Since the origins of surgery many millennia ago, the goal of caring for a wound was simply healing. As the complexity of surgical procedures evolved, the same realistic outcome remained the same, that being a strong, stable closure that yields a long term, pain free, infection resistant closure.
Wiry, fair-haired and in his 60s, the patient had received a prostate cancer diagnosis a year earlier. When his doctors told him that surgery and radiation therapy were equally effective and that it was up to him to decide, he chose radiation with little hesitation. But one afternoon a month after completing his treatment, the patient was shocked to see red urine collecting in the urinal.
The following is a short interview conducted at the recent American College of Surgeons Clinical Congress with Christopher Rupp, MD, Assistant Professor for Surgery and Co-Director, Center for Pancreatic and Biliary Diseases at the University of North Carolina School of Medicine.
I think it’s clear when you look at the history of wound closure that we’ve made huge strides in terms of defining, developing and changing utilization for suture in the last couple of decades. One of the great achievements more recently has been the exploration of barbed suture.
Though I’ve spoken about breast cancer for Susan G. Komen for the Cure (emphasizing the importance of early screening and detection), until recently I had never had a mammogram. In my training I’d been taught that mammograms weren’t that accurate or useful in women under 40 (our health system’s protocols reflect that), so I got regularly checked by my physician whenever I had a physical and otherwise was waiting until I was older to get testing.
Surgeons want to be confident, efficient and safe when closing incisions to provide the best healing results. The following factors are instrumental in closing a wound: Strength - First and foremost, a wound closure device must keep the wound closed. Both the surgeon and the patient want to leave the O.
It was a beautiful time of day - early evening as the sun was setting. She has just turned sixty and traveled south to visit her 39-year old daughter in a warmer climate. Both had decided to go swimming at the local pool early one evening. The water was perfect: not too warm and not too cool. The clear blue water was made more inviting by the pool lights that illuminated the swimming lanes.
What should surgeons consider when choosing wound closure and healing solutions to attain the best surgical outcome? Recent advances in the scientific understanding of the physiology of wound healing, substantiated by clinical data on the benefits of the presence of natural healing factors, has resulted in a trend toward the use of biologic wound coverings.
Is the doctor-patient relationship really more sacrosanct than the nurse-patient relationship? That’s the provocative question asked by Theresa Brown in a recent column from Well, the New York Times’ health blog.
Oncoplastic breast conservation surgery combines breast cancer surgery with plastic surgery techniques to offer breast cancer patients an option that rids them of their cancer while providing a better cosmetic result. October 29, 2010 Dr. Melvin Silverstein is a renowned oncoplastic surgeon, Clinical Professor of Surgery at the University of Southern California Keck School of Medicine and Director of the Hoag Breast Program at Hoag Hospital.
I don't know what your destiny will be, but one thing I do know: the only ones among you who will be really happy are those who have sought and found how to serve. - Albert Schweitzer The middle-aged Tanzanian woman lived many hours away and had traveled to the academic medical center in Moshi.
I am in New Jersey at the New York General Surgery board review course (time to re-certify already!). It is an intense, one-week, extravaganza so chock full of information you once knew (before you went into private practice) that your mind wanders from time to time (as is evidenced by the fact that I came up with this column during the first day of the course).
Several years ago I helped care for a man who had been hospitalized with a severe infection of the abdominal wall. When his primary doctors discovered that the bacteria responsible was resistant to most antibiotics, they quickly isolated him, moving him into a single room with a sign on the door proclaiming “Contact Precautions” and directing visitors to put on gloves, mask and gown before entering.
By Edwin G. Avery, IV, M.D., C.P.I. Chief, Division of Cardiothoracic Anesthesia Vice Chairman, Director of Research University Hospitals Case Medical Center Associate Professor of Anesthesiology Case Western Reserve University School of Medicine Cleveland, OH October 22, 2010 Introduction Near-infrared spectroscopy (NIRS) based cerebral oximetry has been adopted by many cardiothoracic and vascular anesthesiologists to provide continuous intraoperative insight into brain perfusion and oxygenation dynamics.