Patient outcomes can be associated with organizational changes: a quality improvement case study.

Aims/background: We report the results of a university surgical intensive care (SICU), which are influenced by a reorganization of the department because of a downsizing of beds with the corresponding reduction of personnel resulting in a decrease in nurse-to-bed ratio. Moreover, we report the subsequent interventions and adjustments resulting in favorable results.

Design: We performed a prospective observational cohort study of all consecutive surgical patients entering the SICU of our hospital, over the period 2000-2004.

Traumatic hemipelvectomy: Improvements in the last decennia illustrated by 2 case reports.

Introduction: In this article we present two cases of young men who sustained a traumatic hemipelvectomy.

Presentation Of Case: The first case occurred more than 10 years ago and the second case happened less than 1 year ago. Changes in the management for resuscitation, surgical intervention, and in postoperative treatment are detailed.

[Necrotising fasciitis and myositis as serious complications after liposuction].

Three days after liposuction of the lower abdomen, a 41-year-old woman was admitted for toxic shock-like syndrome with necrotising fasciitis and myositis, caused by Lancefield-group-A beta-haemolytic streptococci. The patient was treated by radical debridement of the skin, subcutis, fasciae and part of the pectoral muscle, plus antibiotics. Postoperatively she required artificial respiration for respiratory insufficiency.

Effect of dopexamine on outcome after major abdominal surgery: a prospective, randomized, controlled multicenter study. European Multicenter Study Group on Dopexamine in Major Abdominal Surgery.

Objective: To test the hypothesis that dopexamine reduces postoperative mortality and morbidity in high-risk, major abdominal surgery patients, when given to fluid-resuscitated patients starting before the operation and continued for 24 hrs after surgery.

Design: Prospective, randomized, controlled, double-blind multicenter trial.

Setting: Intensive care units in 13 hospitals from six European countries.

Open management of the abdomen and planned reoperations in severe bacterial peritonitis.

Objective: To assess the results of open management of the abdomen and planned re-operations in severe bacterial peritonitis after perforation or anastomotic disruption of the digestive tract.

Design: Retrospective study.

Setting: University Hospital, The Netherlands.