Journal of the American College of Surgeons
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Adult trauma centers, including combined pediatric/adult centers (CPACs), see high volumes of penetrating trauma. Few studies have compared outcomes of adolescents presenting with gunshot wounds (GSWSs) at CPACs vs. pediatric only hospitals (POHs). This study aimed to compare injury patterns, complications, and mortality for adolescents sustaining GSWs presenting to CPACs vs POHs, hypothesizing decreased associated risk of complications and mortality at CPACs. ⋯ Adolescent GSW patients had similar associated risk of mortality and complications when comparing POHs to CPACs. This suggests that adolescents with GSWs receive similar care at both CPACs and POHs. Additional research is warranted to corroborate these findings.
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This study compared the clinical and economic outcomes of laparoscopic (LLR) and open liver resection (OLR) for all hepatectomies, including minor and major hepatectomies. ⋯ LLR is a safe and cost-effective alternative to OLR. While LLR has higher initial procedural costs, these are offset by significant reductions in postoperative major complications, LOS, and total costs.
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We conducted a qualitative study to describe surgeon and surgical trainee perspectives of quality improvement (QI) in training and practice to elucidate how surgeons and trainees interact with barriers and leverage facilitators to learn and conduct QI. ⋯ This qualitative evaluation further details gaps in QI demonstrated by previous quantitative studies. There is an opportunity to address these gaps with dedicated QI training and mentorship for surgical trainees and by creating a supportive environment with ample resources for surgeons.