Quick Literature Updates Episode 11

Hello Pediatric Surgery family. I'm M Tombash, a research fellow from Cincinnati Children's Hospital Medical Center. And along with Stakearn, we are sharing knowledge to improve child health around the globe. Today, our team is going to deliver the articles that you should know about. We have three papers today. All three of them are from the Journal of Pediatric Surgery. We don't have much time, so let's start. Our first paper titled National Trends in Pediatric Firearm and Automobile Fatalities by Stevens at all. This paper is summarized by Ellenensisco. She was a research fellow at Cincinnati Children's Hospital, and as of this month, she's back to being a general surgery resident at Mayo Clinic. In this study, the authors wanted to look at national trends in pediatric firearm and automobile fatalities and see how state gun laws might affect those fatality rates. They looked at the CDC's Wonder database to look at data between 1999 and 2020. Then they used the Gifford's Law Center annual gun law scorecard between 2014 and 2020 to look at state gun law scores. As other recent studies had shown, in the last few years, the fatality rate for firearms has surpassed the fatality rate for automobiles in children. And they found that stronger gun laws were associated with decreased fatality rates. There was a 55% lower firearm fatality rate for the states with the strongest gun laws compared to those with the weakest gun laws. So based on this data, it seems like there are things we can do including education, research and advocacy to help reduce the firearm fatality rate in children. Great, moving to the next one. Our second paper is Gabapentin is associated with decreased post-operative opioid use and length of stay after appendectomy in children with perforated appendicitis, a propensity score matched analysis by Lascano at all. And this paper is summarized by Alex Halpern. He's one of our contributors here at Stakearn MD and a General Surgery resident at George Washington University. Pain control after appendectomy for perforated appendicitis can be a huge problem in kids. Gabapentin is an anticonvulsant that's often used off label as a part of multimodal pain control after major surgery. Could Gabapentin help with pain control in these kids? The team from Children's Hospital of LA performed a retrospective cohort study looking at kids age 2 to 18 who underwent appendectomy for perforated appendicitis between the years 2014 and 2019, and found that kids who received Gabapentin both had decreased postop opioid use and a decreased postop length of stay. This shows that Gabapentin can be helpful as a part of multimodal pain control after appendectomy for perforated appendicitis, should probably be looked at further to help with multimodal pain control after other abdominal surgeries in kids. Here's the last paper of today. Evaluating the risk of periumbilical hernia after sutured or sutureless gastroschisis closure by Frazier at all and Midwest Pediatric Surgery Consortium. This one is summarized by Cecilia Hina. She's a research fellow at Cincinnati Children's Hospital. This is a retrospective study from the Midwest Pediatric Surgery Consortium. They follow up 375 patients that had gastrosis and underwent closure between 2013 and 2016. The overall rate for perical hernias was 22.7%. And it was significantly higher in those who underwent a primary closure versus those who needed Silo. Patients who underwent sutureless closures had 50% rates of persistent hernia, but only 16.4% of the patients who underwent a closure had a persistent hernia. Spontaneous closure was seen in 38.8%, and only 31.8 needed a surgery. So, it seems that even though sutu closures lead to more perical hernias, they can be managed as any other congenital Mical hernia and they have no additional risk. Check the link in the description below to read each paper. We hope you like this episode. Please follow us on social media, give us a rating and subscribe to our YouTube channel. And don't forget to download our Stakearn app on App Store or Play Store for more content. Thank you for listening. Cincinnati Children's Hospital and Stakearn are sharing knowledge to improve child health around the globe.