Publications by authors named "Daniel S Howard"
Pancreaticoduodenectomy in trauma patients with grade IV-V duodenal or pancreatic injuries: a post hoc analysis of an EAST multicenter trial.
Trauma Surg Acute Care Open
December 2024
Introduction: The utility of pancreaticoduodenectomy (PD) for high-grade traumatic injuries remains unclear and data surrounding its use are limited. We hypothesized that PD does not result in improved outcomes when compared with non-PD surgical management of grade IV-V pancreaticoduodenal injuries.
Methods: This is a retrospective, multicenter analysis from 35 level 1 trauma centers from January 2010 to December 2020.
Article Synopsis
- Patients with duodenal leaks (DL) who received enteral nutrition (EN) experienced shorter time to leak closure, fewer infectious complications, and reduced hospital stays compared to those receiving parenteral nutrition (PN) or a combination of both.
- The study analyzed data from 113 patients across 35 trauma centers, highlighting that EN patients had significantly fewer days without oral intake and less severe complications.
- The findings suggest that EN is a preferable nutritional strategy for DL patients, as it promotes quicker recovery and fewer hospital-related issues.
Importance: Morbidity and mortality conferences (MMCs) are thought to advance trainee education, quality improvement (QI), and faculty development. However, there is considerable variability with regard to their completion.
Objective: To compile and analyze the literature describing the format, design, and other attributes of MMCs that appear to best advance their stated objectives related to QI and practitioner education.
Outcomes among trauma patients with duodenal leak following primary versus complex repair of duodenal injuries: An Eastern Association for the Surgery of Trauma multicenter trial.
J Trauma Acute Care Surg
July 2023
Background: Duodenal leak is a feared complication of repair, and innovative complex repairs with adjunctive measures (CRAM) were developed to decrease both leak occurrence and severity when leaks occur. Data on the association of CRAM and duodenal leak are sparse, and its impact on duodenal leak outcomes is nonexistent. We hypothesized that primary repair alone (PRA) would be associated with decreased duodenal leak rates; however, CRAM would be associated with improved recovery and outcomes when leaks do occur.
View Article and Find Full Text PDFObjective: Given the declining number of US graduates pursuing transplant surgery as well as regulatory changes regarding transplant rotations for surgical residents, this study examined the transplant surgery operative volume of residents over the past 20 years.
Design: Retrospective analysis of the ACGME database of general surgery operative logs from academic year (AY) 1999-2000 to AY 2020-2021; data was categorized into time periods relative to regulatory changes: Period 1 (1999-2010) and Period 2 (2011-2021).
Setting/participants: All ACGME-accredited general surgery residency programs in the US.