Can Preference Signaling Streamline the Applicant Selection Process?

Objective: In the 2022 match cycle preference signaling was introduced to general surgery. For 3 years (2022-2024) each applicant was able to use 5 signals to indicate a preference for a program. In 2024, the average number of ranked programs among applicants was 12 demonstrating that programs were creating their interview list beyond those who signaled.

Implementation of a quality improvement initiative reduced adult inpatient gastrostomy tube dislodgements.

Background: We examined the success of a quality improvement initiative intended to prevent acute inpatient gastrostomy tube (g-tube) dislodgements.

Study Design: This was a retrospective cohort study of adult inpatients ≥18-years-old who underwent new g-tube placement at our institution (September 2021-August 2023). A new nursing order and revised nursing education, which specified standardized g-tube care, was implemented in September 2022.

Identifying trauma patients who benefit from whole blood transfusion: An effect decomposition analysis on patient survival.

Background: Although whole blood (WB) transfusion has gained attention as a potentially superior alternative to component therapy (CT) for patients experiencing severe traumatic hemorrhage, conflicting evidence leaves its optimal use unclear.

Methods: We conducted a retrospective review of adult trauma patients treated at civilian trauma centers participating in Trauma Quality Improvement Program (TQIP) from 2020 to 2021. All received either WB or CT within four hours of emergency department arrival.

Mining for Gold: A Mixed-Methods Study on Personal Statements in General Surgery Residency Applications.

Introduction: As numeric data are becoming increasingly scarce in general surgery residency applications, the personal statement (PS) may be key to identifying candidates to interview. This study sought to determine if PSs of candidates invited for interview at our residency program had different qualities when compared to those not invited.

Materials And Methods: This single-institution study retrospectively reviewed the PSs of applications for a categorical general surgery position (2022).

Seeing is Believing - A Qualitative Study Exploring What Motivates Medical Students to Pursue a Career In General Surgery.

Objective: The personal statement (PS) is a rich text in which medical students introduce themselves to the programs to which they are applying. There is no prompt or agreed upon structure for the personal statement. Therefore it represents a window in to medical students' beliefs and perceptions.

Timing of venous thromboembolism prophylaxis initiation and complications in polytrauma patients with high-risk bleeding orthopedic interventions: A nationwide analysis.

Introduction: There are no clear recommendations for the perioperative timing and initiation of venous thromboembolism pharmacologic prophylaxis (VTEp) among polytrauma patients undergoing high-risk bleeding orthopedic operative intervention, leading to variations in VTEp administration. Our study examined the association between the timing of VTEp and VTE complications in polytrauma patients undergoing high-risk operative orthopedic interventions nationwide.

Methods: We performed a retrospective cohort study of trauma patients 18 years or older who underwent high-risk bleeding operative orthopedic interventions for pelvic, hip, and femur fractures within 24 hours of admission at American College of Surgeons-verified trauma centers using the 2019-2020 American College of Surgeons Trauma Quality Improvement Program databank.

Long-term outcomes of autologous vein bypass for repair of upper and lower extremity major arterial trauma.

Objective: Autologous vein is the preferred bypass conduit for extremity arterial injuries owing to superior patency and low infection risk; however, long-term data on outcomes in civilians are limited. Our goal was to assess short- and long-term outcomes of autologous vein bypass for upper and lower extremity arterial trauma.

Methods: A retrospective review was performed of patients with major extremity arterial injuries (2001-2019) at a level I trauma center.

Intern Experience Reflects Information Gathered During the Virtual Interview Process.

Objective: The onset of the coronavirus 2019 (COVID-19) pandemic brought many changes to the residency application process including transitioning to a virtual interview platform, which continues today. The transition brought many concerns from general surgery applicants about their ability to obtain adequate information about a program virtually. We sought to characterize how information presented by programs during the first ever virtual interview cycle matched the experience of general surgery interns after training at a program for 1 year.

Reduced rates of pneumonia after implementation of an electronic checklist for the management of patients with multiple rib fractures at a Level One Trauma Center.

Background: Traumatic rib fractures are associated with increased morbidity and mortality, with complications including pneumothorax, difficult to control pain, and pneumonia. Use of a bundled, multi-disciplinary approach to the care of patients with multiple rib fractures has been shown to reduce morbidity and mortality. In this study, we investigate the implementation of a checklist for the multidisciplinary management of patients with multiple rib fractures who present to an urban, level 1 trauma center and safety-net hospital.

Antibiotic use in acute mesenteric ischemia: a review of the evidence and call to action.

Acute mesenteric ischemia (AMI) is a life-threatening condition with a high mortality rate. The standard practice after making the diagnosis includes aggressive resuscitation, anticoagulation, followed by revascularization and resection of necrotic bowel. The role of empiric antibiotics in the management of AMI is not well defined in the literature.

Outcomes following ipsilateral great saphenous vein bypass for lower extremity arterial injuries.

Objective: Use of autologous great saphenous vein (GSV) grafts for repair of extremity arterial injuries is well established. Contralateral great saphenous vein (cGSV) is traditionally used in the setting of lower extremity vascular injury given the risk of occult ipsilateral superficial and deep venous injury. We evaluated outcomes of ipsilateral GSV (iGSV) bypass in patients with lower extremity vascular trauma.

Surgical stabilization versus nonoperative treatment for flail and non-flail rib fracture patterns in patients with traumatic brain injury.

Purpose: Literature on outcomes after SSRF, stratified for rib fracture pattern is scarce in patients with moderate to severe traumatic brain injury (TBI; Glasgow Coma Scale ≤ 12). We hypothesized that SSRF is associated with improved outcomes as compared to nonoperative management without hampering neurological recovery in these patients.

Methods: A post hoc subgroup analysis of the multicenter, retrospective CWIS-TBI study was performed in patients with TBI and stratified by having sustained a non-flail fracture pattern or flail chest between January 1, 2012 and July 31, 2019.

Emesis of an enteral bullet: A rare case of bullet embolism to the thoracic esophagus.

A case of migration of a foreign body from the stomach to the thoracic esophagus is described. The bullet was successfully retrieved endoscopically after exploratory laparotomy was performed to address the patient's injuries. Enteral migration of bullets is a rare phenomenon that should be considered when the location of retained ballistic fragments is inconsistent with gunshot wounds and expected trajectories.

High Mortality and Venous Thromboembolism Risk Following Major Penetrating Abdominal Venous Injuries.

Background: Penetrating injuries to the inferior vena cava and/or iliac veins are a source of hemorrhage but may also predispose patients to venous thromboembolism (VTE). We sought to determine the relationship between iliocaval injury, VTE and mortality.

Methods: The National Trauma Data Bank was queried for penetrating abdominal trauma from 2015-2017.

The majority of major amputations after resuscitative endovascular balloon occlusion of the aorta are associated with preadmission trauma.

Objective: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a potentially life-saving intervention. However, recent reports of associations with limb loss and mortality have called its safety into question. We aimed to evaluate patient and hospital characteristics associated with major amputation and in-hospital mortality among patients undergoing REBOA for trauma.

Outcome after surgical stabilization of rib fractures versus nonoperative treatment in patients with multiple rib fractures and moderate to severe traumatic brain injury (CWIS-TBI).

Background: Outcomes after surgical stabilization of rib fractures (SSRF) have not been studied in patients with multiple rib fractures and traumatic brain injury (TBI). We hypothesized that SSRF, as compared with nonoperative management, is associated with favorable outcomes in patients with TBI.

Methods: A multicenter, retrospective cohort study was performed in patients with rib fractures and TBI between January 2012 and July 2019.

The Boston Medical Center Coronavirus Disease 2019 (COVID-19) Procedure Team: Optimizing the surgeon's role in pandemic care at a safety-net hospital.

Background: The coronavirus disease 2019 pandemic has claimed many lives and strained the US health care system. At Boston Medical Center, a regional safety-net hospital, the Department of Surgery created a dedicated coronavirus disease 2019 Procedure Team to ease the burden on other providers coping with the surge of infected patients. As restrictions on social distancing are lifted, health systems are bracing for additional surges in coronavirus disease 2019 cases.

Progressive Increase in Scholarly Productivity of New American Board of Anesthesiology Diplomates From 2006 to 2016: A Bibliometric Analysis.

Background: Improving research productivity is a common goal in academic anesthesiology. Initiatives to enhance scholarly productivity in anesthesiology were proposed more than a decade ago as a result of emphasis on clinical work. We hypothesized that American Board of Anesthesiology diplomates certified from 2006 to 2016 would be progressively more likely to have published at least once during this time period.

Implementation of a Novel Structured Social and Wellness Committee in a Surgical Residency Program: A Case Study.

This article provides a theoretical and practical rational for the implementation of an innovative and comprehensive social wellness program in a surgical residency program at a large safety net hospital on the East Coast of the United States. Using basic needs theory, we describe why it is particularly important for surgical residency programs to consider the residents sense of competence, autonomy, and belonging during residence. We describe how we have developed a comprehensive program to address our residents' (and residents' families) psychological needs for competence, autonomy, and belongingness.

Tactical medicine -- the Israeli revised protocol.

Limited conflicts and the war against terrorism, in particular, have changed the emphasis in the present trend from preparing to cope with full-scale wars to the need to combat in limited conflicts. This shift has affected significantly medical units' preparations. Law enforcement organizations have come together with medical first responders in a combined new model.