scholarly journals Assessment of Intraoperative Blood Loss during Oral and Maxillofacial Surgical Procedures in a Nigerian Tertiary Health Care Center

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Babatunde O. Akinbami ◽  
Bisola Onajin-Obembe
Keyword(s):  
Blood Loss ◽  
Surgical Procedures ◽  
Significant Relationship ◽  
Cleft Lip ◽  
Soft Tissues ◽  
Care Center ◽  
Mean Value ◽  
Health Care Center ◽  
Estimated Blood Loss ◽  
Duration Of Surgery

Background. Reports on estimated amount of blood loss in maxillofacial surgical procedures will guide clinicians through units of blood required for each procedure. The aim of the study was to assess the amount of blood loss and duration of surgery. Methods. All cases of maxillofacial surgical procedures done under GA in the MFU theatre, from January 2007 to December 2013, were included in the study. Pre- and postoperative haematocrit values, number of units of whole blood requested and used, amount of blood loss, and duration of surgery were recorded. Results. 139 patients were analyzed, of which 75 (54.0%) were males and 64 (46.0%) were females. Fifty-six (40.3%) cases involved soft tissues. Eighty-three cases involved hard tissues. Age range was 2 months to 78 years; mean ± (SD) was 21.3±(18.5) years. Isolated unilateral cleft lip had the lowest mean value of estimated blood loss of 10.4±10.8 mLs and also the lowest duration of surgery of 58 (76) minutes. There was no significant relationship between both parameters for cleft lip. Fractures of the mandible had mean blood loss of 352 mLs and duration was 175 min. Conclusion. In this study, there was significant relationship between estimated blood loss and duration of surgery for mandibular and zygomatic complex fractures.

Effect of Coblation Polypectomy on Estimated Blood Loss in Endoscopic Sinus Surgery

2009 ◽  
Vol 23 (5) ◽  
pp. 535-539 ◽  
Author(s):  
Jean Anderson Eloy ◽  
Thomas J. Walker ◽  
Roy R. Casiano ◽  
Jose W. Ruiz
Keyword(s):  
Blood Loss ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyposis ◽  
Care Center ◽  
Tertiary Care ◽  
Sinus Surgery ◽  
New Device ◽  
Estimated Blood Loss ◽  
Duration Of Surgery ◽  
University Of Miami

Background We conducted a pilot study comparing estimated blood loss (EBL) using coblation-assisted endoscopic sinus surgery (CAESS) where coblation is used to debulk nasal polyps before microdebridement with a traditional microdebrider technique in chronic rhinosinusitis (CRS) patients with sinonasal polyps undergoing endoscopic sinus surgery (ESS). Methods A retrospective analysis was performed at a tertiary care center on patients with nasal polyposis undergoing ESS between January 2008 and July 2008. The University of Miami CT staging system was used preoperatively to evaluate the extent of sinonasal disease. The duration of surgery, blood loss per minute, total EBL, and demographic data were collected. Results Twenty-one patients underwent nasal polypectomy/ESS using CAESS and 16 patients underwent nasal polypectomy/ESS using microdebridement. The two groups had comparable University of Miami CT staging scores (p > 0.05). The average EBL was 307.1 ± 169.8 mL using coblation compared with 627.8 ± 424.2 mL using microdebridement (p < 0.05). The average duration of surgery using coblation was 116.2 ± 41.7 minutes, compared with 125.3 ± 48.4 minutes using microdebridement (p > 0.05). The average blood loss per minute was 2.8 ±1.7 mL in the coblation group compared with 4.8 ± 2.1 mL in the microdebridement group (p < 0.05). Subgroup analyses showed a significant decrease in average EBL and EBL/minute to be only significant for revision cases (p < 0.05) and not for primary cases (p > 0.05). Conclusion Coblation-assisted nasal polypectomy/ESS is associated with a statistically significant lower EBL and blood loss per minute when compared with traditional microdebridement technique. Coblation represents a new device that can reduce blood loss in patients with nasal polyposis undergoing traditional revision ESS. Further prospective randomized trials are needed to validate these findings.

Risk of Sharp Device–Related Blood and Body Fluid Exposure in Operating Rooms

2008 ◽  
Vol 29 (12) ◽  
pp. 1139-1148 ◽  
Author(s):  
Douglas J. Myers ◽  
Carol Epling ◽  
John Dement ◽  
Debra Hunt
Keyword(s):  
Blood Loss ◽  
Surgical Procedures ◽  
Body Fluid ◽  
Operating Rooms ◽  
University Hospital ◽  
Operating Room Personnel ◽  
Surgical Equipment ◽  
Glove Perforation ◽  
Estimated Blood Loss ◽  
Duration Of Surgery

Objective.The risk of percutaneous blood and body fluid (BBF) exposures in operating rooms was analyzed with regard to various properties of surgical procedures.Design.Retrospective cohort study.Setting.A single university hospital.Methods.All surgical procedures performed during the period 2001–2002 (n = 60,583) were included in the analysis. Administrative data were linked to allow examination of 389 BBF exposures. Stratified exposure rates were calculated; Poisson regression was used to analyze risk factors. Risk of percutaneous BBF exposure was examined separately for events involving suture needles and events involving other device types.Results.Operating room personnel reported 6.4 BBF exposures per 1,000 surgical procedures (2.6 exposures per 1,000 surgical hours). Exposure rates increased with an increase in estimated blood loss (17.5 exposures per 1,000 procedures with 501–1,000 cc blood loss and 22.5 exposures per 1,000 procedures with >1,000 cc blood loss), increased number of personnel ever working in the surgical field (20.5 exposures per 1,000 procedures with 15 or more personnel ever in the field), and increased surgical procedure duration (13.7 exposures per 1,000 procedures that lasted 4–6 hours, 24.0 exposures per 1,000 procedures that lasted 6 hours or more). Associations were generally stronger for suture needle–related exposures.Conclusions.Our results support the need for prevention programs that are targeted to mitigate the risks for BBF exposure posed by high blood loss during surgery (eg, use of blunt suture needles and a neutral zone for passing surgical equipment) and prolonged duration of surgery (eg, double gloving to defend against the risk of glove perforation associated with long surgery). Further investigation is needed to understand the risks posed by lengthy surgical procedures.

Orthodontic Pre Grafting Closure of Large Alveolar Bony and Soft Tissue Gaps: A Novel Nonsurgical Protraction of the Lesser Segments in Growing Patients With Cleft Lip and Palate

2021 ◽  
pp. 105566562110076
Author(s):  
Maria Costanza Meazzini ◽  
Noah Cohen ◽  
Valeria Marinella Augusta Battista ◽  
Cristina Incorvati ◽  
Federico Biglioli ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Surgical Procedures ◽  
Efficient Method ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Soft Tissues ◽  
Cleft Lip And Palate ◽  
Face Mask ◽  
Younger Patients ◽  
Good Healing

Background: Closure of wide alveolar clefts with large soft tissue gaps and reconstruction of the dentoalveolar defect are challenging for the surgeon. Some authors successfully used interdental segmental distraction, which requires an additional surgical procedure. Objective: This study evaluates the effectiveness of tooth borne devices utilized to orthopedically advance the lesser segments, with a complete approximation of the soft tissue of the alveolar stumps, allowing traditional simultaneous soft tissue closure and bone grafting, and avoiding the need for supplementary surgery. Methods: Eight growing patients, 2 with unilateral complete cleft lip and palate (UCLP) and 6 with bilateral complete cleft lip and palate (BCLP), with large soft tissue and bony alveolar defects prior to bone grafting were prospectively selected. A banded rapid palatal expander (RPE) in BCLP and a modified RPE in UCLP combined with protraction face mask in younger patients or a modified Alt-Ramec in patients older than 12 years were applied. Radiographic and photographic records were available at T0, at the end of protraction (T1) and at least 1 year after bone grafting (T2). Results: Patients with large gaps showed a significant reduction in the bony cleft area and approximation of the soft tissues at T1. All patients received bone grafting with good healing and ossification at T2. Conclusion: In growing patients with UCLP and BCLP with large gaps, presurgical orthodontic protraction seems to be an efficient method to reduce the cleft defect, minimizing the risk of post grafting fistulas, reducing the need for supplementary surgical procedures.

scholarly journals A study of preoperative, intra-operative and postoperative factors responsible for postoperative wound infection

2017 ◽  
Vol 4 (5) ◽  
pp. 1569
Author(s):  
Shobha S. Nisale ◽  
Meghraj Chawada ◽  
Ganesh K. Kharkate ◽  
Sudhir B. Deshmukh
Keyword(s):  
Wound Infection ◽  
Care Center ◽  
Hospital Environment ◽  
Initial Assessment ◽  
Postoperative Wound Infection ◽  
Surgical Wound ◽  
Postoperative Wound ◽  
Health Care Center ◽  
Duration Of Surgery ◽  
Operative Findings

Background: Many factors affect the incidence of surgical wound infection, in addition to the surgeon’s skill and the hospital environment. Host attributes, such as age over 60 years, diabetes mellitus, malignant disease, obesity, malnutrition, length of preoperative stay or pre-existing infection may influence risk, as may such operation characteristics as site, urgency, duration and time of skin shaving. Objective was to study the preoperative, intra-operative and postoperative factors responsible for postoperative wound infection.Methods: This descriptive study was designed to study the problem of postoperative wound infection at tertiary health care center at rural set up over a period of two years during 2014 to 2016. Initial assessment of intra operative findings divided these cases into clean, clean contaminated and contaminated cases.Results: As the length of pre-operative stay increased, the occurrence of SSIs increased. As the duration of post operative hospital stay increased, the occurrence of SSIs also increased. The occurrence of SSI increased as the quality of surgical wound deteriorated. As the duration of surgery increased, the occurrence of SSIs increased. It was found that the order of surgery was not related to occurrence of SSIs. It was found that the rate of SSI was more (21.55%) when the drain was used in comparison to only 8.04% when the drain was not used. The most common organism found to cause SSIs was staphylococcus aureus in 33.07% of cases.Conclusions: Slightly low incidence of SSIs in our study may be attributed to the better infection control practices though it must be concluded that more stringent aseptic measures including rational antibiotic policy will be contributory in lowering the SSI rate further.

scholarly journals Non Descent Vaginal Hysterectomy: A Rational Surgical Approach

KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 637-641
Author(s):  
Arifa Akter Zahan ◽  
Kh Shahnewaz ◽  
Ummay Salma
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Average Duration ◽  
Uterine Prolapse ◽  
Rational Approach ◽  
Medical College ◽  
Gynecological Disorders ◽  
Estimated Blood Loss ◽  
Duration Of Surgery

Aims: To evaluate the rational approach of non-descent vaginal hysterectomy in advancing gynaecology practice.Study Design: Retrospective study and period from 1st July 2013 to 31st June 2014. Setting Kumudini Women's Medical College & Hospital, Mirzapur, Tangail.Patients: All selective patients requiring hysterectomy for benign gynecological disorders who did not have any uterine prolapse were recruited for this study. In bigger size uterus morcellation techniques like bisection, debulking, myomectomy, slicing, or combination of these were used to remove the uterus.Main outcome measures: Data regarding indication, age, parity, uterine size, estimated blood loss, length of operation, complication and hospital stay were recorded.Results: A total of 50 cases were selected for non-descent vaginal hysterectomy all of them successfully underwent non-descent vaginal hysterectomy. Commonest age group was (41-45 years) i.e. 46%. All patients were parous. Uterus size was less then 8 wks 21 cases, 8wks to 12 wks in 27 cases, more then 12 wks 02 cases. Commonest indication was DUB of uterus (44%). Mean duration of surgery was 50.5 minutes. Mean blood loss was 100ml. Blood transfusion was required in four cases. Average duration of hospital stay was 3.1 days. Complications were minimal which included UTI and Vault infection.Conclusions: NDVH is safe feasible and patient friendly. We suggest that our modern gynecologist will be more expertise and familiar to this procedure in near future.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 637-641

Tissue Welding Forceps Usage in Superficial Parotidectomy: A Clinical Assessment

2008 ◽  
Vol 74 (1) ◽  
pp. 51-55
Author(s):  
Randall G. Michel ◽  
Kang Tsau ◽  
Bernard I. Weinstock
Keyword(s):  
Blood Loss ◽  
Blood Vessel ◽  
Surgical Procedures ◽  
Clinical Assessment ◽  
Facial Weakness ◽  
Facial Paresis ◽  
Superficial Parotidectomy ◽  
Safety And Efficacy ◽  
Tissue Welding ◽  
Estimated Blood Loss

Tissue welding forceps (TWF) have been used effectively in a number of surgical procedures including blood vessel harvesting and tonsillectomy. Our objective was to assess the safety and efficacy of TWF usage in superficial parotidectomy. We performed a retrospective review of 25 patients between November 2002 and July 2006 who underwent superficial parotidectomy using TWF. The inpatient and outpatient records were reviewed for diagnosis, operative times, estimated blood loss, and postoperative facial paresis. Only one of the 25 patients (4%) who underwent superficial parotidectomy using TWF had transient postoperative facial weakness and no procedure had blood loss of greater than 150 cc. This initial evaluation suggests that use of TWF is safe in superficial parotidectomy and may help reduce the development of postoperative facial paresis.

scholarly journals The Effectiveness and Safety of Ultrasonic Bone Scalpel Versus Conventional Method in Cervical Laminectomy: A Retrospective Study of 311 Patients

2019 ◽  
Vol 10 (6) ◽  
pp. 760-766
Author(s):  
Bharat R. Dave ◽  
Ajay Krishnan ◽  
Ravi Ranjan Rai ◽  
Devanand Degulmadi ◽  
Shivanand Mayi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Conventional Method ◽  
Nerve Root ◽  
Surgical Complications ◽  
Nerve Root Injury ◽  
Cervical Laminectomy ◽  
C5 Palsy ◽  
Root Injury ◽  
Estimated Blood Loss ◽  
Duration Of Surgery

Study Design: Retrospective cohort study. Objectives: The aim of this study was to compare the results of cervical laminectomy (CL) performed with ultrasonic bone scalpel (UBS) or conventional method (CM). Method: This study comprised 311 CL performed by a single surgeon between January 2004 and December 2017. Group A (GpA) comprised 124 cases of CL performed using UBS, while Group B (GpB) comprised 187 cases of CL performed using CM. These 2 groups were compared in terms of demographic characteristics of patients, duration of surgery, estimated blood loss, and surgical complications. Results: GpA included 112 males and 12 females, mean age being 61.18 years. GpB comprised 166 males and 21 females, mean age being 62.04 years. Mean duration of surgery, estimated blood loss, and length of hospital stay was 65.52/70.87 minutes, 90.24/98.40 mL, and 4.80/4.87 days in GpA and GpB, respectively. Six patients were reported to have dural injuries in each group. In GpA, 2 cases of C5 palsy and 1 nerve root injury was observed, while in GpB, 3 cases of C5 palsy and no nerve root injury was reported. One patient had developed transient neurological deterioration postsurgery in GpA as against 11 patients in GpB. Conclusion: Neurological complications observed in CM leads to intensive care unit admission, additional morbidity, and additional expenditure, whereas UBS provides a safe, rapid, and effective means of performing CL, thereby decreasing the rate of surgical complications and postoperative morbidity.

scholarly journals Investigating Effective Factors on Estimated Hemorrhage Intraoperative in Brain Meningioma Surgery

2020 ◽  
Vol 11 (5) ◽  
pp. 631-638
Author(s):  
Alireza Tabibkhooei ◽  
◽  
Maziar Azar ◽  
Ahmad Alagha ◽  
Javad Jahandideh ◽  
...  
Keyword(s):  
Blood Loss ◽  
Preoperative Imaging ◽  
Intracranial Meningioma ◽  
Cross Sectional ◽  
Estimated Blood Loss ◽  
Duration Of Surgery ◽  
History Of ◽  
Main Determinants ◽  
Magnetic Resonance Imaging Mri ◽  
Meningioma Surgery

Introduction: The primary and definitive diagnosis of meningioma is based on histological assessment; however, employing imaging methods, like Magnetic Resonance Imaging (MRI) is very helpful to describe lesion’s characteristics. Accordingly, we decided to study the effect of imaging factors, like MRI data on the volume of hemorrhage (estimated blood loss) during meningioma surgery. Methods: This was a cross-sectional, retrospective, and analytical study. The eligible patients were those with meningioma who were candidates for surgery. A total of 40 patients with meningioma were selected and assessed. The preoperative imaging findings were recorded, then estimated blood loss during the surgery was determined Results: A reverse association was revealed between the degree of proximity to the nearest sinus and the rate of bleeding. Furthermore, the size of the mass was positively associated with the rate of bleeding; however, there was no significant correlation between the volume of bleeding and other parameters, including the degree of edema, the volume of mass, the site of the tumor in the brain, and the histological subtype of the tumor. The mean time of operation was strongly correlated with blood loss. The rate of bleeding was more expected in hypertensive versus normotensive patients. Conclusion: Bleeding in various volumes could be a frequent finding in intracranial meningioma surgery. Overall, tumor size, the duration of surgery, a history of hypertension, and distance to the nearest sinuses were the main determinants for the severity of hemorrhage in patients undergoing meningioma surgery.

scholarly journals Comparative Study of Occupational Burnout and Job Stress of Frontline and Non-Frontline Healthcare Workers in Hospital Wards during COVID-19 Pandemic

2021 ◽  
Author(s):  
Farnaz Etesam ◽  
Mitra Akhlaghi ◽  
Zahra Vahabi ◽  
Samaneh Akbarpour ◽  
Mohammad Hossein Sadeghian
Keyword(s):  
Job Stress ◽  
Significant Relationship ◽  
Time Pressure ◽  
Care Center ◽  
Maslach Burnout Inventory ◽  
Two Dimensions ◽  
Occupational Burnout ◽  
Factors Affecting ◽  
Center Staff ◽  
Health Care Center

Background: Paying attention to the issue of mental health in the workplace, especially with current pandemic conditions of COVID-19 is of significant importance. Therefore, this study aimed to determine the factors affecting occupational burnout among health care center staff during the pandemic of coronavirus infection. Methods: The present study was a case-control study carried out in the first half of the year 2020 on medical staff working in hospitals in Tehran. The sample size was 324 individuals, including 175 employees working in general (non-COVID) wards and 149 people working in COVID-19 wards. Demographic characteristics questionnaire and two standard questionnaires of Maslach Burnout Inventory and Parker and DeCotiis Job Stress Scale were distributed. Results: Total score of job stress and its two dimensions (time and pressure) had a significant relationship with different levels of occupational burnout. Logistic regression analyses showed significant relations between job stress with emotional exhaustion (95% CI, 1.11-1.19, OR=1.15) and depersonalization. Participants in both wards experienced statistically significant increasing trends given the different components of occupational burnout concurrently by increasing their total stress score. Conclusion: Hospital staff’s levels of stress and occupational burnout regardless of where they worked (COVID-19 wards or general wards) were not significantly different and existed among the members of both groups. On the other hand, job stress and its dimensions (time pressure and anxiety) had a significant relationship with the main dimensions of occupational burnout.

scholarly journals Limiting blood loss in orthognathic surgery with Esmolol as a hypotensive agent

2017 ◽  
Vol 2 (2) ◽  
pp. 86
Author(s):  
Sailesh Kumar Mukul ◽  
Amit Kumar ◽  
Ejaz Ahmad Mokhtar ◽  
Shweta Pandey
Keyword(s):  
Blood Loss ◽  
Surgical Procedures ◽  
Orthognathic Surgery ◽  
Induced Hypotension ◽  
Hypotensive Anesthesia ◽  
Group I ◽  
Anesthesia Group ◽  
Duration Of Surgery ◽  
Group 2 ◽  
Fast Acting

Orthognathic surgery may be complicated by difficulty in achieving hemostasis because unlike soft tissue, the vessels traversing bone cannot be identified and isolated before osteotomy. In this study we evaluated the amount of blood loss and duration of surgery under deliberate hypotensive anesthesia in comparison to amount of blood loss and duration of surgery under normotensive anesthesia on patients undergoing orthognathic surgical procedures. A total of 16 cases undergoing orthognathic surgery were included in this clinical study.Patients were randomly grouped under normotensive (group I) or hypotensive group (group 2). Patients in hypotensive anesthesia group were given Esmolol to maintain mean arterial pressure in the range of 70-80 mm of Hg till osteotomy segments were fixed. There was more than 40% reduction in blood loss in orthognathic surgical procedures when induced hypotension was used, but there was not statistically significant (p=0.91) reduction in the operative time. Based on surgeons and anesthetist’s assessment fast acting agents like Esmolol can be used intraoperatively to induce hypotension as and when required.  

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