Langenbeck's archives of surgery
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Langenbecks Arch Surg · Jun 2012
Comparative StudyValue of the SOFA score as a predictive model for short-term survival in high-risk liver transplant recipients with a pre-transplant labMELD score ≥ 30.
The Sequential Organ Failure Assessment (SOFA) score has been applied for the prediction of survival in critically ill patients. We analysed the value of the SOFA score for the prediction of short-term survival after liver transplantation in high-risk liver transplant recipients with a labMELD score ≥30. ⋯ Our results confirm the usefulness of the SOFA score in high-risk liver recipients during the early post-operative course, especially on PODs 7-8 for the prediction of hospital mortality, 30-day mortality and 3-month mortality and may be useful to predict futile early acute retransplantation.
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Langenbecks Arch Surg · Mar 2012
PCR-based rapid sepsis diagnosis effectively guides clinical treatment in patients with new onset of SIRS.
Early detection of the causing microorganism and timely therapeutic intervention are crucial for improved outcome of patients with sepsis. Quite recently, we evaluated the technical and diagnostic feasibility of a commercial multiplex real-time polymerase chain reaction (PCR) (LightCycler SeptiFast® assay) for detection of blood stream infections in a cohort of intensive care unit (ICU) patients with the risk of abdominal sepsis. ⋯ Our study demonstrates improved detection of specific pathogens with a high intrinsic resistance and positive impact on therapeutic decision-making by additional multiplex-PCR-based analysis of blood samples for infectious agents in patients with new onset of SIRS. Thus, we showed for the first time that PCR test results guide clinical treatment successfully.
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Langenbecks Arch Surg · Mar 2012
Multicenter Study Clinical TrialEvaluation of the safety and efficacy of MonoMax® suture material for abdominal wall closure after primary midline laparotomy-a controlled prospective multicentre trial: ISSAAC [NCT005725079].
Different suture techniques and various suture materials are in use to close midline incisions after primary laparotomy. The ISSAAC study aimed to assess the safety and efficacy of the new ultra-long-term absorbable, elastic monofilament suture material MonoMax® for abdominal wall closure. ⋯ The ultra-long-term absorbable, elastic monofilament suture material MonoMax® is safe and efficient for abdominal wall closure.
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Langenbecks Arch Surg · Feb 2012
Multicenter Study Comparative StudyOpen tension-free hernioplasty using a novel lightweight self-gripping mesh: medium-term experience from two institutions.
The process of mesh fixation and the potential risk of associated chronic pain are always surgeon's main concerns in hernia surgery. A wide variety of lightweight mesh models are currently available on the market to overcome some of these problems showing good preliminary results, but no data representing the medium- or long-term results. The present study aims to report the clinical outcomes of two institutional series of patients who underwent hernia repair using a partially absorbable auto adherent mesh (Parietene™ Progrip™--PP). ⋯ In our experience, the use of the PP mesh for hernioplasties offers a potential benefit not only in the short-term period but also in a medium-term follow-up with low recurrence and late chronic pain rates. However, this particular mesh does not fully prevent all complications and chronic pain and recurrent hernias have been reported for the first time.
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Langenbecks Arch Surg · Feb 2012
Multicenter Study Comparative StudyAppendectomy and diagnosis-related groups (DRGs): patient classification and hospital reimbursement in 11 European countries.
As part of the EuroDRG project, researchers from 11 countries (i.e., Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Sweden, and Spain) compared how their diagnosis-related groups (DRG) systems deal with appendectomy patients. The study aims to assist surgeons and national authorities to optimize their DRG systems. ⋯ Large variations in the classification of appendectomy patients raise concerns whether all systems rely on the most appropriate classification variables. Surgeons and national DRG authorities should consider how other countries' DRG systems classify appendectomy patients in order to optimize their DRG system and to ensure fair and appropriate reimbursement.