Where's the difference? Presentation of nosocomial infection in critically ill trauma versus general surgery patients.

Background: Diagnosing infection efficiently is integral to managing critically ill patients. Knowing if and how trauma and general surgery patients differ in their presentation of new infectious complications could be useful. We hypothesized these populations would differ in presentation in the intensive care unit (ICU).

Bacterial species-specific hospital mortality rate for intra-abdominal infections.

Background: Intra-abdominal infections (IAIs) are a major cause of morbidity and death. We hypothesized that the involvement of specific organisms would predict death independently.

Patients And Methods: All patients with IAIs treated at an academic tertiary-care facility over eight years (June 1999-June 2007) were included.

Diagnosis of infection after splenectomy for trauma should be based on lack of platelets rather than white blood cell count.

Background: There is a lack of evidence-based criteria to assist the diagnosis of infection following trauma splenectomy (TS). However, the literature suggests that white blood cell count (WBC) is associated with infection in patients who undergo TS. We sought to find whether there exist key differences in laboratory and clinical parameters that can assist the diagnosis of infection after TS.

Suture choice matters in rabbit model of laparoscopic, preperitoneal, inguinal hernia repair.

Purpose: We evaluated the effect of different suture materials in a laparoscopic preperitoneal ligation of the patent processus vaginalis in a rabbit survival model.

Materials And Methods: New Zealand White rabbits underwent laparoscopic assisted preperitoneal ligation of the patent processus vaginalis. The processus vaginalis was closed with silk (n=10), polyglactin 910 (Vicryl(®); Ethicon, a Johnson & Johnson Company, Somerville, NJ) (n=10), or polypropylene (Prolene(®); Ethicon) (n=10).

Pediatric abdominal wall defects.

This article reviews the incidence, presentation, anatomy, and surgical management of abdominal wall defects found in the pediatric population. Defects such as inguinal hernia and umbilical hernia are common and are encountered frequently by the pediatric surgeon. Recently developed techniques for repairing these hernias are aimed at improving cosmesis and decreasing pain while maintaining acceptably low recurrence rates.

Anterior abdominal stab injury: a comparison of self-inflicted and intentional third-party stabbings.

Background: There is minimal literature comparing self-inflicted (SI) with non-self-inflicted (NSI) anterior abdominal stab wounds (AASW).

Methods: Adult patients treated at a level 1 trauma center from 2006 through 2011 with an AASW were reviewed.

Results: There were 215 patients with an AASW; 20% were SI.

Stitch versus scar--evaluation of laparoscopic pediatric inguinal hernia repair: a pilot study in a rabbit model.

Background: Many have questioned whether the laparoscopic, percutaneous hernia repair technique is as durable as an open repair in which the sac is divided and ligated. We set out to assess if the suture alone causes enough injury and scar over time to obliterate the internal ring.

Materials And Methods: In total, 28 male rabbits with congenital patent processus vaginalis underwent laparoscopic repair with the subcutaneous endoscopically assisted ligation technique.

Continued rationale of why hospital mortality is not an appropriate measure of trauma outcomes.

Background: We hypothesized that standardized withdrawal of care (WOC) practices and an aggressive long-term acute care facility (LTAC) discharge protocol could change hospital mortality and national ranking among trauma centers.

Study Design: Patients who died while admitted to the trauma service at a level 1 trauma center were classified as either an "LTAC candidate" or "not a LTAC candidate" at 4 time points before death.

Results: A total of 216 patients died, and 48% had WOC.

Formative evaluation of standardized training for CT colonographic image interpretation by novice readers.

Purpose: To introduce an educational intervention-specifically, a specialized training course-and perform a formative evaluation of the effect of the intervention on novice reader interpretation of computed tomography (CT) colonographic data.

Materials And Methods: The study was institutional review board approved. Ten normal and 50 abnormal cases, those of 60 patients with 93 polyps-61 polyps 6-9 mm in diameter and 32 polyps 10 mm or larger-were selected from a previously published trial.