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This research is a descriptive and cross-sectional study aimed at examining the use of three different scales to assess the risk of pressure injury (PI) in surgical patients. This study was conducted between February 1 and July 1, 2022. The study included patients who had planned surgery in general surgery clinic. The sample size was 388 patients. Patients who agreed to participate in the study were asked to fill out the " Introductory Information Form " and perform a risk assessment using the Braden, Munro and 3S Scales. The statistics program IBM SPSS Statistics 25.0 packaged software was used in the analyses of data. It is evident that the relationship between the scales and the diagnosis of PI, as well as the strength of this relationship, are statistically significant (p < 0.05). The Munro Scale exhibited the highest value of Phi value and validity coefficient c, indicating a stronger association with the diagnosis of PI, thus suggesting its greater effectiveness in discrimination. According to the validity coefficients found, it can be stated that the correct classification percentages for Munro, Braden, and 3S Scales were 91 %, 71 %, and 66 %, respectively. The findings of this study indicate that both the Braden, Munro, and 3S Scales can be used for PI risk assessment in surgical patients, but the Munro Scale exhibits superior predictive validity compared to the Braden and 3S Scales in terms of overall sensitivity and specificity. • The risk of PI in surgical patients should be assessed with a valid and reliable risk assessment tool. • There is no clear evidence regarding which PI risk assessment tool should be used in surgical patients. • Munro and 3S Scale are among the PI risk assessment tools in surgical patients. [ABSTRACT FROM AUTHOR]

Use of anaesthesia is essential in clinical procedures, be it minor or major. Without anaesthesia, the procedure may be technically infeasible. Though the use of anaesthetic drugs help in painless and smooth conduction of medical procedures, yet it is not risk free. There are many factors that influence the performance of anaesthesia and so the associated risks. Among all factors, health of a person has the greatest impact on the performance of anaesthesia. In this study, we computationally analyse the impact of nutritional status of a person on the performance of anaesthesia in terms of required time and quantity. We formulate mathematical equations to relate all the three situations of nutritional status with the performance of anaesthesia. Our experimental results show that under-nutritional status and over-nutritional status have significant impact on the performance of anaesthesia while normal-nutritional status doesn't have much impact (negative or positive). This computational analysis can add an extra flavour to the pre-operative and post-operative preparations and decision making of the clinicians which can mitigate the associated risks. [ABSTRACT FROM AUTHOR]

The present opioid epidemic in the United States is a significant cause for concern in healthcare. In 1995, the concept of pain was introduced as the fifth vital sign. Since then, the sales of opioids have increased dramatically, as have the number of opioid deaths. The misuse and diversion of retained opioids following surgical procedures contribute to the problem. The objective of this project was to review the latest scholarly work and evaluate the findings related to patient education and disposal of opioid medications to decrease opioid misuse and increase disposal. A systematic review. The systematic search strategy included PubMed, Ovid Technologies (OVID), and Cumulative Index of Nursing and Allied Health Literature (CINAHL) electronic databases. A total of 4 randomized controlled trials (RCTs), 2 quasi-experimental studies, and 2 quality improvement projects met the criteria for inclusion. The studies found that as many as 92% of patients had leftover unused opioids. The retention rate of opioids among surgical patients was found to be 33 to 95%. When educational material was provided about disposal, the studies found that the disposal rate was as high as 71%. Patient education about opioid misuse, diversion, and disposal are essential topics that need to be addressed with patients and caregivers. [ABSTRACT FROM AUTHOR]

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The objective for the present study was to compare the collapsibility (IcIVC) and distensibility (IdIVC) indices of the inferior vena cava with pulse pressure variation (PPV) and determine the accuracy and cutoff points of IcIVC and IdIVC that best predict response to intravenous fluid therapy in surgical patients. Observational, prospective, nonblinded, single center. Hospital do Servidor Público Estadual de São Paulo, in São Paulo, Brazil. Volunteer surgical patients. This prospective study evaluated adult surgical patients before and after they underwent mechanical ventilation. IcIVC and IdIVC measurements were obtained with echocardiography and PPV through arterial catheterization. Twenty-two patients with a mean age of 55.7 ± 10.9 years were included; 31.8% of the study participants had PPV values >13% and were shown to be responsive to fluid. A good correlation was detected between PPV and icIVC (R2 = 0.71; p < 0.001) and between PPV and idIVC (R2 = 0.79; p < 0.001). The area under the receiver operating characteristic curve was 0.98 for icIVC (95% confidence interval 0.81-0.99; p < 0.001) and 0.88 for idIVC (95% confidence interval 0.67-0.98; p < 0.001). PPV was found to have good correlation with the inferior vena cava diameter variation using echocardiography in surgical patients undergoing spontaneous and artificial ventilation. The cutoff values that best predicted PPV >13% were >40% for icIVC and >17.6% for idIVC. [ABSTRACT FROM AUTHOR]

To evaluate the following question: In adult surgical patients, does the use of aromatherapy affect the incidence of nausea and vomiting postoperatively? Systematic review of research focusing on aromatherapy and the effect on postoperative nausea and vomiting (PONV) in adult surgical patients. A search of Medline, PubMed, Cumulative Index of Nursing and Allied Literature, and Cochrane Database of Systematic Reviews using specific inclusion and exclusion criteria yielded five randomized controlled trials. The overall synthesis of evidence supports the use of aromatherapy in PONV. Aromatherapy has a positive effect on PONV, and therefore should be considered as a complementary therapy or as an adjunct to antiemetic medications. Aromatherapy is one modality that should be considered as treatment for PONV in adult surgical patients. More research should be conducted to provide additional support in the use of aromatherapy for PONV. Future research could aim at standardizing a nausea scale that would provide more reliable and valid results in studies that research PONV. [ABSTRACT FROM AUTHOR]

Objective: To compare Bhumibol Nutrition Triage (BNT) to Subjective Global Assessment (SGA) in surgical patients. Study design: diagnostic test. Subjects: A total of 200 patients admitted to the general surgical units, Bangkok Metropolitan Administration (BMA) Medical College and Vajira Hospital between January and June 2008. Methods: The nutritional status was evaluated by BNT and SGA in term of score. Age, sex and diseases were also recorded. Main outcome measures: sensitivity, specificity and 95% confidence interval. Results: A total of 200 patients with mean age of 50.5 ± 11.5 years old were recruited. Thirty six percent of them were male while 64% were female. The most common diseases were hepatobiliary disease (20.0%) and large bowel malignancy (16.0%). Prevalence of malnutrition was 44.5% including mild-moderate malnutrition 35.0% and severe malnutrition 9.5%. The BNT score ≥ 4 had 78.7% sensitivity (95% CI, 73.0-84.3%) and 86.5% specificity (95% CI, 81.8-91.2%) to detect malnutrition. Conclusion: Bhumibol nutritional screening tool is a simple and effective screening tool for detecting malnutrition in surgical patients. [ABSTRACT FROM AUTHOR]

Objective: The study describes the clinical characteristics, bacteriology and risk factors for mortality of patients with necrotizing fasciitis (NF), seen in a university medical centre. Methods: The medical charts of NF patients admitted to the institution from January 2004 to July 2007 were retrieved and reviewed retrospectively. Results: The majority of the 67 patients included in the study presented with localized nonspecific inflammatory manifestations: tenderness (94%), warmth (86%), oedema (76%), skin necrosis (75%), and ulceration (68%). Diabetes mellitus (22%) was the most common predisposing medical condition. The most frequent isolates were Escherichia coli (44%), Acinetobacter baumannii (19%), Staphylococcus aureus (15%) and Enterococcus faecium (15%). Overall mortality rate was 36%. Risk factors significantly associated with mortality were truncal involvement (p = 0.034), leukocytosis (p = 0.038), acidosis (p = 0.001), hypoalbuminaemia (p = 0.004), hypocalcaemia (p = 0.000) and hyponatraemia (p = 0.023). Logistic regression analysis revealed acidosis [p < 0.05, odds ratio (OR) = 9] and hypoalbuminaemia (p < 0.05, OR = 14) as significant independent risk factors for mortality. Conclusion: The identified risk factors can inform clinicians of increased mortality risks for certain patients with NF. They should serve as a trigger for more aggressive surgical and critical care, and antimicrobial therapy for these patients. [Copyright &y& Elsevier]

Abstract: Optimization is the process by which blood flow and oxygen delivery to tissues are maximized in high-risk surgical patients. Optimization requires careful attention to stabilization and functional improvement in premorbid conditions (e.g. congestive cardiac failure, chronic obstructive pulmonary disease) and a programmed increase in available tissue oxygenation in the hours before, during and after surgery. Optimization reduces morbidity, mortality and length of hospital stay. [Copyright &y& Elsevier]