Strategies to accommodate resident work-hour restrictions: impact on surgical education.

Background: The introduction of duty-hour restrictions has impacted surgical training. Several strategies were introduced by training programs in response to these restrictions. The purpose of this study was to assess the various strategies employed by residency programs to comply with work-hour restrictions with respect to the impact on the quality of surgical education.

Endovascular stent graft repair of left renal artery pseudoaneurysm from malignant fibrous histiosarcoma.

A renal artery pseudoaneurysm is a rare but life-threatening complication. Historically, these vascular abnormalities have been treated using open surgery, but today's endovascular techniques provide less invasive forms of treatment. Though literature supports selective angio-embolization as an effective form of repair, there are little data on covered stent placement for renal artery psuedoaneurysms.

The chimney procedure is an emergently available endovascular solution for visceral aortic aneurysm rupture.

A 79-year-old woman presented with a ruptured saccular thoracoabdominal aortic aneurysm involving the celiac and mesenteric artery. The patient was unfit for open surgical repair. A "chimney" procedure was performed, which involved placement of stents in the aortic side branches alongside the endograft.

Should all duty hours be the same? Results of a national survey of surgical trainees.

Background: Although duty hours regulations (DHR) were introduced as a measure to improve patient safety and graduate medical education, new evidence suggests that the opposite might be happening. This study was designed to assess surgery resident perceptions of the impact that DHR have had on their education, the number of hours they believed would be ideal for their training, and to evaluate the effect of seniority on these opinions.

Study Design: An Internet-based survey was electronically distributed to all Resident and Associate members of the American College of Surgeons.

Frequency of inappropriate continuation of acid suppressive therapy after discharge in patients who began therapy in the surgical intensive care unit.

Study Objective: To determine the frequency with which patients who begin to receive stress ulcer prophylaxis in the surgical intensive care unit (SICU) are discharged receiving inappropriate acid suppressive therapy (AST).

Design: Prospective, observational evaluation. Setting.

Effects of differences in percent total body surface area estimation on fluid resuscitation of transferred burn patients.

We sought to analyze the effect that differences in estimation of burn size and burn resuscitation had on complications and death among our transferred burn patients, in comparison with outcomes for burn patients directly admitted to our rural Level 1 trauma center. A retrospective chart review was performed for all patients suffering thermal injuries who were treated at a rural Level I trauma center and regional burn center. Percent TBSA burn estimates at referring hospitals were compared to burn center estimates.

A survey of airway and ventilator management strategies in North American pediatric burn units.

A survey was used to gather information regarding airway management patterns in thermally injured children. North American pediatric burn centers listed by the American Burn Association were sent a survey designed to examine patterns of pediatric airway management in children with acute respiratory failure. The sample population means for the number of patients ventilated more than 48 hours and the number of patients ventilated more than 48 hours with inhalation injury were used to separate centers into large and small pediatric burn centers.