Mastalgia is Not An Indication for Mammogram.

METHODS: RESULTS: CONCLUSIONS:

Re-evaluating if observation continues to be the best management of idiopathic granulomatous mastitis.

Background: The presentation of idiopathic granulomatous mastitis can mimic breast cancer. Therefore, awareness of the condition is important for surgeons. The current series is the largest in a US population.

Awareness of residents' technical ability can affect margin status in breast conserving operations.

Purpose: The current study was performed to determine if awareness of the potential affect of residents could affect margin status.

Methods: Retrospective review of all patients who underwent lumpectomy from July 2006 to May 2017 was evaluated. The effect of surgical residents' participation and their technical ability was evaluated to determine the effect on margin status.

Renal Replacement Therapy in Severe Burns: A Multicenter Observational Study.

Acute kidney injury (AKI) after severe burns is historically associated with a high mortality. Over the past two decades, various modes of renal replacement therapy (RRT) have been used in this population. The purpose of this multicenter study was to evaluate demographic, treatment, and outcomes data among severe burn patients treated with RRT collectively at various burn centers around the United States.

Temporary Abdominal Closure Combined With an Irrigating System Utilizing Hypochlorous Acid Solution to Decrease Abdominal Mucopurulence.

Leaving the abdominal cavity open is a well-described and frequently utilized technique in the treatment of severe intra-abdominal sepsis. Irrigation through a negative pressure wound therapy device is a technique employed to assist in the closure of wounds as well as the reduction of bacterial contamination. Furthermore, hypochlorous acid has been found to be safe and effective in microorganismal elimination from extremity wounds.

Retroperitoneal Necrotizing Fasciitis from Fournier's Gangrene in an Immunocompromised Patient.

Introduction: Necrotizing fasciitis (NF) is a devastating soft tissue disease causing fulminant clinical deterioration, and extension into the retroperitoneum has a high mortality rate. This disease process demands a strong clinical suspicion for early identification which must be coupled with frequent wide surgical debridements and intravenous antibiotics for improved outcomes. Various clinical risk factors may render a weakness in the patient's immune status including diabetes mellitus, chronic renal failure, obesity, and autoimmune disorders, such as a human immunodeficiency virus (HIV) infection.

Lemons in the Arizona Sunshine: The Effects of Furocoumarins Leading to Phytophotodermatitis and Burn-like Injuries.

Introduction: Phytophototoxic dermatitis is a strong phototoxic reaction to ultraviolet A (UV-A) radiation exposure after cutaneous contact with citrus fruit containing furocoumarins, leading to skin injury. At the Arizona Burn Center (Phoenix, AZ), the majority of these injuries are managed in the outpatient setting.

Case Report: The authors present a pediatric admission for burn-like injuries following prolonged cutaneous exposure to lemons while playing in the Arizona sunshine.

High-volume hemofiltration in adult burn patients with septic shock and acute kidney injury: a multicenter randomized controlled trial.

Background: Sepsis and septic shock occur commonly in severe burns. Acute kidney injury (AKI) is also common and often results as a consequence of sepsis. Mortality is unacceptably high in burn patients who develop AKI requiring renal replacement therapy and is presumed to be even higher when combined with septic shock.

A Novel Approach To Sealing The Denuded Dermis of the Abdominal Wall With A Negative Pressure Wound Device After A Decompressive Laparotomy.

The open abdomen is a well-known technique that is applied in a wide variety of clinical situations, including treatment of abdominal compartment syndrome, damage control laparotomy, and severe intraabdominal sepsis. Disease states such as Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis or extensive deep partial and/or full-thickness torso burns involving the abdomen often result in a complete epidermal and partial dermal loss. When ABThera Open Abdomen Negative Pressure Wound Therapy is attempted in these patients, the exposed subcutaneous tissue rarely allows for an adequate seal between the adhesive barrier and the denuded skin.

Monitoring End Points of Burn Resuscitation.

This article discusses commonly used methods of monitoring and determining the end points of resuscitation. Each end point of resuscitation is examined as it relates to use in critically ill burn patients. Published medical literature, clinical trials, consensus trials, and expert opinion regarding end points of resuscitation were gathered and reviewed.

Does Self-Assessment Improve the Effectiveness of Grand Rounds Lectures in a Community-Based Teaching Hospital?

Objective: To determine whether use of self-assessment (SA) questions affects the effectiveness of weekly didactic grand rounds presentations.

Design: From 26 consecutive grand rounds presentations from August 2013 to April 2014, a 52-question multiple-choice test was administered based on 2 questions from each presentation.

Setting: Community teaching institution.

The effect of an evidence-based medicine curriculum on breast cancer knowledge and satisfaction of surgical residents.

Objective: The current study was performed to determine if evidence-based medicine (EBM) curriculum would affect education of surgical residents.

Design: A 5-year prospective study was designed to determine if EBM curriculum could improve residents' satisfaction and understanding of breast cancer management during a breast surgical oncology rotation. During the first 2 years, 45 journal articles were used.

A multicenter study of preventable contact burns from glass fronted gas fireplaces.

Glass fronted gas fireplaces (GFGFs) have exterior surfaces that can reach extremely high temperatures. Burn injuries from contact with the glass front can be severe with long-term sequelae. The Consumer Product Safety Commission reported that these injuries are uncommon, whereas single-center studies indicate a much higher frequency.

Measuring the burden of pediatric burn injury for parents and caregivers: informed burn center staff can help to lighten the load.

This study sought to identify which commonly experienced burn-related issues parents/caregivers of burn-injured youth deemed most stressful, difficult, and disruptive during their child's initial acute burn care hospitalization, and following the child's discharge. Parents completed an 11-item survey, asking them to rate the difficulty of items regarding their child's burn injury. The scale was created by burn doctors, nurses, and psychologists with an average of 10.

The reported pain coping strategies of pediatric burn survivors-does a correlation exist between coping style and development of anxiety disorder?

Unresolved pediatric pain, both acute and chronic, has been associated with negative short- and long-term physical and mental health outcomes. This study sought to determine whether an association existed between self-reported pain coping skills and anxiety levels in a cohort of pediatric burn patients, and whether gender would influence their responses. The sample comprised burn-injured children in attendance at one of three mature burn camp sites.

Burn-injured youth may be at increased risk for long-term anxiety disorders.

This study aimed to determine the prevalence of long-term anxiety disorder in burn-injured youth. It is well documented that inpatient pediatric burn patients experience heightened anxiety. However, the prevalence of anxiety disorder in pediatric burn survivors warrants further investigation.

The blue man: burn from muriatic acid combined with chlorinated paint in an adult pool construction worker.

Muriatic acid (hydrochloric acid), a common cleaning and resurfacing agent for concrete pools, can cause significant burn injuries. When coating a pool with chlorinated rubber-based paint, the pool surface is initially cleansed using 31.45% muriatic acid.

Clinical Evaluation of NIKS-Based Bioengineered Skin Substitute Tissue in Complex Skin Defects: Phase I/IIa Clinical Trial Results.

Background: Complex skin defects, such as burns and acute cutaneous trauma, are life-threatening injuries, often requiring temporary allograft placement to maintain fluid homeostasis and prevent infection until permanent wound closure is possible.

The Problem: The current standard of care for the management of full-thickness wounds that are unable to be closed in a single surgical stage is temporary coverage with cadaver allograft until an acceptable wound bed has been established. This approach has limitations including limited availability of human cadaver skin, the risk of disease transmission from cadaveric grafts, and inconsistent cadaver allograft quality.

Burn-injured adolescents report gaining multiple developmental benefits and improved life skills as a result of burn camp attendance.

Anecdotally, burn camp has been reported to be a positive developmental and rehabilitative experience for attendees; there is little empirical data to support this belief. This study sought to explore whether burn camp either directly or indirectly elicits positive development outcomes in pediatric burn survivors or increases their psychosocial well-being and achievement. The Youth Experience Survey 2.

StrataGraft skin substitute is well-tolerated and is not acutely immunogenic in patients with traumatic wounds: results from a prospective, randomized, controlled dose escalation trial.

Objective: The goal of this study was to assess the immunogenicity and antigenicity of StrataGraft skin tissue in a randomized phase I/II clinical trial for the temporary management of full-thickness skin loss.

Background: StrataGraft skin tissue consists of a dermal equivalent containing human dermal fibroblasts and a fully stratified, biologically active epidermis derived from Near-diploid Immortalized Keratinocyte S (NIKS) cells, a pathogen-free, long-lived, consistent, human keratinocyte progenitor.

Methods: Traumatic skin wounds often require temporary allograft coverage to stabilize the wound bed until autografting is possible.

A psychological profile of surgeons and surgical residents.

Background: Approximately 20 percent of general surgery residents never complete their original residency programs. The psychological, programmatic, and financial costs for this attrition are substantial for both the residents, who spend valuable time and money pursuing incompatible career paths, and the residency programs, which also lose valuable time and money invested in these residents. There is a large amount of information in the field about the performance dimensions and skill sets of surgeons and surgical residents.

Burn care professionals' attitudes and practices regarding discussions of sexuality and intimacy with adult burn survivors.

Burn injury survival means coping with more than just the physical changes and disabilities often encountered after burn injury. Overall quality of life is important, and issues such as sexuality and intimacy are significant facets of quality of life. A literature review revealed limited research regarding current burn center practices related to sexuality and intimacy concerns of burn survivors and their partners.