The EasyTube during general anesthesia for minor surgery: A randomized, controlled trial.

BACKGROUND: The EasyTube (EzT) is a supraglottic airway device that is used for emergency airway situations. Ventilation during general anesthesia should also be feasible, but literature on the EzT is scarce. We evaluated the EzT in comparison with the endotracheal tube (ETT) in its use during general anesthesia in a comparative study. METHODS: A total of 400 patients with American Society of Anesthesiologists (ASA) physical status I to II scheduled for minor surgery in 4 centers were randomized for ventilation via the ETT or EzT. RESULTS: In all patients, the EzT and the ETT could be inserted within 3 attempts. In all EzT patients, the inspiratory and expiratory minute volumes (6.64 ±â€Š0.71 and 6.34 ±â€Š0.69 L/min) were sufficient to reach target oxygenation values, similar to ETT patients (P  =  .59). Mean peak pressure, mean plateau pressure, and mean dynamic compliance did not differ between the groups. Sore throat and blood on the cuff after removal were the most frequent complications in both groups. CONCLUSION: Ventilation for up to 1 hour during general anesthesia in patients with ASA physical status I to II with the EzT is feasible and safe.

Los cadáveres en fresco, un antiguo modelo quirúrgico en la cirugía general actual / Fresh cadaver, an old surgical model in current general surgery

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Sterile or non-sterile gloves for minor skin excisions?

Non-sterile gloves are just as effective as sterile gloves in preventing surgical site infection after minor skin surgeries.

Comparing non-sterile to sterile gloves for minor surgery: a prospective randomised controlled non-inferiority trial.

OBJECTIVE: To compare the incidence of infection after minor surgery conducted using non-sterile clean boxed gloves with surgery conducted using sterile gloves. DESIGN: Prospective randomised controlled single-centre trial testing for non-inferiority in infection rates. SETTING: Primary care regional centre, Queensland, Australia. PARTICIPANTS: Consecutive patients presenting to participating general practitioners for a minor skin excision, between 30 June 2012 and 28 March 2013, were eligible to participate. INTERVENTION: The use of non-sterile clean boxed gloves was compared with normal treatment using sterile gloves in the control group. MAIN OUTCOME MEASURES: Wound infection, assessed at the time of removal of sutures, and other adverse events. RESULTS: Four hundred and ninety-three consecutive patients presenting for minor skin excisions were randomly allocated to the two treatment groups: non-sterile clean boxed gloves (n = 250) or sterile gloves (n = 243). Four hundred and seventy-eight patients contributed data for analysis (241 non-sterile, 237 sterile gloves). The incidence of infection in the non-sterile gloves group (8.7%; 95% CI, 4.9%-12.6%) was significantly non-inferior compared with the incidence in the control group (9.3%; 95% CI, 7.4%-11.1%). The two-sided 95% CI for the difference in infection rate (- 0.6%) was - 4.0% to 2.9%, and did not reach the predetermined margin of 7% which had been assumed as the non-inferiority limit. RESULTS of the intention-to-treat analysis were confirmed by per-protocol and sensitivity analyses. There were no important adverse effects. CONCLUSION: Our study suggests that in regard to wound infection, non-sterile clean boxed gloves are not inferior to sterile gloves for minor skin excisions in general practice. TRIAL REGISTRATION: ACTRN12612000698875.

Correlación clínico-patológica en cirugía menor en un área de salud rural / Correlation between clinical and histological diagnosisv in minor surgery in a rural health area

Introducción. La cirugía menor forma parte de las actividades programadas en un número cada vez más creciente de nuestros centros de atención primaria. El objetivo de este trabajo es conocer el grado de correlación entre el diagnóstico clínico previo al proceso de cirugía menor y su concordancia con el resultado de anatomía patológica. Material y método. Para ello realizamos un estudio retrospectivo a partir del Registro de Actividades de Cirugía Menor de un Centro de Salud Rural de la Comarca de Valdejalón de Aragón. Sujetos. Se incluyeron 1.231 pacientes atendidos durante el periodo comprendido entre abril de 1999 y julio del año 2009 a los que se realizaron un total de 1.391 diagnósticos con sus correspondientes actuaciones. Mediciones. Diagnóstico clínico y resultado clínico-patológico. Correlaciones entre ambos Resultados Se remitieron 820 piezas para estudio clínico-patológico (el 59% de las intervenidas). Se valoraron los 11 diagnósticos clínicos y clínico-patológicos principales con los que se construyó una tabla de contingencia. Se obtuvo un coeficiente kappa de 0,638 Conclusiones. Analizados estos resultados y comparándolos con otros trabajos similares realizados en el ámbito de la cirugía menor en atención primaria, podemos afirmar que hay una buena correspondencia entre el diagnóstico clínico inicial y los resultados de anatomía patológica (AU)

Introduction. Minor Surgery is an ever-increasing programmed activity in Primary Health Care Centres. The aim of this paper is to determine the relationship between the clinical diagnosis prior to Minor Surgery and its concordance with the histological results. Material and methods. We carried out a retrospective study using the registered activity log in a Primary Health Care Centre in the region of Valdejalón of Aragón. Subjects. A total of 1231 patients were included between April 1999 and June 2009. A total of 1391 diagnoses were given, together with the corresponding medical care. Measurements. Clinical diagnosis and histological results, and the level of correlation between both. Results. A total of 820 samples were submitted for histological study (59% of the total sample). Eleven of the main clinical and histological diagnoses were evaluated, and a contingency table was prepared. The result of the correlation gave a Kappa coefficient of 0.638. Conclusions. Once the results were analysed and compared to similar studies of Minor Surgery carried out in Primary Care, our results confirm that there is a high correlation between the clinical diagnosis and the histological results (AU)

Wrist arthroscopy using a shoulder traction boom.

Overhead boom traction is commonly used in shoulder arthroscopy. In this article, we describe using overhead boom traction in wrist arthroscopy. The advantages are circumferential fluoroscopic access; lack of central post interference with instrumentation; and continuous, uninterrupted traction without need for frequent "dialing up" of traction tower height.

Subcision surgery for the correction of ear deformities.

The authors report the application of subcision surgery to ear deformities for crosscutting and weakening of the deformed cartilage. The subcision techniques for correction of a deformed cartilage are divided into two groups. With the first method, termed "horizontal subcision," a 18-gauge needle is inserted horizontally through a puncture in the skin surface, and multiple passes are made. With the second method, termed "vertical subcision," a sweeping motion of the needle is used for crosscutting of the deformed cartilage. An experimental study was conducted using 10 rabbits (20 ears) to test the authors clinical observations. On the basis of histologic analysis, the authors hypothesized that with the horizontal subcision technique, the sharp edge of the needle damages the perichondrium and weakens the cartilage by creating multiple irregular microincisions. With regard to the vertical incision technique, gross examination showed partial or complete cuts of the cartilage. Subcision surgery was successfully used in eight cases.

Manejo de herida operatoria con apósito oclusivo / Management of operatory wounds using occlusive dressing

Con el propósito de evaluar una alternativa eficaz, sencilla y económica en el manejo de las heridas operatorias, se diseñó un estudio prospectivo y randomizado, comparando el sistema tradicional de curación de heridas, con el uso de un apósito oclusivo que se mantuvo hasta la remoción de los puntos. Ciento cinco pacientes consecutivos, con 110 heridas operatorias limpias o limpias-contaminadas, intervenidos en el Hospital de Quilpué entre junio y septiembre de 1999, se separaron en dos grupos al azar de los cuales 52 recibieron apósito oclusivo y 58 apósito tradicional. El grupo que recibió parche oclusivo tuvo un 5,8 por ciento de complicaciones locales de la herida, mientras que el grupo tradicional tuvo un 10,3 por ciento. El costo intrahospitalario fue de $100 y $2.346 respectivamente. Se demuestra la ventaja del método propuesto en relación a efectividad, costo, tiempo y confort de los pacientes

Urethral calculus extraction using a penile ring block anesthetic.

Urethral calculi are rare and usually originate from the kidney or bladder. Classically, they are extracted endoscopically under anesthesia. We present two cases of impacted distal urethral calculi extracted using a penile ring block and forceps.

Subcutaneous incisionless (subcision) surgery for the correction of depressed scars and wrinkles.

BACKGROUND: A new method of subcuticular underming for the treatment of depressed cutaneous scars and wrinkles is introduced. OBJECTIVE: To define the newly coined term "Subcision" and to describe this minor surgical procedure for treating depressed scars and wrinkles. METHODS: A tri-beveled hypodermic needle is inserted through a puncture in the skin surface (hence, "incisionless" surgery), and its sharp edges are maneuvered under the defect to make subcuticular cuts or "-cisions." RESULTS: The depression is lifted by the releasing action of the procedure, as well as from connective tissue that forms in the course of normal wound healing. CONCLUSION: This technique is useful in treating a variety of cutaneous depressions, including scars and wrinkles.

The diagnostic accuracy of a microlaparoscope.

The performance of microlaparoscopy has been limited until recently. The introduction of a 2-mm laparoscope for diagnostic and minor procedural work may represent a technologic advance. Before such systems are used widely, their diagnostic accuracy must be validated. Twenty patients underwent laparoscopy first with a 2-mm microlaparoscope and then immediately with a 10-mm laparoscope. All cases were videotaped. The fiberoptic system in the 2-mm laparoscope gave pictures of sufficient diagnostic accuracy so that no pathology was missed and minor procedures could be performed.

A simple technique for managing digital mucous cysts.

Digital mucous cysts can be effectively managed by multiple needlings and expression of contents. This simple technique cures about two thirds of the lesions. Most of those remaining are reduced to small asymptomatic nodules.