Articles: cations.
-
Adv Skin Wound Care · Nov 2015
Comparative StudySurgical Treatment of Pressure Ulcers with a Fibrin Sealant in Patients with Spinal Cord Injury: A Cost-Consequence Analysis.
A comparative study was performed to evaluate the effectiveness and costs of a fibrin sealant (Tissucol Duo [known as Tisseel in the United States], Baxter International, Deerfield, Illinois) to improve postoperative outcomes in patients with spinal cord injury undergoing surgical treatment for pressure ulcers (PrUs). ⋯ The application of Tissucol Duo during surgical treatment of PrUs in patients with spinal cord injury has been shown to be effective in reducing postoperative complications and in shortening the duration of the hospital stay with a consequent savings in costs.
-
There is growing concern over the effect of starting non-emergent cardiac surgery later in the day on clinical outcomes and resource utilization. Our objective was to determine the differences in patient outcomes for starting non-emergent cardiac surgery after 3 pm. ⋯ Starting non-emergent cardiac cases later in the day is associated with 2 times higher absolute and risk-adjusted mortality. These data should be carefully considered, not only by surgeons and patients but also in the context of the operating room system when scheduling non-emergent cardiac cases.
-
The 2012 international consensus guidelines for the management of intraductal papillary mucinous neoplasms (IPMN) recommend surgical treatment in main-duct IPMN patients with a main pancreatic duct (MPD) diameter of ≥10 mm. Aim of the present study was to analyze cancer risk in patients with an MPD diameter of less than 10 mm. ⋯ Main-duct IPMNs with a MPD between 5 and 9 mm already bear a significant risk of malignancy. Therefore, surgical treatment is clearly indicated in patients with a MPD diameter of ≥5 mm and the 2012 guidelines should be discussed and adapted with regard to this topic.
-
In our present health and medical education system, participation of residents and fellows is under increasing scrutiny regarding their role in surgery and the outcomes of the procedure. Our goal was to perform a clinical outcomes analysis investigating resident and fellow participation in breast surgery. ⋯ Resident/fellow participation does not negatively affect early postoperative breast surgery outcomes, and complication rates are unrelated to the training level of the participating resident/fellow surgeon.
-
Patients with severe hypernatremia who receive conventional treatment are often undertreated. Data on the management of acute hypernatremia using continuous venovenous hemofiltration (CVVH) are limited to anecdotes. This study aimed to evaluate the efficacy and safety of CVVH treatment for acute severe hypernatremia in critically ill patients in a retrospective cohort. ⋯ The CVVH group had a significantly greater reduction in the serum sodium concentration (0.78 [0.63-1.0] mmol/L/h versus 0.13 [0.009-0.33] mmol/L/h), P < 0.001) and an improved 28-day survival rate (34.8% vs. 8.7%, P = 0.002) compared with the conventional treatment group. The two groups did not differ significantly in treatment-related complications. CVVH treatment is possibly more effective than conventional treatment for the management of acute severe hypernatremia in critically ill patients.