Abstract:
BACKGROUND:Local custom, rather than evidence-based medicine, dictates how a surgeon closes abdominal wounds. Closures might be more secure if grounded on statistical data. MATERIALS AND METHODS:A meta-analysis of 12,249 patients with abdominal wound closures was made. Infections, hernias, and dehiscences were compared examining continuous versus interrupted closures, continuous (absorbable versus nonabsorbable), interrupted (absorbable versus nonabsorbable), and mass versus layered. RESULTS:Continuous absorbable closures showed more hernias (P = 0.0007). Dehiscences were significantly more with continuous nonabsorbable suture (P = 0.01). Interrupted nonabsorbable closures showed a higher incidence of hernias and dehiscences (P = 0.0002, P = 0.04). Mass closures produced significantly less hernias and dehiscences when compared with layered closures (P = 0.02, P = 0.0002). CONCLUSIONS:Continuous closures with nonabsorbable suture should be used to close most abdominal wounds. However, if infection or distention is anticipated, interrupted absorbable sutures are preferred. Mass closures are superior to layered closures.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Weiland DE,Bay RC,Del Sordi Sdoi
10.1016/s0002-9610(98)00277-3subject
Has Abstractpub_date
1998-12-01 00:00:00pages
666-70issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(98)00277-3journal_volume
176pub_type
杂志文章,meta分析abstract::Immunologic changes after blood transfusions cannot be studied ethically in normal individuals. We therefore studied two comparable groups of patients with atherosclerotic cardiovascular disease who received similar drug treatment and experienced a similar degree of surgical trauma, except that one group received an a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(92)90114-7
更新日期:1992-02-01 00:00:00
abstract::Allergy to metal implants is under study at the Dartmouth-Hitchcock Medical Center using in vitro examination of white blood cell migration. Retrospective data from 121 patients confirm that allergic responses do occur. Prospective data are being gathered to investigate the incidence, prevalence and relation to morbid...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90323-2
更新日期:1980-04-01 00:00:00
abstract::Forty-one patients with significant pulmonary emboli were reviewed. The presence of heart disease and obesity was found with relatively constant frequency throughout the groups presented. Postoperative infections (wounds or abscess) were frequently associated with fatal or significant pulmonary embolism, particularly ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90067-9
更新日期:1979-03-01 00:00:00
abstract::This article reviews the philosophy and principles of the National Surgical Quality Improvement Program (NSQIP) that the founders of the program had in mind when they developed the program; explains how the philosophy and principles led to the design and statistical methods that were chosen for the program; and review...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.07.025
更新日期:2009-11-01 00:00:00
abstract::Pulmonary metastases are the primary cause of death due to bone and soft tissue sarcomas. We have previously shown that an aggressive approach and a new technique of multiple pulmonary metastasectomies have resulted in improved survival for patients with pulmonary metastases. In this follow-up study, an expanded datab...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81150-x
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to assess how the practice patterns of breast surgeons affect their income and job satisfaction. METHODS:A 19-question survey regarding practice patterns and income and job satisfaction was mailed to all active US members of the American Society of Breast Surgeons. RESULTS:The...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.09.006
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:A clear understanding of simulation-based curricula in use at American College of Surgeons Accredited Education Institutes (ACS-AEIs) is lacking. METHODS:A 25-question online survey was sent to ACS-AEIs. RESULTS:The response rate approached 60%. The most frequent specialties to use the ACS-AEIs are general...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.08.011
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Antibiotic prophylaxis is controversial in patients undergoing axillary lymph node dissection (ALND). We determined whether preoperative antibiotics decreased incidence or treatment cost of infectious complications following ALND. METHODS:Two hundred patients entered this prospective, randomized, double-bli...
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/s0002-9610(98)00154-8
更新日期:1998-09-01 00:00:00
abstract::This review of the literature has revealed that isotonic fluids, such as 0.9 percent sodium chloride and Ringer's lactate, are effective plasma volume expanders. Despite the continued use of a variety of colloid solutions in resuscitation, there is no good evidence to document a benefit of these solutions over the cry...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(88)80106-5
更新日期:1988-03-01 00:00:00
abstract:BACKGROUND:Medical schools are undergoing major curricular reform, partly in attempts to increase the number of graduates pursuing careers in the generalist disciplines. These reforms have often resulted in a shortening of the surgery clerkship, decreasing students' experiences in several domains important to the gener...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)89595-5
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Selective shunting during carotid endarterectomy is associated with the lowest operative stroke rate; therefore, patient selection for carotid shunting is critical. Electroencephalography (EEG) can detect ischemic brain cell dysfunction before irreversible injury. The carotid stump back pressure (CSP) has be...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(99)80275-x
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND:Colonic inertia (CI) is a disturbance of colonic motility characterized by severe constipation and abdominal pain. This study was conducted to assess the results of total abdominal colectomy (TAC) in the management of CI. METHODS:A retrospective chart review of 55 patients who underwent TAC for CI was condu...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00820-0
更新日期:2001-12-01 00:00:00
abstract::Fixation of polypropylene (Marlex) mesh in the epigastrium and at the iliac crest can be ineffective because of insufficient local fascia; however, two techniques have been described to obtain firm and durable attachment of polypropylene grafts at these sites. Perichondral slips at the costal margin permit very satisf...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80194-x
更新日期:1985-06-01 00:00:00
abstract::In a prospective randomized clinical trial, whole gut lavage was evaluated against conventional mechanical cleansing for colonic operations. The lavage took less time to perform, was better tolerated by patients, and resulted in more satisfactory preparation as judged by frequency of collapsed intestines. There was no...
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(79)90014-x
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND:Accuracy of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) and contribution to surgical decision making in recurrent or metastatic colorectal cancer were evaluated. METHODS:One hundred whole-body PET tests in colorectal cancer patients (1994 to 1998) were compared with computed tomography (...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00406-2
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:To prevent hepatic failure after major hepatectomy, it is important to assess preoperative factors related to liver failure. METHODS:We examined 80 patients who underwent right-sided hepatectomy. Hyperbilirubinemia, uncontrolled ascites, and prolonged postoperative hospital stay were defined as liver failur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.12.013
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Thyroglossal duct cysts (TGDCs) are common in children but also present in adults. This study evaluates the preoperative management and postoperative outcomes in patients with a resected TGDC. METHODS:A retrospective analysis was performed on patients with a surgically treated TGDC. Clinicopathologic variab...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.06.018
更新日期:2014-06-01 00:00:00
abstract::A technique for carotid endarterectomy done under general anesthesia features the routine use of a straight shunt, precise removal of all plaque and shreds of media, and routine completion angiography done as a means of quality control. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80274-0
更新日期:1990-02-01 00:00:00
abstract:BACKGROUND:This study aimed to assess the transferability of basic laparoscopic skills between a virtual reality simulator (MIST-VR) and a video trainer box (D-Box). METHODS:Forty-six medical students were randomized into 2 groups, training on MIST-VR or D-Box. After training with one modality, a crossover assessment ...
journal_title:American journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.amjsurg.2009.05.016
更新日期:2010-06-01 00:00:00
abstract::Millions of people continue to smoke. Recent studies confirm the pioneering epidemiologic data that indicated that, despite the well-established effects on the lung, most of the hundreds of thousands of premature deaths annually result from extrapulmonary toxicity, particularly accelerated cardiac and vascular disease...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90421-5
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:Debates continue regarding optimal structures for governance and administration between medical schools and their teaching hospitals. METHODS:Structural integration (SI) for 85 academic health centers was characterized as high (single leader or fiduciary) or low (multiple leaders or fiduciaries). Functional...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2011.05.001
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Burnout affects surgical residents' well-being. OBJECTIVE:We sought to identify factors associated with burnout among surgery residents. METHODS:An electronic/anonymous survey was sent to surgical residents at 18 programs, consisting of demographic/programmatic questions and validated scales for burnout, d...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.07.004
更新日期:2020-06-01 00:00:00
abstract::Extralaryngeal branches of the recurrent laryngeal nerve have been noted in the literature, but frequently the researchers fail to indicate with accuracy the site of bifurcation. The current study was undertaken to designate the exact level of bifurcation of the recurrent laryngeal nerve, with more precise localizatio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90425-1
更新日期:1982-10-01 00:00:00
abstract::Performing a timely fasciotomy for compartment syndrome prevents ischemic injury to muscles and nerves. Fasciotomy entails incision of the overlying skin and investing fascia of the compartment, relieving pressure and enhancing tissue perfusion. Delayed primary closure is ideal, but because of skin edge retraction, th...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90130-9
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:Magnetic resonance cholangiopancreatography (MRCP) is a newly developing noninvasive examination of the biliopancreatic trees. Roles of MRCP in the diagnosis of pancreatic diseases have not been scrutinized. METHODS:Endoscopic retrograde cholangiopancreatography (ERCP) and MRCP were reviewed in 52 Japanese ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)00287-0
更新日期:1998-03-01 00:00:00
abstract::Six patients with intestinal obstruction secondary to benign adhesions so dense and vascular that the operating surgeon could not free them, were placed on a home total parenteral nutrition program. Four patients had enterocutaneous fistulas, and two had their bowels divided and stomas created to divert intestinal con...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90331-8
更新日期:1983-12-01 00:00:00
abstract::In his presidential address to the Southwestern Surgical Congress, he examines surgery as a profession from three different perspectives: his experience as a patient, a surgeon, and a photographer. He uses photography to illustrate the importance of perspective and illumination. He respectfully suggests that we should...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.09.002
更新日期:2015-12-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to determine if there are clinical features that raise suspicion for parathyroid hyperplasia. MATERIALS & METHODS:We retrospectively reviewed patients with primary hyperparathyroidism who underwent parathyroidectomy from 1991 to 2017, analyzing demographics, calcium and PTH, ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.10.051
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Academic institutions have increasingly focused on educating physicians and surgeons in concepts of value-based care, including quality improvement (QI). The extent to which QI curricular competencies are addressed in specialty surgical residency training is unclear. METHODS:A survey instrument was develope...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.09.036
更新日期:2020-09-29 00:00:00
abstract:BACKGROUND:Accurate assessment is imperative for learning, feedback and progression. The aim of this study was to examine whether surgeons can accurately self-assess their technical and nontechnical skills compared with expert faculty members' assessments. METHODS:Twenty-five surgeons performed a laparoscopic cholecys...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.01.024
更新日期:2011-10-01 00:00:00