Surgery
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Comparison of Postoperative Antibiotic Regimens for Complex Appendicitis
In a pragmatic, open-label, randomized trial conducted at 15 hospitals in the Netherlands, two days of postoperative intravenous antibiotics for complex appendicitis was found to be noninferior to five days in terms of infectious complications and mortality within 90 days.
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Antibiotic Choice for Preventing SSIs in Gynecologic Surgery
In a retrospective review of 3,087 patients undergoing hysterectomy or laparotomy for gynecologic surgery at a single institution who received cefazolin alone or a combination cefazolin and metronidazole for surgical prophylaxis, the combination resulted in a significantly lower surgical site infection rate (4.5% vs. 2.3%; P = 0.0115).
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Shorter Length of Stay if ED Workup Completed Before Surgical Consult
Researchers reported completion of workups, such as basic labs and imaging before consultation, resulted in patients spending less time in the ED. Average consultant-to-decision time was 2.5 hours for patients with complete workups vs. 4.9 hours for those with incomplete workups.
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Plastic Surgeon Ethics Complaints: Expert Testimony, Marketing
Allegations concerned deceptive advertising, including using altered pictures and making claims that could not be verified. Also, some surgeons have been accused of exaggerating their expertise or scope of practice to cash in on lucrative expert testimony opportunities.
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Medical Therapy Before Mitral Valve Edge-to-Edge Repair for Congestive Heart Failure Patients
This study of U.S. registry of mitral transcatheter edge-to-edge repair data revealed a minority of patients undergoing this procedure experience optimized medical therapy, with wide variations across sites.
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Surgeons May Need Additional Ethical Guidance
There is an evolving recognition of surgical ethics as a distinct branch of medical ethics — and an integral part of surgical practice itself.
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Many Ethical Considerations if Surgeons Record Procedures
Ideally, the surgical team uses the recordings in conjunction with quality improvement and risk management to assess efficiency, professionalism, communication, and leadership. The ethics of video recording should be integrated into graduate and continuous education modules.
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Initiative Raises Organ Referral Rates, Expands Donor List and Transplanted Organ Supply
An individual’s organ donation wishes should be part of their holistic care plan. Ethicists could provide education to clinicians on this point. A culture of trust between the patient community, clinical care providers, the transplant program, and the organ procurement organization is necessary. This takes years to build — and one bad case to break.
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Multidisciplinary Initiative Leads to More Referrals, Donors, and Transplanted Organs
Staff training and more visible public awareness helped a Georgia hospital make tremendous improvements.
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Was Resident Involved in Surgery? Some Patients Are Not Informed
Further efforts are required to improve communication and education regarding resident involvement in surgery, and address patient concerns and preferences more effectively to protect the physician-patient relationship.