Surgical Procedures, Operative Commons^™

Best Practice For Post-Operative Surgical Site Infection Prevention, Scott Cavinder

Evidence-Based Practice Project Reports

It is estimated that 300 million surgical procedures take place annually throughout the globe (Gillespie et al., 2021). However, the incidence of surgical site infections (SSI) developing in surgical patients within 30 days of surgery have been estimated to be upwards of 11% (Gillespie et al., 2021). The purpose of this evidence-based practice project was to address the PICOT question: In patients who have undergone cardiothoracic or vascular surgery (P) does implementation of an evidence based post-operative care bundle (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period …

Timing Of Dual Antiplatelet Therapy (Dapt) Initiation Post Mechanical Thrombectomy With Stent Placement In Acute Ischemic Sroke, Mallory R. Stringer, Eric Shaw, Osman Perez, Emily G. Bowers

South Atlantic Division Research Day 2023

No abstract provided.

Chewed Versus Swallowed Ticagrelor In P2y12 Inhibitor-Naïve Patients Undergoing Percutaneous Coronary Intervention, Thomas F. Wilson, Muddasir Ashraf, M. Fuad Jan, Tonga Nfor, Louie Kostopoulos, Joaquin Solis, Jayant Khitha, Ahmad Khraisat, Anthony C. Defranco, Tanvir Bajwa, Suhail Q. Allaqaband

Journal of Patient-Centered Research and Reviews

Purpose: Dual antiplatelet therapy is standard for patients undergoing percutaneous coronary intervention (PCI) with stents. Traditionally, patients swallow the loading dose of a P2Y12 inhibitor before or during PCI. Time to achieve adequate platelet inhibition after swallowing the loading dose varies significantly. Chewed tablets may allow more rapid inhibition of platelet aggregation. However, data for this strategy in patients with stable ischemic heart disease or non-ST-elevation acute coronary syndrome (NSTE-ACS) are less robust.

Methods: In this single-center prospective trial, 112 P2Y12-naïve patients with stable ischemic heart disease or NSTE-ACS on aspirin therapy and who received ticagrelor after coronary angiography but …

Efficacy Of Kidney Reperfusion Treatments Relative To Function And Survival Rates After Transplantation, Mitchell Rohr

Senior Honors Theses

Donor kidneys are damaged upon circulatory death before being preserved with machine perfusion until transplantation. During machine perfusion, blood is pumped back into the vasculature of the kidney, causing damage called ischemic reperfusion injury. The two forms of machine perfusion are hypothermic machine perfusion and normothermic machine perfusion. Different methods of treatment can be used during either hypothermic machine perfusion or normothermic machine perfusion to prevent ischemic reperfusion injury. Each of the treatment methods that were reviewed showed potential for preventing ischemic reperfusion injury, with hypothermic treatments having higher average levels of feasibility than normothermic treatments. The effect of the …

Minimalistic Approach To Enhanced Recovery After Pediatric Scoliosis Surgery, Scott A. Barnett, Bryant M. Song, Matthew Bauer, Matthew E. Nungesser, Claudia Leonardi, Michael J. Heffernan

School of Medicine Faculty Publications

Purpose: Prior studies of enhanced recovery protocols (ERP) have been conducted at large institutions with abundant resources. These results may not apply at institutions with less resources directed to quality improvement efforts. The purpose of this study was to assess the value of a minimalistic enhanced recovery protocol in reducing length of stay (LOS) following PSF for adolescent idiopathic scoliosis. We hypothesized that accelerated transition to oral pain medications and mobilization alone could shorten hospital length of stay in the absence of a formal multimodal pain regimen. Methods: AIS patients aged 10–18 who underwent PSF at a tertiary pediatric hospital …

Delayed Thoracodorsal Artery Perforator Free Flap For Calcaneal Degloving Injury Reconstruction, Mallorie L. Huff, Ahmed M. Mansour, Mamtha S. Raj, Robert J. Allen, Sean J. Wallace

School of Medicine Faculty Publications

The thoracodorsal artery perforator (TDAP) flap has a long vascular pedicle that is ideal for lower extremity reconstruction, but it generally relies on the presence of a dominant septocutaneous perforator vessel. Surgical delay optimizes flap survival by creating relative ischemia to augment perforator vessels. In this report, we describe the use of a delayed free TDAP flap in the setting of an absent dominant perforator vessel for the reconstruction of a calcaneal degloving injury. A 22-year-old actively smoking patient with a body mass index of 33.5 presented with a nonhealing left heel wound with overlying necrotic changes after traumatic degloving …

A Modern Multimodal Pain Protocol Eliminates The Need For Opioids For Most Patients Following Total Knee Arthroplasty: Results From A Retrospective Comparative Cohort Study, Leland Van Deventer, Amy Bronstone, Claudia Leonardi, Matthew Bennett, Peter Yager, Vinod Dasa

School of Medicine Faculty Publications

Purpose: Modern multimodal analgesia has been shown to significantly reduce opioid use following total knee arthroplasty (TKA). This study was conducted to determine if changing TKA discharge opioid prescriptions from automatic to upon request resulted in more opioid free recoveries without compromising pain control. Methods: Between December 2019 and August 2021, an orthopedic surgeon performed 144 primary unilateral TKAs; patients received the same multimodal analgesia protocol except for postoperative opioid prescribing. The first consecutively-treated cohort automatically received an opioid prescription following discharge (automatic group) and the second cohort received opioid prescriptions only upon request (upon request group). Opioid prescription data …

Hemoglobinopathy Is Associated With Total Hip Arthroplasty Indication Even Beyond Sickle Cell Anemia, Maxwell J. Rakutt, Daniel N. Bracey, Anna Cohen-Rosenblum, Peter K. Sculco, Franco M. Sabatini, Cale A. Jacobs, Stephen T. Duncan, David C. Landy

School of Medicine Faculty Publications

Background: The extent to which hemoglobinopathies other than sickle anemia (HbSS) are associated with hip osteonecrosis is unknown. Sickle cell trait (HbS), hemoglobin SC (HbSC), and sickle/β-thalassemia (HbSβTh) may also predispose to osteonecrosis of the femoral head (ONFH). We sought to compare the distributions of indications for a total hip arthroplasty (THA) in patients with and without specific hemoglobinopathies. Methods: PearlDiver, an administrative claims database, was used to identify 384,401 patients aged 18 years or older undergoing a THA not for fracture from 2010 to 2020, with patients grouped by diagnosis code (HbSS N = 210, HbSC N = 196, …

Impact Of Perioperative Dexamethasone On Hospital Length Of Stay And Glycemic Control In Patients With Type 2 Diabetes Undergoing Total Hip Arthroplasty, Vanessa Williams, Mohammad J. Uddin Ansari, Amruta Jaju, Stacey Ward, Daniel O'Keefe, Jumana Abdelkarim, Nicole Montes, Ula Tarabichi, Albert Botchway, Michael G. Jakoby Iv

Journal of Patient-Centered Research and Reviews

Purpose: This study aimed to evaluate effects of perioperative dexamethasone on hospital length of stay (LOS) and glycemic control for patients with type 2 diabetes mellitus undergoing total hip arthroplasty (THA).

Methods: We performed retrospective case review of THA performed in adults (≥ 18 years old) with type 2 diabetes at Springfield Memorial Hospital (Springfield, IL) immediately before (2013), during (2014), and after (2015) publication of consensus guidelines for use of perioperative dexamethasone. Hospital LOS was the primary endpoint. Capillary blood glucose by hospital day, proportion of patients treated with insulin, and median insulin dose by hospital day …

Microvascular Responsiveness To Cardiopulmonary Bypass, Michael O'Neil

Electronic Thesis and Dissertation Repository

Cardiopulmonary bypass can result in multiple organ failure due to mechanisms of ischemia reperfusion injury and the systemic inflammatory response syndrome. The primary objective of this thesis was to investigate and monitor the microvasculature in cardiac surgery patients using multiple methodologies and real-time monitoring techniques. The purpose of our first study was to determine whether pulsatile blood flow during bypass improves microvascular perfusion compared to non-pulsatile flow. We found that changes in sublingual mucosal microcirculation using orthogonal polarization spectral imaging correlate with indices of thenar muscle tissue oxygen saturation and its recovery during a vascular occlusion test using near-infrared spectroscopy …

A Retrospective Study Comparing Mortality Rates Between Vaccinated And Unvaccinated Kidney Transplant Recipients, Anaam Fayyaz, Judy Pozzerle, Suresh Antony

Central & West Texas Research Day 2023

No abstract provided.

Are We “Pushing” Our Patients Toward Addiction? A Preliminary Post-Cesarean Survey To Quantify Narcotic Requirements For Pain Control, Aliya Nurani, Mikalah Maury, Merritt Mcgowan, Stephanie Tootle, Anthony Royek, Eric Shaw

South Atlantic Division Research Day 2023

No abstract provided.

Operative Management Of Grade V Liver Injury After Blunt Trauma: A Case Report, Laura Mena Albors, Garret Perry, Samantha Reiss, Darwin Ang

North Florida Division Research Day 2023

No abstract provided.

Rare Case Of Chylopericardium Status Post Coronary Artery Bypass Graft, Hytham Rashid, Harris R. Khawaja, Ashley Charales, Essam Girgawy, Ramesh Kesavan, Michael Daniel

Gulf Coast Division Research Day 2023

No abstract provided.

Comparing 30-Day Outcomes Of Open Versus Endovascular Revascularization For Chronic Limb-Threatening Ischemia, David Kosoy, Waseem Wahood

East Florida Research Day 2023

Abstract: Chronic limb-threatening ischemia (CLTI) is a serious condition that can lead to amputation and even death. Open and endovascular revascularization are two common treatment options for CLTI, but the optimal treatment approach remains controversial. This study compared the 30-Day outcomes of open and endovascular revascularization using data from the National Surgical Quality Improvement Program (NSQIP) database. The study included 6,780 patients who underwent open bypass with saphenous vein, 4,201 patients who underwent open bypass with alternative conduit, and 8,887 patients who underwent endovascular intervention. Compared to open bypass with saphenous vein, endovascular intervention was associated with a higher rate …

A Delphi Consensus To Identify Perioperative Antibiotic Prescribing Best Practices In Mohs Surgery, Cari Carpenter Bs, Ba, Glenn Goldman Md, Katelyn Shea Md

Larner College of Medicine Fourth Year Advanced Integration Teaching/Scholarly Projects

Abstract: Surgical site infections (SSI) make a significant global contribution to morbidity, mortality, and cost while remaining one of the most preventable causes of healthcare-associated infection. Perioperative antibiotics are a mainstay of prevention, but antibiotics are also associated with cost, risk, and increasing resistance. Dermatology is responsible for more oral antibiotic prescriptions than any other discipline. Despite a trend toward conservative prescribing practices and antibiotic stewardship in dermatology overall, antibiotic prescriptions in dermatologic surgery continue to increase, with a notable rise in short-term perioperative prescribing. There is currently a lack of evidence-based perioperative antibiotic prescribing guidelines within the dermatology literature. …

Technique For Osteochondral Allograft Transplant For 1st Metatarsal Head Cartilage Damage, Bren Koerner, Angela Walker, Kyle Barner, Yale Williams

Continental, MidAmerica, & Mountain Divisions Research Day 2023

No abstract provided.

Is Night Time The Right Time For Hernia Surgery And Dictations, Ali Siddiqui, Nicole B. Lyons, Said Maldonado, Jonathan Lall, Brianna L. Cohen

Gulf Coast Division Research Day 2023

No abstract provided.

Assessment Of Patient And Surgeon Perception On Prophylactic Mesh: A Standard Gamble, Kayla Nguyen, Duyen Quach, Niharika Neela, Nicole Lyons, Oscar Olavarria

Gulf Coast Division Research Day 2023

No abstract provided.

The Role Of Preoperative Magnetic Resonance Cholangiopancreatography/Endoscopic Retrograde Cholangiopancreatography In The Setting Of Mildly Elevated Liver Enzymes Prior To Cholecystectomy, Rachel Groening, Salah Abdel Jalil, Jeffery Durbin, Rahul Kashyap, Aaron D. Pinnola

South Atlantic Division Research Day 2023

No abstract provided.