Publications by authors named "R S Cowles"
A Data-Driven Approach to Inguinal Hernia Repairs in Infants and Children.
J Laparoendosc Adv Surg Tech A
December 2024
Laparoscopic inguinal hernia repair has become increasingly popular in children. The laparoscopic technique inherently assesses the contralateral processus vaginalis, reducing the risk of metachronous contralateral hernias. We hypothesized that primary laparoscopic repair would be associated with lower rates of subsequent hernia repair in the youngest patients, in whom metachronous contralateral hernias are most common.
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.
Objectives: Observational data to support delaying elective pediatric thoracic surgery during peak respiratory viral illness season is lacking. This study evaluated whether lung surgery during peak viral season is associated with differences in postoperative outcomes and resource utilization.
Methods: A retrospective observational cohort study was performed using the Pediatric Health Information System (PHIS).
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.