The perioperative safety profile of clopidogrel, a potent antiplatelet agent used in the management of cardiovascular disease, is unknown, and there are no evidence-based guidelines recommending for either its interruption or continuation at this time. The aim of this study was to determine whether patients who are maintained on clopidogrel before general surgical procedures are at increased risk of perioperative bleeding complications. ⋯ The outcomes from this prospective study suggest that, patients undergoing commonly performed elective general surgical procedures can be safely maintained on clopidogrel without increased perioperative bleeding risk.