Abstract:
:In addition to its own inherent morbidity, the pain associated with chronic wounds presents a primary obstacle to healing. To initiate safe and effective therapy, we used a multidisciplinary approach that required the wound-healing clinician and pain-management practitioner to work together to diagnose and treat the pain associated with these wounds. This approach emphasizes wound pathophysiology, which facilitates treatment modalities that focus on the cause of the pain as well as more efficient analgesia. All wound patients were approached with the assurance that they should not experience pain. The most important part of pain control is objective assessment and assuring patients that their pain will be resolved. Differential diagnosis is critical (eg, wound pain associated with infection, necrosis, spinal cord injury, neuropathy). We determined that to resolve pain, the following 4 goals must be achieved: (1) removal of all nonviable, locally infected tissue and elimination of all cellulitis; (2) determination of wound pathogenesis; (3) availability of both local and systemic analgesia; and (4) assessment of objective improvement through the periodic use of an analgesic scale. By following this protocol, the wound-healing clinician can expect decreased length of hospital stay and resolution of pain in nearly all patients with wounds.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Freedman G,Entero H,Brem Hdoi
10.1016/S0002-9610(03)00289-7subject
Has Abstractpub_date
2004-07-01 00:00:00pages
31-5issue
1A Suppleissn
0002-9610issn
1879-1883pii
S0002961003002897journal_volume
188pub_type
杂志文章abstract::Arteriovenous fistulas were performed in 100 patients over a three year period with a 90 per cent overall success rate. Various technics for construction of the fistula using autologous veins are discussed, with emphasis on pre- and intraoperative assessment of vessel condition and its relation to the prevention of im...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90009-x
更新日期:1976-05-01 00:00:00
abstract:BACKGROUND:Obesity is a risk factor for many comorbid conditions that increase the cost of health care. We sought to examine the effect of obesity on surgical complications and cost in a group of patients undergoing intestinal surgery. METHODS:Using the Veterans Affairs Surgical Quality Improvement Program (VASQIP), w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.01.013
更新日期:2012-10-01 00:00:00
abstract:INTRODUCTION:The few series of synchronous lung cancers have included small cell and carcinoid tumors. We wished to determine the prognosis for patients with synchronous non-small cell lung cancer (NSCLC). METHODS:A database of 3034 lung cancer patients was reviewed for synchronous NSCLC. Survival was determined by Ka...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00019-0
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Core biopsy finding of atypical ductal hyperplasia (ADH) are generally followed by open biopsy to avoid underestimation of malignant disease. METHODS:Retrospective examination of 11 gauge stereotactic-guided vacuum-assisted core biopsies was made with respect to ADH diagnosis, follow-up open biopsy, and upg...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00727-9
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:The adipocyte hormone leptin has been shown to increase migration and angiogenesis in epithelial cells. Therefore, we hypothesized that leptin would induce prostate cancer cell migration and growth factor expression in vitro. METHODS:Prostate cancer cell lines DU145 and PC-3 (androgen-resistant) were treate...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.07.031
更新日期:2004-11-01 00:00:00
abstract::Between 1982 and 1985, 83 patients with hypopharyngeal or extensive laryngeal cancers underwent pharyngoesophagectomy (48 patients), circumferential pharyngectomy (8 patients), and partial pharyngectomy (27 patients), depending on the site and extent of tumor involvement. The resultant hypopharyngeal defects were reco...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90007-x
更新日期:1987-10-01 00:00:00
abstract:BACKGROUND:Mental skills training refers to the implementation of cognitive performance-enhancing strategies to promote optimal performance. We aimed to develop a surgery-specific mental skills curriculum (MSC) and obtain initial evidence of efficacy. METHODS:The developed MSC consisted of 8 proven performance-enhanci...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.06.027
更新日期:2017-02-01 00:00:00
abstract::Various reports have demonstrated that the intraoperative utilization of the choledochoscope has significantly reduced the incidence of unsuspected retained common duct stones from approximately 10 percent to 0 to 2 percent. Our series revealed a 4 percent incidence of retained stones before choledochoscopy was utiliz...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90406-3
更新日期:1983-09-01 00:00:00
abstract:BACKGROUND:Coagulopathy is frequently encountered during supraceliac aortic clamping. Patients are routinely heparinized during these operations. This experiment was undertaken to evaluate the effect of supraceliac aortic cross-clamping (XC) on heparin pharmacodynamics. MATERIAL AND METHODS:Fourteen mongrel dogs were ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00140-7
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:As medicinal and recreational marijuana use broadens across the United States, knowledge of its effects on the body will become increasingly important to all health care providers, including surgeons. DATA SOURCES:We performed a literature review of Pubmed for articles discussing the basic science related t...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2018.10.053
更新日期:2019-04-01 00:00:00
abstract::Nitric oxide (NO), a paracrine-acting gas enzymatically synthesized from L-arginine, is a unique biologic mediator that has been implicated in a myriad of physiologic and pathophysiologic states. It is an important regulator of vascular tone and may be the mediator of the hemodynamic changes involved in sepsis and cir...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(05)80017-0
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:The successful excision of a renal cell carcinoma (RCC) invading the inferior vena cava (IVC) remains a technical intraoperative challenge and requires a careful preoperative surgical management planning. Although a radical operation remains the mainstay of the therapy for RCC, the optimal management of the ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)00782-1
更新日期:2002-03-01 00:00:00
abstract::Experience with 37 patients with adult colovesical fistula over the past 19 years is reviewed. Specific guidelines for treatment of adult colovesical fistula are influenced by the location and cause of the fistula, the patient's general condition, the presence of a pelvic abscess and the presence of colonic obstructio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90421-3
更新日期:1980-07-01 00:00:00
abstract::A loop colostomy in infants and children is usually temporary, made through a small abdominal incision, and frequently prolapses its distal limb within months of its construction. Once this prolapse occurs, its permanent reduction is hardly ever achieved. On the other hand, the colostomy that is made at the time of a ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90100-4
更新日期:1984-02-01 00:00:00
abstract:BACKGROUND:Currently, >200 meshes are commercially available in the United States. To help guide appropriate mesh selection, the investigators examined the postsurgical experiences of all patients undergoing ventral hernia repair at their facility from 2008 to 2011 with ≥12 months of follow-up. METHODS:A retrospective...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.01.026
更新日期:2013-05-01 00:00:00
abstract::An improved technic has been developed to predict rapidly the critical number of bacteria in tissues. This technic gave reliable and accurate measurements for wounds containing more than 2 X 10(5) organisms per gram of tissue. It is fortuitous that 10(6) bacteria is the critical number of bacteria that will induced cl...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90174-x
更新日期:1977-06-01 00:00:00
abstract:BACKGROUND:Sentinel lymph node (SLN) biopsy (SLNB) is an accurate and proven axillary staging procedure for early breast cancer. The aim of this study was to determine if the "10% rule" is applicable to the performance of SLNB at the investigators' institution and if the criteria used for SLNB at their institution coul...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.01.010
更新日期:2012-05-01 00:00:00
abstract::Although the incidence of anastomotic false aneurysms decreased precipitously with the cessation of usage of silk sutures for vascular anastomoses, the prevalence of these aneurysms has undoubtedly increased in keeping with an ever-increasing volume of peripheral vascular operations. Most aneurysms occur at femoral an...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90338-0
更新日期:1983-12-01 00:00:00
abstract::The multicentric occurrence of tumors of the upper aerodigestive tract has been well described, with an incidence ranging from 5 to 16 percent. Detection of a synchronous primary tumor at the time of initial work-up is crucial both for management and final outcome. However, there is a diversity of opinions regarding t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80036-9
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:The incidence of hernia accident for inguinal hernias in men who are minimally symptomatic is sufficiently low that watchful waiting is an acceptable alternative to routine repair. Our aim was to determine whether a delay in hernia surgery affects short- and long-term outcomes. METHODS:Patients from a multi...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.amjsurg.2007.07.021
更新日期:2008-01-01 00:00:00
abstract::Preoperative embolization of highly vascular soft tissue tumors was performed in four patients. Selective catheterization of branch vessels supplying the tumors successfully avoided inadvertent embolization of adjacent normal tissue. Operative blood loss was significantly less than anticipated, permitting an easier, m...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90429-4
更新日期:1983-09-01 00:00:00
abstract:BACKGROUND:Definitive practice guidelines regarding the utility of chest x-ray (CXR) following chest tube removal in trauma patients have not been established. The authors hypothesized that the selective use of CXR following chest tube removal is safe and cost effective. METHODS:A retrospective review of chest tube in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.03.011
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive method for diagnosing choledocholithiasis. It is said to be as accurate as the gold standard endoscopic retrograde cholangiopancreatography (ERCP) for detecting common bile duct (CBD) stones. A study was needed to look at the accuracy of MRC...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.07.033
更新日期:2013-04-01 00:00:00
abstract::The popliteal artery entrapment syndrome is increasingly recognized as a cause of arterial insufficiency in the leg. Diagnosis is based on a clinical history of claudication, which may be atypical, physical examination, noninvasive exercise testing and angiography. Patients with normal ankle pulses and resting ankle/b...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90285-8
更新日期:1980-03-01 00:00:00
abstract::A retrospective review of 58 rare breast neoplasms encountered at the British Columbia Cancer Agency between 1972 and 1992 was undertaken. There were 38 cystosarcoma phyllodes tumors, 6 carcinosarcomas, and 14 other sarcomas. Initial management involved total mastectomy in 37 cases, wide excision in 14, and excision b...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90238-0
更新日期:1994-05-01 00:00:00
abstract::Trovafloxacin, a new fluoronaphthyridone derivative related to fluoroquinolone antimicrobial drugs, has demonstrated the following characteristics: significant gram-positive and gram-negative activity; significant activity against anaerobes and atypical respiratory pathogens; approximately 11-hour elimination half-lif...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00213-x
更新日期:1998-12-01 00:00:00
abstract::It is important that physicians participate in the debate and planning process that will ultimately guide how we reform the way health care is financed and delivered in the United States. Herein is offered a perspective on the problem, one which is not necessarily appreciated by health planners. While we deliver the b...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/0002-9610(94)90081-7
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are sequelae of severe trauma. It is unknown if certain races are at greater risk of developing ALI/ARDS, and once established, if there are racial differences in the severity of lung injury or mortality. METHODS:Retrospective cohort stu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.02.003
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:To identify trends in total and subtotal gastrectomy for middle and distal third gastric adenocarcinoma in the U.S. METHODS:NCDB was queried for patients with stage 0-III middle or distal gastric adenocarcinoma treated with total or subtotal gastrectomy. Statistical analysis including cox proportional hazar...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.04.012
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Traditional treatment of breast abscesses involves incision and drainage, with and without ultrasound guidance. These procedures cause considerable discomfort and morbidity for the patient. This study was conducted to determine whether needle aspiration of breast abscesses without ultrasound guidance was an ...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(01)00683-3
更新日期:2001-08-01 00:00:00