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iatrogenic wounds:a common but often overlooked problem

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Burns & Trauma 2019年第1期7卷 160-166页

作者： Biao Cheng Ju Tian Yan Peng Xiaobing Fu Department of Plastic Surgery General Hospital of Southern Theater Command of PLA111 Liuhua RoadGuangzhou 510010GuangdongPeople’s Republic of China Department of Plastic Surgery and the Key Laboratory of Trauma Treatment and Tissue Repair of Tropical Area PLAGuangzhouPeople’s Republic of China Department of Orthopaedics and Traumatology Li Ka Shing Faculty of MedicineThe University of Hong Kong21 Sassoon RoadPokulamHong Kong SARPeople’s Republic of China Wound Healing Unit The First Affiliated HospitalGeneral Hospital of PLA51 Fu Cheng RoadBeijing 100048People’s Republic of China Department of Plastic Surgery Zhongshan City People’s HospitalZhongshan 528400GuangdongPeople’s Republic of China

iatrogenic wounds are a common but often overlooked *** can lead to increases in hospital stays,therapy costs,repeat surgeries,and implant *** not handled properly,these wounds have a very poor prognosis and will cause serious physical and psychological harm to patients,which may result in medicolegal *** recent years,the incidence of iatrogenic wounds has increased because of(1)an increase in the population of older people owing to increased life expectancy,(2)the continued expansion of surgical indications,(3)an increase in difficult surgeries,and(4)the constant emergence and application of new implantable biomaterials and other ***,there is a pressing clinical need to improve the therapy of iatrogenic ***,the difficulty in treating these wounds is considerable due to the emergence of drug-resistant bacteria,the high number of patients with metabolic diseases,and complex complications in *** particular,iatrogenic wounds caused by surgical site infections due to implantable biomaterials could lead to material leakage and conflicts regarding whether to retain or remove the *** review provides a definition of iatrogenic wounds,describes their characteristics,classifies them,and provides information about the importance of analyzing iatrogenic *** hope that this review will provide useful information for the diagnosis and treatment of iatrogenic wounds and help to reduce their incidence in the future.

关键词： Wound iatrogenic Implantable Biomaterial Surgical site infection

iatrogenic flexor tendon rupture caused by misdiagnosing sarcoidosis-related flexor tendon contracture as tenosynovitis: A case report

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World Journal of Clinical Cases 2023年第36期11卷 8512-8518页

作者： Rui Yan Zhe Zhang Long Wu Zhi-Peng Wu He-De Yan The Second Clinical Medical College Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina Department of Orthopedics(Division of Hand Surgery) The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityWenzhou 325026Zhejiang ProvinceChina Department of Hand Surgery The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityWenzhou 325026Zhejiang ProvinceChina

BACKGROUND Sarcoidosis is a multisystem disease characterized by granuloma formation in various ***-related flexor tendon contractures are uncommon in clinical *** contracture is similar to stenosing tenosynovitis and po-tentially leads to misdiagnosis and ***,we report a rare case of sarcoidosis-related finger flexor tendon contracture that was misdiagnosed as tenosynovitis.A 44-year-old woman presented to our department with flexion contracture of the right ring and middle *** patient was misdiagnosed with tenosynovitis and underwent acupotomy release of the A1 pulley of the middle finger in an-other hospital that resulted in iatrogenic rupture of both the superficial and profundus *** presentation showed multiple sarcoid involve-ments in the pulmonary locations and ipsilateral forearm.A diagnosis of sar-coidosis was made based on the presence of non-caseating granulomas with tubercles consisting of Langhans giant cells with lymphocyte infiltration on biopsy,and the patient underwent surgical repair for the *** 2 mo,the patient experienced another spontaneous rupture of the repaired middle finger tendon and underwent surgical *** results were achieved at the 10 mo follow-up after *** Sarcoidosis-related finger contractures are rare;thus,caution should be exercised when dealing with such patients to avoid incorrect treatment.

关键词： Sarcoidosis Finger Contracture iatrogenic Misdiagnosis Case report

iatrogenic bladder neck rupture due to traumatic urethral catheterization: A case report

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World Journal of Clinical Cases 2023年第30期11卷 7413-7417页

作者： Ozgur Ekici Ercüment Keskin Fatih Kocoglu Ali Seydi Bozkurt Department of Urology Faculty of MedicineErzincan Binali Yıldırım UniversityErzincan 24000Turkey

BACKGROUND In this article,we present a case of iatrogenic bladder neck rupture due to catheter insertion in a 94-year-old comorbid male *** SUMMARY The patient,who had a urethral catheter inserted in the palliative service 3 d ago,was consulted because the catheter did not *** the fluid given to the bladder could not be recovered,computed tomography was performed,which revealed that the catheter had passed the bladder neck first into the retrovesical area then into the intraabdominal *** appearance of the anterior urethra and verumontanum was normal at ***,extremely severe stenosis of the bladder neck,and perforated posterior wall of the urethral segment between the prostatic urethra and the bladder neck were *** urethrotomy was applied to the bladder neck with a *** urethral catheter was sent over the guide wire into the *** patient was followed in the palliative care service and the catheter was removed 7 d *** extravasation was observed in the control *** Although catheter insertion is a simple and frequently performed procedure in hospitalized patients,it is necessary to avoid unnecessary extra-indication catheter insertion.

关键词： Bladder neck rupture Uretrhral catheterization iatrogenic Extravasation False route Case report

iatrogenic extrahepatic bile duct injury in 182 patients: causes and management

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Hepatobiliary & Pancreatic Diseases International 2002年第2期1卷 265-269页

作者： Yang F.-Q. Dai X.-W. Wang L. Yu Y. Department of Hepatobiliary Surgery Second Hospital China Medical University Shenyang 110004 China

Objective: To describe the causes and treatment ofiatrogenic bile duct injury caused by ***: 182 patients with iatrogenic extrahepaticbile duct injury from 4 university hospitals of Chinawere reviewed. Details of primary cholecystectomy,biliary reconstruction as well as postoperative ma-nagement were recorded. All patients were followedup for at least 6 months (6 months to 9 years, medi-an 3.5 years). The adequacy of repair was assessedby regular evaluation of the patients clinical statusand liver function variables. Hepatobiliary B-ultra-sonography was used routinely in the follow up of pa-tients, and magnetic resonance cholangiopancreatog-raphy was applied in the patients suggestive of ***: In 152 patients, bile duct injury happenedduring open cholecystectomy, and in 30 patients dur-ing laparoscopic cholecystectomy. All the injuries de-veloped during anterograde cholecystectomy (at theCalot’s triangle). All the patients with these injuriesunderwent choledochocholedochostomy or Roux-en-Ycholedochojejunostomy with good results (161 pa-tients), recurrent stricture (11), and death (10).Conclusions: During cholecystectomy, the Calot’s tri-angle should be identified anatomically, but retro-grade cholecystectomy is the optimal choice. Bileduct injury should be discovered as soon as possibleand be managed timely. Different operative methodsare optional according to the degree of injury and thepostoperative period.

关键词： iatrogenic injury bile duct laparoscopic cholecystectomy choledochojejunostomy magnetic resonance cholangiopancreatography biliary hepatic cirrhosis

International multi-center study of iatrogenic retinal tears in pars plana vitrectomy

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International Journal of Ophthalmology(English edition) 2019年第6期12卷 996-1000页

作者： Omar A.Saleh Rami A.Al-Dwairi Hasan Mohidat Denis Jusufbegovic Brooke Nesmith Yoreh Barak Michael Mimouni Shlomit Schaal Department of Ophthalmology Jordan University of Science and TechnologyIrbid 22110Jordan Department of Ophthalmology and Visual Sciences University of LouisvilleLouisvilleKentucky 40202United States Department of Ophthalmology Rambam Health Care CampusHaifa 3109601Israel Department of Ophthalmology and Visual Sciences University of Massachusetts Medical SchoolWorcesterMassachusetts 01605United States

AIM: To study and compare the effect of different surgical settings on the development of iatrogenic retinal tears(IRT) in conventional(20-gauge) and microincisional ***: An international retrospective comparative study of 394 patients who had simple vitrectomy at three tertiary centers. Surgeries were performed by four retina surgeons using different viewing systems. Two groups of eyes were compared: microincisional vitrectomy(327 eyes) and conventional(67 eyes) vitrectomy. An iatrogenic tear was defined as the occurrence of one or more peripheral retinal tears during surgery or at any visit in the first 6 wk ***: Mean age was 67±12 y and 55% were female. iatrogenic tears occurred in 11/394(2.8%) of eyes. The rate of tears was similar among different surgeons and viewing systems(P=0.93 and P=0.76, respectively). Surgical indication, preexisting pseudophakia/aphakia, induction of posterior vitreous detachment(PVD) during surgery, and the use triamcinolone acetonide didn’t significantly affect the rate of tears(P>0.1 for all factors). A higher rate of tears was found in the conventional group compared to the microincisional group(respectively, 7.5%, 1.8%, P=0.02).CONCLUSION: The rate of IRT in vitrectomy is not significantly affected by surgical indication, preexisting PVD or pseudophakia, or use of triamcinolone or different viewing systems but is significantly higher in conventional vitrectomy. Microincisional platforms improve the safety of vitrectomy regardless of the viewing system used.

关键词： microincisional vitrectomy iatrogenic retinal tear 20-gauge

Treatment of a rotator cuff tear combined with iatrogenic glenoid fracture and shoulder instability:A rare case report

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World Journal of Orthopedics 2020年第11期11卷 516-522页

作者： Chen-Hao Chiang Ting-Chien Tsai Kuan-Kai Tung Wei-Hsing Chih Ming-Long Yeh Wei-Ren Su Department of Biomedical Engineering National Cheng Kung UniversityTainan 70428Taiwan Department of Orthopaedic Surgery Ditmanson Medical Foundation Chia-Yi Christian HospitalChia-Yi 60002Taiwan Department of Orthopaedic Surgery Taichung Veterans General HospitalTaichung 40705Taiwan Department of Orthopaedic Surgery National Cheng Kung University HospitalTainan 70428Taiwan

BACKGROUND The brisement manipulation is an effective treatment for refractory shoulder *** cuff tears can sometimes exist in combination with adhesive *** capsular release combined with rotator cuff repair has achieved good outcomes in published *** SUMMARY We report the case of a patient with right shoulder pain for more than 1 year that was suspected to have adhesive capsulitis and a rotator cuff tear that was treated with brisement manipulation and arthroscopic *** iatrogenic glenoid fracture with shoulder instability occurred during the *** treatment for fracture fixation,capsular release,and rotator cuff repair was performed,and the functional results are *** Arthroscopic fixation for iatrogenic glenoid fracture and repairing coexisting rotator cuff tear can provide the stability needed for early rehabilitation.

关键词： Frozen shoulder Bursitis Arthroscopy Fracture Glenoid fracture Manipulation iatrogenic Case report

Percutaneous transcatheter super-selective renal arterial embolization with N-butyl cyanoacrylate for iatrogenic renal hemorrhage

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Journal of Interventional Medicine 2022年第4期5卷 200-206页

作者： Xishan Li Guodong Chen Dongliang Zhu Department of Interventional Radiology Guangzhou First People's HospitalNo.1 Panfu RoadGuangzhou510180PR China Department of Interventional Operation Center Guangzhou First People's HospitalNo.1 Panfu RoadGuangzhou510180PR China

Background:To evaluate the safety and efficacy of percutaneous transcatheter super-selective renal arterial embolization(SRAE)with N-butyl cyanoacrylate(NBCA)for iatrogenic renal ***:Between January 2014 and December 2019,45 patients(including 18 patients with coagulopathy),who underwent percutaneous transcatheter SRAE with NBCA for iatrogenic renal hemorrhage at our institution,were retrospectively *** technical success rate,clinical success rate,and embolization-related complications were *** values of estimated glomerular filtration rate(eGFR),serum creatinine(sCr),and serum urea(sUr)were analyzed at the time of pre-SRAE,post-SRAE,and last follow-up to evaluate the effects of NBCA-based SRAE on renal ***:Diagnostic renal arteriography revealed contrast extravasation in 18 patients and pseudoaneurysms in 27 *** mixed with iodized oil in a 1:2–1:4 ratio was the sole embolic *** procedure-related mortality or major complications *** technical and clinical success rates were both 100%.The values of eGFR,sCr and sUr were not found to be significantly different between pre-SRAE,post-SRAE and last follow-up(eGFR:91.52±21.17 vs.90.98±22.11 vs.92.14±23.51 mL/min/1.73 m^(2),p=0.729;sCr:74.73±11.08 vs.75.27±12.43 vs.73.95±10.14μmol/L,p=0.543;sUr:5.69±0.84 vs.5.71±0.96 vs.5.70±0.79,p=0.515,respectively).Conclusions:Percutaneous transcatheter SRAE with NBCA is a safe and effective treatment modality for iatrogenic renal hemorrhage with no deterioration of renal function.

关键词： iatrogenic Renal hemorrhage N-butyl cyanoacrylate Super-selective Renal arterial embolization

iatrogenic Urethral Stenoses: Epidemiological Aspects Clinics and Therapeutic in the Urology Department of the National Hospital of Conakry

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Open Journal of Urology 2023年第1期13卷 36-47页

作者： Demba Cisse Youssouf Keita Fode Oumar Keita Mamadou II Barry Alimou Diallo Thierno Mamadou Oury Diallo Mamadou Diawo Bah Mamadou Bissiriou Bah Alpha Oumar Barry Daouda Kante Ibrahima Bah Oumar Raphiou Bah The Faculty of Health Sciences and Techniques Gamal Abdel Nasser University of Conakry Conakry Guinea

The aim is to highlight the epidemiological, clinical and therapeutic aspects of iatrogenic urethral strictures. Methodology: This was a retrospective study, descriptive type, 6 years from January 1st 2012, to December 31st 2017 carried out in the Urology-Andrology department of the National Hospital Ignace Deen of Conakry. All records of patients carrying the Diagnosis of iatrogenic urethral stricture were included in this study. Results: We collected 30 cases of iatrogenic urethral stricture, with a frequency of 2.5%. The average age of the patients was 62.33 years. The most affected age group is from 71 to 80 years (33.33%). Dysuria was the main reason for consultation. Retrograde urethrocystography plus voiding cystourethrography (RUC-VCU) allowed us to make the diagnosis. The treatment was essentially surgical and several techniques were used. Endoscopic internal urethrotomy alone was the most performed surgical technique, followed by segmental uretrectomy associated with end-to-end urethrography. Conclusion: iatrogenic urethral stricture is easy to diagnose but difficult to manage due to the frequency of recurrences. Improving the quality of care, in particular urethral catheterizations and transurethral endoscopic maneuvers, makes it possible to prevent it.

关键词： Stenosis Urethra iatrogenic Conakry

iatrogenic Tracheal Ruptures: Review of the Literature and Personal Experience on 11 Cases

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Open Journal of Thoracic Surgery 2013年第4期3卷 130-134页

作者： Bulent Aydemir Sezai Celik Oya Uncu Handan Tanrıkulu Tamer Okay Department of Thoracic Surgery Dr.Siyami Ersek Thoracic and Cardiovascular Surgery CenterIstanbulTurkey Department of Thoracic Surgery Haydarpasa Numune Training and Research HospitalIstanbulTurkey.

Objective: iatrogenic tracheal rupture is a rare, but life-threatening complication of orotracheal intubation. In this retrospective study, etiology, and diagnostic and therapeutic approaches for iatrogenic tracheal ruptures were reviewed. Method: Eleven patients (6 males and 5 females) were diagnosed and treated for iatrogenic tracheal rupture in our clinic. The laceration occurred after orotracheal intubation in 7 cases, and during percutaneous tracheostomy and emergency tracheostomy in the other four cases, respectively. Diagnosis was made during thoracic surgery in 5 cases. The remaining cases were diagnosed in the post-operative period;the most common symptoms were mediastinal and subcutenous emphysema and pneumothorax. Results: The diagnosis was confirmed by bronchoscopy in all cases. The lacerations were longitudinal, 1-7 cm in length and were located in the distal membranous trachea. While ruptures detected intraoperatively were repaired during the surgery, the others were treated conservatively. No mortality was observed among cases treated surgically. However, three of the cases treated conservatively died (50%), and the cause of death was the underlying disease requiring intubation. Conclusion: We are in the opinion that primary disease is a determinant of patient outcome. Except cases identified during surgery, emergency surgical interventions should be preferred in patients, in whom ventilation cannot be achieved. On the other hand, bronchoscopic fibrin glue instillation should additively be applied to conservative treatment of tracheal lacerations.

关键词： Tracheal Rupture iatrogenic Surgery Conservative Treatment