In a cohort of 171 patients with necrotizing fasciitis, a high mortality rate was observed, particularly in individuals with elevated LRINEC scores and procalcitonin levels. Key findings revealed that early extensive surgical debridement is essential for improving patient survival, independent of disease severity. Streptococcus pyogenes was frequently identified, and 69% of patients presented with a […]
Category: Appendix, Gallbladder and Surgical Emergencies
AI-based POTTER Calculator Validated for Emergency Surgery Outcomes
A prospective study validated the AI-based POTTER calculator for predicting outcomes in emergency general surgery patients undergoing laparotomy. Involving 361 patients, it demonstrated high accuracy, with a c-statistic of 0.90 for 30-day postoperative mortality prediction and between 0.80 and 0.89 for other complications. The tool’s user-friendliness and interpretability enhance its value for preoperative counseling, establishing […]
Compliance with Quality Performance Indicators in Acute Pancreatitis
The PANORAMA study aims to assess how well New Zealand hospitals adhere to quality performance indicators (QPIs) for acute pancreatitis management. Researchers will gather data from adult patients diagnosed over a three-month period to evaluate compliance levels. In addition, the study will explore the connection between QPI compliance and early clinical outcomes, such as complications […]
Many trauma centers lack standardized communication tools for surgery
A survey of all 23 adult major trauma centers in England revealed that only 39.1% utilize truncated preoperative checklists for damage control surgery, while 52.2% have formal policies for situational reporting. The identified checklist components include blood products availability, allergies, and surgical planning discussions, among others. These findings highlight significant gaps in communication practices that […]
Specialized colorectal surgeons improve outcomes in emergency surgeries
Emergency colorectal surgeries performed by specialized colorectal surgeons lead to significantly lower 30-day and in-hospital mortality rates (30-day mortality odds ratio 0.64; p < 0.0001). These specialists also demonstrate higher rates of primary anastomosis (odds ratio 2.95; p < 0.0001) and laparoscopic procedures (odds ratio 2.38; p = 0.001), paired with a reduced likelihood of […]
Intraoperative administration of indocyanine green enhances visualization
The study compared intraoperative (IS) and preoperative (PS) indocyanine green administration for near-infrared cholangiography during laparoscopic cholecystectomy. While both methods yielded similar signal-to-background ratios, IS significantly lowered liver fluorescence intensity and achieved higher visualization scores for common hepatic ducts. Furthermore, IS facilitated a quicker critical view of safety, taking an average of 9.4 minutes versus […]
Laparoscopic cholecystectomy is optimal for pregnant patients with gallbladder disease
In a systematic review of 63,523 pregnant women, laparoscopic cholecystectomy (LC) emerged as the most favorable treatment for gallbladder disease. It significantly reduced risks of preterm delivery (RR: 0.23), fetal complications (RR: 0.42), and maternal complications (RR: 0.44) compared to open cholecystectomy. While cholecystectomy is safe in any trimester, the third trimester poses heightened maternal […]
Super-oxidized solution reduces surgical-site infections in appendicitis
In a randomized clinical trial involving 102 patients with perforated appendicitis, peritoneal and wound lavage with super-oxidized solution significantly lowered surgical-site infections compared to normal saline. The results showed a reduction in overall infections from 37.2% to 15.6% and superficial infections from 35.3% to 9.8%. With a number-needed-to-treat of four, the findings suggest this intervention […]
Robotic surgery is feasible for acute care surgeons.
Findings indicate that robotic surgery can be safely integrated into acute care surgery practices. An analysis of 200 procedures revealed that common operations included cholecystectomies and hernia repairs, achieving comparable hospital lengths of stay to laparoscopic methods. Notably, only two operations required a conversion to open surgery. These results suggest that robotic techniques could enhance […]
5-Hydroxyindoleacetic acid levels distinguish perforated from nonperforated appendicitis
5-hydroxyindoleacetic acid (5-HIAA) levels in urine significantly differed between patients with perforated and non-perforated appendicitis, indicating its potential as a diagnostic biomarker. Specifically, 5-HIAA was higher in the perforated group (0.5 mg/dl) compared to the non-perforated group (0.3 mg/dl), and the study reported a diagnostic accuracy of 88%, with sensitivity at 82%. These findings suggest […]