Surgery Research and Practice
 Journal metrics
See full report
Acceptance rate5%
Submission to final decision119 days
Acceptance to publication12 days
CiteScore-
Journal Citation Indicator-
Impact Factor-

Porous Cage Macro-Topography Improves Early Fusion Rates in Anterior Cervical Discectomy and Fusion

Read the full article

 Journal profile

Surgery Research and Practice provides a forum for surgeons and the surgical research community. The journal focuses on clinical and laboratory research relevant to surgical practice and teaching.

 Editor spotlight

Surgery Research and Practice maintains an Editorial Board of practicing researchers from around the world, to ensure manuscripts are handled by editors who are experts in the field of study.

 Abstracting and Indexing

This journal's articles appear in a wide range of abstracting and indexing databases, and are covered by numerous other services that aid discovery and access. Find out more about where and how the content of this journal is available.

Latest Articles

More articles
Research Article

Impact of Short-Term Weight Loss on Hemostasis and Thrombosis after Bariatric Surgery

Introduction. Obesity causes thrombophilia and many coagulation problems related to slowing the capillary flow. We aimed to evaluate rapid weight loss outcomes in the early period after bariatric surgery on the coagulation system. Materials and Method. A prospective study enrolled 28 patients with a BMI > 40 kg/m2 who underwent bariatric surgery. Preoperative and postoperative (first and third months) demographic criteria—such as age, gender, weight, height, and alcohol and tobacco use, and biochemical parameters such as PLT, PT, aPTT, INR, bleeding time, coagulation time, fibrinogen, D-dimer, albumin, calcium, ionized calcium, vitamin D, and PTH—were analyzed. Results. We found that both bleeding and thrombotic parameters increase in early-slowing surgery. The first-month platelet levels were significantly different from the preoperative values ( < 0.001). The prothrombin time in the first ( < 0.001) and third months ( < 0.009) was also comparable. The PTT in the first month was higher than in the preoperative period ( < 0.011). INR in the first month ( < 0.001) was higher than that in the preoperative period and the third month ( = 0.007) value was higher than in the first month. In terms of fibrinogen levels, all parameters indicated statistical significance within each other; preoperative to the first month ( < 0.001), the first month to the third month ( < 0.016). Third-month D-dimer levels were lower than the first month’s values ( = 0.032). Conclusion. Thromboembolic events have crucial importance in the converse scenario of haemorrhagic diathesis during the first months of bariatric surgery. Vitamin support and antithrombotic agents may be recommended in the early postoperative period.

Research Article

Standardized Protocol for Chest Tube Management for Trauma Patients Significantly Decreases Complications

Background. As health care shifts to a value-based model with a focus on patient outcomes per dollar spent, it is important to develop and evaluate standardized protocols that ultimately lead to improved patient outcomes and decreased hospital complications. Prior to our chest tube protocol, chest tube management at our Trauma Center was nonuniform and surgeon-specific. The aim of this study was to (1) develop an institutional standardized protocol for chest tube management at our Level II Trauma Center and (2) compare patient outcomes before and after the implementation of our protocol. Methods. An institutional, standardized protocol was initiated at our Level II-Certified Trauma Center teaching hospital in 2014. An IRB-approved, single-institution retrospective chart review was performed between January 2011 and May 2017, in order to capture the 3 years prior and 3 years after protocol implementation. All patients with a diagnosis of hemothorax or pneumothorax (H/PTX) from blunt or penetrating trauma that resulted in a >24 French chest tube placement were included in the study. Patients were excluded if interventional radiology (IR) placed the chest tube, the mechanism was nontraumatic, or the patient expired at index hospitalization. Univariate analyses were performed to evaluate significant differences in patient outcomes before and after the implementation of the protocol. Results. A total of 143 patients were analyzed for this study, with 43 preprotocol patients and 100 postprotocol patients. Hospital length of stay (LOS), persistent H/PTX, and the need for further surgical intervention all improved after the implementation of the standardized protocol ( < 0.04). Conclusions. Our standardized protocol for chest tube management at our Level II Trauma Center significantly improved patient outcomes and can serve as a model for similar institutions.

Research Article

How Efficient Are Isolation Protocols? Outcome of Isolation Protocol in Surgery during COVID-19 Pandemic: A Single Institute Experience

Background. The timing of screening for SARS-CoV-2 preoperatively by RT-PCR/CBNAAT, isolation protocols in preoperative wards, operation theatres, and postoperative wards are not well established. Methods. Evaluating the effectiveness of maintaining three pathways of two COVID-19 negative pathways (1) immediate testing pathway (2) isolation, or quarantine for five days and testing prior to surgery pathway, and (3) the tested COVID-19-positive pathway, was the aim of the study. The primary objective was to assess the utility and outcome of the two COVID-19 negative pathways adopted before surgery in terms of infectivity (seroconversion; COVID-19 positivity rate before surgery and symptomatic COVID-19 disease after surgery). The secondary objective was to derive a practical protocol for isolation or quarantine for emergency and elective surgery. Enrolled patients were grouped based on the need for surgery; Group-1 emergency basis, Group-2 urgent basis, and Group-3 COVID-19 positive and the three channels were kept separate with separate dedicated healthcare staff for each channel. Results. There were 199 (4.56%) COVID-19-positive patients, of whom 80 (40%) were operated. COVID-19 positivity rate was low in Group 2 (3% vs. Group 1, 11%). There was no seroconversion from negative to positive in our patients during the peri-operative period. Conclusion. COVID-19 positivity rate in Group-2 was significantly less. None of the COVID-19-negative patients turned symptomatic and the probability of seroconversion from COVID-19-negative was less during the peri-operative period. The isolation protocol of non-COVID-19 positive patients with the separate channel is effective.

Research Article

Management of Blunt Sternal Fractures in a Community-Based Hospital

Background. Sternal fractures are not commonly observed in patients with blunt trauma. The routine use of computed tomography (CT) in the evaluation of chest trauma helps identify these fractures. We studied the incidence, injury mechanism, management, and outcome of sternal fractures in patients with blunt trauma treated at our community-based hospital. Methods. We retrospectively reviewed the chest CT scans of all patients with blunt trauma who were presented to our community-based hospital from October 2010 to March 2019. The study variables included age at the time of injury, sex, mechanism of injury, type, and site of fracture, associated injuries, Glasgow Coma Scale, Injury Severity Score, need for intensive care unit admission, hospital stay, and long-term outcome. Results. In total, 5632 patients with blunt trauma presented to our hospital during the study period, and chest CT scan was performed for 2578 patients. Sternal fractures were diagnosed in 63 patients. The primary mechanism of injury was a motor vehicle collision. The most common site of fracture was the body of the sternum (47 patients; 74.6%). Twenty (31.7%) patients had an isolated sternal fracture with no other injuries. Seven (11.1%) patients were discharged directly from the emergency department. Two patients died (overall mortality rate, 3.2%) and two experienced long-term disability. Conclusions. The incidence of sternal fractures in our patient population was similar to that reported by tertiary hospitals. Patients with a sternal fracture and normal cardiac enzyme levels and electrocardiogram may be safely discharged from the emergency department, provided there are no other major injuries.

Research Article

Short Term Outcomes of Open and Minimally Invasive Approaches to Segmental Colectomy for Benign Colovesical Fistula

Background. We speculated that a minimally invasive (MIS) colectomy for colovesical fistula is associated with less morbidity compared to an open colectomy. Methods. Multivariate analysis using logistic regression was used to investigate the outcomes of patients who underwent colectomy for benign colovesical fistula during 2012–2017 by surgical approach using the NSQIP database. Results. We identified 748 patients underwent partial colectomy for benign colovesical fistula during 2012–2017. Surgeons used the MIS approach in 72.7% of operations, with a conversion rate of 13.1%. The MIS approach was associated with lower morbidity (27.4% vs. 43.1%, AOR: 0.46, ) compared to the open approach. The mean operation duration was longer in MIS operations compared to open (225 min vs. 201 min, ). The robotic approach to colectomy showed no significant difference in morbidity (28.4% vs. 27.2%, ) but a decrease in conversion rate (8.1% vs. 13.8%, ) and an increase in operation length (249 min vs. 222 min, mean difference: 27 min, ) compared to a laparoscopic approach. There was no significant difference in the anastomotic leak rate between MIS and open approaches (3.7% vs. 5.4%, ) and between laparoscopic and robotic approaches (2.8% vs. 3.8%, ). Conclusions. We found a 72.7% utilization rate of MIS approach to colectomy for benign colovesical fistula in the NSQIP hospitals with a 13.6% conversion rate. Patients with MIS approach had significantly lower morbidity compared to open. A robotic approach to partial colectomy has the same morbidity risk with a decreased conversion rate compared to laparoscopic approach.

Research Article

Efficacy of Prophylactic Negative-Pressure Wound Therapy with Delayed Primary Closure for Contaminated Abdominal Wounds

Background. Prophylactic negative-pressure wound therapy (NPWT) to prevent surgical site infection (SSI) may be effective for severely contaminated wounds. We investigated the safety and efficacy of NPWT with delayed primary closure (DPC) for preventing SSI. Methods. For patients with contaminated and dirty/infected surgical wounds after an emergency laparotomy, the abdominal fascia was closed with antibacterial absorbent threads and the skin was left open. Negative pressure (−80 mmHg) was applied through the polyurethane foam, which was replaced on postoperative days 3 and 7. DPC was performed when sufficient granulation was observed. The duration and adverse events of NPWT, the development of SSI, and the postoperative hospital stay were retrospectively reviewed. Results. We analyzed the cases of patients with contaminated (n = 15) and dirty/infected wounds (n = 7). The median duration of NPWT was 7 days (range 5–11 days). NPWT was discontinued in one (4.5%) patient due to wound traction pain. SSI developed in seven patients (31.8%), with incisional SSI in one (4.5%) and organ/space SSI in six (27.3%). The median postoperative hospital stay was 17 days (range 7–91 days). There was no significant relationship between postoperative hospital stay and wound classification () or type of SSI (). Conclusion. Prophylactic NPWT with DPC was feasible and may be particularly suitable for severely contaminated wounds, with a low incidence of incisional SSI.

Surgery Research and Practice
 Journal metrics
See full report
Acceptance rate5%
Submission to final decision119 days
Acceptance to publication12 days
CiteScore-
Journal Citation Indicator-
Impact Factor-
 Submit Check your manuscript for errors before submitting

Article of the Year Award: Impactful research contributions of 2022, as selected by our Chief Editors. Discover the winning articles.