Publications by authors named "J V DeFazio"
Introduction: Laparoscopic inguinal hernia repair (IHR) is being performed more frequently in children, but few studies have evaluated surgical practice patterns in infants. In this study, we surveyed pediatric surgeons within a regional consortium to assess current preferences for IHR strategy in infants. We hypothesized that early-career pediatric surgeons would prefer laparoscopic IHR over open IHR in this patient population.
View Article and Find Full Text PDFRole of ileal diversion in pediatric inflammatory bowel disease.
J Pediatr Gastroenterol Nutr
October 2024
Surgical intervention is often indicated in pediatric inflammatory bowel disease (IBD) for medically refractory disease or complications of severe disease. Specifically, surgical intervention via ileal diversion allows for fecal flow to be redirected away from diseased distal bowel and through an ileostomy. It is utilized in patients who have medically refractory colitis, severe perianal disease, or irreversible bowel damage.
View Article and Find Full Text PDFObjective: To develop a severity-adjusted, hospital-level benchmarking comparative performance report for postoperative organ space infection (OSI) and antibiotic utilization in children with complicated appendicitis.
Background: No benchmarking data exist to aid hospitals in identifying and prioritizing opportunities for infection prevention or antimicrobial stewardship in children with complicated appendicitis.
Methods: This was a multicenter cohort study using National Surgical Quality Improvement Program-Pediatric data from 16 hospitals participating in a regional research consortium, augmented with antibiotic utilization data obtained through supplemental chart review.
Importance: Gangrenous, suppurative, and exudative (GSE) findings have been associated with increased surgical site infection (SSI) risk and resource use in children with nonperforated appendicitis. Establishing the role for postoperative antibiotics may have important implications for infection prevention and antimicrobial stewardship.
Objective: To compare SSI rates in children with nonperforated appendicitis with GSE findings who did and did not receive postoperative antibiotics.
Article Synopsis
- The study aims to compare postoperative drainage rates and culture profiles in children with complicated appendicitis treated with two common antibiotic regimens: piperacillin-tazobactam (PT) and ceftriaxone with metronidazole (CM).
- A retrospective analysis of 1,002 children from 15 hospitals was conducted between 2015 and 2020, leading to a matched sample of 778 patients for comparison of drainage rates and infection-related cultures.
- Results showed that PT had similar overall drainage rates to CM but higher rates of drainage related to specific organisms, indicating that the use of antipseudomonal antibiotics did not lead to better outcomes in this context.