Thirty-day outcomes of Asian Americans in endovascular repair of intact infrarenal abdominal aortic aneurysm.

Background: Endovascular aneurysm repair (EVAR) has become the predominant treatment for Abdominal aortic aneurysm (AAA). Racial disparity has been observed in EVAR but Asian Americans have been largely excluded from previous studies. This study aimed to comprehensively evaluate 30-day outcomes of Asian Americans undergoing EVAR for intact infrarenal AAA using a multi-institutional national database.

Atypical Multifocal Granular Cell Tumor with FLT3 Y842C Somatic Mutation: A case report and a review of the literature.

Introduction: Granular cell tumors (GCT) are predominantly benign neoplasms composed by cells with abundant eosinophilic granular cytoplasm. Although the majority of GCTs exhibit a benign clinical course, a minority display cytological atypia and may exhibit aggressive, cancer-like behavior. Definitive evidence of malignancy in GCTs is reliably established only through the presence of metastasis.

The economic and quality effects of wound cleansing with pure hypochlorous acid: evidence-based evaluation and clinical experience.

Background: Chronic or hard-to-heal wounds fail to proceed through an orderly and timely healing process, resulting in a lack of anatomic and functional integrity. Infection is a common driver of nonhealing processes; therefore, infection prevention and management are essential components to healing chronic wounds. Inexpensive specialized cleansers, such as pure hypochlorous acid (pHA), can be used to cleanse vulnerable wounds to reduce microbial burden, thereby reducing the risk of infection and significantly decreasing the likelihood of the patient developing a costly wound complication.

Gunshot wound causing thoracic aortic injury with bullet embolization to the common femoral artery.

Penetrating traumatic aortic injury (PTAI) is increasing in prevalence given the rise in firearm violence in the United States and is associated with significant morbidity and mortality. These injuries often result in hemorrhagic shock, with patients presenting in extremis or pulseless, traditionally requiring open approaches for repair. A rare but potentially devastating complication of firearm-related PTAI is bullet embolization.

Reassessing Glycemic Control: A Novel Method for 90-Day Major Complication Stratification Based on Hemoglobin A1c and Same-Day Glucose Levels for Patients Undergoing Total Knee Arthroplasty.

Background: Glucose levels obtained on the day of surgery may be predictive of complications following total knee arthroplasty (TKA). Established glucose thresholds for TKA are either nonspecific or have low predictive power. Therefore, the purpose of this study was to create data-driven hemoglobin A1c (HbA1c) and same-day glucose thresholds associated with varying risks of 90-day major and surgical site infection (SSI) complications following TKA.

Pediatric Diffuse Lung Disease in Infants: Imaging Findings and Histopathologic Correlation.

Childhood interstitial lung disease (chILD) encompasses a diverse group of genetic, infectious, and inflammatory conditions affecting infants and children. The recognition and understanding of these entities have highlighted the necessity for more accurate classification. This group of rare heterogeneous diseases comprises more than 200 different conditions and has a combined estimated prevalence of less than one patient per 100 000 children.

Popliteal-distal bypass affords better limb salvage than tibial angioplasty for chronic limb-threatening ischemia.

Objective: Chronic limb-threatening ischemia (CLTI) due to isolated tibial occlusive disease is treated by either popliteal-distal bypass (PDB) or tibial angioplasty (TA), although there is limited data directly comparing efficacy and outcomes between these two treatment modalities. This study compares 30-day mortality and major adverse limb events following infrapopliteal bypass and TA in patients with CLTI.

Methods: Patients who underwent PDB for CLTI were extracted from American College of Surgeons National Surgical Quality Improvement Program targeted lower extremity open database, whereas patient with CLTI who underwent isolated TA were identified in the targeted lower extremity endovascular database.

Locoregional Versus General Anesthesia in Prolonged Carotid Endarterectomy: A Propensity Score-Matched Study from the American College of Surgeons National Surgical Quality Improvement Program Database from 2011 to 2022.

Background: Carotid endarterectomy (CEA) is an effective treatment for carotid stenosis. Previous studies yielded conflicting findings regarding postoperative outcomes after CEA when comparing those under general and locoregional anesthesia. However, these findings may be influenced by an inherent selection bias, as general anesthesia is frequently selected for more complex CEA.

Less Is () More: Laparoscopic Peritoneal Lavage and Drainage for Diverticulitis.

Laparoscopic lavage and drainage (LLD) emerged as an alternative to Hartmann's procedure (HP) for patients with diverticulitis and uncontained perforation. Although initially popular as a less invasive approach, its use in modern practice is in question. This summary will review the available literature to show techniques, outcomes, and indications.

Evaluating Racial Disparities in 30-day Outcomes for African Americans Following Colectomy for Volvulus.

Background: Surgery is the definitive treatment for colonic volvulus despite initial decompression therapy. In general surgery, African Americans were found to have higher risks of mortality and morbidities. However, racial disparity in colectomy outcomes for volvulus among African Americans had not been explored.

Liver Disease Increases the Risk of Postoperative Complications in Patients Undergoing Aseptic Revision Total Hip and Knee Arthroplasty.

Background: Due to the multiorgan effects of liver disease, surgical patients with liver disease have an increased risk of perioperative complications. With revision total hip and knee arthroplasty surgeries increasing, it is important to determine the effects of liver disease in this patient population. The purpose of this study was to evaluate the impact of underlying liver disease on postoperative outcomes following revision total joint arthroplasty (TJA).

Antibiotic Prophylaxis for Genitourinary Procedures in Patients with Artificial Joint Replacement and Artificial Heart Valves.

Prosthetic joint infection (PJI) and prosthetic valve endocarditis (PVE) are uncommon but serious complications. According to current best practice statements, prior to a genitourinary procedure, patients with prosthetic joints should receive antibiotic prophylaxis if they are within 2 years of arthroplasty, if they are high risk for infection due to their individual comorbidities, or if the procedure poses a high risk for bacteremia. Patients with prosthetic valves should not receive antibiotic prophylaxis for the sole purpose of prevention of endocarditis.

Advances in Bowel Preparation and Antimicrobial Prophylaxis for Open and Laparoscopic Urologic Surgery.

Surgical site infections (SSIs) represent a major source of postoperative complications adversely impacting morbidity and mortality indices in surgical care. The discovery of antibiotics in the mid-20th century, and their ensuing use for preoperative antimicrobial bowel preparation and prophylaxis, drastically reduced the occurrence of SSIs providing a major tool to surgeons of various specialties, including urology. Because, the appropriate use of these antimicrobials is critical for their continued safety and efficacy, an understanding of the recommendations guiding their application is essential for all surgeons.

Spliced-Vein Conduit Offers Better Patency and Limb Salvage Than Prosthetic Graft for Femoral-Tibial Bypasses in Critical Limb-Threatening Ischemia.

Background: Single-segment great saphenous vein (ssGSV) is the gold standard conduit for femoral-tibial bypasses in patients with critical limb-threatening ischemia (CLTI). In the absence of a good single-segment saphenous vein, alternative options are prosthetic grafts or spliced-vein (SpV) conduits. Although SpV conduits may provide better long-term patency/limb salvage, prosthetic grafts are more often the chosen conduit due to shorter operative and presumably better immediate postoperative outcomes; nevertheless, there are little data supporting this practice.

Malnutrition is associated with adverse 30-day outcomes after endovascular repair of abdominal aortic aneurysm.

Background: Malnutrition is particularly pertinent in patients undergoing vascular surgery, who frequently present with a high burden of comorbidities and advanced age that can impede nutrient absorption. While previous studies have established that vascular surgery patients with malnutrition had poorer outcomes, the impact of nutritional status in patients undergoing endovascular aneurysm repair (EVAR) has not yet been investigated. Therefore, this study aimed to assess the effect of malnutrition on 30-day outcomes following non-ruptured EVAR.

Tranexamic Acid Is Not Associated With a Change in Infection Risk in Trauma Patients.

Introduction: Tranexamic acid (TXA) has been used as an adjunct in traumatic hemorrhage management. Outside of trauma, TXA has been used to limit blood loss across multiple surgical fields. TXA has also been found to have an immune-modulating effect, reducing postoperative infection rates.

Hybrid 1 randomized controlled trial of an integrated stepped-care mental health intervention for traumatic injury patients.

Background: Annually, nearly 3 million individuals in the US are hospitalized after experiencing a traumatic injury (e.g., serious automobile crash, gunshot wound, stab injury).