0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
This Month in Archives of Surgery |

This Month in Archives of Surgery FREE

[+] Author Affiliations

Section Editor: Gerald W Peskin, MD


Arch Surg. 2002;137(3):249. doi:10.1001/archsurg.137.3.249.
Text Size: A A A
Published online

LITTLE GEMS

To assist with your constant desire to improve clinical services, we offer a number of suggestions to mull over and perhaps apply to your current techniques in the way of modification.

First, a Mayo Clinic studyArticleexamines intramural small-bowel hematoma, presenting in many instances as bowel obstruction. The series of cases emphasizes the benign nature of this entity and the conservative treatment following computed tomographic scan.

Second, a randomized controlled studyArticleof the use of polymeric sealant as a means of rapidly stopping bleeding from suture holes at anastomotic sites of graft material in vascular surgery presents another interesting and time-saving idea.

Third, a comparison of matrix excision and segmental phenolization is made for treatment of ingrown toenailsArticle. The authors point out their preference in treatment because the results indicate no real difference between arms of the protocol.

Finally, an interesting study of 40 patients has been performed to evaluate stapled vs excision hemorrhoidectomy. The benefits for the stapled group include shorter operating time, less postoperative pain, and earlier return to work with no overall difference in recurrence. The authors point out that if this is confirmed in a larger, longer study, stapling (Longo technique) may become the standard for treatment of third-degree hemorrhoid disease.

See Article

MELANOMA REVISITED

Hetzer et al point out that thick melanomas (Breslow >4 mm) with no positive nodes have a reasonably favorable prognosis (median overall survival of 70 months and disease-free survival of 51 months) before the era of adjuvant chemotherapy. Thus, the authors conclude that thickness of the melanoma itself should not be used as a criterion for adjuvant therapy but that other factors of prognosis should be considered (150 patients, node negative).

See Article

EFFECTIVE PREVENTION OF ADHESIONS WITH HYALURONIC SODIUM

The surgical world is looking for relief from the consequences of adhesion formation after mesh is placed to bridge a peritoneal defect. Kramer et al have suggested a bioresorbant membrane of hyaluronic acid as a mesh covering to prevent intra-abdominal adhesions. In an animal series, a very significant difference was noted in both the number and severity of adhesions when the bioresorbant membrane was used to conceal the mesh in the course of laparoscopic hernia repair. Studies in humans initially support the animal conclusions.

See Article

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.