Role Of Surgeon Research Articles

Role of Subcutaneous Negative Suction versus Simple Subcutaneous Drain Closure in Contaminated Abdominal Surgeries in Pediatric Age Group

Introduction: Contaminated abdominal surgical laparotomy incisions and their care are basic principles in the field of surgery. In emergency or trauma laparotomy, the primary surgeon's pivotal role is to optimize the untoward incision wound response, excise or debride viable/nonviable tissues, and alleviate the process of wound healing near to normal function. In contaminated abdominal surgeries, wound contamination is unavoidable that occurs at the time of surgery, and several methods are used to prevent wound complications. Material and Methods: To assess the impact of subcutaneous negative suction versus simple subcutaneous drains on the outcome of surgical wound infection, we conducted an observational study involving patients with contaminated abdominal surgical laparotomy wounds. The study was conducted in the Department of Pediatric Surgery at Liaquat University Hospital Hyderabad. Over five years from January 2015 to December 2020 about 300 patients underwent emergency or trauma laparotomy. Patients were divided into two groups A and B 150 each group by random sampling. Results: In our study, negative suction drain versus simple subcutaneous drain without suction during the closure of the contaminated abdominal surgical wound in emergency or trauma laparotomy, the negative suction drain is highly suggestive to decrease postoperative wound infection, seroma formation, and wound disruption. Compared to a simple subcutaneous drain, the utilization of a subcutaneous suction drain following the closure of the abdominal sheath result in effective wound drainage, reducing the risk of wound infection and disruption. Conclusion: Subcutaneous suction drain has a better outcome as compared with simple subcutaneous without suction in the management of contaminated surgical laparotomy wounds. Keywords: Negative suction drain, simple drain, seroma, wound disruption.

Snake Bite Management: A Scoping Review of the Literature.

Background:Around the world, snake bite envenomation remains an underreported human health hazard. Envenomation can cause local and systemic complications, especially when there is a lack of antivenom availability. Although there are established guidelines regarding snake bite management acute care, there is a paucity of data regarding surgical intervention and the plastic surgeon’s role treating this unique patient population.Methods:A review was conducted identifying relevant published articles involving snake bite management and treatment in PubMed and EMBASE.Results:One hundred ten articles were identified and 77 met inclusion criteria. Snake bite envenomation can result in complications that are dependent upon a variety of variables. The literature has shown the best field treatment to be timely transportation to the nearest medical facility, along with antivenom administration. The cytotoxic, hemotoxic, and neurotoxic effects of venom can cause a variety of local soft tissue and systemic complications. Surgical interventions such as fasciotomies, wound debridements, skin grafts, and tissue flaps may be necessary in these patients to optimize functional and aesthetic outcomes. Disparities in access to care in resource limited settings are discussed.Conclusions:Global health disparities and insufficient antivenom distribution create an inequality of care in snake bite patients. Plastic surgeons have an important role in managing acute and chronic complications of snake bite envenomations that can lead to improved patient outcomes.

Guiding the Facial Rejuvenation Journey: Fulfilling the Complete Role of Surgeon and Aesthetic Practitioner.

The facial plastic surgeon's role today includes more than provision of procedural excellence. To provide excellent quality of care effective planning and guidance for patients through the aesthetic journey is needed. Methods for the delivery of this level of care are presented and discussed.

A Response to: The Plastic Surgeon's Role in Health Equity Research and Policy.

A Response to: The Plastic Surgeon's Role in Health Equity Research and Policy.

整形外科医の家事・育児の役割分担, 現状と課題—夫婦へのアンケート調査および主婦業体験を踏まえて—

整形外科医の家事・育児の役割分担, 現状と課題—夫婦へのアンケート調査および主婦業体験を踏まえて—

The Plastic Surgeon's Role in Health Equity Research and Policy.

Although a growing body of research explores the interplay of social, economic, and environmental conditions that underlie health disparities, there is no clear path forward to combat health inequity. Plastic surgeons continue to witness how changes in healthcare delivery processes, insurance coverage, and payment structures interfere with patients' access to specialty services. However, their perspectives are rarely incorporated into meaningful strategies that ensure equitable care for the diverse patient population. The goal of this article was to convey how plastic surgeons can play a more active role in the development of policies and initiatives to reduce health disparities. A greater focus on modifiable legislative, healthcare system, and provider factors is needed to catalyze progress.

A surgeon's role in fighting a medical pandemic: Experiences from the unit at the epicentre of COVID-19 in Singapore - A cohort perspective.

ImportanceAlthough Singapore was one of the first countries outside of China to be affected by COVID-19, for the first 2.5 months since its first reported case on January 23, 2020, it remained one of the few nations with successful containment of spread of the pandemic with little mortality and zero intra-hospital transmissions, without instituting a major lockdown of the country. In times of an infectious epidemic where medical subspecialties lead the frontline, a surgeon's role becomes rather vague. However, the only obstacle that stands in between the surgeon and fighting in the frontline of an infectious disease outbreak, is the traditional perception of what a surgeon can do. By presenting the strategies employed by our institution and its surgical unit, which remains the epicenter of the COVID-19 fight in Singapore, together with our medical counterparts, we hope to be able to improve our practices to respond and prevent the pandemic from escalating further as a collective community of surgeons across the globe.ObservationsContingencies should be in place for prioritization of existing patients, triaging and treatment of suspected patients, infection control, manpower management and novel strategies for inter-disciplinary communications and education in a hospital's surgical unit during a pandemic. Working in a high risk environment with manpower and resource limitations for prolonged periods of time has effect on morale and affects surgeon burn-out. Transparent communication, avenues to address psychological needs of surgeons and leadership by example are key strategies in ensuring a sustainable fight against the pandemic.Conclusions and RelevanceWith the varies strategies implemented, every surgical discipline and every surgeon should be unified and place their desire to operate aside. There should not be any differentiation between surgeon and physician, but instead, everyone has to work together as one united health care front battling the common enemy – COVID-19.

The Surgeon's Role During the Coronavirus Pandemic.

The coronavirus pandemic has disrupted delivery of healthcare globally, forcing healthcare providers at all levels to adjust their methods of care. Surgeons in the community must respond accordingly and not only take necessary precautions during patient management, but also find opportunities to better educate patients moving forward. Additionally, to best preserve personal protective equipment and staffing resources, surgeons should thoroughly assess their patient load and determine which planned surgeries can be safely delayed to a later date. While not necessarily on the front lines of the pandemic response, surgeons have a vital role in maintaining the public health in the time of crisis.

Addressing domestic violence: the surgeon's role.

Addressing domestic violence: the surgeon's role.

The Surgeon's Role in the Opioid Crisis: A Narrative Review and Call to Action.

Over the past two decades, there has been a sharp rise in the use of prescription opioids. In several countries, most notably the United States, opioid-related harm has been deemed a public health crisis. As surgeons are among the most prolific prescribers of opioids, growing attention is now being paid to the role that opioids play in surgical care. While opioids may sometimes be necessary to provide patients with adequate relief from acute pain after major surgery, the impact of opioids on the quality and safety of surgical care calls for greater scrutiny. This narrative review summarizes the available evidence on rates of persistent postsurgical opioid use and highlights the need to target known risk factors for persistent postoperative use before patients present for surgery. We draw attention to the mounting evidence that preoperative opioid exposure places patients at risk of persistent postoperative use, while also contributing to an increased risk of several other adverse clinical outcomes. By discussing the prevalence of excess opioid prescribing following surgery and highlighting significant variations in prescribing practices between countries, we note that there is a pressing need to optimize postoperative prescribing practices. Guided by the available evidence, we call for specific actions to be taken to address important research gaps and alleviate the harms associated with opioid use among surgical patients.

A Single Pediatric Surgeon Working in a Single Center: Was There a Change in the Pediatric Surgeon's Role Following 25 Years of Service in Suwon City?

A Single Pediatric Surgeon Working in a Single Center: Was There a Change in the Pediatric Surgeon's Role Following 25 Years of Service in Suwon City?

The importance of surgical therapy with expansion of TAVR to low-risk patients.

Despite the landmark release of recent transcatheter aortic valve replacement data, the gold standard of surgical therapy is here to stay. Surgery remains vital in patient populations with low coronary height raising risk of coronary occlusion, aneurysmal ascending aorta, isolated aortic regurgitation, noncalcific disease, bicuspid valves, and multivessel coronary disease, or other structural abnormality requiring cardiac surgery. Consideration of these issues highlights the ongoing importance of multidisciplinary consideration of individual patient cases, careful review of imaging, and preservation of a robust surgical program to complement transcatheter development. As the landscape of valvular heart disease management continues to evolve, the surgeon's role is changing, but by no means diminished and their engagement in heart team decision making remains paramount.

The Anterolateral Approach in Robotic Lung Cancer Surgery

The anterolateral approach in robotic lung cancer surgery was developed for the purpose of more efficient port placement by removing the posterior port, decreasing the total number of ports, and securing enough distance between the robotic arms. When this approach is used, 4 ports are made in the anterolateral area of the patient, and the robot can be docked from an anterolateral direction. By using this port placement, the assistant surgeon's role can be minimized, and solo surgery is possible using the robotic procedure. An anterolateral approach can be considered as a useful port placement method in robotic lung cancer surgery.

Advances in Fetal Surgery: Current and Future Relevance in Plastic Surgery.

Scarless healing has long been the holy grail for plastic surgery. While historically fetal surgery has tempted plastic surgeons with the allure of scarless correction of congenital abnormalities, the risks far outweighed the benefits and these interventions never materialized. Current advances in fetal surgery with minimally invasive fetoscopic surgery have made these early fetal interventions safer, leading to expanding applications. While the plastic surgeon's role is limited as of yet, this article provides a review of the history of fetal surgery and the advances that may become relevant to the future plastic surgeon.

Trends and attitudes of spine surgeons regarding osteoporosis

Background and objectivesNeurosurgeons and other specialists are increasingly having to treat patients with osteoporosis who require spinal fusion surgery.Although there are effective pharmacological treatments and innovations in surgical techniques that can benefit these patients, low rates of diagnosis and preoperative treatment of osteoporosis have been reported, in addition to the limited participation of spine surgeons in this area.The objective of this study was to evaluate trends in diagnosis and treatment of osteoporosis with regard to spine surgeons of the neurosurgical community. Material and methodsAn electronic survey with 10 multiple-choice questions was issued to Spanish Neurosurgery Society (SENEC) members. The following were evaluated: (1) the surgeon's role regarding osteoporosis in spinal arthrodesis, (2) the influence of osteoporosis in pseudarthrosis, and (3) treatment trends in relation to osteoporotic vertebral fractures. ResultsA total of 77 completed questionnaires were obtained. In patients with suspected osteoporosis, 32.5% of respondents did not consider any measure to diagnose it before spinal arthrodesis. In osteoporosis without treatment, 37.7% would proceed with surgery without treatment or would do so after surgery. A total of 48% of respondents would choose to modify their surgical strategy in patients with osteoporosis. The preferred surgical technique was the placement of augmentation screws (70%). In pseudarthrosis, 46.1% did not consider an osteoporosis diagnosis to be necessary for a reoperation. In osteoporotic vertebral fractures, 80.5% of surgeons considered some measure that would facilitate the treatment of osteoporosis. ConclusionsGreater participation of the spine surgeon could improve the diagnosis and preoperative treatment of osteoporosis in spinal arthrodesis surgery and pseudarthrosis. In vertebral fractures, there is greater awareness of the optimisation of treatment and monitoring of osteoporosis.

A Call to Action for Male Surgeons in the Wake of the #MeToo Movement: Mentor Female Surgeons.

A Call to Action for Male Surgeons in the Wake of the #MeToo Movement: Mentor Female Surgeons.

Trends and attitudes of spine surgeons regarding osteoporosis.

Neurosurgeons and other specialists are increasingly having to treat patients with osteoporosis who require spinal fusion surgery. Although there are effective pharmacological treatments and innovations in surgical techniques that can benefit these patients, low rates of diagnosis and preoperative treatment of osteoporosis have been reported, in addition to the limited participation of spine surgeons in this area. The objective of this study was to evaluate trends in diagnosis and treatment of osteoporosis with regard to spine surgeons of the neurosurgical community. An electronic survey with 10 multiple-choice questions was issued to Spanish Neurosurgery Society (SENEC) members. The following were evaluated: 1) the surgeon's role regarding osteoporosis in spinal arthrodesis, 2) the influence of osteoporosis in pseudarthrosis, and 3) treatment trends in relation to osteoporotic vertebral fractures. A total of 77 completed questionnaires were obtained. In patients with suspected osteoporosis, 32.5% of respondents did not consider any measure to diagnose it before spinal arthrodesis. In osteoporosis without treatment, 37.7% would proceed with surgery without treatment or would do so after surgery. A total of 48% of respondents would choose to modify their surgical strategy in patients with osteoporosis. The preferred surgical technique was the placement of augmentation screws (70%). In pseudarthrosis, 46.1% did not consider an osteoporosis diagnosis to be necessary for a reoperation. In osteoporotic vertebral fractures, 80.5% of surgeons considered some measure that would facilitate the treatment of osteoporosis. Greater participation of the spine surgeon could improve the diagnosis and preoperative treatment of osteoporosis in spinal arthrodesis surgery and pseudarthrosis. In vertebral fractures, there is greater awareness of the optimisation of treatment and monitoring of osteoporosis.

Specialty-specific reduction in opioid prescribing after common pediatric surgical operations

BackgroundOpioid misuse has reached epidemic proportions, and postoperative opioids have been linked to overdose, diversion, and dependency. We recently found our opioid prescribing practices following common pediatric operations to be inconsistent and excessive. In this study, we evaluate the efficacy of an educational intervention on opioid prescriptions following tonsillectomy and hernia repair. MethodsRetrospective chart review of prescriptions following outpatient tonsillectomies and hernia repairs at a single institution before and after an educational intervention was performed. The intervention consisted of a single campus-wide grand rounds presentation detailing the surgeon's role in the opioid epidemic. ResultsPostoperative opioid prescriptions were significantly reduced for hernia repair following the educational intervention: 4.2 ± 2.9 vs 2.7 ± 2.6 days' supply (p = 0.004). Such a reduction was not observed for post-tonsillectomy opioid prescriptions: 6.3 ± 4.4 vs 5.4 ± 3.0 days' supply (p = 0.226). A greater decrease in interprovider variation was observed for hernia providers after the educational intervention than for tonsillectomy providers, though significant variation continued to be present for both procedures after the intervention. ConclusionsThe efficacy of an educational intervention at reducing postoperative pediatric opioid prescribing may be tied to the specialty-specific role model relationship of the educator to the prescriber.Type of study: retrospective comparative chart review.Level of evidence: IV.

Physician and Dental Surgeon's roles in diagnosing hypertension in association with Lichen Planus and Geographic Tongue - The perspective of a Clinician

Physician and Dental Surgeon's roles in diagnosing hypertension in association with Lichen Planus and Geographic Tongue - The perspective of a Clinician

Knowledge and practices of dentists in France regarding oral mucosal diseases: a national survey

Introduction:One of the dental surgeon's roles is to identify, diagnose and supervise the treatment of oral pathologies (OP), and/or to refer patients to the appropriate specialists. Today, the delay in diagnosing patients with OP is very long and may impact their prognosis.Objective:We conducted a national survey of French practitioners to estimate their knowledge and practices regarding the management of these pathologies.Methods:About 15,000 dentists were contacted by email to complete a questionnaire designed to assess the diagnoses and management of OP.Results:Overall, for 560 answers (3.8%), DS did not declare any significant difficulties in diagnosing and managing any kind of pathologies. However, we were able to distinguish statistical differences among practitioners depending on the type of lesions and between the practitioners themselves. The associated factors were gender, graduation year, mode of practice and continuing education over the last 5 years. The majority of DS justified their diagnostic difficulties by the fact that they do not encounter patients with these types of pathology frequently enough, and by insufficient education.Conclusion:According to our study, it is necessary to reinforce the training and the continuing medical education of DS regarding OP, especially through the use of practical cases.