Pub Date : 2021-03-31DOI: 10.47363/jsar/2021(2)118
Gaurav Govil, L. Tomar, Pawan Dhawan
Normally, the surgeon would plan to fix a displaced fracture, replace a chronic painful joint or scope a joint to evaluate and treat injury and painful joint lesions. The aim being to achieve a desirable functional improvement, early rehabilitation and return to pre-injury level at the earliest. The treatment strategy is guided by the goal to attain a good quality of life. With the pandemic raging amongst the population at large, there is “new paradigm” the surgeon is adopting. The basic orthopaedic principle of “movement is life and life is movement” is being challenged for decision making of an orthopaedic procedure.
{"title":"Orthopaedic Surgeon Changing Perspective during Covid-19 Pandemic","authors":"Gaurav Govil, L. Tomar, Pawan Dhawan","doi":"10.47363/jsar/2021(2)118","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)118","url":null,"abstract":"Normally, the surgeon would plan to fix a displaced fracture, replace a chronic painful joint or scope a joint to evaluate and treat injury and painful joint lesions. The aim being to achieve a desirable functional improvement, early rehabilitation and return to pre-injury level at the earliest. The treatment strategy is guided by the goal to attain a good quality of life. With the pandemic raging amongst the population at large, there is “new paradigm” the surgeon is adopting. The basic orthopaedic principle of “movement is life and life is movement” is being challenged for decision making of an orthopaedic procedure.","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132676073","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}
Pub Date : 2021-03-31DOI: 10.47363/JSAR/2021(2)124
UwaisRiaz UlHasan, M. Almasoud, N. Dossary
Hidradenitis suppurativa (HS) is a chronic skin disease primarily affecting the sweat glands apocrine zone of the body and what starts initially as an abscess progresses to nodules, sinus tracts, with cicatrisation fistula formation and ulcers. It is common to see all the stages of clinical spectrum viz multiple solitary abscess to nodules with sinus, fistulas with ulceration and cicatrisation in chronic patients. This chronic illness takes a toll on the psyche of these individuals as the need to avoid foul smell and the constant need for dressing dictate their social life. The patients are notoriously know for follow up for years. A low self-esteem and depression are companions of hidradenitis suppurativa (HS) individuals. Early involvement of the surgeon can substantially improve the progress and evolution of this chronic skin condition and could obviate the development of SCC the end stage of all Chronic neglected Hidradenitis suppurativa (HS) cases especially in the hi risk older age group of individuals
{"title":"Hidradenitis Suppurativa: “A surgical Update with Review of Literature”","authors":"UwaisRiaz UlHasan, M. Almasoud, N. Dossary","doi":"10.47363/JSAR/2021(2)124","DOIUrl":"https://doi.org/10.47363/JSAR/2021(2)124","url":null,"abstract":"Hidradenitis suppurativa (HS) is a chronic skin disease primarily affecting the sweat glands apocrine zone of the body and what starts initially as an abscess progresses to nodules, sinus tracts, with cicatrisation fistula formation and ulcers. It is common to see all the stages of clinical spectrum viz multiple solitary abscess to nodules with sinus, fistulas with ulceration and cicatrisation in chronic patients. This chronic illness takes a toll on the psyche of these individuals as the need to avoid foul smell and the constant need for dressing dictate their social life. The patients are notoriously know for follow up for years. A low self-esteem and depression are companions of hidradenitis suppurativa (HS) individuals. Early involvement of the surgeon can substantially improve the progress and evolution of this chronic skin condition and could obviate the development of SCC the end stage of all Chronic neglected Hidradenitis suppurativa (HS) cases especially in the hi risk older age group of individuals","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128125672","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}
Pub Date : 2021-03-31DOI: 10.47363/jsar/2021(2)116
M. B. Mengistu, Yonatan Mehari Andemeske, AriamTsegay Emhatsion, HabtomTareke Wrieta, NatsnetYacob Gebreyesus
Background: Delirium is a common but often underdiagnosed set of transient symptoms often seen in elderly patients following surgeries under spinal anesthesia. With early recognition and diagnosis based on the established standard criteria delirium can be improved. Early identification of the possible contributingfactors and the magnitude of the burden will help in the management of the fragile elderly patients. The aim of this study is to determine the incidence of postoperative delirium and associated risk factors in elderly patients who have done surgery under spinal anesthesia. Method: This cross sectional study was conducted in the National Referral Hospitals and Sembel PrivateHospital, in Asmara, Eritrea from February to May, 2019. The study participants were elderly patients (age ≥65 years) having no known history of dementia or delirium or no mental disorder, no history of acute cerebrovascular disease. Basic background and clinical characteristics of the patients was collected. To assess the status of cognitive impairment level, the Mini Mental State Examination and Confusion Assessment Method tools were used. Data was collected through an interview method. After the data was entered into SPSS version 22 software, data was analyzed with frequency, percentage, bivariate and multivariate logistic regression analysis method as appropriate. P value <0.05 was considered as statistically significant. Results: The mean age of the participants was 74 ±6.62 and 102 (79.1%) of the participants were males. POD occurred in 14 (10.9%) of the patients. Adjusting all the potential factors, age was identified as arisk factor for developing POD. Conclusion: Age was determined to be a significant risk factor of delirium. Elderly patients require more attention and care and the findings might help to develop preventive strategies to the occurrence of POD
背景:谵妄是一种常见但常被误诊的一过性症状，常见于脊柱麻醉手术后的老年患者。根据已建立的标准标准及早识别和诊断谵妄可得到改善。及早发现可能的致病因素和负担的严重程度，将有助于对脆弱的老年患者进行管理。本研究的目的是确定脊柱麻醉下手术的老年患者术后谵妄的发生率及相关危险因素。方法:本横断面研究于2019年2 - 5月在厄立特里亚阿斯马拉的国家转诊医院和Sembel私立医院进行。研究参与者为老年患者(年龄≥65岁)，无已知痴呆或谵妄史，无精神障碍，无急性脑血管疾病史。收集患者的基本背景和临床特征。采用Mini Mental State Examination和Confusion Assessment Method两种工具评估患者的认知障碍程度。通过访谈法收集数据。将数据输入SPSS 22版软件后，酌情采用频率、百分比、双变量、多变量logistic回归分析方法对数据进行分析。P值<0.05为差异有统计学意义。结果:参与者平均年龄为74±6.62岁，男性102人(79.1%)。14例(10.9%)患者发生POD。调整所有潜在因素后，年龄被确定为发生POD的危险因素。结论:年龄是谵妄发生的重要危险因素。老年患者需要更多的关注和护理，研究结果可能有助于制定预防POD发生的策略
{"title":"Incidence and Risk Factors of Post-Operative Delirium in Elderly Patients Who Underwent Spinal Anesthesia in Orotta, Halibet and Sembel Hospitals: A Cross Sectional Study in Eritrea","authors":"M. B. Mengistu, Yonatan Mehari Andemeske, AriamTsegay Emhatsion, HabtomTareke Wrieta, NatsnetYacob Gebreyesus","doi":"10.47363/jsar/2021(2)116","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)116","url":null,"abstract":"Background: Delirium is a common but often underdiagnosed set of transient symptoms often seen in elderly patients following surgeries under spinal anesthesia. With early recognition and diagnosis based on the established standard criteria delirium can be improved. Early identification of the possible contributingfactors and the magnitude of the burden will help in the management of the fragile elderly patients. The aim of this study is to determine the incidence of postoperative delirium and associated risk factors in elderly patients who have done surgery under spinal anesthesia. Method: This cross sectional study was conducted in the National Referral Hospitals and Sembel PrivateHospital, in Asmara, Eritrea from February to May, 2019. The study participants were elderly patients (age ≥65 years) having no known history of dementia or delirium or no mental disorder, no history of acute cerebrovascular disease. Basic background and clinical characteristics of the patients was collected. To assess the status of cognitive impairment level, the Mini Mental State Examination and Confusion Assessment Method tools were used. Data was collected through an interview method. After the data was entered into SPSS version 22 software, data was analyzed with frequency, percentage, bivariate and multivariate logistic regression analysis method as appropriate. P value <0.05 was considered as statistically significant. Results: The mean age of the participants was 74 ±6.62 and 102 (79.1%) of the participants were males. POD occurred in 14 (10.9%) of the patients. Adjusting all the potential factors, age was identified as arisk factor for developing POD. Conclusion: Age was determined to be a significant risk factor of delirium. Elderly patients require more attention and care and the findings might help to develop preventive strategies to the occurrence of POD","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121989596","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}
Pub Date : 2021-03-31DOI: 10.47363/jsar/2021(2)120
S. Ayoade
In 1901, Duncan MacDougall performed one of the most controversial experiments of all time. He claimed that at the exact point of death a human being lost 21.3 grams [1-2]. This, he concluded, was the weight of the human soul
{"title":"Seun Ayoade’s Law of Living Things and the 21 Grams Controversy; Related Paradigms","authors":"S. Ayoade","doi":"10.47363/jsar/2021(2)120","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)120","url":null,"abstract":"In 1901, Duncan MacDougall performed one of the most controversial experiments of all time. He claimed that at the exact point of death a human being lost 21.3 grams [1-2]. This, he concluded, was the weight of the human soul","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127849671","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}
Pub Date : 2021-03-31DOI: 10.47363/jsar/2021(2)125
A. Li, Reuben Ndegwa, Goutham Sivasuthan
Background: Gallstone ileus is mechanical intestinal obstruction secondary to impaction of a gallstone within the gastrointestinal tract, and accounts for 1-4% of mechanical bowel obstruction, with a preponderance in the female population [1]. Case Presentation: 56 year-old female presented with right upper quadrant pain (RUQ) and multiple vomits, current smoker. Mechanical obstruction noted on computerised-tomography and underwent laparotomy revealing gallstone ileus. This is on a background of two prior episodes of RUQ pain, presenting to the hospital but lost of follow-up after discharging against medical advice two years ago
{"title":"Gallstone Ileus: A Rare Cause of Intraluminal Small Bowel Obstruction","authors":"A. Li, Reuben Ndegwa, Goutham Sivasuthan","doi":"10.47363/jsar/2021(2)125","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)125","url":null,"abstract":"Background: Gallstone ileus is mechanical intestinal obstruction secondary to impaction of a gallstone within the gastrointestinal tract, and accounts for 1-4% of mechanical bowel obstruction, with a preponderance in the female population [1]. Case Presentation: 56 year-old female presented with right upper quadrant pain (RUQ) and multiple vomits, current smoker. Mechanical obstruction noted on computerised-tomography and underwent laparotomy revealing gallstone ileus. This is on a background of two prior episodes of RUQ pain, presenting to the hospital but lost of follow-up after discharging against medical advice two years ago","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131743924","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}
Pub Date : 2021-03-31DOI: 10.47363/jsar/2021(2)121
P. Heise, M. Baabor, C. Marin
Objective: To compare the effectiveness between balanced general anaesthesia and total intravenous anaesthesia for the hemodynamic control of patients undergoing percutaneous balloon microcompression of the Gasser’s ganglion in trigeminal neuralgia. Patients and methods: A retrospective trial was conducted in thirty patients with the diagnosis of essential trigeminal neuralgia, aged 37 to 82 years old, ASA I and II. The participants were randomly allocated in two groups: Group A, to receive balanced general anaesthesia (BGA) with isoflurane/fentanyl, or Group B, to receive total intravenous anesthesia (TIVA) with propofol/remifentanil. The systolic, diastolic and mean arterial blood pressure, heart rate and oximetry were measured at basal state, entrance to Meckel’s cavum and during the balloon compression. Statistical analysis with the Student T test for continuous quantitative variables and x2 (Chi square) for qualitative variables was performed. Results: The systolic blood pressure was significantly higher in group A at the moment of greatest stimulation. The technique propofol/remifentanil (group B) obtained better hemodynamic control and its management was easier. The incidence of bradycardia was similar in both groups and kept inverse relation with use of previous atropine. Conclusions: Total intravenous anesthesia (TIVA) is an attractive alternative to balanced general anesthesia due to the better hemodynamic response and the quick recovery that this technique offers. Moreover, Atropine use before the procedure is a measure that could benefit patients
{"title":"Comparison of Balanced General and Total Intravenous Anaesthesia for Gasser Ganglion Percutaneous Balloon Microcompression for Trigeminal Neuralgia","authors":"P. Heise, M. Baabor, C. Marin","doi":"10.47363/jsar/2021(2)121","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)121","url":null,"abstract":"Objective: To compare the effectiveness between balanced general anaesthesia and total intravenous anaesthesia for the hemodynamic control of patients undergoing percutaneous balloon microcompression of the Gasser’s ganglion in trigeminal neuralgia. Patients and methods: A retrospective trial was conducted in thirty patients with the diagnosis of essential trigeminal neuralgia, aged 37 to 82 years old, ASA I and II. The participants were randomly allocated in two groups: Group A, to receive balanced general anaesthesia (BGA) with isoflurane/fentanyl, or Group B, to receive total intravenous anesthesia (TIVA) with propofol/remifentanil. The systolic, diastolic and mean arterial blood pressure, heart rate and oximetry were measured at basal state, entrance to Meckel’s cavum and during the balloon compression. Statistical analysis with the Student T test for continuous quantitative variables and x2 (Chi square) for qualitative variables was performed. Results: The systolic blood pressure was significantly higher in group A at the moment of greatest stimulation. The technique propofol/remifentanil (group B) obtained better hemodynamic control and its management was easier. The incidence of bradycardia was similar in both groups and kept inverse relation with use of previous atropine. Conclusions: Total intravenous anesthesia (TIVA) is an attractive alternative to balanced general anesthesia due to the better hemodynamic response and the quick recovery that this technique offers. Moreover, Atropine use before the procedure is a measure that could benefit patients","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117002695","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}
Pub Date : 2021-03-31DOI: 10.47363/jsar/2021(2)122
M. Aziz
Objective: To determine the frequency of seroma formation after flap fixation by quilting technique in MRM patients as compared to control group. Study Design: Randomized controlled trial. Place and Duration of study: This study was conducted from 11th November ,2017 to 10th May , 2018 in Department of Surgery, Holy family Hospital, Rawalpindi. Patients and Method: A total of 60 patients were included in the study having histologically proven breast cancer stage 2 or 3 in age group of 40-70 years undergoing modified radical mastectomy. Patients were allocated to group1 or 2 by random selection. In group I patients, flap fixation was done by quilting technique during MRM . In group II , no quilting was done. Post operative follow up was done after 05 days in OPD and development of seroma was observed clinically. Results: Mean age of patients was 55.23 ± 7.94 years. Mean BMI was 30.05 ± 2.63 kg/m2. Seroma formation was seen in 04 patients (13.33%) in group I (flap fixation by quilting technique ) and 19 patients (63.33%) in group II (control group) with p-value of 0.0001. Conclusion: This study concluded that there is significantly low incidence of post mastectomy seroma formation in MRM patients with quilting technique as compared to the conventional method of wound closure in MRM
{"title":"Randomized Controlled Trial of Modified Radical Mastectomy with and Without Quilting Technique and Its Effect on Seroma Formation","authors":"M. Aziz","doi":"10.47363/jsar/2021(2)122","DOIUrl":"https://doi.org/10.47363/jsar/2021(2)122","url":null,"abstract":"Objective: To determine the frequency of seroma formation after flap fixation by quilting technique in MRM patients as compared to control group. Study Design: Randomized controlled trial. Place and Duration of study: This study was conducted from 11th November ,2017 to 10th May , 2018 in Department of Surgery, Holy family Hospital, Rawalpindi. Patients and Method: A total of 60 patients were included in the study having histologically proven breast cancer stage 2 or 3 in age group of 40-70 years undergoing modified radical mastectomy. Patients were allocated to group1 or 2 by random selection. In group I patients, flap fixation was done by quilting technique during MRM . In group II , no quilting was done. Post operative follow up was done after 05 days in OPD and development of seroma was observed clinically. Results: Mean age of patients was 55.23 ± 7.94 years. Mean BMI was 30.05 ± 2.63 kg/m2. Seroma formation was seen in 04 patients (13.33%) in group I (flap fixation by quilting technique ) and 19 patients (63.33%) in group II (control group) with p-value of 0.0001. Conclusion: This study concluded that there is significantly low incidence of post mastectomy seroma formation in MRM patients with quilting technique as compared to the conventional method of wound closure in MRM","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122814310","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}
Pub Date : 2021-01-07DOI: 10.47363/JSAR/2020(1)115
H. Mumtaz, Hassan Mansoor, K. Bangash
Introduction: JJ stenting has been routinely used in endourology with a wide variety of implications. These stents have beneficial effects in postoperative period improving surgical outcome. Though they are widely used in urology practice, JJ stents cause lower urinary tract symptoms (LUTS) in majority of patients.
{"title":"Efficacy of Alpha Blockers in Relieving Symptoms of JJ Stent","authors":"H. Mumtaz, Hassan Mansoor, K. Bangash","doi":"10.47363/JSAR/2020(1)115","DOIUrl":"https://doi.org/10.47363/JSAR/2020(1)115","url":null,"abstract":"Introduction: JJ stenting has been routinely used in endourology with a wide variety of implications. These stents have beneficial effects in postoperative period improving surgical outcome. Though they are widely used in urology practice, JJ stents cause lower urinary tract symptoms (LUTS) in majority of patients.","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125302741","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}
Pub Date : 2020-12-31DOI: 10.47363/JSAR/2020(1)107
L. Phuc
In Vietnam, Incidence of Old Unreduced Hip Dislocation may account for up to 20%. Old Dislocation is defined as older than 3 weeks not relocated. Inside the dislocated hip, develop many inflammatory tissues such as granulation, fibrous with injured a surrounding structure (capsule, ligaments, tendons, bony pieces etc...) which filled up the acetabulum, prevents the head to be relocated. Over effort to reduce closely an old hip dislocation risks fracture of neck or trochanteric femur. In this case, open reduction is almost mandatory. There are many approaches to access and relocate a dislocated hip, we propose a new one which enables surgeon to expose the acetabulum, to liberate the femoral head, reconstruct the defect of acetabulum and /or femoral head and relocate the hip. Skin incision in shape of S for the left hip, in shape of Z for the right hip, from iliac wing to trochanter, then along the femoral shaft. Figure1 Follow strictly on the bone of lateral iliac wing, go posteriorly will find out the acetabulum; determine the anterior border of Gluteus Medius, dissect the muscles toward greater trochanter, and get complete exposure of operative field. Femoral head is found out & liberated from surrounding tissue. Clear up the acetabulum, reconstruct the bony lesions. Relocate the femoral head in acetabulum, and stabilize with a K-wire. The hip is often immobilized with a Spica casting for > 3 weeks.
{"title":"A New Effective Approach to the Hip (for Old Unreduced Dislocation)","authors":"L. Phuc","doi":"10.47363/JSAR/2020(1)107","DOIUrl":"https://doi.org/10.47363/JSAR/2020(1)107","url":null,"abstract":"In Vietnam, Incidence of Old Unreduced Hip Dislocation may account for up to 20%. Old Dislocation is defined as older than 3 weeks not relocated. Inside the dislocated hip, develop many inflammatory tissues such as granulation, fibrous with injured a surrounding structure (capsule, ligaments, tendons, bony pieces etc...) which filled up the acetabulum, prevents the head to be relocated. Over effort to reduce closely an old hip dislocation risks fracture of neck or trochanteric femur. In this case, open reduction is almost mandatory. There are many approaches to access and relocate a dislocated hip, we propose a new one which enables surgeon to expose the acetabulum, to liberate the femoral head, reconstruct the defect of acetabulum and /or femoral head and relocate the hip. Skin incision in shape of S for the left hip, in shape of Z for the right hip, from iliac wing to trochanter, then along the femoral shaft. Figure1 Follow strictly on the bone of lateral iliac wing, go posteriorly will find out the acetabulum; determine the anterior border of Gluteus Medius, dissect the muscles toward greater trochanter, and get complete exposure of operative field. Femoral head is found out & liberated from surrounding tissue. Clear up the acetabulum, reconstruct the bony lesions. Relocate the femoral head in acetabulum, and stabilize with a K-wire. The hip is often immobilized with a Spica casting for > 3 weeks.","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"279 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121406320","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}
Pub Date : 2020-12-31DOI: 10.47363/jsar/2020(1)103
L. E. Imbelloni, André Augusto de Araujo, J. Sakamoto, E. Viana, Wagner Camargo Ferreira Filho, Marcos Kayu Mori, Geraldo Borges de Morais Filho
In 2010, we started implementing the ACERTO project in a hospital in the northeast of the Brazilian Public Health (SUS) after five weeks with all stakeholders involved in the departments of Anesthesiology, Orthopedics, Geriatrics, Nutrition, Nursing, Physiotherapy, Psychology and Social Service. In the same way as in other hospitals, the implementation of fast track surgery was not obtained by all departments and all health professionals. The use of ACERTO protocol with clinical measures of accelerating patient recovery decreased length of stay, the number of suspensions of surgery, the need for ICU, the use of vesical catheter, the time of fasting, the time of oral food reintroduction, high earlier and faster return to family life, working as humanization of treatment to the elderly. Analgesia in all patients was obtained with local anesthetics through different plexus blocks with neurostimulator and no patient used spinal opioids. In medicine the vast majority is terribly attached to their arguments and no one is willing to give in to new truths. Dreaming costs nothing and the implementation of the ACERTO Project will cost nothing to any institution
{"title":"Fast Track (Acerto) in Elderly Patients for Hip Orthopedic Surgeries. Ten Years of Experience","authors":"L. E. Imbelloni, André Augusto de Araujo, J. Sakamoto, E. Viana, Wagner Camargo Ferreira Filho, Marcos Kayu Mori, Geraldo Borges de Morais Filho","doi":"10.47363/jsar/2020(1)103","DOIUrl":"https://doi.org/10.47363/jsar/2020(1)103","url":null,"abstract":"In 2010, we started implementing the ACERTO project in a hospital in the northeast of the Brazilian Public Health (SUS) after five weeks with all stakeholders involved in the departments of Anesthesiology, Orthopedics, Geriatrics, Nutrition, Nursing, Physiotherapy, Psychology and Social Service. In the same way as in other hospitals, the implementation of fast track surgery was not obtained by all departments and all health professionals. The use of ACERTO protocol with clinical measures of accelerating patient recovery decreased length of stay, the number of suspensions of surgery, the need for ICU, the use of vesical catheter, the time of fasting, the time of oral food reintroduction, high earlier and faster return to family life, working as humanization of treatment to the elderly. Analgesia in all patients was obtained with local anesthetics through different plexus blocks with neurostimulator and no patient used spinal opioids. In medicine the vast majority is terribly attached to their arguments and no one is willing to give in to new truths. Dreaming costs nothing and the implementation of the ACERTO Project will cost nothing to any institution","PeriodicalId":198093,"journal":{"name":"Journal of Surgery & Anesthesia Research","volume":"455 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124311310","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}
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