Obstetrics and gynecology
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Obstetrics and gynecology · Dec 2010
EditorialA simple checklist for preventing major complications associated with cesarean delivery.
I propose a simple, evidence-based, eight-item checklist that, if followed, should reduce the frequency of many of the most serious complications associated with cesarean delivery: endometritis, wound infection, wound disruption, thrombophlebitis, and uterine scar dehiscence in a subsequent pregnancy. The frequency of abdominal wound infections can be reduced significantly by using electric clippers, rather than a razor, to remove the hair at the site of the surgical incision, washing the skin with a chlorhexidine solution, and administering broad-spectrum antibiotic prophylaxis before the start of surgery rather than after the neonate's umbilical cord has been clamped. ⋯ Closure of the deep subcutaneous layer in patients whose subcutaneous tissue is greater than 2 cm in thickness will significantly reduce the risk of seroma, hematoma, and subsequent wound disruption. Institution of appropriate prophylaxis for deep vein thrombosis in intermediate and high-risk patients will reduce the risk of subsequent thromboembolic events.
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Obstetrics and gynecology · Dec 2010
Review Comparative StudyRobotic-assisted hysterectomy for endometrial cancer compared with traditional laparoscopic and laparotomy approaches: a systematic review.
To summarize comparative studies describing clinical outcomes of robotic-assisted surgeries compared with traditional laparoscopic or laparotomy techniques for the treatment of endometrial cancer. ⋯ Perioperative clinical outcomes for robotic and laparoscopic hysterectomy appear similar with the exception of less blood loss for robotic cases and longer operative times for robotic and laparoscopy cases.
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Obstetrics and gynecology · Oct 2010
Randomized Controlled Trial Multicenter StudyTranexamic acid treatment for heavy menstrual bleeding: a randomized controlled trial.
To assess the efficacy and safety of an oral formulation of tranexamic acid for the treatment of heavy menstrual bleeding. ⋯ I.
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Obstetrics and gynecology · Oct 2010
Randomized Controlled TrialImproving continuous wound infusion effectiveness for postoperative analgesia after cesarean delivery: a randomized controlled trial.
To evaluate in which anatomical layer (above the fascia or below the fascia) continuous wound infusion of local anesthetic, combined with nonsteroidal antiinflammatory drugs, through a multiorifice catheter has the best effectiveness during the first 48 hours on postoperative pain intensity after elective cesarean delivery. ⋯ I.