Journal of Surgical Research最新文献

{"title":"Prolonged Antibiotic Duration is Not Associated With Reduced Surgical Site Infection After Lower Extremity Bypass Surgery.","authors":"Hana S Shafique, Christina L Cui, Anthony N Eze, Adam P Johnson, Young Kim","doi":"10.1016/j.jss.2025.09.038","DOIUrl":"https://doi.org/10.1016/j.jss.2025.09.038","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical site infection (SSI) is among the most common complications following infrainguinal bypass surgery, despite being considered a preventable complication. The timing and selection of perioperative antibiotic prophylaxis are a key measure in SSI prevention efforts. Current practice guidelines recommend a prophylactic antibiotic duration of less than 24 h; however, there are limited data on the efficacy of prolonged antibiotic duration after lower extremity bypass (LEB) surgery.</p><p><strong>Methods: </strong>In this national cohort study, the Vascular Quality Initiative (VQI) database was retrospectively reviewed for all infrainguinal bypass operations performed from January 2014 to December 2023. The primary outcome of interest was postoperative SSI. Perioperative antibiotics included first- and second-generation cephalosporins. Standard duration was defined as discontinuation of perioperative antibiotics within 24 h of surgical end time; and prolonged duration was defined as any extension beyond 24 h.</p><p><strong>Results: </strong>Over the 10-y study period, 21,647 infrainguinal bypasses were performed and had complete antibiotic-related data. A total of 461 cases (2.1%) developed a postoperative SSI. All patients received preoperative antibiotics. The majority of patients (97.7%) received antibiotic within 1 h preoperatively, with no difference between patients with SSI and no SSI (97.7% versus 96.8%, P = 0.186). Prolonged antibiotics were reported in 6.6% of cases. After adjusting for patient, perioperative, and antibiotic-related factors, prolonged duration was associated with an increased SSI occurrence compared with standard duration (adjusted odds ratio [aOR] 2.01; 95% confidence interval [CI], 1.52-2.67; P < 0.001). Other risk factors included diabetes mellitus (aOR 1.24; 95% CI, 1.03-1.51; P = 0.027), end stage renal disease (ESRD) (aOR 1.86; 95% CI, 1.33-2.61; P < 0.001), and longitudinal groin incision configuration compared with a transverse incision (aOR 1.65; 95% CI, 1.23-2.20; P < 0.001). Preoperative chlorhexidine showers or wipes were associated with fewer SSI events (aOR 0.48; 95% CI, 0.29-0.78; P = 0.003).</p><p><strong>Conclusions: </strong>In this large multi-institutional study, prolonged duration of perioperative antibiotic prophylaxis was not associated with a reduction in SSI after infrainguinal bypass surgery. These findings support antimicrobial stewardship efforts in limiting perioperative antibiotic course within 24 h of surgery.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"315 ","pages":"291-297"},"PeriodicalIF":1.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crossing Lines: Expiration of Title 42 and the Injury Landscape at the US-Mexico Border.","authors":"Parisa Oviedo, John R Austin, Louis Perkins, Alan H Tyroch, Ira Swinney, Jamila Boukari, Andrea Krzyzaniak, Vishal Bansal, Erika Brigmon, Samantha Murphy, Benjamin A Keller, Romeo C Ignacio, Allison E Berndtson","doi":"10.1016/j.jss.2025.09.015","DOIUrl":"https://doi.org/10.1016/j.jss.2025.09.015","url":null,"abstract":"<p><strong>Introduction: </strong>Title 42 is an emergency public health mandate reenacted in 2020 during the SARS-CoV-2 pandemic, allowing expulsion of migrants entering the United States. This policy ended on May 11, 2023. We hypothesized that border crossing injuries would continue to increase despite expiration.</p><p><strong>Methods: </strong>We performed a retrospective analysis of data from five US trauma centers along the US-Mexico border. Included patients were adults injured while crossing the border from November 10, 2022-November 12, 2023; the time periods 6 mo before (Title 42 Era) and after (Post 42 Era) expiration were compared. Data collected included demographics, injuries, need for surgery, and hospital outcomes and charges.</p><p><strong>Results: </strong>There were 531 patients in the Title 42 Era and 493 in the Post 42 Era. During Title 42, there was an upward trend in monthly injuries which ceased after Title 42 expired. There were less Central Americans (P = 0.004) and more South Americans in the Post 42 Era (P < 0.001). More patients Post 42 were discharged to law enforcement (P = 0.02). Median hospital charges per patient increased from $95,740 [$64,630-$179,773] to $104,678 [$70,775-$219,394] after Title 42 ended. Cohort was not associated with age, sex, Spanish language, intensive care unit or ventilator days, mortality, injury mechanism or severity, number of operations, or type of operation.</p><p><strong>Conclusions: </strong>The increasing numbers of monthly border-related injuries during the Title 42 Era flattened in the Post 42 Era, indicating that Title 42's expiration was not correlated with a rise in patient injuries. We did note differences in patient demographics, discharge location, and hospital charges per patient between eras.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"315 ","pages":"284-290"},"PeriodicalIF":1.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Human Leukocyte Antigens in Vascularized Composite Allotransplantation.","authors":"Faisal A A Shurafa, Kevin M Klifto, Stephen J Kovach, L Scott Levin, Saïd C Azoury","doi":"10.1016/j.jss.2025.09.021","DOIUrl":"https://doi.org/10.1016/j.jss.2025.09.021","url":null,"abstract":"<p><p>Vascularized composite allotransplantation (VCA) has all the immunogenic risks of solid organ transplantation, while including the complexity and immunogenicity of the skin. This review provides an overview of the human leukocyte antigens (HLAs) system and its current role in VCA. HLA are cell surface glycoproteins critical for immune system surveillance. Their physiological function is to present self-recognized and foreign peptides to inhibit or initiate an immune response through induction, regulation of immune responses, and the selection of T-cells. The HLA system provides targets for stimulation during graft versus host disease, donor-specific HLA antibodies, and allograft rejection. HLA matching, identifying and using acceptable mismatches, and desensitization strategies may increase the immunologic compatibility of the HLA system between a donor and recipient in VCA.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"315 ","pages":"298-305"},"PeriodicalIF":1.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Interprofessional Communication Between Urology and Palliative Care: A Qualitative Analysis.","authors":"Alekhya Gunturi, Bhagvat J Maheta, Monica Bodd, Jonathan Bergman, John T Leppert, Karl A Lorenz, Isabella G Raspi, Nainwant K Singh, Karleen F Giannitrapani","doi":"10.1016/j.jss.2025.09.013","DOIUrl":"https://doi.org/10.1016/j.jss.2025.09.013","url":null,"abstract":"<p><strong>Introduction: </strong>Good-quality care for patients with a serious illness often requires interdisciplinary expertise. In the urologic perioperative period, this can include urologists and Palliative Care (PC). Our objective is to understand how to improve perioperative coordination between urologists and PC providers in the context of urologic serious illness.</p><p><strong>Materials and methods: </strong>We interviewed 38 providers: urologists (13), PC physicians (12), and clinical team members (13) in phase I of this study. From these interviews, there were 96 examples of interdisciplinary communication that were analyzed using qualitative content analysis with dual review in phase II of this study.</p><p><strong>Results: </strong>Two key themes emerged regarding communication between urology and PC teams. First, effective collaboration is often hindered by logistical challenges, such as surgeons' limited availability due to time spent in surgery and difficulties coordinating in-person meetings. Fostering bidirectional, timely communication through asynchronous communication and structured meetings improves alignment within the clinical team before patient interactions. Second, hierarchical structures within medical teams can discourage open dialogue, with nonsurgeons sometimes feeling hesitant to share input. Promoting mutual respect is essential to creating a more balanced and collaborative environment. Together, these themes highlight the need for systemic changes that support accessibility, respect, and communication in interdisciplinary care.</p><p><strong>Conclusions: </strong>Future directions include implementing an evidence-based intervention with structures and processes to improve interdisciplinary collaboration among urologists and PC.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"315 ","pages":"275-283"},"PeriodicalIF":1.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beauty Is in the Eye of the Beholder: Cosmetic Outcomes After Precision Breast Intraoperative Radiation Therapy.","authors":"Maria Reyes-Matos, Lena M Turkheimer, Chris A Campbell, Shayna L Showalter","doi":"10.1016/j.jss.2025.09.029","DOIUrl":"https://doi.org/10.1016/j.jss.2025.09.029","url":null,"abstract":"<p><strong>Introduction: </strong>Precision Breast Intraoperative Radiation Therapy (PB-IORT) is a novel form of IORT that combines computed tomography-guided treatment planning with high-dose-rate brachytherapy to deliver individualized radiation that spares the skin and chest wall. We analyzed cosmetic outcomes following PB-IORT as scored by breast clinicians, a plastic surgeon, and patients, and assessed the interrater reliability between the scores.</p><p><strong>Methods: </strong>As part of a phase II clinical trial, the study cohort included 357 patients treated with PB-IORT who had up to 24 mo of follow-up data. At each follow-up visit, the patient, plastic surgeon, and breast clinicians completed the Harvard Cosmesis Scale and a survey that evaluates changes in breast pigmentation, shape, and size. Interrater agreement was assessed using Kappa statistics.</p><p><strong>Results: </strong>At 24 mo, 88.7% (95% confidence interval [CI]: 84.77, 92.61) of patients rated their cosmesis as \"excellent\" or \"good' with the Harvard Cosmesis Scale; 93.7% (95% CI: 90.80, 96.14) and 80.3% (95% CI: 75.08, 85.50) of patients were rated similarly by the breast clinicians and the plastic surgeon, respectively. There was minimal agreement between patients, breast clinicians, and the plastic surgeon for all variables (Kappa <0.40). Breast clinicians rated cosmesis the most favorably.</p><p><strong>Conclusions: </strong>PB-IORT delivers a single, high dose of radiation without compromising cosmetic outcomes. Cosmetic outcome scores from patients, breast clinicians, and the plastic surgeon had low interrater reliability. The patient's perspective is paramount when assessing cosmetic outcomes after breast surgery. We advocate that future studies include patient-reported outcomes as the primary means of evaluating cosmetic outcomes.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"315 ","pages":"210-217"},"PeriodicalIF":1.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"22-Modifier Designation Accurately Predicts Perioperative Resource Utilization and Outcomes in Liver Transplantation.","authors":"Molly Weavers, Zach Leslie, Matthew Wright, Michael Dryden, Michael G Megaly, Joseph Sushil Rao, Abraham J Matar","doi":"10.1016/j.jss.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.jss.2025.09.004","url":null,"abstract":"<p><strong>Introduction: </strong>Significant ambiguity exists regarding the diagnostic accuracy of a 22-modifier designation, especially in technically complex operations such as liver transplantation (LT). We sought to evaluate the diagnostic accuracy of 22-modifier in LT by correlating 22-modifier designation with LT outcomes.</p><p><strong>Methods: </strong>All adult liver transplants between January 1, 2015, and December 31, 2022, at a single academic medical center were reviewed. Hospital billing records were queried, and patients were stratified into two groups - with and without a procedural 22-modifier reimbursed.</p><p><strong>Results: </strong>Among 588 LT included, 55 (9.4%) received a 22-modifier designation while 533 (90.6%) did not. The most common indications for 22-modifier were adhesiolysis >60 min (77.8%) and portal vein thrombosis (16.7%). In both univariate and multivariate analysis, prior abdominal surgery and retransplantation were pretransplant risk factors associated with 22-modifier use. 22-modifier LT were associated with increased perioperative resource utilization including case length (P = 0.002), intraoperative transfusion requirements (red blood cell [P < 0.0001], fresh frozen plasma [<0.0001], cryoprecipitate [0.003]), length of intensive care unit stay (P = 0.01), and length of hospital stay (P = 0.01). Similarly, 22-modifier LT were associated with increased postoperative complications including abdominal re-exploration (P < 0.0001) and biliary complications (P = 0.04). Finally, 22-modifier LT were associated with inferior long term outcomes including graft (P = 0.0003) and patient survival (P = 0.0002).</p><p><strong>Conclusions: </strong>22-modifier designation in LT accurately identifies higher complexity cases associated with increased perioperative resource utilization, postoperative complications, and inferior long-term graft and patient survival.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"315 ","pages":"260-267"},"PeriodicalIF":1.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracellular Matrix Hydrogel Reduces Anastomotic Leaks in a Rodent Model of Rectal Anastomosis.","authors":"Vincent Antonelli, Charles Patterson, Catalina Pineda Molina, Scott A Johnson, Michael Hu, George S Hussey, David S Medich, Stephen F Badylak","doi":"10.1016/j.jss.2025.09.008","DOIUrl":"https://doi.org/10.1016/j.jss.2025.09.008","url":null,"abstract":"<p><strong>Introduction: </strong>Anastomotic leaks remain a significant source of morbidity following rectal resections. Despite advances in technique, the incidence of leaks remains high, often necessitating temporary fecal diversion which carries its own risks and requires additional surgery for restoration of intestinal continuity. Reducing leak rates could minimize the need for prophylactic diversion. Extracellular matrix (ECM)-based surgical devices have shown potential to support gastrointestinal healing. Urinary bladder matrix (UBM), a versatile, acellular ECM material that promotes constructive tissue remodeling, has not been extensively studied in colorectal anastomoses. A lack of reliable small animal models has limited progress in this field.</p><p><strong>Methods: </strong>A reproducible rat model of low rectal anastomosis was developed to evaluate ECM-based interventions. Female Sprague-Dawley rats underwent standardized distal colonic resection and sutured anastomosis below the peritoneal reflection. Rats were randomized to receive no adjunct, UBM extraluminal wraps, or UBM hydrogel applied directly to the anastomosis. Healing was assessed using a multimodal evaluation strategy.</p><p><strong>Results: </strong>Control animals demonstrated a 46% anastomotic leak rate, while UBM hydrogel treatment significantly reduced leak rates to 8%. Extraluminal wraps did not confer a protective effect. Rats treated with hydrogel also exhibited fewer perianastomotic adhesions. Histological analysis showed improved composite healing scores in the hydrogel group.</p><p><strong>Conclusions: </strong>This reliable small animal model provides a valuable platform for testing surgical adjuncts. UBM hydrogel shows promise in reducing rectal anastomotic leak rates through both mechanical support and biochemical modulation of healing. This model enables further investigation into anastomotic healing mechanisms and potential therapeutic strategies.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"315 ","pages":"241-250"},"PeriodicalIF":1.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key Indicators Associated With Survival in Pediatric Trauma Massive Transfusion Protocol.","authors":"Theodore Wang, Sorasicha Nithikasem, Thomas Hong, Sathyaprasad Burjonrappa","doi":"10.1016/j.jss.2025.09.026","DOIUrl":"https://doi.org/10.1016/j.jss.2025.09.026","url":null,"abstract":"<p><strong>Introduction: </strong>Prior studies and scoring systems have been developed to optimize massive transfusion protocol (MTP) in adults, but an established protocol for children does not yet exist. This study aimed to evaluate the factors associated with survival in MTP activation among pediatric trauma patients.</p><p><strong>Methods: </strong>Patients aged 18 y and under who received MTP were queried from the National Trauma Data Bank from 2017 to 2019, with MTP defined as receiving >40 mL/kg of blood products (e.g., red blood cells, plasma, and platelets) within 4 h of admission. Patients with fatal injuries and/or no signs of life on admission were excluded. Baseline characteristics and clinical outcomes were compared between patients who were discharged alive (DC-alive) and those who died (DC-deceased). Multivariable regression was performed to identify indicators predictive of survival and expressed in odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Of 9115 patients who underwent transfusion, 947 (10.4%) required MTP and remained in the cohort. A total of 642 patients (68%) survived. Patients who survived were more likely to undergo hemorrhage control surgery (71% versus 40%, P < 0.001). No predominance of any combination of blood products transfused (e.g., red blood cells, plasma, and platelets) was observed between groups (P = 1.00). Factors associated with survival included tachycardia (OR 2.44, 95% CI 1.60-3.76) and presentation to level I pediatric trauma centers (OR 1.47, 95% CI 0.96-2.27). Poor prognostic factors for survival included hypothermia (OR 0.52, 95% CI 0.32-0.85), severe Glasgow coma score (GCS; OR 0.07, 95% CI 0.04-0.12), very severe injury severity score (ISS; OR 0.38, 95% CI 0.22-0.64), self-payment (OR 0.35, 95% CI 0.19-0.65), and >80 mL per kilogram (mL/kg) of transfused blood products (OR 0.56, 95% CI 0.37-0.85).</p><p><strong>Conclusions: </strong>Tachycardia and pediatric-verified trauma centers appear to be protective in pediatric trauma MTP; decreased survival was associated with hypothermia, severe Glasgow coma score, very severe injury severity score, self-payment, and >80 mL/kg of transfused blood products. Prediction tools should identify patients who are most likely to benefit from MTP and alternative interventions for those unlikely to improve with MTP.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"315 ","pages":"251-259"},"PeriodicalIF":1.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geriatric Trauma Activation.","authors":"Samara Sober, Lauren Langman, Ambika Mukhi, Jonathan Martin, James Vosswinkel, Adam J Singer, Suzanne Fields, Randeep S Jawa","doi":"10.1016/j.jss.2025.09.010","DOIUrl":"https://doi.org/10.1016/j.jss.2025.09.010","url":null,"abstract":"<p><strong>Introduction: </strong>The American College of Surgeons indicated geriatric-specific trauma team activation criteria to minimize undertriage. We evaluated activation volumes and outcomes for older adults before and after implementation of revised criteria.</p><p><strong>Methods: </strong>Data were collected from institutional trauma registry and nonregistry data repository for patients ≥65 y presenting directly to a level I trauma center with blunt trauma, preguideline, and post guideline revision. The repository encompasses activation patients with no injuries or minor injuries who are discharged home from the ED or admitted for noninjury related reasons. Trauma team activation rates, resource utilization, and outcomes were examined.</p><p><strong>Results: </strong>After revision, trauma registry (prerevision: 295 versus post revision: 915 patients) and nonregistry (prerevision: 132 versus post revision: 1703 patients) activations markedly increased. The most common activation criterion post revision was elderly fall on antithrombotic (prerevision: 34.9% versus post revision: 69.6%). Activated registry patients had significantly lower median Injury Severity Scores (prerevision: 10 versus post revision: 5) and mortality rates (prerevision: 8.1% versus post revision: 4.3%), with higher emergency department to home discharge rates (prerevision: 10.2% versus post revision: 28.9%) post guideline revision. Activations were associated with prerevision: 4.5-fold and post revision: 4.0-fold faster time to index computed tomography scan completion than nonactivations.</p><p><strong>Conclusions: </strong>Activations markedly increased post guideline revision with many patients having no injuries or minor injuries that did not meet registry inclusion criteria. The increased activations were largely associated with elderly falls on antithrombotics. Among those meeting criteria, the Injury Severity Score was low, and they were more frequently discharged home from the ED. An opportunity for optimizing resource utilization may exist.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"315 ","pages":"231-240"},"PeriodicalIF":1.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caveat Emptor: Characterizing Water Bead Consumer and Safety Reporting.","authors":"Jennifer M Schuh, Mallory N Perez, Emmanuel L Abebrese, Araceli A Morelos, Carlos A Dounce, Mehul V Raval, Jose H Salazar","doi":"10.1016/j.jss.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.jss.2025.09.011","url":null,"abstract":"<p><strong>Introduction: </strong>Water beads, often marketed as toys, rapidly expand in water and have caused injuries from ingestion, aspiration, and as projectiles. This study analyzed consumer reports to assess the scope and severity of such reported injuries compared to the published literature.</p><p><strong>Methods: </strong>The United States Consumer Product Safety Commission Reports database was searched for \"water beads\" yielding 5931 entries spanning 2012-2023. Twenty-six relevant reports were analyzed for state, age, mechanism, anatomic injury location, setting of medical encounters, imaging obtained, interventions, and outcomes.</p><p><strong>Results: </strong>The 26 consumer reports described 45 individuals across 15 states. Ingestion cases (mean age 1.3 y; range 0-4) and noningestion injuries (mean age 13.1 y; range 1-37) were reported. The most common injuries were projectile ocular trauma (38%) and ingestions (31%). Medical encounters included three emergency room visits, 15 hospital admissions, and six unspecified visits. Diagnostic imaging was reported in 31% of cases. Surgery was reported in 62% of reports (16/26), including 10 intestinal operations. Outcomes included permanent neurologic injury, ocular impairment, and otologic damage.</p><p><strong>Conclusions: </strong>Water beads have been found to cause aspiration, ingestion, and projectile injuries resulting in long-term neurologic, otologic, and ocular damage. Special care is needed for children of ≤4 y old for whom there is a risk of obstruction after ingestion. Medical professionals should maintain a high index of suspicion when children report water bead exposure. The consumer reports underrepresent the true scope and degree of injury; increased consumer reporting is important for regulatory agencies, the public, and provider awareness.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"315 ","pages":"218-223"},"PeriodicalIF":1.7,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}