Unexpected ICU Admission Is Associated with Pulmonary Complications but Not Increased Mortality; Rescue Is Essential for Optimal Patient Outcome.

ICU beds are in demand in large regional referral hospitals; therefore, nonintubated polytrauma patients are often admitted to general care (GC) wards. We hypothesized that trauma patients with Injury Severity Score (ISS) greater than 15 and unexpected ICU admission (U-ICU) after initial admission to GC had increased morbidity and mortality. We also hypothesized that those requiring U-ICU could be predicted based on admission parameters.

Multi-institutional experience using human acellular dermal matrix for ventral hernia repair in a compromised surgical field.

Background: A complex ventral hernia repair (CVHR) involves a compromised surgical field where gastrointestinal, biliary, and genitourinary procedures are performed. Complex ventral hernia is a significant problem in trauma, emergency, and elective general surgery in which prosthetic material is contraindicated. In this clinical scenario, primary fascia closure carries a 50% risk of developing a hernia.

Hemodynamic effects of the vacuum-assisted closure device on open mediastinal wounds.

Background: Application of the Vacuum-Assisted Closure device (VAC) to open sternal wounds has negative hemodynamic effects. We hypothesized that the interposition of a muscle flap attenuates these negative hemodynamic effects.

Materials And Methods: After institutional approval, monitoring lines were placed in anesthetized, ventilated pigs.

Sutureless robot-assisted mitral valve repair: an animal model.

Background: Robotic mitral valve repair with the da Vinci robotic surgical system has been performed in more than 70 patients at our institution. This procedure reduces the need for blood transfusions, shortens hospital stay, and hastens return to normal activities. However, the robot-assisted repair also requires longer cardiopulmonary bypass and arrested-heart times than conventional open repairs.

Popliteal artery trauma in a rural level I trauma center.

Popliteal vascular trauma has historically been an urban phenomenon. We hypothesized that rural popliteal artery injury would result more often from blunt mechanisms of injury (MOI), have a longer time to operation, and result in a higher amputation rate. We retrospectively reviewed all cases of popliteal artery injury from December 1994 to May 2001 at our rural trauma center.