it's safe to say that for babies with uncomplicated gastrochesis, it's safe to start feeding immediately after closure. And if they're tolerating for a few days and have even one bout of emesis, it's okay to continue with the feeding protocol.
it's safe to say that outpatient management of intersusception after air enema reduction results in a shorter hospital stay with no difference in the rate of returns to the emergency department, recurrence, need for an operation, or mortality.
it's safe to say that for babies with uncomplicated gastrochesis, it's safe to start feeding immediately after closure. And if they're tolerating for a few days and have even one bout of emesis, it's okay to continue with the feeding protocol.
it's safe to say that outpatient management of intersusception after air enema reduction results in a shorter hospital stay with no difference in the rate of returns to the emergency department, recurrence, need for an operation, or mortality.
it's safe to say that for babies with uncomplicated gastrochesis, it's safe to start feeding immediately after closure. And if they're tolerating for a few days and have even one bout of emesis, it's okay to continue with the feeding protocol.
it's safe to say that outpatient management of intersusception after air enema reduction results in a shorter hospital stay with no difference in the rate of returns to the emergency department, recurrence, need for an operation, or mortality.
quoteHello pediatric surgery family. I'm M. Tombash, a research fellow from Cincinnati Children's Hospital Medical Center. And along with StayCurrent, we are sharing knowledge to improve child health around the globe.↗
Update Course Rewind: 2022 Top Ten Key Takeaways
▶Ep 31 · 0:00
quoteCincinnati Children's and State Current are sharing knowledge to improve child health around the globe.↗
▶Ep 31 · 0:10
quoteHi everyone, I'm M. Tom Bash, a research fellow at Cincinnati Children's Hospital Medical Center.↗
▶Ep 31 · 1:00
clinicalInfants with gastroschisis often require prolonged hospitalization for surgical repair and then initiation and advancement of feeds↗
▶Ep 31 · 2:30
guidelineFor babies with uncomplicated gastroschisis, feeds can be started immediately after sutureless abdominal closure, beginning with 10 to 20 milliliters per kilogram per day with advancements of 20 milliliters per kilogram per day if tolerated↗
▶Ep 31 · 3:00
clinicalImmediate feeding after gastroschisis closure has been shown to be associated with shorter length of stay and faster attainment of goal feeds↗
▶Ep 31 · 3:30
quoteit's safe to say that for babies with uncomplicated gastrochesis, it's safe to start feeding immediately after closure. And if they're tolerating for a few days and have even one bout of emesis, it's okay to continue with the feeding protocol.↗
▶Ep 31 · 3:30
guidelineFor babies with uncomplicated gastroschisis tolerating feeds for a few days, it is okay to continue with the feeding protocol even after one bout of emesis↗
▶Ep 31 · 5:00
clinicalHigh resolution esophageal manometry, esophagography, and endoscopy can help determine the diagnosis of congenital esophageal stenosis↗
▶Ep 31 · 5:30
guidelineSurgical resection for congenital esophageal stenosis can be reserved for patients where serial dilatations are unsuccessful or there is concern for cartilaginous component↗
▶Ep 31 · 5:30
guidelineSerial dilatations may be used to manage congenital esophageal stenosis if there is no cartilage component suspected in the stenotic area↗
▶Ep 31 · 5:30
quoteinitial conservative management should be considered for patients with congenital esophageal stenosis, especially if a cartilagenous component is not suspected.↗
▶Ep 31 · 7:30
epidemiologicalA systematic review and meta-analysis found that overall recurrence rates and recurrences within 24 and 48 hours of intussusception were similar between inpatient and outpatient management groups after enema reduction↗
▶Ep 31 · 8:00
epidemiologicalBoth inpatient and outpatient groups had similar rates of requiring operative intervention after intussusception reduction↗
▶Ep 31 · 8:00
epidemiologicalThere was no significant difference in the rate of return to the emergency department between inpatient and outpatient management of intussusception after enema reduction↗
▶Ep 31 · 8:30
clinicalOutpatient management of intussusception after air enema reduction results in a shorter hospital stay with no difference in rate of returns to emergency department, recurrence, need for operation, or mortality↗
▶Ep 31 · 8:30
quoteit's safe to say that outpatient management of intersusception after air enema reduction results in a shorter hospital stay with no difference in the rate of returns to the emergency department, recurrence, need for an operation, or mortality.↗
▶Ep 31 · 9:30
epidemiologicalThere is no compelling evidence in pediatric or adult literature to support mechanical bowel preparation for reducing surgical site infections in colorectal surgery↗
▶Ep 31 · 10:00
epidemiologicalRecent adult studies have shown no benefit from mechanical bowel preparation in terms of reducing surgical site infections, and some studies showed an increase in wound infections↗
▶Ep 31 · 10:30
guidelineCase appropriate pre-operative IV antibiotics may reduce surgical site infection incidents in colorectal operations↗
▶Ep 31 · 10:30
quotewe have seen no benefit of mechanical bowel preparations for reducing SSIs. However, case appropriate pre-operative IV antibiotics may reduce SSI incidents.↗
▶Ep 31 · 11:30
quotefirearms are now the leading cause of death in all children and adolescence in the United States, overtaking motor vehicle crashes in 2019.↗
▶Ep 31 · 11:30
epidemiologicalFirearms are now the leading cause of death in all children and adolescents in the United States, overtaking motor vehicle crashes in 2019↗
▶Ep 31 · 12:00
quoteWe believe as pediatric surgeons that we need to advocate with protecting children's health and well-being, no matter what the topic is.↗
▶Ep 31 · 14:00
clinicalLow-dose non-contrast CT of the chest has high sensitivity and specificity for identification of airway foreign bodies↗
▶Ep 31 · 14:30
clinicalCT bronchoscopy can avoid the cost and resources of taking a child to the operating room for a non-therapeutic bronchoscopy procedure↗
▶Ep 31 · 16:00
epidemiologicalDeath or neurodevelopmental impairment occurred in 69% of patients with necrotizing enterocolitis who underwent initial laparotomy versus 85% of those who underwent initial peritoneal drainage↗
▶Ep 31 · 16:30
epidemiologicalA prospective randomized cohort study showed no difference in overall survival between laparotomy and peritoneal drainage for necrotizing enterocolitis, but did show improved long-term neurodevelopmental outcomes with laparotomy↗
▶Ep 31 · 18:00
opinionRacism and sexism that manifest as microaggressions are commonly experienced by members of minority groups in medical settings↗
▶Ep 31 · 18:30
opinionMicroaggressions can harm trainees's performance and sense of belonging↗
▶Ep 31 · 18:30
quoteBystanders can and should make an effort to become upstanders, which means bystanders who respond with action.↗
▶Ep 31 · 20:00
epidemiologicalIn a 10-year retrospective review of isolated traumatic skull fractures with normal neurologic exam findings, 77% of patients were admitted for observation but none needed neurosurgical intervention or additional imaging during the index admission↗
▶Ep 31 · 20:30
clinicalPediatric isolated skull fractures are low risk conditions with a low likelihood of complications and can be discharged safely from the emergency department without inpatient observation↗
▶Ep 31 · 22:00
epidemiologicalIn the IMPACT trial, patients with perforated appendicitis taking piperacillin-tazobactam had lower incidence of intra-abdominal abscesses, lower usage of CT scans, and fewer ED revisits compared to ceftriaxone and metronidazole combination therapy↗
▶Ep 31 · 22:30
quotemonotherapy with piperacilin and tazobactam has been shown to be associated with decreased incidence of intra-abdominal abscesses after surgery for patients with perforated appendicitis.↗
▶Ep 31 · 22:30
epidemiologicalPiperacillin-tazobactam monotherapy did not have an increase in antibiotic usage or increase in antibiotic related complications compared to combination therapy↗
clinicalWounds with tissue adhesive had poorer cosmesis at six weeks↗
▶Ep 138 · 4:25
clinicalThe cosmesis difference between tissue adhesive and other closure methods was gone by six months↗
▶Ep 138 · 4:35
clinicalThere was no difference between the three closure groups at six months for clinicians or for parents↗
Quick Literature Updates Episode 10
▶Ep 143 · 0:00
quoteHello Pediatric Surgery family. I'm M. Tumbush, a research fellow from Cincinnati Children's Hospital Medical Center. And along with Stakern, we are sharing knowledge to improve child health around the globe.↗
▶Ep 143 · 1:21
clinicalThe bleeding study compared patients presenting with traumatic bleeding, operative bleeding, and medical bleeding↗
▶Ep 143 · 2:16
quoteThey found that children in the high compliance group had a statistically significant decrease in rates of superficial surgical site infection when compared to children in the low compliance group.↗
▶Ep 143 · 2:16
opinionStandardization of perioperative care may decrease morbidity and improve outcomes in colorectal surgery↗
▶Ep 143 · 2:16
clinicalChildren in the high compliance group had a statistically significant decrease in rates of superficial surgical site infection when compared to children in the low compliance group↗
▶Ep 143 · 3:29
quoteSo, it seems that contrast enema prior to stoma reversal is only useful if patients had neck.↗
▶Ep 143 · 3:29
opinionContrast enema prior to stoma reversal is only useful if patients had necrotizing enterocolitis↗
Journal of Pediatric Surgery Article Review: May 2023, CAPS Issue
▶Ep 144 · 0:36
quoteCAPS is the Canadian Association of Pediatric Surgeons.↗
▶Ep 144 · 4:32
epidemiologicalThe COVID-19 study assessed patients from February 2018 to June 2019 as pre-pandemic control and mid-February 2020 to June 2021 as COVID period↗
▶Ep 144 · 4:55
epidemiologicalA larger proportion of complicated appendicitis occurred during COVID-19 compared to pre-pandemic period↗
▶Ep 144 · 4:55
epidemiological1100 patients total: 44% in pre-pandemic group, 56% in COVID-19 group↗
▶Ep 144 · 5:28
epidemiologicalSymptom duration at presentation and length of stay were not significantly different between pre-pandemic and COVID groups↗
epidemiologicalMalrotation occurs in about 1 in 200 to 500 live births↗
▶Ep 48 · 8:33
clinicalYou can have malrotation without midgut volvulus, but you cannot have midgut volvulus without malrotation↗
Quick Literature Updates Episode 6
▶Ep 49 · 0:00
quoteHello pediatric surgery family. I'm M. Tombash, a research fellow from Cincinnati Children's Hospital Medical Center. And along with StayCurrent, we are sharing knowledge to improve child health around the globe.↗
Update Course Rewind: 2022 Top Ten Key Takeaways
▶Ep 50 · 0:00
quoteCincinnati Children's and State Current are sharing knowledge to improve child health around the globe.↗
▶Ep 50 · 0:10
quoteHi everyone, I'm M. Tom Bash, a research fellow at Cincinnati Children's Hospital Medical Center.↗
▶Ep 50 · 1:00
clinicalInfants with gastroschisis often require prolonged hospitalization for surgical repair and then initiation and advancement of feeds↗
▶Ep 50 · 2:30
guidelineFor babies with uncomplicated gastroschisis, feeds can be started immediately after sutureless abdominal closure, beginning with 10 to 20 milliliters per kilogram per day with advancements of 20 milliliters per kilogram per day if tolerated↗
▶Ep 50 · 3:00
clinicalImmediate feeding after gastroschisis closure has been shown to be associated with shorter length of stay and faster attainment of goal feeds↗
▶Ep 50 · 3:30
quoteit's safe to say that for babies with uncomplicated gastrochesis, it's safe to start feeding immediately after closure. And if they're tolerating for a few days and have even one bout of emesis, it's okay to continue with the feeding protocol.↗
▶Ep 50 · 3:30
guidelineFor babies with uncomplicated gastroschisis tolerating feeds for a few days, it is okay to continue with the feeding protocol even after one bout of emesis↗
▶Ep 50 · 5:00
clinicalHigh resolution esophageal manometry, esophagography, and endoscopy can help determine the diagnosis of congenital esophageal stenosis↗
▶Ep 50 · 5:30
guidelineSerial dilatations may be used to manage congenital esophageal stenosis if there is no cartilage component suspected in the stenotic area↗
▶Ep 50 · 5:30
guidelineSurgical resection for congenital esophageal stenosis can be reserved for patients where serial dilatations are unsuccessful or there is concern for cartilaginous component↗
▶Ep 50 · 5:30
quoteinitial conservative management should be considered for patients with congenital esophageal stenosis, especially if a cartilagenous component is not suspected.↗
▶Ep 50 · 7:30
epidemiologicalA systematic review and meta-analysis found that overall recurrence rates and recurrences within 24 and 48 hours of intussusception were similar between inpatient and outpatient management groups after enema reduction↗
▶Ep 50 · 8:00
epidemiologicalBoth inpatient and outpatient groups had similar rates of requiring operative intervention after intussusception reduction↗
▶Ep 50 · 8:00
epidemiologicalThere was no significant difference in the rate of return to the emergency department between inpatient and outpatient management of intussusception after enema reduction↗
▶Ep 50 · 8:30
clinicalOutpatient management of intussusception after air enema reduction results in a shorter hospital stay with no difference in rate of returns to emergency department, recurrence, need for operation, or mortality↗
▶Ep 50 · 8:30
quoteit's safe to say that outpatient management of intersusception after air enema reduction results in a shorter hospital stay with no difference in the rate of returns to the emergency department, recurrence, need for an operation, or mortality.↗
▶Ep 50 · 9:30
epidemiologicalThere is no compelling evidence in pediatric or adult literature to support mechanical bowel preparation for reducing surgical site infections in colorectal surgery↗
▶Ep 50 · 10:00
epidemiologicalRecent adult studies have shown no benefit from mechanical bowel preparation in terms of reducing surgical site infections, and some studies showed an increase in wound infections↗
▶Ep 50 · 10:30
guidelineCase appropriate pre-operative IV antibiotics may reduce surgical site infection incidents in colorectal operations↗
▶Ep 50 · 10:30
quotewe have seen no benefit of mechanical bowel preparations for reducing SSIs. However, case appropriate pre-operative IV antibiotics may reduce SSI incidents.↗
▶Ep 50 · 11:30
quotefirearms are now the leading cause of death in all children and adolescence in the United States, overtaking motor vehicle crashes in 2019.↗
▶Ep 50 · 11:30
epidemiologicalFirearms are now the leading cause of death in all children and adolescents in the United States, overtaking motor vehicle crashes in 2019↗
▶Ep 50 · 12:00
quoteWe believe as pediatric surgeons that we need to advocate with protecting children's health and well-being, no matter what the topic is.↗
▶Ep 50 · 14:00
clinicalLow-dose non-contrast CT of the chest has high sensitivity and specificity for identification of airway foreign bodies↗
▶Ep 50 · 14:30
clinicalCT bronchoscopy can avoid the cost and resources of taking a child to the operating room for a non-therapeutic bronchoscopy procedure↗
▶Ep 50 · 16:00
epidemiologicalDeath or neurodevelopmental impairment occurred in 69% of patients with necrotizing enterocolitis who underwent initial laparotomy versus 85% of those who underwent initial peritoneal drainage↗
▶Ep 50 · 16:30
epidemiologicalA prospective randomized cohort study showed no difference in overall survival between laparotomy and peritoneal drainage for necrotizing enterocolitis, but did show improved long-term neurodevelopmental outcomes with laparotomy↗
▶Ep 50 · 18:00
opinionRacism and sexism that manifest as microaggressions are commonly experienced by members of minority groups in medical settings↗
▶Ep 50 · 18:30
quoteBystanders can and should make an effort to become upstanders, which means bystanders who respond with action.↗
▶Ep 50 · 18:30
opinionMicroaggressions can harm trainees's performance and sense of belonging↗
▶Ep 50 · 20:00
epidemiologicalIn a 10-year retrospective review of isolated traumatic skull fractures with normal neurologic exam findings, 77% of patients were admitted for observation but none needed neurosurgical intervention or additional imaging during the index admission↗
▶Ep 50 · 20:30
clinicalPediatric isolated skull fractures are low risk conditions with a low likelihood of complications and can be discharged safely from the emergency department without inpatient observation↗
▶Ep 50 · 22:00
epidemiologicalIn the IMPACT trial, patients with perforated appendicitis taking piperacillin-tazobactam had lower incidence of intra-abdominal abscesses, lower usage of CT scans, and fewer ED revisits compared to ceftriaxone and metronidazole combination therapy↗
▶Ep 50 · 22:30
quotemonotherapy with piperacilin and tazobactam has been shown to be associated with decreased incidence of intra-abdominal abscesses after surgery for patients with perforated appendicitis.↗
▶Ep 50 · 22:30
epidemiologicalPiperacillin-tazobactam monotherapy did not have an increase in antibiotic usage or increase in antibiotic related complications compared to combination therapy↗
Quick Literature Updates Episode 10
▶Ep 51 · 0:00
quoteHello Pediatric Surgery family. I'm M. Tumbush, a research fellow from Cincinnati Children's Hospital Medical Center. And along with Stakern, we are sharing knowledge to improve child health around the globe.↗
▶Ep 51 · 1:21
clinicalThe bleeding study compared patients presenting with traumatic bleeding, operative bleeding, and medical bleeding↗
▶Ep 51 · 2:16
clinicalChildren in the high compliance group had a statistically significant decrease in rates of superficial surgical site infection when compared to children in the low compliance group↗
▶Ep 51 · 2:16
quoteThey found that children in the high compliance group had a statistically significant decrease in rates of superficial surgical site infection when compared to children in the low compliance group.↗
▶Ep 51 · 2:16
opinionStandardization of perioperative care may decrease morbidity and improve outcomes in colorectal surgery↗
▶Ep 51 · 3:29
quoteSo, it seems that contrast enema prior to stoma reversal is only useful if patients had neck.↗
▶Ep 51 · 3:29
opinionContrast enema prior to stoma reversal is only useful if patients had necrotizing enterocolitis↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
▶Ep 18 · 3:32
clinicalIt's the waves of peristalsis going over the villi that give absorptive surface area, not the length of exposed bowel↗
▶Ep 18 · 3:32
quoteThe intestine is like the ocean. It's the waves coming in and out over the villa that give you absorptive surface area, not the length, exposed area of the bowel that gets these kids off of nutrition of TPN.↗
▶Ep 18 · 7:21
clinicalGastroschisis patients have inherent dysmotility↗
▶Ep 18 · 7:21
quotePatients with gastroschisis seems to just have this inherent dysmotility.↗
▶Ep 18 · 9:21
clinicalThe length gained from STEP depends on the starting diameter of the bowel and the width of the stapler cuts↗
▶Ep 18 · 11:22
guidelineIt's critical to record bowel measurements before and after the procedure↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
▶Ep 19 · 2:29
clinicalThe first 4 months of life is when care for intestinal failure patients is most uncoordinated and surgical decisions have the most profound effect on long-term outcome↗
▶Ep 19 · 3:32
quoteThe intestine is like the ocean. It's the waves coming in and out over the villa that give you absorptive surface area, not the length, exposed area of the bowel that gets these kids off of nutrition of TPN.↗
▶Ep 19 · 3:32
clinicalAbsorptive surface area comes from the waves of peristalsis moving over the villi, not from the exposed length of bowel↗
▶Ep 19 · 7:21
clinicalGastroschisis patients have inherent dysmotility from enteric nervous system damage due to amniotic fluid exposure↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
▶Ep 66 · 3:32
clinicalIt's the waves of peristalsis going over the villi that give absorptive surface area, not the length of exposed bowel↗
▶Ep 66 · 3:32
quoteThe intestine is like the ocean. It's the waves coming in and out over the villa that give you absorptive surface area, not the length, exposed area of the bowel that gets these kids off of nutrition of TPN.↗
▶Ep 66 · 7:21
clinicalGastroschisis patients have inherent dysmotility↗
▶Ep 66 · 7:21
quotePatients with gastroschisis seems to just have this inherent dysmotility.↗
▶Ep 66 · 9:21
clinicalThe length gained from STEP depends on the starting diameter of the bowel and the width of the stapler cuts↗
▶Ep 66 · 11:22
guidelineIt's critical to record bowel measurements before and after the procedure↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
▶Ep 67 · 2:29
clinicalThe first 4 months of life is when care for intestinal failure patients is most uncoordinated and surgical decisions have the most profound effect on long-term outcome↗
▶Ep 67 · 3:32
quoteThe intestine is like the ocean. It's the waves coming in and out over the villa that give you absorptive surface area, not the length, exposed area of the bowel that gets these kids off of nutrition of TPN.↗
▶Ep 67 · 3:32
clinicalAbsorptive surface area comes from the waves of peristalsis moving over the villi, not from the exposed length of bowel↗
▶Ep 67 · 7:21
clinicalGastroschisis patients have inherent dysmotility from enteric nervous system damage due to amniotic fluid exposure↗
Malrotation with Dr. Meera Kotagal
▶Ep 70 · 0:28
epidemiologicalMalrotation occurs in about 1 in 200 to 500 live births↗
▶Ep 70 · 8:33
clinicalYou can have malrotation without midgut volvulus, but you cannot have midgut volvulus without malrotation↗
Quick Literature Updates Episode 6
▶Ep 71 · 0:00
quoteHello pediatric surgery family. I'm M. Tombash, a research fellow from Cincinnati Children's Hospital Medical Center. And along with StayCurrent, we are sharing knowledge to improve child health around the globe.↗
Quick Literature Updates Episode 7
▶Ep 72 · 4:17
clinicalWounds with tissue adhesive had poorer cosmesis at six weeks↗
▶Ep 72 · 4:25
clinicalThe cosmesis difference between tissue adhesive and other closure methods was gone by six months↗
▶Ep 72 · 4:35
clinicalThere was no difference between the three closure groups at six months for clinicians or for parents↗
Update Course Rewind: 2022 Top Ten Key Takeaways
▶Ep 74 · 0:00
quoteCincinnati Children's and State Current are sharing knowledge to improve child health around the globe.↗
▶Ep 74 · 0:10
quoteHi everyone, I'm M. Tom Bash, a research fellow at Cincinnati Children's Hospital Medical Center.↗
▶Ep 74 · 1:00
clinicalInfants with gastroschisis often require prolonged hospitalization for surgical repair and then initiation and advancement of feeds↗
▶Ep 74 · 2:30
guidelineFor babies with uncomplicated gastroschisis, feeds can be started immediately after sutureless abdominal closure, beginning with 10 to 20 milliliters per kilogram per day with advancements of 20 milliliters per kilogram per day if tolerated↗
▶Ep 74 · 3:00
clinicalImmediate feeding after gastroschisis closure has been shown to be associated with shorter length of stay and faster attainment of goal feeds↗
▶Ep 74 · 3:30
guidelineFor babies with uncomplicated gastroschisis tolerating feeds for a few days, it is okay to continue with the feeding protocol even after one bout of emesis↗
▶Ep 74 · 3:30
quoteit's safe to say that for babies with uncomplicated gastrochesis, it's safe to start feeding immediately after closure. And if they're tolerating for a few days and have even one bout of emesis, it's okay to continue with the feeding protocol.↗
▶Ep 74 · 5:00
clinicalHigh resolution esophageal manometry, esophagography, and endoscopy can help determine the diagnosis of congenital esophageal stenosis↗
▶Ep 74 · 5:30
guidelineSerial dilatations may be used to manage congenital esophageal stenosis if there is no cartilage component suspected in the stenotic area↗
▶Ep 74 · 5:30
guidelineSurgical resection for congenital esophageal stenosis can be reserved for patients where serial dilatations are unsuccessful or there is concern for cartilaginous component↗
▶Ep 74 · 5:30
quoteinitial conservative management should be considered for patients with congenital esophageal stenosis, especially if a cartilagenous component is not suspected.↗
▶Ep 74 · 7:30
epidemiologicalA systematic review and meta-analysis found that overall recurrence rates and recurrences within 24 and 48 hours of intussusception were similar between inpatient and outpatient management groups after enema reduction↗
▶Ep 74 · 8:00
epidemiologicalThere was no significant difference in the rate of return to the emergency department between inpatient and outpatient management of intussusception after enema reduction↗
▶Ep 74 · 8:00
epidemiologicalBoth inpatient and outpatient groups had similar rates of requiring operative intervention after intussusception reduction↗
▶Ep 74 · 8:30
clinicalOutpatient management of intussusception after air enema reduction results in a shorter hospital stay with no difference in rate of returns to emergency department, recurrence, need for operation, or mortality↗
▶Ep 74 · 8:30
quoteit's safe to say that outpatient management of intersusception after air enema reduction results in a shorter hospital stay with no difference in the rate of returns to the emergency department, recurrence, need for an operation, or mortality.↗
▶Ep 74 · 9:30
epidemiologicalThere is no compelling evidence in pediatric or adult literature to support mechanical bowel preparation for reducing surgical site infections in colorectal surgery↗
▶Ep 74 · 10:00
epidemiologicalRecent adult studies have shown no benefit from mechanical bowel preparation in terms of reducing surgical site infections, and some studies showed an increase in wound infections↗
▶Ep 74 · 10:30
guidelineCase appropriate pre-operative IV antibiotics may reduce surgical site infection incidents in colorectal operations↗
▶Ep 74 · 10:30
quotewe have seen no benefit of mechanical bowel preparations for reducing SSIs. However, case appropriate pre-operative IV antibiotics may reduce SSI incidents.↗
▶Ep 74 · 11:30
epidemiologicalFirearms are now the leading cause of death in all children and adolescents in the United States, overtaking motor vehicle crashes in 2019↗
▶Ep 74 · 11:30
quotefirearms are now the leading cause of death in all children and adolescence in the United States, overtaking motor vehicle crashes in 2019.↗
▶Ep 74 · 12:00
quoteWe believe as pediatric surgeons that we need to advocate with protecting children's health and well-being, no matter what the topic is.↗
▶Ep 74 · 14:00
clinicalLow-dose non-contrast CT of the chest has high sensitivity and specificity for identification of airway foreign bodies↗
▶Ep 74 · 14:30
clinicalCT bronchoscopy can avoid the cost and resources of taking a child to the operating room for a non-therapeutic bronchoscopy procedure↗
▶Ep 74 · 16:00
epidemiologicalDeath or neurodevelopmental impairment occurred in 69% of patients with necrotizing enterocolitis who underwent initial laparotomy versus 85% of those who underwent initial peritoneal drainage↗
▶Ep 74 · 16:30
epidemiologicalA prospective randomized cohort study showed no difference in overall survival between laparotomy and peritoneal drainage for necrotizing enterocolitis, but did show improved long-term neurodevelopmental outcomes with laparotomy↗
▶Ep 74 · 18:00
opinionRacism and sexism that manifest as microaggressions are commonly experienced by members of minority groups in medical settings↗
▶Ep 74 · 18:30
quoteBystanders can and should make an effort to become upstanders, which means bystanders who respond with action.↗
▶Ep 74 · 18:30
opinionMicroaggressions can harm trainees's performance and sense of belonging↗
▶Ep 74 · 20:00
epidemiologicalIn a 10-year retrospective review of isolated traumatic skull fractures with normal neurologic exam findings, 77% of patients were admitted for observation but none needed neurosurgical intervention or additional imaging during the index admission↗
▶Ep 74 · 20:30
clinicalPediatric isolated skull fractures are low risk conditions with a low likelihood of complications and can be discharged safely from the emergency department without inpatient observation↗
▶Ep 74 · 22:00
epidemiologicalIn the IMPACT trial, patients with perforated appendicitis taking piperacillin-tazobactam had lower incidence of intra-abdominal abscesses, lower usage of CT scans, and fewer ED revisits compared to ceftriaxone and metronidazole combination therapy↗
▶Ep 74 · 22:30
quotemonotherapy with piperacilin and tazobactam has been shown to be associated with decreased incidence of intra-abdominal abscesses after surgery for patients with perforated appendicitis.↗
▶Ep 74 · 22:30
epidemiologicalPiperacillin-tazobactam monotherapy did not have an increase in antibiotic usage or increase in antibiotic related complications compared to combination therapy↗
Quick Literature Updates Episode 10
▶Ep 75 · 0:00
quoteHello Pediatric Surgery family. I'm M. Tumbush, a research fellow from Cincinnati Children's Hospital Medical Center. And along with Stakern, we are sharing knowledge to improve child health around the globe.↗
▶Ep 75 · 1:21
clinicalThe bleeding study compared patients presenting with traumatic bleeding, operative bleeding, and medical bleeding↗
▶Ep 75 · 2:16
clinicalChildren in the high compliance group had a statistically significant decrease in rates of superficial surgical site infection when compared to children in the low compliance group↗
▶Ep 75 · 2:16
quoteThey found that children in the high compliance group had a statistically significant decrease in rates of superficial surgical site infection when compared to children in the low compliance group.↗
▶Ep 75 · 2:16
opinionStandardization of perioperative care may decrease morbidity and improve outcomes in colorectal surgery↗
▶Ep 75 · 3:29
opinionContrast enema prior to stoma reversal is only useful if patients had necrotizing enterocolitis↗
▶Ep 75 · 3:29
quoteSo, it seems that contrast enema prior to stoma reversal is only useful if patients had neck.↗
quoteCincinnati Children's and State Current are sharing knowledge to improve child health around the globe.↗
▶Ep 19 · 0:10
quoteHi everyone, I'm M. Tom Bash, a research fellow at Cincinnati Children's Hospital Medical Center.↗
▶Ep 19 · 1:00
clinicalInfants with gastroschisis often require prolonged hospitalization for surgical repair and then initiation and advancement of feeds↗
▶Ep 19 · 2:30
guidelineFor babies with uncomplicated gastroschisis, feeds can be started immediately after sutureless abdominal closure, beginning with 10 to 20 milliliters per kilogram per day with advancements of 20 milliliters per kilogram per day if tolerated↗
▶Ep 19 · 3:00
clinicalImmediate feeding after gastroschisis closure has been shown to be associated with shorter length of stay and faster attainment of goal feeds↗
▶Ep 19 · 3:30
guidelineFor babies with uncomplicated gastroschisis tolerating feeds for a few days, it is okay to continue with the feeding protocol even after one bout of emesis↗
▶Ep 19 · 3:30
quoteit's safe to say that for babies with uncomplicated gastrochesis, it's safe to start feeding immediately after closure. And if they're tolerating for a few days and have even one bout of emesis, it's okay to continue with the feeding protocol.↗
▶Ep 19 · 5:00
clinicalHigh resolution esophageal manometry, esophagography, and endoscopy can help determine the diagnosis of congenital esophageal stenosis↗
▶Ep 19 · 5:30
guidelineSerial dilatations may be used to manage congenital esophageal stenosis if there is no cartilage component suspected in the stenotic area↗
▶Ep 19 · 5:30
quoteinitial conservative management should be considered for patients with congenital esophageal stenosis, especially if a cartilagenous component is not suspected.↗
▶Ep 19 · 5:30
guidelineSurgical resection for congenital esophageal stenosis can be reserved for patients where serial dilatations are unsuccessful or there is concern for cartilaginous component↗
▶Ep 19 · 7:30
epidemiologicalA systematic review and meta-analysis found that overall recurrence rates and recurrences within 24 and 48 hours of intussusception were similar between inpatient and outpatient management groups after enema reduction↗
▶Ep 19 · 8:00
epidemiologicalThere was no significant difference in the rate of return to the emergency department between inpatient and outpatient management of intussusception after enema reduction↗
▶Ep 19 · 8:00
epidemiologicalBoth inpatient and outpatient groups had similar rates of requiring operative intervention after intussusception reduction↗
▶Ep 19 · 8:30
clinicalOutpatient management of intussusception after air enema reduction results in a shorter hospital stay with no difference in rate of returns to emergency department, recurrence, need for operation, or mortality↗
▶Ep 19 · 8:30
quoteit's safe to say that outpatient management of intersusception after air enema reduction results in a shorter hospital stay with no difference in the rate of returns to the emergency department, recurrence, need for an operation, or mortality.↗
▶Ep 19 · 9:30
epidemiologicalThere is no compelling evidence in pediatric or adult literature to support mechanical bowel preparation for reducing surgical site infections in colorectal surgery↗
▶Ep 19 · 10:00
epidemiologicalRecent adult studies have shown no benefit from mechanical bowel preparation in terms of reducing surgical site infections, and some studies showed an increase in wound infections↗
▶Ep 19 · 10:30
quotewe have seen no benefit of mechanical bowel preparations for reducing SSIs. However, case appropriate pre-operative IV antibiotics may reduce SSI incidents.↗
▶Ep 19 · 10:30
guidelineCase appropriate pre-operative IV antibiotics may reduce surgical site infection incidents in colorectal operations↗
▶Ep 19 · 11:30
epidemiologicalFirearms are now the leading cause of death in all children and adolescents in the United States, overtaking motor vehicle crashes in 2019↗
▶Ep 19 · 11:30
quotefirearms are now the leading cause of death in all children and adolescence in the United States, overtaking motor vehicle crashes in 2019.↗
▶Ep 19 · 12:00
quoteWe believe as pediatric surgeons that we need to advocate with protecting children's health and well-being, no matter what the topic is.↗
▶Ep 19 · 14:00
clinicalLow-dose non-contrast CT of the chest has high sensitivity and specificity for identification of airway foreign bodies↗
▶Ep 19 · 14:30
clinicalCT bronchoscopy can avoid the cost and resources of taking a child to the operating room for a non-therapeutic bronchoscopy procedure↗
▶Ep 19 · 16:00
epidemiologicalDeath or neurodevelopmental impairment occurred in 69% of patients with necrotizing enterocolitis who underwent initial laparotomy versus 85% of those who underwent initial peritoneal drainage↗
▶Ep 19 · 16:30
epidemiologicalA prospective randomized cohort study showed no difference in overall survival between laparotomy and peritoneal drainage for necrotizing enterocolitis, but did show improved long-term neurodevelopmental outcomes with laparotomy↗
▶Ep 19 · 18:00
opinionRacism and sexism that manifest as microaggressions are commonly experienced by members of minority groups in medical settings↗
▶Ep 19 · 18:30
opinionMicroaggressions can harm trainees's performance and sense of belonging↗
▶Ep 19 · 18:30
quoteBystanders can and should make an effort to become upstanders, which means bystanders who respond with action.↗
▶Ep 19 · 20:00
epidemiologicalIn a 10-year retrospective review of isolated traumatic skull fractures with normal neurologic exam findings, 77% of patients were admitted for observation but none needed neurosurgical intervention or additional imaging during the index admission↗
▶Ep 19 · 20:30
clinicalPediatric isolated skull fractures are low risk conditions with a low likelihood of complications and can be discharged safely from the emergency department without inpatient observation↗
▶Ep 19 · 22:00
epidemiologicalIn the IMPACT trial, patients with perforated appendicitis taking piperacillin-tazobactam had lower incidence of intra-abdominal abscesses, lower usage of CT scans, and fewer ED revisits compared to ceftriaxone and metronidazole combination therapy↗
▶Ep 19 · 22:30
quotemonotherapy with piperacilin and tazobactam has been shown to be associated with decreased incidence of intra-abdominal abscesses after surgery for patients with perforated appendicitis.↗
▶Ep 19 · 22:30
epidemiologicalPiperacillin-tazobactam monotherapy did not have an increase in antibiotic usage or increase in antibiotic related complications compared to combination therapy↗
Intestinal Rehabilitation, Episode 4: Surgical Management, Part 1
▶Ep 5 · 2:29
clinicalThe first 4 months of life is when care for intestinal failure patients is most uncoordinated and surgical decisions have the most profound effect on long-term outcome↗
▶Ep 5 · 3:32
clinicalAbsorptive surface area comes from the waves of peristalsis moving over the villi, not from the exposed length of bowel↗
▶Ep 5 · 3:32
quoteThe intestine is like the ocean. It's the waves coming in and out over the villa that give you absorptive surface area, not the length, exposed area of the bowel that gets these kids off of nutrition of TPN.↗
▶Ep 5 · 7:21
clinicalGastroschisis patients have inherent dysmotility from enteric nervous system damage due to amniotic fluid exposure↗
Quick Literature Updates Episode 7
▶Ep 6 · 4:17
clinicalWounds with tissue adhesive had poorer cosmesis at six weeks↗
▶Ep 6 · 4:25
clinicalThe cosmesis difference between tissue adhesive and other closure methods was gone by six months↗
▶Ep 6 · 4:35
clinicalThere was no difference between the three closure groups at six months for clinicians or for parents↗
