0000000001145058
AUTHOR
Julio Villanueva
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, r…
Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries
© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods: First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assess…
Systematic mapping review of interventions to prevent blood loss, infection and relapse in orthognathic surgery
This systematic mapping review aims to identify, describe, and organize the currently available evidence in systematic reviews (SR) and primary studies regarding orthognathic surgery (OS) co-interventions and surgical modalities, focusing on the outcomes blood loss, infection and relapse. A comprehensive search strategy was performed to identify all SRs, randomized controlled trials and observational studies that evaluate surgical modalities and perioperative co-interventions in OS that evaluate the outcomes blood loss, infection and relapse, regardless of language or publication date. Searches were conducted in MEDLINE, EMBASE, Epistemonikos, Lilacs, Web of Science, and CENTRAL. In additio…
Antiplatelet therapy in patients undergoing oral surgery: A systematic review and meta-analysis.
Background The number of patients under antiplatelet therapy (APT) continues to raise as current recommendations foster this practice. Although some recommendations to manage this treatment during oral surgery procedures exist, these have methodological shortcomings that preclude them from being conclusive. Material and Methods A systematic review and meta-analysis of the best current evidence was carried out; The Cochrane Library, EMBASE and MEDLINE databases were searched for Randomized Controlled Trials (RCT) concerning patients undergoing oral surgery with APT, other relevant sources were searched manually. Results 5 RCTs met the Inclusion criteria. No clear tendency was observed (RR= 0…
Odontogenic calcificant cystic tumor : a report of two clinical cases
Odontogenic Calcificant Cystic Tumor (OCCT) is an infrequent injury. It arises from odontogenic epithelial rests present in the maxilla, jaw or gum. Gorlin and col. described the OCCT for first time as an own pathological entity in 1962. Clinically, the OCCT represents 1% of the odontogenic injuries. It is possible to be found from the first decade to the eighth decade. It affects in same proportion the maxilla and the jaw, being the most common in the dented zones, with greater incidence in the first molar area. Two case reports of OCCT in two different ages, both in female individuals, one at 5 years old and the other at 35 years old are presented. Enucleation of the tumor was the treatme…
SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study
SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 da…
Infectious postoperative complications in oral surgery. An observational study
Background The main objective of this investigation was to determine the incidence of infectious postoperative complications in oral surgery. Material and methods A observational and descriptive study was developed, with the use of prospective registry of the patients admitted for oral surgery at the San Borja Arriaran Hospital Complex during twelve months observation period (April 2017 to March 2018). Results The sample consisted of 532 patients undergoing surgical procedures of oral surgery and 19 cases of infectious postoperative complications. The incidence of complications reached 3,57% and it was observed predominantly in exodontic type interventions. The most commonly observed compli…
Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study
We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26…
Osteocondroma de apófisis coronoides
El osteocondroma es la neoplasia benigna más común del esqueleto. En la cabeza se ha descrito su localización en base de cráneo, cara posterior del maxilar, senos maxilares, y en diferentes áreas de la mandíbula, como cóndilo, rama, cuerpo y región sinfisiaria, siendo los osteocondromas coronoídeos de baja frecuencia. Presentamos una revisión de la literatura y el informe de un nuevo caso. Una mujer de 44 años que consulta por limitación de la apertura bucal y deformidad en la mejilla izquierda, de límites difusos, consistencia ósea, indolora y cubierta por piel de aspecto normal. No presentaba patología en la articulación témporomandibular. En la radiografía panorámica se evidencia un tumo…
Osteochondroma of the coronoid process
El osteocondroma es la neoplasia benigna más común del esqueleto. En la cabeza se ha descrito su localización en base de cráneo, cara posterior del maxilar, senos maxilares, y en diferentes áreas de la mandíbula, como cóndilo, rama, cuerpo y región sinfisiaria, siendo los osteocondromas coronoídeos de baja frecuencia. Presentamos una revisión de la literatura y el informe de un nuevo caso. Una mujer de 44 años que consulta por limitación de la apertura bucal y deformidad en la mejilla izquierda, de límites difusos, consistencia ósea, indolora y cubierta por piel de aspecto normal. No presentaba patología en la articulación témporomandibular. En la radiografía panorámica se evidencia un tumo…
Effect of antibiotic prophylaxis for preventing infectious complications following impacted mandibular third molar surgery. A randomized controlled trial
Background The objective of this study was to determine the effect of antibiotic prophylaxis in preventing postoperative infections after extraction of impacted mandibular third molars. Material and Methods A Parallel-group, randomized, blind, placebo-controlled trial was performed. 154 patients were randomly allocated to 2 groups; experimental (n=77) receiving 2g amoxicillin 1 hour prior to surgery and control (n=77) receiving placebo. Primary outcome was postoperative infections and secondary outcome was the need for rescue analgesia. Results 4.5% of patients developed postoperative infections, five patients of the control group (4 alveolar osteitis, 1 surgical site infection) and two of …