Clearly identifying patients with prediabetes and diabetes prior to surgery allows the clinical team to target interventions and reduce the risks of complications. Yet, protocols for preoperative diabetes screening vary. The purpose of this article is to present an evidence-based practice project examining the implementation of preoperative diabetes screening in an elective total joint patient population. The American Diabetes Association (ADA) Risk Test was used to assess diabetes risk and guide further testing. A total of 121 patients were screened. Of the sample, 55 were undiagnosed and at risk for diabetes according to the instrument. Twelve patients (21.8%) who screened at risk also revealed elevated fasting blood glucose levels. These patients were identified as potentially having prediabetes. The findings of this project support adoption of the ADA Risk Test in the preoperative setting, emphasize the feasibility of its integration in order to obtain valuable patient information, and assist with optimizing patients for surgery.
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http://dx.doi.org/10.1097/NOR.0000000000000879 | DOI Listing |
Head Neck
December 2024
Department of Otolaryngology - Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA.
Objectives: Virtual surgical planning (VSP) allows for optimal reconstruction of maxillary defects with fibula free flaps. Current data are limited regarding long-term complications of patient-specific plates (PSPs) in this setting. Our objective was to determine long-term complications of PSPs in maxillary reconstruction using fibula free flaps.
View Article and Find Full Text PDFBMC Surg
December 2024
General Surgery Section, Zherong County Hospital, No. 8 Shangqiao Road, Ningde, Fujian, 355300, China.
Background: To investigate the effect of postoperative supplementary parenteral nutrition (SPN) containing varying energy intake levels during the early postoperative period on the clinical outcomes of patients diagnosed with gastric cancer.
Methods: Data from 237 patients, who were diagnosed with gastric cancer between January 2016 and June 2022, were retrospectively analyzed. Patients were divided into 2 groups based on mean daily SPN energy intake: low (L-SPN; < 20 kcal/kg/day); and high (H-SPN; ≥ 20 kcal/kg/day).
J Reconstr Microsurg
December 2024
Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, District of Columbia.
Background: Multidisciplinary care with vascular surgery and plastic surgery is essential for lower extremity free flap (LEFF) success in the chronic wound population with diabetes and peripheral vascular disease. There is a lack of understanding on performing targeted direct endovascular reperfusion on a vessel that will be used as the flap recipient. Our study compares outcomes of patients who received targeted revascularization (TR) to the recipient vessel for LEFF anastomosis versus nontargeted revascularization (NR) of arterial recipients prior to LEFF.
View Article and Find Full Text PDFJ Craniofac Surg
December 2024
Department of Burn and Plastic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, P. R. China.
Background: Autologous breast reconstruction provides substantial benefits in terms of aesthetics and longevity. However, the risk of flap necrosis poses potential challenges to patients' appearance and psychological well-being, while also escalating health care costs. Consequently, examining the risk factors, assessment techniques, and therapeutic approaches for flap necrosis is critically important.
View Article and Find Full Text PDFPituitary
December 2024
Department of Diabetes and Endocrinology, St Vincent's Hospital Sydney, Darlinghurst, NSW, Australia.
Purpose: Rathke's cleft cysts (RCC) are present in up to 20% of autopsy studies but only a minority necessitate surgical treatment. Inflammation of RCC is thought to be significant in three processes: the development of classical symptoms, a predisposition to rupture or apoplexy, and increasing the rate of RCC recurrence. We aim to characterize clinical presentation, histological and radiological findings in patients with surgically managed RCC.
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