scholarly journals Surgical Management of a Chronic Neck Abscess in a U.S. Navy Bottlenose Dolphin

2019 ◽  
Vol 184 (7-8) ◽  
pp. e360-e364 ◽  
Author(s):  
Clara Lee ◽  
Eric D Jensen ◽  
Jenny Meegan ◽  
Marina Ivančić ◽  
James Bailey ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Bottlenose Dolphin ◽  
Intraoperative Ultrasound ◽  
Antifungal Drugs ◽  
Inspiratory Stridor ◽  
Clinically Normal ◽  
Suction Drain ◽  
Closed Suction Drain ◽  
External Drain ◽  
One Year

Abstract Surgical intervention on cetaceans is rarely performed due to challenges including general anesthesia and post-operative wound healing. This report describes the evaluation and treatment of an adult female bottlenose dolphin (Tursiops truncatus) with the US Navy Marine Mammal Program, with a chronic ventral cervical abscess caused by Candida glabrata. Despite aspiration and lavage along with multiple antifungal drugs, the patient developed inspiratory stridor with decreased performance level and surgical treatment was pursued. Under general anesthesia with the dolphin in dorsal recumbency position a 12-cm longitudinal ventral midline neck incision was used for exploration. Intraoperative ultrasound aided the identification of surgical landmarks and the abscess cavity. After adequate drainage and curettage, a closed-suction drain was placed in the surgical site. Retention sutures were used to close the incision and the external drain bulb was secured to a pectoral fin strap. One-year post-op, the dolphin was clinically normal and follow-up imaging showed no significant recurrence of the abscess. This case demonstrates a novel surgical approach of managing abscesses in dolphins, including placement and management of a negative suction drain in a submerged patient. The successful collaboration between veterinary anesthesiology, veterinary medicine, radiology, and general surgery allowed the patient to continue her normal activities as a full-duty service member.

scholarly journals A simple novel technique for closure of simple and complex pilonidal sinus with either simple (tongueshaped) or bilobed rotation fl ap

2007 ◽  
Vol 40 (01) ◽  
pp. 47-50
Author(s):  
M.S. Awad Mohamed ◽  
Tolba Mohamed ◽  
H. Gharib Osama
Keyword(s):  
Complete Healing ◽  
Common Disease ◽  
Rotation Flap ◽  
Suction Drain ◽  
Closed Suction Drain ◽  
One Year ◽  
To Receive ◽  
Mean Time ◽  
Simple Rotation

ABSTRACT Background:Pilonidal sinus is a common disease in young adults that carries high postoperative morbidity and patients′ discomfort; controversy still exists regarding the best surgical technique for the treatment of the disease. We successfully treat it with a rotation flap technique (simple rotation and bilobed rotation flap).Materials and Methods: Sixty-two patients were randomized to receive surgical treatment in the form of either simple rotation or bilobed rotation flap by eccentric elliptical excision of the diseased tissues down to the sacral fascia and closure of the defect with the flap, then placing a closed suction drain at the base of the wound, with its tip being brought out in the gluteal region at least 5 cm laterally to the lower end of the suture. Results: All our patients healed completely without recurrence after a mean follow-up of about one year. Mean hospital stay 1.5 days (range 1-3) Mean time to complete healing 11.9 days (range 8-14). Mean time off work was 11.5 days (range 10-21), wound infection and breakdown, three (4.8%), recurrence (0%), and time to sitting on the toilet and walking without pain was 10-15 days.Conclusions: A tension-free suture and cleft left via the rotation flap, either the bilobed flap or monolobed, is the key to success without recurrence and low patient discomfort.

Surgical Closed Suction Drain Use After Craniotomy for Evacuation of Supratentorial Epidural Hematomas: A Case Series of Radiographic and Clinical Outcomes

2020 ◽  
Vol 134 ◽  
pp. e460-e468
Author(s):  
Phillip A. Bonney ◽  
Tats Fujii ◽  
Casey A. Jarvis ◽  
Martin H. Pham ◽  
Steven L. Giannotta
Keyword(s):  
Clinical Outcomes ◽  
Case Series ◽  
Closed Suction ◽  
Suction Drain ◽  
Closed Suction Drain

scholarly journals A case report of an immunocompetent patient with Coccidioides meningoencephalitis with atypical brain magnetic resonance imaging findings during a 1 year follow-up

2019 ◽  
Vol 7 (28) ◽  
pp. 33-37
Author(s):  
Dongkwan Jin ◽  
Juliana Gomez
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Image ◽  
Brain Magnetic Resonance Imaging ◽  
Immunocompetent Patient ◽  
Antifungal Drugs ◽  
Resonance Imaging ◽  
Meningeal Enhancement ◽  
Brain Magnetic Resonance Image ◽  
One Year

Coccidioides meningoencephalitis is a central nervous system (CNS) fungal infection withCoccidioides species which can lead to various CNS complications, such as hydrocephalus,vasculitis, and stroke. Most cases reported with Coccidioides meningoencephalitis were inimmunocompromised patients, and the radiologic characteristics on this condition are not wellestablished. Here we report a case of Coccidioides meningoencephalitis in an immunocompetentpatient with one-year follow-up brain magnetic resonance image (MRI) studies after successfultreatment with antifungal drugs. The MRI demonstrated subcortical parenchymal lesions,selectively involving the white matter, and persistent meningeal enhancement.

scholarly journals A study to evaluate the role of suction drains in orthopedic surgery

1970 ◽  
Vol 9 (2) ◽  
pp. 91-94 ◽  
Author(s):  
GP Khanal ◽  
R Rijal ◽  
BP Shrestha ◽  
NK Karn ◽  
P Chaudhary
Keyword(s):  
Beneficial Effect ◽  
Orthopedic Surgery ◽  
Postoperative Infection ◽  
Wound Care ◽  
Demographic Data ◽  
Superficial Infection ◽  
Postoperative Wound ◽  
Suction Drain ◽  
One Year

Background: There is controversy in routine use of suction drain in orthopedic surgeries. Devastating postoperative infection and years of treatment had forced on extra measures of postoperative wound care and use of drains. Objective: To find out the necessity of intraoperative drains in routine orthopedic surgery. Methods: Thirty patients were enrolled in the study. All of the patients were followed up on 2nd, 14th days and 3 monthly till one year of period. All the demographic data and preoperative investigations and intraoperative and postoperative parameters were recorded in standard proforma. Data were analysed using appropriate statistical method. Results: All the patients were followed up to one year period. Six patients had superficial infection on 2nd postoperative day. They were managed with antibiotics and no patient showed signs of infections on 14th postoperative day and thereafter. No patient needed postoperative reinforcement of dressing. Conclusion: Routine use of intraoperative drain in hip surgeries has beneficial effect of decreasing reinforcement of postoperative dressing. Keywords: orthopedic surgery; suction drain; BPKIHS DOI: http://dx.doi.org/10.3126/hren.v9i2.4980 Health Renaissance 2011: Vol.9 (No.2): 91-94

scholarly journals Cardiac Arrest after Connecting Negative Pressure to the Subgaleal Drain during Craniotomy Closure

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Monu Yadav ◽  
Sapna A. Nikhar ◽  
Dilip Kumar Kulkarni ◽  
R. Gopinath
Keyword(s):  
Cardiac Arrest ◽  
Negative Pressure ◽  
Surgical Procedure ◽  
Vacuum System ◽  
Suction Drain ◽  
Pressure Application ◽  
Neurosurgical Patients ◽  
One Year ◽  
Pressure Suction ◽  
Subgaleal Space

A one-year-old child operated on for arachnoid cyst in right frontoparietotemporal region had sudden bradycardia followed by cardiac arrest leading to death after connecting negative pressure to the subgaleal drain during craniotomy closure. The surgical procedure was uneventful. It is a common practice to place epidural or subgaleal drains connected to a vacuum system towards the end of craniotomy to prevent accumulation of intracranial and extracranial blood. The phenomenon of bradycardia with hypotension is known to occur following negative pressure application to the epidural, epicranial, or subgaleal space after craniotomy closure. However cardiac arrest as a complication of negative pressure suction drain in neurosurgical patients is not described in the literature.

A European multicentric experience using the CardioSEAL® and Starflex double umbrella devices to close interatrial communications holes within the oval fossa

2000 ◽  
Vol 10 (5) ◽  
pp. 519-526 ◽  
Author(s):  
M. Carminati ◽  
S. Giusti ◽  
G. Hausdorf ◽  
S. Qureshi ◽  
M. Tynan ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Surgical Repair ◽  
Clinical Success ◽  
The Other ◽  
Thromboembolic Events ◽  
Clinical Complications ◽  
The Mean ◽  
One Year ◽  
Flap Valve

AbstractIn this review, we describe the experience from 13 European centres using the CardioSEAL and Starflex double umbrella devices to close interatrial communications within the oval fossa (so-called ‘stcundum’ defects). Between October 1996 and April 1999, the procedure was attempted in 334 patients with a mean age of 12 years and a mean weight of 44kg. The mean measured stretched diameter of the defect was 15 mm. In the overall group, the defect was solitary in 245 patients (73%), multiple in 21 (6%), associated with an aneurysm of the flap valve in 15 (5%), was represented by patency of the oval foramen in 44 (13%), and was a fenestration in a Fontan repair in 9 (3%). In all patients, the devices were inserted under general anesthesia, using fluoroscopic and transesophageal echocardiographic control. Implantation was achieved in 325 (97,3%). The device embolized within either a few minutes or a few hours in 13 patients (4%). Of these, uncomplicated surgical repair was undertaken in 10, while the device was retrieved in 3 using catheters and a second device was successfully implanted. Residual shunting was detected immediately after the procedure in 41% of the patients, with the incidence decreasing to 31% at discharge, 24% at 1 month, 21% at 6 months, and 20.5% at one year. During the period of follow-up, elective surgical repair became necessary in two patients, due to malposition of the device in one, and late embolization in the other. Fractures of arms were seen in 6.1%, most commonly with the largest devices. All those with fractured arms of the device were asymptomatic, and no clinical complications related to the fractures were observed. There were no arrythmias, endocarditis, valvar distortion, thromboembolic events, or other complications. After one year of follow-up, clinical success, defined as complete closure of the defect or presence of only a trivial leak, had been obtained in 92.5% of the patients. We conclude, therefore, that these devices produce excellent results when used to close defects of small to moderate size. Results are less than optimal, or else complications ensure, when attempts are made to close very large defects.

scholarly journals Postoperative drainage in head and neck surgery

2010 ◽  
Vol 92 (8) ◽  
pp. 651-654 ◽  
Author(s):  
Ida Amir ◽  
Pradeep Morar ◽  
Antonio Belloso
Keyword(s):  
Head And Neck ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Optimal Time ◽  
Routine Practice ◽  
Economic Implications ◽  
Drainage Rate ◽  
Suction Drain ◽  
Drain Removal ◽  
Closed Suction Drain

INTRODUCTION A major factor affecting patients’ length of hospitalisation following head and neck surgery remains the use of surgical drains. The optimal time to remove these drains has not been well defined. A routine practice is to measure the drainage every 24 h and remove the drain when daily drainage falls below 25 ml. This study aims to determine whether drainage measurement at shorter intervals decreases the time to drain removal and hence the length of in-patient stays. PATIENTS AND METHODS A 6-month prospective observational study was performed. The inclusion criteria were patients who underwent head and neck surgery without neck dissection and had a closed suction drain inserted. Drainage rates were measured at 8-hourly intervals. Drains were removed when drainage-rate was ≤ 1 ml/h over an 8-h period. RESULTS A total of 43 patients were evaluated. The highest drainage rate occurred in the first 8 postoperative hours and decreased significantly in the subsequent hours. The median drainage rates at 8, 16, 24, 32 and 40 postoperative hours were 3.375, 1, 0, 0 and 0 ml/h, respectively. Applying our new removal criteria of ≤ 1 ml/h drainage rate, the drains were removed in 22 (51%) patients at the 16th postoperative hour; 37 (86%) were removed by 24 h after operation. In comparison, only nine (20.9%) patients could potentially be discharged the day after surgery if previous criteria of ≤ 25 ml/24-h were used to decide on drain removal. CONCLUSIONS Our 8-hourly drainage-rate monitoring has facilitated safe earlier discharge of an additional 28 (65%) patients on the day after surgery. This has led to improvement in patient care, better optimisation of hospital resources and resulted in positive economic implications to the department.

scholarly journals Early Rupture of an Ultralow Duodenal Stump after Extended Surgery for Gastric Cancer with Duodenal Invasion Managed by Tube Duodenostomy and Cholangiostomy

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Konstantinos Blouhos ◽  
Konstantinos A. Boulas ◽  
Anna Konstantinidou ◽  
Ilias I. Salpigktidis ◽  
Stavroula P. Katsaouni ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Subtotal Gastrectomy ◽  
Postoperative Management ◽  
Enzyme Concentration ◽  
Distal Margin ◽  
Duodenal Stump ◽  
Extended Surgery ◽  
Suction Drain ◽  
Closed Suction Drain ◽  
Duodenal Invasion

When dealing with gastric cancer with duodenal invasion, gastrectomy with distal resection of the duodenum is necessary to achieve negative distal margin. However, rupture of an ultralow duodenal stump necessitates advanced surgical skills and close postoperative observation. The present study reports a case of an early duodenal stump rupture after subtotal gastrectomy with resection of the whole first part of the duodenum, complete omentectomy, bursectomy, and D2+ lymphadenectomy performed for a pT3pN2pM1 (+ number 13 lymph nodes) adenocarcinoma of the antrum. Duodenal stump rupture was managed successfully by end tube duodenostomy, without omental patching, and tube cholangiostomy. Close assessment of clinical, physical, and radiological signs, output volume, and enzyme concentration of the tube duodenostomy, T-tube, and closed suction drain, which was placed near the tube duodenostomy site to drain the leak around the catheter, dictated postoperative management of the external duodenal fistula.

Sign in / Sign up

Export Citation Format

Share Document