Arch Surg Chicago
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Measurement of pelvic hemorrhage on computed tomographic (CT) scans can estimate the pelvic fracture component of total patient blood loss and predict the need for angiography. ⋯ Pelvic hemorrhage volumes derived from pelvic CT scans were predictors of the need for pelvic arteriography and transfusions.
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Biography Historical Article
On being a surgeon, or the good old days of surgery.
The early US physician and medical educator, Nathan Smith, MD, was also--perhaps above all--a surgeon of considerable distinction. This brief look at the surgical side of his career presents some of the evidence for Smith's having been singled out so often as a seminal figure in early American medicine. ⋯ This article also provides insights into Smith's actual surgical practice. Here, readers can see how much surgery has changed while being reminded once again of what some important characteristics of outstanding surgeons are.
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Infectious complications are the main causes of postoperative morbidity in abdominal surgery. Identification of risk factors, which could be avoided in the perioperative period, may reduce the rate of postoperative infectious complications. ⋯ Our data show that risk factors for SSI and for global infectious complications are disparate. Indeed, only the placement of a suture or having an anastomosis of the bowel in the digestive tract is a risk factor for both SSI and global infections. Some of these factors may be modifiable before or during the surgical procedure to reduce the infection rate or to prevent postoperative complications.
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Comparative Study
Advantages of laparoscopic colectomy in older patients.
Few data describe the relative benefits of an expedited recovery program and laparoscopic technique in older vs younger patients undergoing colectomy. We compared short-term outcomes in age-matched cohorts of patients undergoing laparoscopic vs open segmental colectomy managed with the Controlled Rehabilitation With Early Ambulation and Diet program. ⋯ The Controlled Rehabilitation With Early Ambulation and Diet program in combination with laparoscopic segmental colectomy can be safely performed in all age groups. The technique offers particular advantages to older patients because of reductions in length of hospital stay, morbidity and mortality rates, and direct cost of care.