The Journal of surgical research
-
Controversy exists over optimal timing of tracheostomy in patients with respiratory failure after blunt trauma. The study aimed to determine whether the timing of tracheostomy affects mortality in this population. ⋯ Among non-head injured blunt trauma patients with prolonged respiratory failure, tracheostomy placement within 10 d of admission may result in increased mortality compared with later time points.
-
Information technology is transforming health care communication. Using smartphones to remotely monitor incisional wounds via digital photos as well as collect postoperative symptom information has the potential to improve patient outcomes and transitional care. We surveyed a vulnerable patient population to evaluate smartphone capability and willingness to adopt this technology. ⋯ Our survey demonstrates that an older patient cohort with significant comorbidity is able and willing to adopt a smartphone-based postoperative monitoring program. Patient training and caregiver participation will be essential to the success of this intervention.
-
Pediatric trauma patients presenting with stable, isolated injuries are often admitted to the trauma service for initial management. The purpose of this study was to evaluate admission patterns in trauma patients with isolated injuries and compare outcomes based on admitting service. ⋯ Pediatric trauma patients presenting with stable, isolated injuries may be efficiently and safely managed by nontrauma services without an increase in missed injuries or complications.
-
Randomized Controlled Trial Comparative Study
Karydakis flap versus excision-only technique in pilonidal disease.
Karydakis flap (K-flap) and excision with healing by secondary intention (EHSI) are currently accepted methods for surgical management of sacrococcygeal pilonidal disease. This clinical trial study aimed to compare early and late outcomes of these two surgical techniques. ⋯ Although both techniques are safe, the K-flap is associated with significantly lower rates of complications and recurrence and significantly shorter time of wound healing and return to work.
-
To clarify whether propofol (PROP) and dexmedetomidine (DEX) differentially affect preload dependency in an endotoxemic model based on evaluations of the systemic vascular system and cardiac function. ⋯ PROP more effectively increased PPV than DEX in an endotoxemic shock model after fluid resuscitation during norepinephrine infusion. DEX, but not PROP, at the highest dose influenced vascular resistance and heart contractility.