Pub Date : 2022-06-30DOI: 10.23937/2378-3397/1410142
Shirah Hamza Assad, Zabeery Ibraheem Abdulaziz, Sogair Osama Abdulqader, Alahmari Ahmed Medawi, Aljabri Waal Nafa
Background: Necrotizing fasciitis is a life-threatening rapidly progressing bacterial infection associated with necrotic changes of the superficial fascia, subcutaneous tissue, and the deep fascia. It is a surgical emergency requiring a high suspicion, early diagnosis, and early treatment. We aim to analyze the clinical and microbiological pattern of necrotizing fasciitis and to determine factors associated with mortality. Methods: A prospective cohort study of the results of 476 patients who were diagnosed and treated for necrotizing fasciitis between January 2005 and December 2014in Al Ansar general public health hospital in Medina, Saudi Arabia was done. Results: Age ≥ 40 years was found statistically to be associated with developing necrotizing fasciitis for both males and females. The majority of the patients had involvement of the lower limb; 31.7% in the right calf and 29.8% in the left calf. Soft tissue infection in 24.4% of the patients was the most common etiology. The most common organism isolated in the monomicrobial infection was Beta-hemolytic Streptococcus in 46.7% of the patients, and the most common organism isolated in the polymicrobial infection was Staphylococcus aureus in 72.8% of the patients. Surgical debridement was done to all patients (100%). The mortality rate was (7.1%). Acidosis (p ˂ 0.05) and hypoalbuminemia (p ˂ 0.05) were the significant factors for mortality. Conclusion: The aggressive course of necrotizing fasciitis could lead to considerable morbidity and mortality. Acidosis and hypoalbuminemia were found to be factors strongly associated with high mortality. Other possible factors include truncal location (from the neck to the pelvic region) and leukocytosis.
{"title":"Necrotizing Fasciitis: Analysis of the Clinical, Microbiological Pattern, and Factors Associated with Mortality","authors":"Shirah Hamza Assad, Zabeery Ibraheem Abdulaziz, Sogair Osama Abdulqader, Alahmari Ahmed Medawi, Aljabri Waal Nafa","doi":"10.23937/2378-3397/1410142","DOIUrl":"https://doi.org/10.23937/2378-3397/1410142","url":null,"abstract":"Background: Necrotizing fasciitis is a life-threatening rapidly progressing bacterial infection associated with necrotic changes of the superficial fascia, subcutaneous tissue, and the deep fascia. It is a surgical emergency requiring a high suspicion, early diagnosis, and early treatment. We aim to analyze the clinical and microbiological pattern of necrotizing fasciitis and to determine factors associated with mortality. Methods: A prospective cohort study of the results of 476 patients who were diagnosed and treated for necrotizing fasciitis between January 2005 and December 2014in Al Ansar general public health hospital in Medina, Saudi Arabia was done. Results: Age ≥ 40 years was found statistically to be associated with developing necrotizing fasciitis for both males and females. The majority of the patients had involvement of the lower limb; 31.7% in the right calf and 29.8% in the left calf. Soft tissue infection in 24.4% of the patients was the most common etiology. The most common organism isolated in the monomicrobial infection was Beta-hemolytic Streptococcus in 46.7% of the patients, and the most common organism isolated in the polymicrobial infection was Staphylococcus aureus in 72.8% of the patients. Surgical debridement was done to all patients (100%). The mortality rate was (7.1%). Acidosis (p ˂ 0.05) and hypoalbuminemia (p ˂ 0.05) were the significant factors for mortality. Conclusion: The aggressive course of necrotizing fasciitis could lead to considerable morbidity and mortality. Acidosis and hypoalbuminemia were found to be factors strongly associated with high mortality. Other possible factors include truncal location (from the neck to the pelvic region) and leukocytosis.","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115771363","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":"Protection Status of Healthcare Professionals Working in the Operating Room from Surgical Smoke","authors":"Cavdar Ikbal, Özhanlı Yasemin, Karaman Ahmet, Özbaş Ayfer, Daştan Çağla, Göksoy Ertuğrul","doi":"10.23937/2378-3397/1410140","DOIUrl":"https://doi.org/10.23937/2378-3397/1410140","url":null,"abstract":"","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130416246","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 : 2022-03-31DOI: 10.23937/2378-3397/1410138
H. Mora, Diana L Labastida Ramírez, L. M. M. Zamora, O. I. G. Valmana, Carlos H Flores Juárez
{"title":"Acute Appendicitis Secondary to Kaposi's Sarcoma: Case Report and Literature Review","authors":"H. Mora, Diana L Labastida Ramírez, L. M. M. Zamora, O. I. G. Valmana, Carlos H Flores Juárez","doi":"10.23937/2378-3397/1410138","DOIUrl":"https://doi.org/10.23937/2378-3397/1410138","url":null,"abstract":"","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130170865","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 : 2022-01-30DOI: 10.23937/2378-3397/1410137
Tiang Thomas, Sidhu Ankur, W. David, Bui Andrew
{"title":"Impact of Neoadjuvant Chemotherapy Interval on Tumour Regression Grading for Rectal Cancer","authors":"Tiang Thomas, Sidhu Ankur, W. David, Bui Andrew","doi":"10.23937/2378-3397/1410137","DOIUrl":"https://doi.org/10.23937/2378-3397/1410137","url":null,"abstract":"","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128882365","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 : 2022-01-24DOI: 10.23937/2378-3397/1410136
Bolbol Akram, Ahmed Abdulhakam, Suliman Osman EA, Abduraboh Abdullah Al-mater
Background: Whole-body computed tomography (WBCT) is one of the standard non-invasive tests for trauma patients, to avoid the overuse of the WBCT and unnecessary radiation to the patients, a combination of evidence-based indications, approved guidelines and the clinical decision should be used. This study was done to emphasize on limitation of unnecessary WBCT following international or local criteria along with clinical assessment and decision without compromising the patient’s safety. Methodology: This study was performed in King Fahad Hospital-Emergency Department in Albaha region in the kingdom of Saudi Arabia, the study was done in the period from January 2020 to December 2020, the study population is polytrauma patients of the age of 18 years old and above, it is a descriptive, retrospective database analysis of 233 patients diagnosed with polytrauma in the emergency department, all patients were received by emergency physicians and trauma team members, where they received their initial management and stabilized then sent to the Radiology department for WBCT according to the order by senior ED physician or on-call surgeon who is a member of the trauma team, Informed consent was taken according to the hospital protocol. Results: Whole-body CT was carried out on 233 polytrauma patients arriving at the emergency department, the outcome of the WBCT was n ≈ 70 (30%) were negative findings, n ≈ 87 (37.3%) they have a single organ involved in trauma and n ≈ 76 (32.7%) the reports came with multiple organs (more than 1) involved in trauma. Conclusion: This study showed slight overuse of WBCT in our facility, 30% of reports came of negative findings. The combination of senior’s clinical decisions, application of appropriate local or international evidence-based criteria for performing WBCT will lead to avoiding a good number of unnecessary WBCT, radiation exposure, and side effects of contrast materials besides reducing the costs for the health economic system.
{"title":"Whole-Body Computed Tomography for Polytrauma Patients in the Emergency Department: Recommended or Unnecessary Radiation","authors":"Bolbol Akram, Ahmed Abdulhakam, Suliman Osman EA, Abduraboh Abdullah Al-mater","doi":"10.23937/2378-3397/1410136","DOIUrl":"https://doi.org/10.23937/2378-3397/1410136","url":null,"abstract":"Background: Whole-body computed tomography (WBCT) is one of the standard non-invasive tests for trauma patients, to avoid the overuse of the WBCT and unnecessary radiation to the patients, a combination of evidence-based indications, approved guidelines and the clinical decision should be used. This study was done to emphasize on limitation of unnecessary WBCT following international or local criteria along with clinical assessment and decision without compromising the patient’s safety. Methodology: This study was performed in King Fahad Hospital-Emergency Department in Albaha region in the kingdom of Saudi Arabia, the study was done in the period from January 2020 to December 2020, the study population is polytrauma patients of the age of 18 years old and above, it is a descriptive, retrospective database analysis of 233 patients diagnosed with polytrauma in the emergency department, all patients were received by emergency physicians and trauma team members, where they received their initial management and stabilized then sent to the Radiology department for WBCT according to the order by senior ED physician or on-call surgeon who is a member of the trauma team, Informed consent was taken according to the hospital protocol. Results: Whole-body CT was carried out on 233 polytrauma patients arriving at the emergency department, the outcome of the WBCT was n ≈ 70 (30%) were negative findings, n ≈ 87 (37.3%) they have a single organ involved in trauma and n ≈ 76 (32.7%) the reports came with multiple organs (more than 1) involved in trauma. Conclusion: This study showed slight overuse of WBCT in our facility, 30% of reports came of negative findings. The combination of senior’s clinical decisions, application of appropriate local or international evidence-based criteria for performing WBCT will lead to avoiding a good number of unnecessary WBCT, radiation exposure, and side effects of contrast materials besides reducing the costs for the health economic system.","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126702678","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 : 2021-12-31DOI: 10.23937/2378-3397/1410133
Al-Shehr Dhafer Mohamed, Qasem Fawaz Ali Ahmed
Purpose: Paraganglioma is a neural crest-derived endocrine cells or organs located generally at the extraadrenal glands, head, necks, or abdomen. This research case study brings a detailed information of paraganaglioma occurred for a patient in Aseer region.
{"title":"Retroperitoneal Paraganglioma in the Extra-Adrenal Gland: A Case Study Report, Aseer Central Hospital, Saudi Arabia","authors":"Al-Shehr Dhafer Mohamed, Qasem Fawaz Ali Ahmed","doi":"10.23937/2378-3397/1410133","DOIUrl":"https://doi.org/10.23937/2378-3397/1410133","url":null,"abstract":"Purpose: Paraganglioma is a neural crest-derived endocrine cells or organs located generally at the extraadrenal glands, head, necks, or abdomen. This research case study brings a detailed information of paraganaglioma occurred for a patient in Aseer region.","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129973655","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 : 2021-12-31DOI: 10.23937/2378-3397/1410134
Reyhanoglu Hasan, Ozcan Kaan
Background: The aim of this study was to evaluate the complications associated with totally implantable venous port catheter interventions and the management of these complications. Methods: Between January 2011 and October 2020, we reviewed patients who had totally implantable venous port catheter interventions. A total of 543 catheters were inserted into cancer patients via the subclavian, jugular, or femoral vein. Demographic data, venous access, primary diagnosis, catheter-related complications, catheter duration of stay, and reasons for catheter removal were retrospectively analyzed. Results: The mean age of the patients was 53.6 years, with the sample consisting of 304 (55.98%) females and 239 (44.02%) males. The first three cancer diagnoses were breast cancer (35.72%), colon cancer (31.67%), and stomach cancer (12.89%). In most patients (72.37%), the right subclavian vein was used as the intervention site. Complications occurred in 8.8% (48 patients) of the patients in the early (1.28%) or late periods (6.8%) after the procedure. Catheter-related infection was the most common complication, at 2.5%. Conclusion: Some complications may occur during the insertion and use of totally implantable venous port catheters, although they are convenient for use in the treatment of patients undergoing chemotherapy. Given their long-term use in these patients, most of whom have metastatic cancer and are on immunosuppressive therapy, a careful approach during surgery and chemotherapy will reduce potential complications.
{"title":"Complications after Totally Implantable Venous Port Catheter Intervention in Cancer Patients","authors":"Reyhanoglu Hasan, Ozcan Kaan","doi":"10.23937/2378-3397/1410134","DOIUrl":"https://doi.org/10.23937/2378-3397/1410134","url":null,"abstract":"Background: The aim of this study was to evaluate the complications associated with totally implantable venous port catheter interventions and the management of these complications. Methods: Between January 2011 and October 2020, we reviewed patients who had totally implantable venous port catheter interventions. A total of 543 catheters were inserted into cancer patients via the subclavian, jugular, or femoral vein. Demographic data, venous access, primary diagnosis, catheter-related complications, catheter duration of stay, and reasons for catheter removal were retrospectively analyzed. Results: The mean age of the patients was 53.6 years, with the sample consisting of 304 (55.98%) females and 239 (44.02%) males. The first three cancer diagnoses were breast cancer (35.72%), colon cancer (31.67%), and stomach cancer (12.89%). In most patients (72.37%), the right subclavian vein was used as the intervention site. Complications occurred in 8.8% (48 patients) of the patients in the early (1.28%) or late periods (6.8%) after the procedure. Catheter-related infection was the most common complication, at 2.5%. Conclusion: Some complications may occur during the insertion and use of totally implantable venous port catheters, although they are convenient for use in the treatment of patients undergoing chemotherapy. Given their long-term use in these patients, most of whom have metastatic cancer and are on immunosuppressive therapy, a careful approach during surgery and chemotherapy will reduce potential complications.","PeriodicalId":326011,"journal":{"name":"International Journal of Surgery Research and Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120882688","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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