Improvement of surgical wound classification following a targeted training program at a children's hospital.

Abstract:

BACKGROUND:Inaccurate assignment of surgical wound class (SWC) remains a challenge in perioperative documentation. The purpose of our intervention was to increase the accuracy of SWC through a targeted training program directed toward pediatric surgeons and nurses. METHODS:A retrospective electronic medical record (EMR) chart review of 400 operations was performed according to NSQIP criteria during specified periods in 2014 and 2017, assessing SWC errors before and after a training program and posting of reference materials in operating rooms at a 165-bed children's hospital. After each operation, nurses confirmed SWC with the surgeon before recording the value in the EMR. Differences in proportions of misclassified SWC were evaluated with a chi-square test. RESULTS:Following the educational program, misclassified SWC improved from 70/200 (35.0%) to 18/200 (9.0%), p < 0.001. Misclassified SWC for appendectomies improved from 46/95 (48.4%) to 12/108 (11.1%), p < 0.001. CONCLUSIONS:Accurate SWC assignment in the EMR was improved by an educational program and posting of materials to aid assignment, as well as enhanced communication between surgeons and nurses at the conclusion of each operation. We present the first known attempt to list all pediatric surgery procedures according to SWC. Accurate SWC allows stratification of risks and more effective targeted interventions. LEVEL OF EVIDENCE:Level III.

journal_name

J Pediatr Surg

authors

Butler MW,Zarosinski S,Rockstroh D

doi

10.1016/j.jpedsurg.2018.08.037

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

2378-2382

issue

12

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(18)30543-8

journal_volume

53

pub_type

杂志文章
  • A comparison of laparoscopic and traditional open splenectomy in childhood.

    abstract::This study aimed to determine whether laparoscopic splenectomy is more advantageous than open splenectomy in pediatric patients. Data from 61 patients treated between June 1983 and September 1994 were reviewed. Length of hospitalization, hospital costs, operating time, and postoperative complications were evaluated. F...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(96)90330-9

    authors: Janu PG,Rogers DA,Lobe TE

    更新日期:1996-01-01 00:00:00

  • Computed tomography before transfer to a level I pediatric trauma center risks duplication with associated increased radiation exposure.

    abstract:INTRODUCTION:Community hospitals commonly obtain computed tomographic (CT) imaging of pediatric trauma patients before triaging to a level I pediatric trauma center (PTC). This practice potentially increases radiation exposure when imaging must be duplicated after transfer. METHODS:A retrospective review of our level ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2008.08.061

    authors: Chwals WJ,Robinson AV,Sivit CJ,Alaedeen D,Fitzenrider E,Cizmar L

    更新日期:2008-12-01 00:00:00

  • Management of perforated appendicitis in children: a decade of aggressive treatment.

    abstract::Perforated appendicitis in children continues to be associated with significant morbidity. In 1976, a treatment algorithm was begun at the authors' institution, which included immediate appendectomy, antibiotic irrigation of the peritoneal cavity, transperitoneal drainage through the wound, and 10-day treatment with i...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/0022-3468(94)90294-1

    authors: Lund DP,Murphy EU

    更新日期:1994-08-01 00:00:00

  • Pediatric papillary thyroid cancer >1 cm: is total thyroidectomy necessary?

    abstract:PURPOSE:Treatment of pediatric papillary thyroid cancer (p-PTC) often follows adult guidelines, including total thyroidectomy for tumors >1cm. This study examined the association between operation type and overall survival (OS) for tumors >1cm in size in the pediatric population. METHODS:Patients ≤ 21 years of age wit...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2015.03.031

    authors: Nice T,Pasara S,Goldfarb M,Doski J,Goldin A,Gow KW,Nuchtern JG,Vasudevan SA,Langer M,Beierle EA

    更新日期:2015-06-01 00:00:00

  • The anterior mediastinal approach for management of tracheomalacia.

    abstract:BACKGROUND:Tracheomalacia occurs as a primary developmental defect or may be secondary to vascular compression. It is common in association with esophageal atresia and tracheoesophageal fistula. Collapse of the weak trachea is a cause of recurrent respiratory symptoms but may be severe and life threatening. METHODS:Be...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1053/jpsu.2000.16413

    authors: Morabito A,MacKinnon E,Alizai N,Asero L,Bianchi A

    更新日期:2000-10-01 00:00:00

  • Diaphragmatic hernia in the fetus: prenatal diagnosis and outcome in 94 cases.

    abstract::Most babies born with congenital diaphragmatic hernia (CDH) die after birth. The natural course of CDH in the human fetus is not known. We found 94 cases of fetal CDH in the records of surgeons and obstetricians surveyed in the United States and Canada. We found the following: (1) prenatal diagnosis of CDH is accurate...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(85)80219-0

    authors: Adzick NS,Harrison MR,Glick PL,Nakayama DK,Manning FA,deLorimier AA

    更新日期:1985-08-01 00:00:00

  • Rectal manometry, computed tomography, and functional results of anal atresia surgery.

    abstract::Children with anal atresia often have compromised function. This is especially common with the anatomic "high lesion." Twenty-five patients have been studied using clinical evaluation, computed tomography (CT), and manometry to make an objective evaluation. The patients were an average of 9.6 years old; the male-to-fe...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(05)80274-x

    authors: Doolin EJ,Black CT,Donaldson JS,Schwartz D,Raffensperger JG

    更新日期:1993-02-01 00:00:00

  • Regional reduction in intestinal neuroendocrine cell populations in enterocolitis complicating Hirschsprung's disease.

    abstract::Enterocolitis (EC) remains the most serious complication of Hirschsprung's disease (HD). The aetiology of EC is uncertain. Ischemic and bacterial causes, and recently rotavirus infection, have been suggested to explain the occurrence of EC. The gut has an abundance of neuroendocrine (NE) cells which modulate gut funct...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/0022-3468(93)90520-u

    authors: Soeda J,O'Briain DS,Puri P

    更新日期:1993-08-01 00:00:00

  • Diaphragmatic agenesis as a distinct clinical entity.

    abstract::Anatomically, diaphragmatic agenesis (DA) is the most extreme form of congenital diaphragmatic defect, but clinically it has not been defined separately from Bochdalek's hernia (BH). Between 1986 and 1992, the authors treated 55 neonates who had diaphragmatic defects. Forty-eight of these cases presented within 24 hou...

    journal_title:Journal of pediatric surgery

    pub_type: 临床试验,杂志文章

    doi:10.1016/0022-3468(95)90599-5

    authors: Tsang TM,Tam PK,Dudley NE,Stevens J

    更新日期:1995-01-01 00:00:00

  • Comparative analysis of robotic-assisted versus laparoscopic cholecystectomy in pediatric patients.

    abstract:BACKGROUND:Despite increased utilization of robotic-assisted surgery in the pediatric population during the past decade, reports of comparative analysis between robotic surgery and laparoscopic surgery are lacking. Our aim was to evaluate outcomes between pediatric robotic-assisted cholecystectomy (RC) and laparoscopic...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2020.11.013

    authors: Kulaylat AN,Richards H,Yada K,Coyle D,Shelby R,Onwuka AJ,Aldrink JH,Diefenbach KA,Michalsky MP

    更新日期:2020-11-20 00:00:00

  • Successful endoscopic drainage of a posttraumatic pancreatic pseudocyst in a child.

    abstract::The successful endoscopic drainage of a posttraumatic pancreatic pseudocyst in a 9-year-old boy is described. This case study suggests that there is a role for endoscopic placement of stents in the treatment of pancreatic pseudocysts in children. ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(99)90116-1

    authors: Kimble RM,Cohen R,Williams S

    更新日期:1999-10-01 00:00:00

  • Urethral duplication with single bladder and multiple genitourinary abnormalities: an example of continent urinary diversion.

    abstract::A 13-year-old girl with multiple genitourinary malformations, incomplete bladder exstrophy, urethral duplication with single bladder, septate vagina, and total urinary incontinence is presented. Prior to admission she had undergone surgery for teratoma and calculi of the bladder and partial fecal incontinence. A conti...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/0022-3468(90)90534-g

    authors: Pintér AB,Farkas AP

    更新日期:1990-12-01 00:00:00

  • Acute impairment of hepatic microcirculation and recruitment of nonparenchymal cells by intrasplenic hepatocyte transplantation.

    abstract:BACKGROUND/PURPOSE:Over the last 20 years, hepatocyte transplantation (HcTx) has advanced from the experimental to the clinical stage. To date, HcTx has been performed in 30 patients in the United States. Regardless whether hepatocytes are transplanted into the spleen and migrate to the liver or are injected directly i...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2004.04.020

    authors: Wilhelm A,Leister I,Sabandal P,Krause P,Becker H,Markus PM

    更新日期:2004-08-01 00:00:00

  • Preputial unfurling to correct the buried penis.

    abstract::Recognition of the buried penis is necessary both to ensure its proper management and to avoid performance of a standard circumcision, which can result in penile degloving. We describe a simple technique of unfurling the prepuce which provides adequate functional and cosmetic replacement for the penile shaft skin. ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/0022-3468(86)90007-2

    authors: Donahoe PK,Keating MA

    更新日期:1986-12-01 00:00:00

  • Nonsurgical management of neonatal adrenal abscess.

    abstract::The fifteenth case of neonatal adrenal abscess is reported. It is the first case successfully diagnosed with needle aspiration and treated with percutaneous drainage. ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(88)80026-5

    authors: Mondor C,Gauthier M,Garel L,Filiatrault D,Grignon A

    更新日期:1988-11-01 00:00:00

  • Antral web in infancy.

    abstract::Eleven patients have been followed from 1 to 6 yr after diagnosis and treatment during infancy of partially obstructing antral web. Seven had surgical correction, six with web excision and pyloroplasty. Four were treated nonoperatively with antispasmodics and small curd formula. Five of the seven operated infants had ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(80)80006-6

    authors: Tunell WP,Smith EI

    更新日期:1980-04-01 00:00:00

  • Magnetic resonance imaging of abdominal masses in children.

    abstract::Seventeen children with abdominal masses (16 solid and 1 complex cystic) were evaluated by magnetic resonance imaging (MRI). Computed tomography (CT) was also performed in 12 cases. MRI findings were correlated with CT and histopathologic findings. In 10 cases MRI provided more specific diagnostic information than CT....

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(05)80362-8

    authors: Vade A,Azienstein R

    更新日期:1993-01-01 00:00:00

  • Institutional experience with laparoscopic partial splenectomy for hereditary spherocytosis.

    abstract:BACKGROUND/PURPOSE:Moderate to severe hereditary spherocytosis (HS) is treated with splenectomy. However, total splenectomy leads to decreased immunologic function with the risk of overwhelming postsplenectomy sepsis. Splenic preservation is postulated as a method to avoid this potentially fatal complication. Although ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2010.01.037

    authors: Slater BJ,Chan FP,Davis K,Dutta S

    更新日期:2010-08-01 00:00:00

  • Prepyloric antral diaphragm: delays in treatment.

    abstract::Six cases of prepyloric antral diaphragm were encountered at Children's Hospital Medical Center of Akron between 1965 and 1985, with approximately 150 cases reported in the literature during this time. In our series, a delay from onset of symptoms to treatment existed for a period of 4 months to 6 years. We suggest th...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(87)80597-3

    authors: Blazek FD,Boeckman CR

    更新日期:1987-10-01 00:00:00

  • A thoracoabdominal approach in revision of the hepatic hilum after left lobe living donor liver transplantation.

    abstract::We present an approach to safely expose the hepatic hilum for revision procedures after left lobe living donor liver transplantation. A 14-year-old adolescent girl who had undergone left lobe living donor liver transplantation experienced repeated episodes of cholangitis. Because treatment with interventional techniqu...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2011.11.004

    authors: Honda M,Takeichi T,Ohya Y,Okumura K,Lee KJ,Yamamoto H,Asonuma K,Inomata Y

    更新日期:2012-03-01 00:00:00

  • Use of gauze-based negative pressure wound therapy in a pediatric burn patient.

    abstract::Negative pressure wound therapy (NPWT) is described as it is used in the treatment of an infant burn victim. This case highlights the ability and techniques used to maintain an airtight dressing seal in the perirectal region. Use of this dressing type post-skin grafting allowed for 100% graft adhesion and no bacterial...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2009.09.022

    authors: Psoinos CM,Ignotz RA,Lalikos JF,Fudem G,Savoie P,Dunn RM

    更新日期:2009-12-01 00:00:00

  • The Cambridge experience with buried bumpers.

    abstract:AIM:Buried Bumper (BB) is a complication of percutaneous endoscopic gastrostomy (PEG) that leads to tube dysfunction and major morbidity. Although many techniques have been described to manage BB, none are universally adopted, and laparotomy remains the mainstay. We introduce a novel endoscopic technique in paediatric ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2018.10.084

    authors: Goneidy A,Malakounides G,Aslam A

    更新日期:2019-02-01 00:00:00

  • A prospective study of methicillin-resistant Staphylococcus aureus colonization in children scheduled for elective surgery.

    abstract:BACKGROUND:Staphylococcus aureus is a major cause of surgical wound infections. To obtain contemporary data on S aureus, we performed a prospective study of colonization and infection in children scheduled for elective surgical procedures. METHODS:A nasal swab and clinical information were obtained at the presurgical ...

    journal_title:Journal of pediatric surgery

    pub_type: 临床试验,杂志文章

    doi:10.1016/j.jpedsurg.2009.02.042

    authors: Vegunta RK,Gray B,Wallace LJ,Mongkolrattanothai K,Mankin P,Stanfill AB,Pearl RH

    更新日期:2009-06-01 00:00:00

  • Giant cutaneous hemangioma associated with axillary arteriovenous fistula causing congestive heart failure in the newborn infant.

    abstract::Although histopathologically benign, cutaneous hemangiomas may be pathophysiologically malignant if they are associated with significant arteriovenous malformation that is hemodynamically compromising. Rapid surgical intervention may be required to prevent clinical deterioration from congestive heart failure as in the...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(87)80270-1

    authors: Lofland GK,Filston HC

    更新日期:1987-05-01 00:00:00

  • Rotation of the gut: fact or fantasy?

    abstract::Clinicians, as well as embryologists, believe that normally a process of rotation of the midgut takes place that can be hampered at any stage resulting in the different types of "malrotations." However, a "malrotated" gut has never been observed in normal embryos. Therefore all theories on the normal and abnormal deve...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/0022-3468(95)90053-5

    authors: Kluth D,Kaestner M,Tibboel D,Lambrecht W

    更新日期:1995-03-01 00:00:00

  • A patient with biliary atresia who died 28 years after hepatic portojejunostomy.

    abstract::A patient who died of hepatic failure nearly 29 years after hepatic portojejunostomy is reported. His death may be attributed to several faults in treatment. From our experiences it can be said that biliary atresia is a curable disease, although liver-transplantation is required in some patients in whom hepato portoen...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(88)80441-x

    authors: Kasai M,Ohi R,Chiba T,Hayashi Y

    更新日期:1988-05-01 00:00:00

  • New method of surgical delayed closure of giant omphaloceles: Lazaro da Silva's technique.

    abstract:BACKGROUND/PURPOSE:The management of patients with a giant omphalocele remains a difficult problem. In this study, the authors described a new surgical approach for delayed closure of ventral hernia--the Lazaro da Silva's technique--in conservatively treated patients. METHODS:Ventral hernias of 11 conservatively treat...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2004.03.064

    authors: Pereira RM,Tatsuo ES,Simões e Silva AC,Guimarães JT,Paixão RM,Lanna JC,Miranda ME

    更新日期:2004-07-01 00:00:00

  • End-tidal carbon dioxide for monitoring primary closure of gastroschisis.

    abstract::Previous criteria for primary reduction of the herniated viscera in newborn infants with gastroschisis included intraoperative respiratory rate, cardiac indices, degree of viscero-abdominal disproportion, size of defect, and lower extremity turgor. From 1976 through 1993, 129 neonates with gastroschisis were treated a...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(96)90016-0

    authors: Puffinbarger NK,Taylor DV,Tuggle DW,Tunell WP

    更新日期:1996-02-01 00:00:00

  • The protective effect of Cold-inducible RNA-binding protein (CIRP) on testicular torsion/detorsion: an experimental study in mice.

    abstract:PURPOSE:To evaluate the expression of Cold-inducible RNA-binding protein (CIRP) in torsion/detorsion of the testes in different phases and demonstrate the protective effect of CIRP on testicular injury after torsion/detorsion (T/D) in an experimental mouse model. METHODS:Twenty-four male BALB/c mice were divided rando...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2013.02.065

    authors: Xia Z,Jiang K,Liu T,Zheng H,Liu X,Zheng X

    更新日期:2013-10-01 00:00:00

  • Comparison of long-term outcomes between open and laparoscopic Thal fundoplication in children.

    abstract:OBJECTIVES:In recent years laparoscopic fundoplication is increasingly performed in pediatric surgery. The aim of this study was to compare the long-term outcomes between open and laparoscopic Thal fundoplication in children. METHODS:This retrospective study includes children who underwent a Thal fundoplication betwee...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2014.02.077

    authors: Kubiak R,Böhm-Sturm E,Svoboda D,Wessel LM

    更新日期:2014-07-01 00:00:00