The Journal of surgical research
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The Modified Hernia Grading System (MHGS) was developed to risk stratify complex ventral hernia repairs (VHRs). MHGS grade 3 patients have mesh infections, dirty or contaminated fields, and/or violation of the alimentary tract. Reported surgical site infection (SSI) rates are over 40% after single-stage VHR in contaminated fields. In an attempt to decrease the SSI rate in MHGS grade 3 patients, we developed a dual-stage VHR (DSVHR) approach. ⋯ DSVHR in MHGS grade 3 patients is associated with a lower SSI rate than previously reported for those undergoing single-stage repairs.
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Immediate postoperative admission to the intensive care unit (ICU) after pancreaticoduodenectomy (PD) is still a standard practice at many institutions. Our aim was to examine whether omission of an immediate postoperative ICU admission would be safe and result in improved outcomes and cost after robotic pancreaticoduodenectomy (RPD). ⋯ A standard policy of omitting a postoperative ICU admission on post operative day 0 after RPD is safe and can result in reduced LOS and overall savings in total hospital cost.
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Black men are disproportionately overrepresented among victims of repeat violent injury. However, little is known about the risk factors that influence violent trauma recidivism among black men. We hypothesize that the following risk factors would be significant among black male victims of repeat violent injury: disrespect; being under the influence; being in a fight and using a weapon in the past year; and previous incarceration when comparing trauma recidivists versus nonrecidivists. ⋯ Trauma recidivism among urban black male victims of violent injury is a major public health issue. Hospital-based violence intervention programs should be engaged in reducing trauma recidivism among this population.
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Biography Historical Article
Vacca pox to pexa vec: John Hunter's and Edward Jenner's contribution to oncolytic virotherapy.
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Clinical Trial
Implementation of national practice guidelines to reduce waste and optimize patient value.
The financial health care crisis has provided the platform to drive operational improvements at US health care facilities. This has led to adoption of lean operation principles by many health care organizations as a means of eliminating waste and improving operational efficiencies and overall value to patients. We believe that standardized implementation of national practice guidelines can provide the framework to help to reduce financial waste. ⋯ Here, we demonstrate that standardized application of a national practice guideline can be used to eliminate nearly $2 billion per year in waste from the US health care system.