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Patient Safety in Surgery

Sascha Halvachizadeh, Henrik Teuber, Paolo Cinelli, Florin Allemann, Hans-Christoph Pape, Valentin Neuhaus
Background: Orthopedic trauma surgery has multiple, both patient-based and surgeon-based risk factors. Evaluating and modifying certain patient safety factors could mitigate some of these risks. This study investigates the influence that the time of day of surgery has on mortality and complication rates. Question/purpose: This study evaluates whether the time of day of orthopedic trauma surgery influences complication or mortality rates. Patients and methods: A prospective Swiss surgical database developed as a nationwide quality assurance project was reviewed retrospectively...
2019: Patient Safety in Surgery
Florin Allemann, Sandro Heining, Boris Zelle, Christian Probst, Hans-Christoph Pape
Background: In terms of upper extremity fractures by patients with multiple injuires, a lot of studies have assessed the functional outcome following trauma to have less favorable outcomes in regards to functional recovery. We tested the hypothesis that differences in clinical outcome occur between shaft and articular injuries of the upper extremity, when patients that sustained neurologic deficits (e.g. brachial plexus lesions) are excluded. Methods: We involved Patients with isolated or combined upper extremity fracture, ISS > 16 in a level one trauma center...
2019: Patient Safety in Surgery
Lawrence A Lynn
The integration of artificial intelligence (AI) into acute care brings a new source of intellectual thought to the bedside. This offers great potential for synergy between AI systems and the human intellect already delivering care. This much needed help should be embraced, if proven effective. However, there is a risk that the present role of physicians and nurses as the primary arbiters of acute care in hospitals may be overtaken by computers. While many argue that this transition is inevitable, the process of developing a formal plan to prevent the need to pass control of patient care to computers should not be further delayed...
2019: Patient Safety in Surgery
Boris A Zelle, Philip F Stahel
No abstract text is available yet for this article.
2019: Patient Safety in Surgery
P Vogel, D H V Vogel
Background: Cognitive errors have a considerable effect on procedural outcome. They play a major role in situational judgement and decision making, especially during cognitively demanding tasks. As such they need to be considered an important factor in medical and surgical procedures. However, whereas cognitive diagnostic errors are well known, as of yet the occurrence of errors due to cognitive heuristics may have been downplayed, underestimated, or simply been ignored during the course of surgical treatment...
2019: Patient Safety in Surgery
Benoit Blondeau, Alessandro Orlando, Stephanie Jarvis, Kaysie Banton, Gina M Berg, Nimesh Patel, Rick Meinig, Allen Tanner, Matthew Carrick, David Bar-Or
Background: Mortality from hemodynamically unstable pelvic fractures remains high. Guidelines offer varying care approaches including the use of pelvic packing (PP), which was recently adopted for potential control of bleeding for this condition. However, the implementation of PP is uncertain as the debate on the optimal resuscitation strategy, angioembolization or PP continues. The study was designed to assess current practices among level 1 trauma centers in the US in regard to PP treatment for hemodynamically unstable pelvic fractures...
2019: Patient Safety in Surgery
Peter C Ambe, Jens Plambeck, Victoria Fernandez-Jesberg, Konstantinos Zarras
Background: Bile duct injury is the most feared complication during laparoscopic cholecystectomy. Real-time intraoperative imaging using indocyanine green (ICG) might reduce the risk of bile duct injury by improving visualization of the biliary tree during laparoscopic cholecystectomy. We compared the outcomes of laparoscopic cholecystectomy in patients with and without real-time ICG. Methods: A retrospective analysis of the data of patients undergoing laparoscopic cholecystectomy with and without ICG in a referral centre for minimally invasive surgery was performed...
2019: Patient Safety in Surgery
C Brückner, E Straube, I Petersen, S Sachse, P Keller, F Layher, G Matziolis, U Spiegl, D Zajonz, M Edel, A Roth
Purpose: Arthrofibrosis after total knee arthroplasty represents a considerable burden for the patient and a therapeutic challenge for the practitioner. One possible cause discussed in the literature is a low-grade infection. This hypothesis should be examined within the scope of this retrospective study. Patients and methods: Nineteen patients with clinical symptoms of arthrofibrosis after primary total knee arthroplasty were examined between January, 1999 and January, 2012...
2019: Patient Safety in Surgery
Kirit Singh, Michael S J Wilson, Maria Coats
Background: Multiple disciplines have described an "after-hours effect" relating to worsened mortality and morbidity outside regular working hours. This retrospective observational study aimed to evaluate whether diagnostic accuracy of a common surgical condition worsened after regular hours. Methods: Electronic operative records for all non-infant patients (age > 4 years) operated on at a single centre for presumed acute appendicitis were retrospectively reviewed over a 56-month period (06/17/2012-02/01/2017)...
2018: Patient Safety in Surgery
Michel Paul Johan Teuben, Roy Spijkerman, Taco Johan Blokhuis, Roman Pfeifer, Henrik Teuber, Hans-Christoph Pape, Luke Petrus Hendrikus Leenen
Background: Nonoperative management for blunt splenic injury is the preferred treatment. To improve the outcome of selective nonoperative therapy, the current challenge is to identify factors that predict failure. Little is known about the impact of concomitant injury on outcome. Our study has two goals. First, to determine whether concomitant injury affects the safety of selective nonoperative treatment. Secondly we aimed to identify factors that can predict failure. Methods: From our prospective trauma registry we selected all nonoperatively treated adult patients with blunt splenic trauma admitted between 01...
2018: Patient Safety in Surgery
Boris A Zelle, Antonio J Webb, Christopher Matson, Michael Morwood, Khang H Dang, Samuel S Ornell, Gabrielle Gostigian, Cody M Ramirez, Hassan Mir
Introduction: Recent advances have led to the design of a new cephalomedullary nail, which aims to decrease the risk of failures in patients with intertrochanteric hip fractures by allowing for insertion of two interdigitating screws into the head segment. The goal of this study is to evaluate the safety and efficacy of this two-screw cephalomedullary nailing system. Patients/participants: Patients 18 years of age and older who underwent intramedullary nailing of their intertrochanteric femoral fracture using the InterTAN nailing system (Smith and Nephew, Memphis, TN) from 2012 to 2016 were included in this retrospective study which was performed at two urban certified level-1 trauma centers and one urban certified level-3 trauma center...
2018: Patient Safety in Surgery
Robert S O'Connell, Bryce N Clinger, Erin E Donahue, Francesco S Celi, Gregory J Golladay
Background: Dexamethasone has been routinely used in the pre-operative setting to enhance analgesia and decrease the incidence of nausea and vomiting in patients undergoing primary arthroplasty. However, dexamethasone has the potential to increase blood glucose levels postoperatively, which is a known risk factor for complications after total joint arthroplasty. The aim of this study was to analyze the effect of dexamethasone administration on post-operative blood glucose levels in diabetic patients after primary hip and knee arthroplasty...
2018: Patient Safety in Surgery
Nabil Alassaf
Background: Open reduction of the congenitally dislocated hip may not be possible without femoral shortening. The goal of this study is to develop a prognostic prediction model for the need of femoral shortening in children undergoing anterior open reduction for the treatment of developmental dysplasia of the hip (DDH). The secondary objective was to determine if femoral shortening influences the risk of adverse events. Methods: A cohort from February 1, 2008 thru July 31, 2017 was studied retrospectively at a single centre...
2018: Patient Safety in Surgery
Abdulrahman Hamad Al-Abdulwahhab, Abdulaziz Mohammad Al-Sharydah, Sari Saleh Al-Suhibani, Saeed Ahmad Al-Jubran, Ali Khalaf Al-Haidey, Abdulkhaliq Ibrahim Al-Hifzi, Wissam Al-Issawi
Background: Spinal myelitis is an infrequent manifestation of spinal cord infection. It is caused by the Schistosoma species, which are endemic in South America, part of the Middle East, and Africa. Case presentation: We report the case of a 13-year-old male adolescent complaining of progressive lower back pain and weakness of the lower extremities for 3 days. Initial magnetic resonance imaging revealed typical transverse myelitis. Subsequently, parasite serology showed a markedly elevated level of Schistosoma antibody titers, and cerebrospinal fluid analysis yielded normal results...
2018: Patient Safety in Surgery
Ala A Alhowary, Haitham Odat, Obada Alali, Ali Al-Omari
Background: Angiotensin II receptor blockers are a class of antihypertensive agent that is developed to exclude the adverse effects of angiotensin converting enzyme inhibitors. However, as angiotensin II receptor blockers have begun to be more widely prescribed, cases of angiotensin II receptor blocker-induced angioedema have been reported. Rare cases of angioedema following surgery in patients using angiotensin converting enzyme inhibitors have been published. Case presentation: A 38-year-old man with past history of hypertension was admitted for an elective lumbosacral spine surgery...
2018: Patient Safety in Surgery
James T Carson, Sabin G Shah, Gezzer Ortega, Sorawut Thamyongkit, Erik A Hasenboehler, Babar Shafiq
Background: There have been no large-scale epidemiological studies of outcomes and perioperative complications in morbidly obese trauma patients who have sustained closed pelvic ring or acetabular fractures. We examined this population and compared their rate of inpatient complications with that of control patients. Methods: We retrospectively reviewed the records of patients treated for closed pelvic ring or acetabular fracture, aged 16-85 years, with Injury Severity Scores ≤15 from the National Trauma Data Bank Research Dataset for the years 2007 through 2010...
2018: Patient Safety in Surgery
Dimonge Joseph Anthony, Basnayaka Mudiyanselage Oshan Deshanjana Basnayake, Yasith Mathangasinghe, Ajith Peiris Malalasekera
Background: The marginal mandibular branch of the facial nerve is vulnerable to iatrogenic injuries during surgeries involving the submandibular region. This leads to significant post-operative morbidity. Studies assessing accurate anatomical landmarks of the marginal mandibular branch are sparse in South Asian countries. Present study was conducted to assess the relationship between the marginal mandibular branch and the inferior border of the body of mandible. Methods: Twenty-two preserved cadavers of Sri Lankan nationality were selected...
2018: Patient Safety in Surgery
Melaku Desta, Addissu Manaye, Abiot Tefera, Atalay Worku, Alemitu Wale, Alemlanchi Mebrat, Negesso Gobena
Background: Elective surgical case cancellation refers to any elective surgical case that is the list on the day prior to surgery but not operated upon as scheduled. Case cancellation has a major cause of psychological trauma to patients and their families. Despite little is known in Ethiopia. Therefore, this study aimed to assess incidence and reasons of cancellations of elective operation on the intended day of surgery at tertiary referral academic medical center in Ethiopia. Methods: A prospective hospital-based cross-sectional study design was conducted in a tertiary referral academic medical center in Ethiopia among 146 participants...
2018: Patient Safety in Surgery
Dimitra Daskalopoulou, Joseph Kankam, Jens Plambeck, Peter C Ambe, Konstantinos Zarras
Background: Bowel incarceration represents a dreaded complication amongst patients with hernias. The intraoperative evaluation of the bowel perfusion following hernia reduction with regard to the need for resection of ischaemic bowel can be challenging. In this case report we discuss intraoperative fluorescence angiography with indocyanine green (ICG) as an objective means of accessing bowel perfusion following hernia reduction. Case presentation: The case of a 92-year-old, caucasian, female patient presenting with symptoms of small bowel obstruction secondary to an incarcerated left sided obturator hernia is presented...
2018: Patient Safety in Surgery
Tushar Patial, Namit Rathore, Angesh Thakur, Digvijay Thakur, Kanika Sharma
Background: A retained surgical sponge remains a dreaded complication of modern surgery. Despite the increasing focus on patient safety instances of "a sponge being left in the abdomen", are all too common in popular media. In this article we report the rare phenomenon of transmigration of a retained surgical sponge in a patient who underwent laparoscopic sterilization. Case presentation: A 30-year-old female presented with progressive abdominal pain for about one month and vomiting with obstipation for 2 days...
2018: Patient Safety in Surgery
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