Abstract:
:Conventional wisdom dictates that autogenous tissue interposition be used in contaminated wounds when direct vascular repair is not feasible. Although there are few reports of successful use of PTFE grafts in grossly contaminated wounds, doubt still exists regarding the use of any prosthetic material in such wounds for reconstruction of vascular injury. Twenty-five vascular reconstructions were performed in 20 patients during a 3.5 year period. These patients had life-threatening multiple trauma and severe local tissue damage along with their arterial and venous injuries in open contaminated wounds after blunt (16 patients) and penetrating (4 patients) trauma. In all patients, 6 mm PTFE was used for interposition bypass for arterial injuries, and in five of these patients, 8 mm PTFE was used for concomitant venous interposition bypass. One patient died and there was one arterial and one venous graft thrombosis in the same patient 3 months after a shotgun blast injury to the groin, but there was no limb loss. All other grafts remained patent without wound infection, sepsis, or anastomatic disruption. Under the circumstances of these peripheral vascular injuries, PTFE was an acceptable choice for primary reconstruction in our patients. Its ready availability in many calibers, sparing of autogenous vein for future use, and its expedience in vascular reconstruction comprise the advantages of using PTFE in multiply traumatized patients without producing the feared evidence of infected prosthetic grafts.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Shah DM,Leather RP,Corson JD,Karmody AMdoi
10.1016/0002-9610(84)90227-7subject
Has Abstractpub_date
1984-08-01 00:00:00pages
229-33issue
2eissn
0002-9610issn
1879-1883pii
0002-9610(84)90227-7journal_volume
148pub_type
杂志文章abstract:BACKGROUND:The relative prognostic impact of intra-aortic balloon pump (IABP) placement before versus after cardiac surgery is not well defined. METHODS:We reviewed data from all cardiac surgical patients who received perioperative IABP support at a veterans' hospital between April 1992 and April 2008. We compared out...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.07.011
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to analyze the influence of age on both the risk of hepatectomy and the prognosis in patients with hepatocellular carcinoma (HCC). METHODS:Patients undergoing an initial hepatectomy for HCC were classified into 2 age groups: 75 years or over (n = 113) and less than 75 years (n ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.05.026
更新日期:2015-04-01 00:00:00
abstract::Histologic material from 42 cases diagnosed as gastric lymphoma at Hartford Hospital was reviewed, confirming the diagnosis in 37. Three cases of pseudolymphoma were found. The incidence of gastric lymphoma has increased steadily over the past 50 years: 35 percent of cases occurred during the past decade. Most patient...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90194-5
更新日期:1982-04-01 00:00:00
abstract:BACKGROUND:Changes in surgical training have raised concerns about residents' operative exposure and preparedness for independent practice. One way of addressing this concern is by optimizing teaching and feedback in the operating room (OR). The objective of this study was to perform a systematic review on perioperativ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2016.12.014
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:The relationship between preoperative stenosis and the effect of carotid endarterectomy (CEA) upon internal carotid blood flow (ICF) is not well understood. With the intention of better characterizing this, we compared intraoperative measurements of internal carotid blood with the maximum single diameter ste...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(94)80051-0
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:This analysis was performed in order to determine whether primary tumor location in breast cancer affects the axillary sentinel lymph node (SLN) identification (ID) rate, the false negative (FN) rate, incidence of axillary nodal metastases, or the number of SLN identified. METHODS:In this prospective multi-...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/s0002-9610(01)00717-6
更新日期:2001-10-01 00:00:00
abstract::This study evaluates the penetration of cephalosporins into the peritoneal fluid. Forty-six patients scheduled for abdominal surgery were randomized into three groups. On call to the operating room each patient was given a single 1 g dose of cefazolin, cefuroxime, or ceftazidime. Samples of the peritoneal fluid and bl...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9610(89)90707-1
更新日期:1989-06-01 00:00:00
abstract::Technetium 99m-pyridoxylideneglutamate (99mTc-PG) administered intravenously is excreted by hepatocytes into the bile canaliculi and enters the gallbladder through the cystic duct and consequently, can be used for scanning the hepatobiliary ductal system. A total of 166 patients representing 27 normal subjects, 84 pat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90204-5
更新日期:1977-01-01 00:00:00
abstract::Spontaneous pneumothorax is rare among Nigerians, but our experience with olive oil confirms its advantages as a good agent for chemical pleurodesis. Clinical and supporting experimental data from rabbits are presented. In high risk patients with poor respiratory reserve, including some who have bronchopleural fistula...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90057-4
更新日期:1980-11-01 00:00:00
abstract::A case is reported of hypercalcemia persisting for seven years after kidney transplantation, with normocalcemia being achieved after subtotal parathyriodectomy. The finding of post-transplantation hyperparathyroidism of this extreme duration, in association with several other reports of hyperparathyroidism persisting ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90296-8
更新日期:1976-07-01 00:00:00
abstract:BACKGROUND:Administrative data can be used to identify cases of postoperative respiratory failure (PRF). We aimed to determine if recent changes to the Agency for Healthcare Research and Quality Patient Safety Indicator 11 (PSI 11) and adoption of clinical documentation improvement programs have improved the validity o...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2019.11.019
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:The relationship between hospital volume and patient outcomes remains controversial for rectal cancer. METHODS:This is a population-based database study. Patients treated with surgery for a stage I to III rectal adenocarcinoma from 2003 to 2009 were identified. High-volume hospitals (HVH) were those centers...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.07.007
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Medical malpractice is a source of stress and cost to physicians. Little is known about how it impacts resident physicians. METHODS:We analyzed data from the Comparative Benchmarking System between 2007 and 2016. We also surveyed surgery residents at our institution regarding malpractice in training. RESUL...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.08.006
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Following appendectomy, management is often guided by surgeon determination of whether the appendicitis is uncomplicated or complicated. Our objectives were to determine the incidence of discordance between intraoperative and pathological findings and determine effect on outcomes. METHODS:We performed a ret...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.05.004
更新日期:2020-01-01 00:00:00
abstract::A biochemical analysis of mitochondrial metabolism was made on biopsy specimens of fifteen jaundiced patients. In all but three jaundiced patients the phosphorylative activity based on mitochondrial protein was within normal limits or higher. In nine jaundiced patients the concentrations of cytochrome a(+a3), as repre...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90534-7
更新日期:1977-03-01 00:00:00
abstract::We attempted to determine the incidence and significance of cytomegalovirus infection and the effect of immunoglobulin G infusions on specific cytomegalovirus titers in burn patients. On admission, 48 percent of a group of 120 patients (mean burn size 28.5 percent of the total body surface area) were seronegative, inc...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(88)80718-9
更新日期:1988-02-01 00:00:00
abstract::The antiproliferative effects of somatostatin on hepatocytes stimulated by hepatocyte growth factor (HGF) or epidermal growth factor (EGF) were investigated using primary cultures of adult rat hepatocytes. Somatostatin inhibits HGF-induced (at a dose of 10 ng/mL) or EGF-induced (at a dose of 100 ng/mL) 3H-thymidine in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(92)90271-r
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Laparoscopic transabdominal preperitoneal (TAPP) herniorrhaphy provides an opportunity to definitively evaluate both inguinal areas without the need for additional dissection. We aimed to establish the rates and contributing patient factors to errors in the preoperative assessment. METHODS:A retrospective r...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.10.015
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:The impact of axillary node dissection on breast cancer survival is unclear. Limited axillary surgery has been proposed but may increase regional recurrence rates. Optimal management for axillary recurrence is poorly understood. METHODS:Axillary recurrences were initial treatment failure sites in 44 of 4,25...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00456-6
更新日期:2000-10-01 00:00:00
abstract::Gastric emptying was delayed preoperatively in 9 of 19 patients with duodenal ulcer disease, but all 9 patients with evidence of retention by scan were asymptomatic; gastric emptying was normal in the remaining 10 patients. A significant delay in gastric emptying was documented by scan in 17 of 19 patients immediately...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90134-9
更新日期:1982-01-01 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:INTRODUCTION:Readmissions have become a focus of pay-for-performance programs. Surgical site infections (SSI) are the reason for most readmissions. Readmissions for SSI could be a unique target for quality improvement. METHODS:Readmission risk for SSI were evaluated for patients undergoing colectomies from 2013 to 201...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2017.04.011
更新日期:2017-11-01 00:00:00
abstract::Controversy continues about how often a negative laparotomy should be accepted in the management of patients with blunt and penetrating trauma. A key issue is the complications, especially small bowel obstruction. To define these complications, the charts of 248 patients who underwent negative laparotomy for trauma we...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80549-x
更新日期:1988-12-01 00:00:00
abstract::The relationship between platelet count and aggregability was serially evaluated after splenectomy in patients with normosplenism and hypersplenism, and the results were compared with those found in patients undergoing only upper abdominal surgery. The preoperative count and aggregability of platelets were significant...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90242-8
更新日期:1978-08-01 00:00:00
abstract:BACKGROUND:For female breast cancer (BC) patients undergoing mastectomy, post-mastectomy breast reconstruction (PMBR) confers significant psychosocial benefits and improved cosmetic outcomes. The objective of this study is to explore whether the utilization of PMBR varies by race, marital status, and geographical locat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.07.025
更新日期:2019-10-01 00:00:00
abstract::A new technique has been described for the placement of an implantable percutaneous triple-lumen catheter. This procedure eliminates the need for a large bore introducer. It also provides a mechanism to change these catheters over a wire if necessary. This cannot be accomplished with the Hickman or Broviac catheters. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80116-1
更新日期:1985-03-01 00:00:00
abstract:BACKGROUND:Head injuries are common in the pediatric population, but when an isolated skull fracture is found, there are no guidelines for repeat imaging. This study evaluated the need for repeat head computed tomography (CT) for isolated skull fracture. METHODS:A 10-year retrospective review was conducted of patients...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.11.011
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:The feasibility and accuracy of sentinel lymph node (SLN) biopsy examination for breast cancer patients with clinically node-negative breast cancer after neoadjuvant chemotherapy (NAC) have been investigated under the administration of a radiocolloid imaging agent injected intradermally over a tumor. In addi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.06.049
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Management of patients with thoracic empyema ranges from tube thoracostomy drainage, with or without fibrinolytics, to operative intervention, with the optimal intervention remaining uncertain. Streptococcus milleri, typically a benign bacterium colonizing the oropharynx, has recently been reported as a pote...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.08.050
更新日期:2006-12-01 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