The Journal of surgical research
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Randomized Controlled Trial
Chlorhexidine bathing and Clostridium difficile infection in a surgical intensive care unit.
Clostridium difficile is the most common causative pathogen for hospital-acquired infections in the intensive care unit. This study evaluated the effect of chlorhexidine bathing every other day in preventing hospital-acquired C. difficile infection (CDI) using data from the CHlorhexidine Gluconate BATHing (CHG-BATH) randomized trial. ⋯ It is inconclusive if there was an association between chlorhexidine bathing and incidence of CDI among surgical intensive care unit patients in this study as statistical power was limited. There are limited published data evaluating the association between chlorhexidine bathing and CDI, and this study provides data for future systematic reviews and meta-analyses.
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Randomized Controlled Trial Comparative Study
Comparison of dexmedetomidine versus propofol on hemodynamics in surgical critically ill patients.
Sedation with dexmedetomidine and propofol may cause hypotension or bradycardia. This study aimed to compare the effects of dexmedetomidine and propofol on hemodynamics and clinical outcomes in surgical intensive care unit (ICU) patients after major abdominal surgery. ⋯ Cardiac index did not differ significantly between the dexmedetomidine and propofol groups in surgical ICU patients after major abdominal surgery.
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Randomized Controlled Trial
Effectiveness of continuous wound infusion of local anesthetics after abdominal surgeries.
To assess the effectiveness of continuous preperitoneal wound infusion of local anesthetic drug bupivacaine in providing pain relief, reducing opioid consumption, and enhancing postoperative recovery. ⋯ Continuous preperitoneal wound infusion of local anesthetic provides effective analgesia, reduces morphine consumption and its associated side effects, and enhances the postoperative recovery by reducing the incidence of prolonged postoperative ileus.
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Randomized Controlled Trial
Seven-day intensive preoperative rehabilitation for elderly patients with lung cancer: a randomized controlled trial.
As a newly developed treatment, preoperative pulmonary rehabilitation (PR) has been studied in depth. However, few studies have assessed the relationship between advanced age and a shorter term intensive pattern of preoperative PR in patients with lung cancer (LC) and especially those patients waiting for therapeutic LC surgeries. This study investigated short-term preoperative PR combined with inspiratory muscle training (IMT) and aerobic endurance training in elderly patients scheduled to undergo LC lobectomy. ⋯ For elderly LC patients scheduled to undergo surgery in China, a 7-d intensive pattern of preoperative PR combined with IMT and aerobic endurance training may be a feasible rehabilitation strategy with positive physical and psychological effects.
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Randomized Controlled Trial Comparative Study
Three-year results of a randomized study comparing self-gripping mesh with sutured mesh in open inguinal hernia repair.
The primary aim of the present study was to evaluate whether usage of self-gripping mesh in open inguinal hernia repair, compared with standard Lichtenstein repair with sutured mesh, could result in a decreased rate of chronic pain. The secondary aim was to evaluate the rate of foreign body feeling, hernia recurrence, and risk factors for chronic pain development. ⋯ We failed to demonstrate the advantages of self-gripping mesh in terms of chronic pain and foreign body feeling. However, usage of self-gripping mesh does not increase hernia recurrence rate. Considering the higher price of self-gripping mesh, analysis of cost-effectiveness is needed to prove its advantage and to justify its usage. As severe early postoperative pain is a risk factor for chronic pain development, a very effective postoperative pain control strategy is important after inguinal hernioplasty to reduce the rate of chronic pain.