Outcomes on 287 Patients with Complex Abdominal Wall Defects Undergoing Abdominal Wall Reconstruction with a Porcine-Derived Acellular Matrix.

Introduction: Complex abdominal wall defects (CAWD) requiring complex abdominal wall reconstruction (CAWR) represent an important surgical challenge in the presence of significant comorbidities. We aimed to report the results on a large patient cohort and identify independent outcome predictors.

Materials And Methods: All patients who underwent CAWR with biologic mesh (Strattice™; Reconstructive Tissue Matrix ®, a porcine-derived acellular dermal matrix; Allergan plc, Branchburg, New Jersey) between July 2016 and November 2021 at the tertiary academic center were studied using univariable and multivariable regressions.

Complex Abdominal Wall Reconstruction with Biologic Mesh for Ventral/Umbilical Hernias in Patients with Cirrhosis: Technique and Outcomes.

Introduction: Patients with cirrhosis undergoing non-liver transplant surgery have a higher risk or adverse events than those without cirrhosis. The main objectives of this study were to describe characteristics, outcomes, and outcome predictors of cirrhotic patients undergoing complex abdominal wall reconstruction (CAWR) with biologic mesh.

Materials And Methods: This study had retrospective and prospective components, including all cirrhotic patients at our center with CAWR for ventral/umbilical hernia repair with biologic mesh between December 2016 and November 2021.

Pelvic fractures in severely injured elderly: a double-adjustment propensity score matched analysis from a level I trauma center.

Purpose: Pelvic trauma has increased risk of mortality in the elderly. Our study aimed to analyze the impact of the additional burden of pelvic fractures in severely injured elderly.

Methods: This is a retrospective analysis of a prospectively maintained trauma registry from 2012 to 2018 at an American College of Surgeons (ACS) verified Level I Trauma Center.

Early Abdominal Wall Reconstruction with Biologic Mesh is Feasible after Catastrophic Abdominal Wall Disruption from Blunt Trauma.

Introduction: Traumatic abdominal wall hernias (TAWHs) after blunt trauma, while rare, are typically associated with severe injuries, particularly those involved with the seatbelt triad of abdominal wall disruption. The aim of this study is to present a case series of patients with TAWHs that were managed at an early stage post injury with a biological mesh.

Materials And Methods: Patients with TAWH undergoing complex abdominal wall reconstruction (CAWR) between 2017 and 2020 were identified from our institutional database.

Early versus delayed complex abdominal wall reconstruction with biologic mesh following damage-control surgery.

Background: Damage-control surgery for trauma and intra-abdominal catastrophe is associated with a high rate of morbidities and postoperative complications. This study aimed to compare the outcomes of patients undergoing early complex abdominal wall reconstruction (e-CAWR) in acute settings versus those undergoing delayed complex abdominal wall reconstruction (d-CAWR).

Method: This study was a pooled analysis derived from the retrospective and prospective database between the years 2013 and 2019.

Biologic Mesh in Surgery: A Comprehensive Review and Meta-Analysis of Selected Outcomes in 51 Studies and 6079 Patients.

Background: In recent decades, biologic mesh (BM) has become an important adjunct to surgical practice. Recent evidence-based clinical applications of BM include but are not limited to: reconstruction of abdominal wall defects; breast reconstruction; face, head and neck surgery; periodontal surgery; other hernia repairs (diaphragmatic, hiatal/paraesophageal, inguinal and perineal); hand surgery; and shoulder arthroplasty. Prior systematic reviews of BM in complex abdominal wall hernia repair had several shortcomings that our comprehensive review seeks to address, including exclusion of laparoscopic repair, assessment of risk of bias, use of an acceptable meta-analytic method and review of risk factors identified in multivariable regression analyses.

Clinical Characteristics Predict the Yield of Head Computed Tomography Scans among Intoxicated Trauma Patients: Implications for the Initial Work-up.

Background And Aims: Alcohol intoxication may confound the clinical assessment of the trauma patient. Head computed tomography (h-CT) is the standard imaging technique to rule out intracranial injury in most intoxicated trauma patients. The objective of this study was to determine whether certain clinical findings (computed clinical score [CCS]) could predict the h-CT yield, admission, and neurosurgical consultation (NSC) among intoxicated trauma patients.

Perioperative complications of complex abdominal wall reconstruction with biologic mesh: A pooled retrospective cohort analysis of 220 patients from two academic centers.

Background: Perioperative outcomes in patients who undergo complex abdominal wall reconstruction (CAWR) may be associated with severe complications, mainly when these procedures are done urgently or emergently. This study aims to identify perioperative predictors of outcomes after CAWR with biologic mesh (BM).

Materials And Methods: In a retrospective study, perioperative complications (length of hospital stay, ventilator support, surgical site infection, need for wound VAC, reoperation, total complications, and mortality), were analyzed in all patients who underwent open CAWR with BM over six years in two academic centers.

Falling Again? Falls in Geriatric Adults-Risk Factors and Outcomes Associated With Recidivism.

Background: The elderly population is at increased risk of fall-related readmissions (FRRs). This study is aimed to identify the factors predictive of repeat falls and to analyze the associated outcomes.

Methods: We studied the Nationwide Readmission Database for the year 2010 and identified the patients (≥65 years) who were admitted after falls, and from that subset, further analyzed patients with ≥1 FRRs.

Inpatient burden of esophageal varices in the United States: analysis of trends in demographics, cost of care, and outcomes.

Background: Esophageal variceal bleeding remains a common reason for hospitalization in the United States. The main objective of this study was to analyze demographic variations and outcomes in hospitalizations related to esophageal varices (EV) in the US.

Methods: We performed a retrospective observational cohort study using National Inpatient Sample (NIS) database for all hospitalizations with discharge diagnoses of EV, with and without hemorrhage from 2001 to 2011.

Screening for methicillin-resistant Staphylococcus aureus: a comparative effectiveness review.

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of health care-associated infections. Although the evidence in support of MRSA screening has been promising, a number of questions remain about the effectiveness of active surveillance.

Methods: We searched the literature for studies that examined MRSA acquisition, MRSA infection, morbidity, mortality, harms of screening, and resource utilization when screening for MRSA carriage was compared with no screening or with targeted screening.

Procalcitonin-guided antibiotic therapy: a systematic review and meta-analysis.

Background: The utility of procalcitonin to manage patients with infections is unclear. A systematic review of comparative studies using procalcitonin-guided antibiotic therapy in patients with infections was performed.

Methods: Randomized, controlled trials comparing procalcitonin-guided initiation, intensification, or discontinuation of antibiotic therapy to clinically guided therapy were included.

Treatment of primary and secondary osteoarthritis of the knee.

Objectives: Systematic review of outcomes of three treatments for osteoarthritis (OA) of the knee: intra-articular viscosupplementation; oral glucosamine, chondroitin or the combination; and arthroscopic lavage or debridement.

Data Sources: We abstracted data from: 42 randomized, controlled trials (RCTs) of viscosupplementation, all but one synthesized among six meta-analyses; 21 RCTs of glucosamine/chondroitin, 16 synthesized among 6 meta-analyses; and 23 articles on arthroscopy. The search included foreign-language studies and relevant conference proceedings.

Evidence for management of small cell lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition).

Purposes: This systematic review addressed the following key questions on managing small cell lung cancer (SCLC): the sequence, timing, and dosing characteristics of primary thoracic radiotherapy (TRTx) for limited-stage disease; primary TRTx for extensive-stage disease; effect of prophylactic cranial irradiation (PCI); positron emission tomography (PET) for staging; treatment of mixed histology tumors; surgery; and second-line and subsequent-line treatment for relapsed/progressive disease.

Methods: The review methods were defined prospectively in a written protocol. We primarily sought randomized controlled trials that compared the interventions of interest.