The American surgeon
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Pulmonary contusion in the adult population is an independent risk factor for respiratory failure, ventilator associated pneumonia, and acute respiratory distress syndrome. Pilot studies in adults note an increased risk when volume of pulmonary contusion exceeds 20 per cent of total lung volume. The purpose of this study was to determine if children with pulmonary contusion suffer the same morbidity as adults. ⋯ No patients required intubation. Pediatric pulmonary contusion does not carry the same morbidity as noted in the adult population. Invasive airway management is rarely required.
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The American surgeon · Jul 2010
The effect of diabetes mellitus on surgical site infections after colorectal and noncolorectal general surgical operations.
Patients undergoing colorectal surgery (CRS) are known to be at increased risk of surgical site infection (SSI). We assessed the effect of diabetes and other risk factors on SSI in patients undergoing CRS and patients undergoing general surgery (GS). American College of Surgeons National Surgical Quality Improvement Program Participant Use Data File from 2005 to 2006 was used. ⋯ In this large hospital-based study, patients undergoing CRS were three times more likely to get SSI than patients undergoing GS. Diabetic patients with CRS (IDDM and NIDDM) and patients undergoing GS (IDDM) were at increased risk of SSI compared with nondiabetics. More intense glycemic control may reduce SSI in patients undergoing CRS with diabetes.
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The American surgeon · Jul 2010
Case ReportsRectosigmoid intussusception through the anus mimicking rectal prolapse.
Intussusception of the colon usually occurs in infants and children. Although rectal prolapse is not uncommon, presentation of more proximal segments of large bowel through the anus is extremely rare. We report two cases of rectosigmoid intussusception in which sigmoid colon intussusception was diagnosed as rectal prolapse preoperatively.
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The American surgeon · Jul 2010
Free and local continuing medical education does not guarantee surgeon participation in maintenance of certification learning activities.
The American Board of Surgery has adopted the Maintenance of Certification requirement for surgeons. It requires continuous professional development (CPD) using active and passive learning modalities in contrast to traditional continuing medical education (CME). The Rural Trauma Team Development Course developed by the American College of Surgeons Committee on Trauma is a CPD learning activity. ⋯ The majority felt that they would change their practice as a result of the course but cited the lack of attendance at the course by emergency physicians and surgeons as a deficit. It may be that surgeons have barriers such as time away from a practice to attending these newer types of educational opportunities. Those who develop and offer these courses may need to develop different strategies to reach this target audience.