Surgical technology international最新文献

{"title":"Excellent Outcomes in Obese Patients Following Cementless Robotic-Assisted Total Knee Arthroplasty.","authors":"Matthew L Magruder, Tanner McClure, Kevin Marchand, Michael A Mont, Robert C Marchand","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The results of cementless robotic-assisted total knee arthroplasty (RA-TKA) have not been evaluated in obese patient populations. The purpose of this study was to evaluate the rates of aseptic loosening, patient-reported outcomes, and surgical complications of cementless RA-TKA cases in obese and nonobese patient cohorts.</p><p><strong>Materials and methods: </strong>A retrospective review between 2018 to 2021 of a single-surgeon series was conducted, producing 1,546 patients. Patients were categorized as either obese (body mass index [BMI] <35) or nonobese (BMI <35), generating 472 and 1,092 patients, respectively. The average BMI was 40.5 (range, 35.0 to 64.1) in the obese group and 28.6 (range, 16.5 to 34.9) in the nonobese group. The primary outcome was the rate of aseptic loosening. Secondary outcomes included patient-reported outcomes, comprising Knee Injury and Osteoarthritis Outcome Scores for Joint Replacement (KOOS JR) scores, and the reduced Western Ontario and McMaster Universities Arthritis Index (r-WOMAC) scores. Charts were reviewed to establish rates of postoperative surgical complications. Significance tests were conducted using either t-tests or Chi-squared independence tests, and a p-value of <0.05 was considered significant.</p><p><strong>Results: </strong>There were no cases of aseptic loosening in the obese or nonobese cohorts, making survivorship 100% for both. While preoperative KOOS JR and r-WOMAC scores were significantly worse in the obese group, they were not statistically significant at either six-week or 12-month timepoints. The obese cohort had statistically greater improvements in r-WOMAC total scores at six weeks and 12 months; they also had statistically significant superior improvement in KOOS JR at 12 months. There were no statistically significant differences in postoperative surgical-related complications.</p><p><strong>Conclusion: </strong>We demonstrated that rates of aseptic loosening and patient-reported outcomes in obese patients undergoing RA-TKA are excellent, and patient-reported outcomes demonstrated superior improvement in the obese cohort compared to those in the non-obese cohort.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"45 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-Assisted Medial Unicompartmental Knee Arthroplasty in an Outpatient Setting.","authors":"Trisha Patel, Jumaa Baker, Allison Eberhard, Eyal Ginesin, Ronak M Patel","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There were 63 outpatient medial unicompartmental knee arthroplasties (UKAs) performed by Mako robotic assistance by six surgeons. There were 40 men and 23 women who had a mean age of 65.1 years (range, 38 to 80). Their mean body mass index (BMI) was 29.6 (range 21.8 to 39.2), and 28 patients had a BMI over 35. Overall, patient perceptions of the procedure were excellent (mean 9.2 rating of 10), which was not different by sex or body mass index. There were no 30-day complications or readmissions. At one year, there was one case revised for maltracking, resulting in a revision rate of 1.6% (1 out of 63 patients) with no cases of aseptic loosening. There were two other patients that had minor procedures (nerve ablation and removal of a loose body). The results of this prospective study confirm that outpatient robotic-arm assisted medial UKA is safe and feasible with a positive patient perspective of the procedure.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"45 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in Wound Bed Preparation of Chronic Wounds.","authors":"Natalie Hickerson, Thao Kimmy Lam, Robert Kirsner, Hadar Lev-Tov","doi":"10.52198/25.STI.45.WH1835","DOIUrl":"10.52198/25.STI.45.WH1835","url":null,"abstract":"<p><p>Chronic wounds are notoriously challenging to heal as they are often halted in their normal healing process. The concept of TIME (Tissue, Inflammation/Infection, Moisture imbalance, Epithelial edge advancement) has been widely utilized in clinical practice to prepare wound beds and promote healing, particularly in longstanding wounds. Traditional methods of wound bed preparation are often inadequate in healing chronic wounds or they may not be tolerated by patients. A variety of interventions have been developed in recent decades to address these components and improve chronic wound outcomes. Evolutions in tissue preparation include emerging enzymatic debridement agents and ultrasound-assisted debridement. Wound infection can be managed through a variety of new methods including advanced wound dressings, surfactants, and fluorescence imaging. Portable negative pressure wound therapy devices provide a new, convenient method for exudate management. Finally, epithelial advancement can be enhanced with technologies such as cellular, acellular, and matrix-like products (CAMPs), topical medications, and electrical stimulation.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"45 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Approaches to Diagnosing Pelvic Varicose Veins in Men: Investigating Efficacy and Outcomes.","authors":"Irina Shakhmalova, Leysan Myasoutova, Vera Morozova, Natalia Molodozhnikova","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pelvic Venous Disorder (PEVD) and May-Thurner syndrome (MTS) represent relatively understudied vascular issues that can significantly impact patients' quality of life. This study aims to evaluate the efficacy of surgical treatment for PEVD and MTS, conduct a comparative analysis of outcomes, and determine the practical significance of different therapeutic approaches. The study was conducted from 2019 to 2022 in Moscow, Russia, encompassing two outpatient clinics. A total of 132 patients diagnosed with pelvic venous disorder and/or May-Thurner syndrome (MTS) participated in the research. Diagnostic confirmation relied on ultrasound, transrectal ultrasound, and magnetic resonance imaging. Surgical treatment methods included angioplasty and stenting of the iliac veins. Evaluation of outcomes was based on a comparison of symptoms and additional investigations before and after treatment. It was found that 36% of patients had a history of previous varicocelectomies, with 21% of them having undergone prior surgical interventions. Comorbidities included chronic prostatitis, sexual dysfunction, haemorrhoids, and the presence of varicose veins in the legs, with these pathologies observed in more than 50% of cases. Following the surgical intervention (placement of stents on the left common iliac vein, LCI), a significant improvement in condition was observed in 91% of cases. The obtained results confirm the high efficacy of surgical intervention in the case of PEVD and MTS. The research findings can assist physicians in making more informed decisions when choosing treatment methods for patients with these conditions.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"45 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fish Skin Graft for the Treatment of Burns: Deep Partial Thickness Burns and Beyond","authors":"Allegra L Fierro, Mary Bridge, Nour Hijazi, George Youssef, John C Lantis","doi":"10.52198/25.STI.45.WH1836","DOIUrl":"10.52198/25.STI.45.WH1836","url":null,"abstract":"<p><p>Thermal or burn injuries cause coagulative necrosis of the epidermis and underlying tissues and the resultant wounds can be long lasting and highly painful. Depending on the depth of a burn, management ranges from local wound care to surgical intervention. When presented with deep-partial thickness and full-thickness burns, autologous skin grafting has been the mainstay of management to prevent scarring and promote healing. However, since the early 2000s, there has been increasing interest in reducing, if not eliminating, the need for autologous grafting considering the morbidity and pain associated with donor site harvesting, lack of appropriate donor sites in the case of larger burns, and to improve overall cosmetic outcomes. In this article, we discuss the available products on the market for the treatment of thermal burn injuries, explore the data advocating for their use and discuss their limitations, and highlight the unique efficacy of intact fish skin grafts, in particular, in this specific patient population.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"45 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Fluoroscopic-Aided Enabling Technology Improve Acetabular Component Position and Reduce Radiation Exposure in Direct Anterior Total Hip Arthroplasty?","authors":"David A Crawford, Todd E Bertrand, Jacob Alexander, Adolph V Lombardi, Keith R Berend","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Accurate acetabular component positioning is crucial for the success of total hip arthroplasty (THA). Malplacement of the acetabular component increases the risk of post-surgery complications, most notably dislocation.1 Furthermore, malposition can also result in wear of the polyethylene liner, limited range of motion, and osteolysis.2,3 These complications have led to controversy regarding the optimal acetabular component position. The historic Lewinnek \"safe zone\" defines the ideal acetabular placement as within 40° +/- 10° abduction and 15° +/- 10° anteversion.4 However, recent controversy has emerged regarding the ideal placement of the acetabular component with one systematic review showing acetabular components placed within the Lewinnek parameters having no significant difference in dislocation rate to those components placed outside the \"safe zone.\"5 Callanan et al. found that a range of 30-45° of abduction and 5-25° of anteversion was the ideal target zone while other studies have argued that the historic safe zone, while useful, should not be considered completely protective against dislocations.6,7 In addition, the spinopelvic relationship as it relates to changes in acetabular cup orientation from a standing to seated position may alter cup placement from the \"ideal\" position to accommodate reduced spinopelvic junction motion and limit the risk of postoperative instability.8 Secondary to risk of acetabular cup malposition during THA, fluoroscopically aided enabling technology (FET) has gained popularity recently, secondary to proposed benefits of improved accuracy of intraoperative component positioning over standard landmark identification or the use of fluoroscopy alone (FA), as well as minimizing the risk of significant postoperative leg length discrepancies.9,10 In addition, further factors such as not needing special preoperative imaging, minimal change to workflow or surgical approach, and the possibility of reduced operative times have made the use of this technology appealing.11 In addition to the debate regarding ideal acetabular component position to reduce postoperative complications, there has been ongoing discussion regarding the potential detrimental effects of cumulative radiation dose to the surgeon, patient, and operating room personnel when using fluoroscopy for placement of the acetabular component in direct anterior approach total hip arthroplasty (DAA-THA). Prior studies have shown that during DAA- THA, average radiation time was 15.1 seconds (secs), and exposure was 2.00mGy with increasing exposure seen as patient body mass index (BMI) increased.12,13 In theory, FET may help to reduce radiation exposure through less use of intraoperative fluoroscopy for confirmation of acetabular component position. The questions proposed in this study are: 1) Does FET improve the accuracy of acetabular component position versus FA in DAA-THA? and 2) Does FET reduce fluoroscopy time and radiation exposure compared to FA in ","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"45 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intact Fish Skin Graft for the Treatment of Burns: Deep Partial Thickness Burns and Beyond.","authors":"Allegra L Fierro, Mary Bridge, Nour Hijazi, George Youssef, John C Lantis","doi":"10.52198/25.STI.45.WH1836","DOIUrl":"10.52198/25.STI.45.WH1836","url":null,"abstract":"<p><p>Thermal or burn injuries cause coagulative necrosis of the epidermis and underlying tissues and the resultant wounds can be long lasting and highly painful. Depending on the depth of a burn, management ranges from local wound care to surgical intervention. When presented with deep-partial thickness and full-thickness burns, autologous skin grafting has been the mainstay of management to prevent scarring and promote healing. However, since the early 2000s, there has been increasing interest in reducing, if not eliminating, the need for autologous grafting considering the morbidity and pain associated with donor site harvesting, lack of appropriate donor sites in the case of larger burns, and to improve overall cosmetic outcomes. In this article, we discuss the available products on the market for the treatment of thermal burn injuries, explore the data advocating for their use and discuss their limitations, and highlight the unique efficacy of intact fish skin grafts, in particular, in this specific patient population.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"45 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Labia Majora Approach to Aesthetic and Functional Complaints. A Standardized Topographic Labia Majora Classification.","authors":"Pablo González-Isaza, Mauricio Wagner, Christine Hamori, Diana Vélez Rizo, Gustavo Parra, Eva Guisantes, Derly Marcela Beltrán, Santiago Palacios","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Functional and aesthetic aberrations of labia majora are poorly described in scientific literature, and there is a lack of standardization and algorithms for treatment. The labia majora differs from the labia minora in that it has transitional epithelium, fascia, erectile tissue, and adipose components connected to crural, pelvic, and perineal structures. Non-surgical treatments, such as radiofrequency and light-based therapy, must match the symptoms and target these unique structures to have an effect. Our aim is to propose an algorithmic approach to the anatomical variants of the labia majora that are most bothersome to women and describe a step-by-step process to improve vulvar appearance and function.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"45 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Hemostatic Powder in Order to Prevent Staple Line Bleeding After Sleeve Gastrectomy in High-Risk Patients: A Multicentric Randomized Controlled Trial.","authors":"Vincenzo Salsano, Vincenzo Consalvo, Iphigenie Chaze","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Preventing staple line bleeding (SLB) is still a main issue in bariatric surgery procedures, especially after laparoscopic sleeve gastrectomy (LSG). Staple line reinforcements (SLR), mattress sutures, or titanium clip application did not show any statistical superiority compared to other methods. In this randomized controlled trial, we tested hemostatic powder (HP) in order to assess a possible role in the prevention of active bleeding, hematoma formation, the need for transfusions, and the increased risk for hospitalization.</p><p><strong>Materials and methods: </strong>Centers involved started the enrollment of patients from September 2023 to August 2024. Two groups of 96 and 98 patients were created after randomization and application of the inclusion and exclusion criteria. Patients in the first group underwent LSG with application of HP, while the second group went with standard hemostasis with bipolar coagulation and titanium clip application.</p><p><strong>Results: </strong>There was no difference between the two groups. Overall bleeding was found to be similar between the two groups (p=1.00). Diffuse bleeding was superior in group 2 (p=0.02), while large hematoma formation was superior in group 1 (p=0.02).</p><p><strong>Conclusion: </strong>The use of HaemoCer™ (BioCer Entwicklungs, GmbH, Bayreuth, Germany) does not reduce staple line bleeding but helps reduce the incidence of hemoperitoneum as well as the reoperation rate, even though hospitalization was similar between the two groups.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"45 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Outcomes Following Operative Repair of the Burst Abdomen: A Retrospective Review of Different Techniques.","authors":"Vincent van Grinsven, Stan A M Bessems, Andreas Renders, Joop Konsten, Johannes A Wegdam, Frits Aarts","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Abdominal wall closure in postoperative burst abdomen remains challenging. Different techniques vary between definitive closure and temporary closure. The aim of this study was to examine the short-term outcomes for different closure techniques.</p><p><strong>Materials and methods: </strong>A multicenter single-arm observational retrospective cohort study examined all patients who underwent emergency operative repair for burst abdomen between January 2010 and May 2020 in two hospitals situated in the Netherlands. Patients underwent definitive closure, static closure with inlay mesh, or dynamic closure with negative pressure wound therapy (NPWT). We evaluated patient and treatment characteristics, length of stay, complications, and survival.</p><p><strong>Results: </strong>119 patients were assessed. Definitive closure was performed in 68 patients (57%), with mesh augmentation in 23 (33%). When temporary closure was performed, 45 patients (88%) underwent mesh bridging. Six patients underwent dynamic closure with NPWT. Mesh bridging resulted in a shorter hospital stay (29 ± 16 days vs. 93 ± 46 days; p<0.001), less severe complications (46% vs. 100%; p=0.001), and less reoperations (20% vs. 100%; p<0.001) when compared to NPWT. There was no significant difference in 30-day and one-year mortality between all patient groups.</p><p><strong>Conclusion: </strong>Definitive closure of the burst abdomen should be performed if possible, depending on intraoperative findings. Our data suggest that mesh bridging for burst abdomen is a valuable alternative in terms of hospital stay, severe complications, and reoperations when compared to NPWT. It can be considered in cases where definitive closure is not feasible.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":"45 ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}