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  1. Article ; Online: Preoperative information: Written first?

    Ollat, Didier

    Orthopaedics & traumatology, surgery & research : OTSR

    2020  Volume 107, Issue 1S, Page(s) 102771

    Abstract: Patient information is now an ethical and legal obligation in France; it is the physician who is required to provide proof. The Law of March 4, 2002 and the code of ethics and main legal and regulatory texts are, however, imprecise on some points. ... ...

    Abstract Patient information is now an ethical and legal obligation in France; it is the physician who is required to provide proof. The Law of March 4, 2002 and the code of ethics and main legal and regulatory texts are, however, imprecise on some points. Written documents, although not stipulated in law, are in practice essential, supplementing the indispensable oral information given by the surgeon in individual personalized interview. Patients remember only some of this information, and overestimate their own understanding of it. Written documents are therefore essential to compensate for this. Their contents need validation by scientific societies. In case of disagreement, the medical file is the essential means of assessing information quality, and should be kept up to date as rigorously as possible. A key document is the letter summarizing the preoperative consultation, validating surgery, which should be drawn up in a manner that meets the obligation to inform. Signed consent is not mandatory in law, but is necessary in practice and should be archived. For judges, proof of information is based on several elements: the complete structured letter to the patient and community physician plus the signed information sheet and consent form constitute solid evidence and all three should be included in the medical file. Information has now become a part of health-care in itself. In a context of increasing litigation, "defensive medicine" is still to be avoided but physicians should have their own check-lists so as to be in a position to prove delivery of structured information if called upon to do so. In the absence of proven information, patients can plead loss of chance and/or prejudice for lack of preparation and/or infringement of dignity, and claim damages from the courts.
    MeSH term(s) France ; Humans ; Informed Consent
    Language English
    Publishing date 2020-12-13
    Publishing country France
    Document type Journal Article ; Review
    ISSN 1877-0568
    ISSN (online) 1877-0568
    DOI 10.1016/j.otsr.2020.102771
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: WALANT in hand surgery: Ischemic complications and their medicolegal implications in France: A systematic review of the literature and of French legal databases.

    Rougereau, G / El Khoury, G / Châtelain, L / Zadegan, F / El Khoury, E / Ollat, D

    Hand surgery & rehabilitation

    2022  Volume 41, Issue 2, Page(s) 157–162

    Abstract: WALANT (Wide Awake Local Anesthesia No Tourniquet) presents a theoretical risk of digital ischemia due to the presence of epinephrine, associated to the local anesthetic. For this reason, in France, the market authorization prohibits the use of ... ...

    Abstract WALANT (Wide Awake Local Anesthesia No Tourniquet) presents a theoretical risk of digital ischemia due to the presence of epinephrine, associated to the local anesthetic. For this reason, in France, the market authorization prohibits the use of epinephrine in digital extremities. The main objective of the present study was to assess the risk of ischemic complications reported in literature, and then to analyze the medicolegal implications in France. A systematic literature review was performed by three independent readers, using the PubMed and Embase databases. Also, declarations of claims and legal proceedings between 2007 and 2020 in France were examined in the official national Légifrance and Doctrine databases. Eight of the 424 articles retrieved were selected. Only 3 cases of digital necrosis following local anesthesia with adrenalized lidocaine were reported. Adrenalized xylocaine may be considered in case of peripheral microcirculation disorder. From a medicolegal point of view, no complaints or medicolegal implications were associated with WALANT in France. It seems that the market authorization for adrenalized local anesthesia could be extended to use in the digital extremities. However, the lack of medical and legal data calls for caution. We therefore recommend the use of an institutional protocol specifying the cases of overdose and the patient's pathway, and training for practitioners wishing to use this technique.
    MeSH term(s) Anesthesia, Local/adverse effects ; Anesthesia, Local/methods ; Epinephrine ; Hand/surgery ; Humans ; Ischemia/etiology ; Lidocaine/adverse effects
    Chemical Substances Lidocaine (98PI200987) ; Epinephrine (YKH834O4BH)
    Language English
    Publishing date 2022-01-29
    Publishing country France
    Document type Journal Article ; Systematic Review
    ZDB-ID 2848776-X
    ISSN 2468-1210
    ISSN (online) 2468-1210
    DOI 10.1016/j.hansur.2022.01.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Comments on: "Is amputation a viable treatment option in lower extremity trauma?" of M Barla, B Gavanier, M Mangin, J Parot, C Bauer, D Mainard published in Orthop Traumatol Surg Res 2017;103(6):971-975.

    Ollat, D / Barbier, O

    Orthopaedics & traumatology, surgery & research : OTSR

    2017  Volume 104, Issue 1, Page(s) 155

    MeSH term(s) Amputation ; Lower Extremity ; Publications
    Language English
    Publishing date 2017-12-16
    Publishing country France
    Document type Letter ; Comment
    ISSN 1877-0568
    ISSN (online) 1877-0568
    DOI 10.1016/j.otsr.2017.12.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Management of Posterior Digital Skin Defect by Pico Negative Pressure Wound Therapy: A Case Report and Literature Review.

    Ollat, Didier / Vuilletet, Emma / Zadegan, Frédéric / Rougereau, Grégoire

    Orthopedic nursing

    2022  Volume 41, Issue 1, Page(s) 21–24

    Abstract: The use of negative pressure therapy for digital skin loss is uncommon. A reason for this is the difficulty of applying dressings to the hand, which are often difficult to seal. However, negative pressure therapy offers some benefits, especially when ... ...

    Abstract The use of negative pressure therapy for digital skin loss is uncommon. A reason for this is the difficulty of applying dressings to the hand, which are often difficult to seal. However, negative pressure therapy offers some benefits, especially when associated with local infection. We present a nonspecific, simple and original technique using a Pico negative pressure dressing that may be easily applied in daily practice.
    MeSH term(s) Bandages ; Humans ; Negative-Pressure Wound Therapy
    Language English
    Publishing date 2022-01-19
    Publishing country United States
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 632639-0
    ISSN 1542-538X ; 0744-6020
    ISSN (online) 1542-538X
    ISSN 0744-6020
    DOI 10.1097/NOR.0000000000000816
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: "Snapping triceps": A rare and misleading condition - a clinical case report.

    Pfister, G / Barbier, O / Ollat, D

    Hand surgery & rehabilitation

    2018  Volume 37, Issue 2, Page(s) 121–123

    Abstract: Snapping triceps corresponds to subluxation of the medial head of the triceps brachii over the medial epicondyle during active elbow flexion. It is a rare and misleading condition that is often associated with ulnar nerve instability. The latter can ... ...

    Abstract Snapping triceps corresponds to subluxation of the medial head of the triceps brachii over the medial epicondyle during active elbow flexion. It is a rare and misleading condition that is often associated with ulnar nerve instability. The latter can result in the snapping triceps being missed. Diagnosis requires a detailed clinical examination. Surgical treatment consists of anterior translocation of the nerve with an adipose flap to stabilize it and transfer of the distal attachment of the medial head of triceps brachii.
    MeSH term(s) Adult ; Elbow Joint/physiopathology ; Elbow Joint/surgery ; Humans ; Male ; Muscle, Skeletal/physiopathology ; Muscle, Skeletal/surgery ; Physical Examination
    Language English
    Publishing date 2018-02-01
    Publishing country France
    Document type Case Reports ; Journal Article
    ZDB-ID 2848776-X
    ISSN 2468-1210
    ISSN (online) 2468-1210
    DOI 10.1016/j.hansur.2017.12.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Comments on: Double tendon transfer for the correction of drop-foot by M.-Y. Grauwin, G. Wavreille, C. Fontaine published in Orthop Traumatol Surg Res 2015;101(1):115-8.

    Ollat, D / Chaise, F

    Orthopaedics & traumatology, surgery & research : OTSR

    2015  Volume 101, Issue 6, Page(s) 767

    MeSH term(s) Gait Disorders, Neurologic/surgery ; Humans ; Tendon Transfer/methods ; Tendons/surgery
    Language English
    Publishing date 2015-10
    Publishing country France
    Document type Comment ; Letter
    ISSN 1877-0568
    ISSN (online) 1877-0568
    DOI 10.1016/j.otsr.2015.07.012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Surgical solutions for preoperative skin preparation in total hip arthroplasty: A cost-effectiveness analysis of Betadine® and Chloraprep™.

    Rougereau, Grégoire / Chatelain, Léonard / Terracher, Richard / Zadegan, Frédéric / Ollat, Didier

    Orthopaedics & traumatology, surgery & research : OTSR

    2022  Volume 108, Issue 6, Page(s) 103355

    Abstract: Objective: The purpose of our study was to compare the cost of surgical site skin preparation using ChloraPrep™ (2% chlorhexidine gluconate [CHG] and 70% isopropyl alcohol [IPA]) with skin cleansing using Betadine® Surgical Scrub and Betadine® 5% ... ...

    Abstract Objective: The purpose of our study was to compare the cost of surgical site skin preparation using ChloraPrep™ (2% chlorhexidine gluconate [CHG] and 70% isopropyl alcohol [IPA]) with skin cleansing using Betadine® Surgical Scrub and Betadine® 5% solution (povidone-iodine [PVI]) in total hip arthroplasty (THA).
    Hypothesis: The hypothesis was that the ChloraPrep™ skin disinfection protocol reduces the cost of perioperative antisepsis.
    Methods: A prospective database was created for all THAs performed at our university hospital between November 1st, 2020, and December 31st, 2020. Each surgeon was randomly assigned one type of antiseptic prior to the start of the study: one surgeon to the ChloraPrep™ group and one to the Betadine® group. In both groups, the enrollment stopped at the 15th patient. The costs related to consumables, waste disposal, and operating room occupancy time of each protocol were then assessed for each patient.
    Results: The mean duration of the ChloraPrep™ protocol was 3.5±0.3minutes compared to 13.5±0.9minutes for the Betadine® protocol. The overall cost of a surgical site skin preparation involving all three steps was on average €46.8±4.2 for the ChloraPrep™ group compared to €155±10.9 for the Betadine® group (p<0.0001).
    Discussion: Not only is the effectiveness of ChloraPrep™ already recognized but it also appears to have health economic benefits. However, further studies are needed to confirm this finding.
    Level of evidence: III, case control study.
    MeSH term(s) 2-Propanol ; Anti-Infective Agents, Local/therapeutic use ; Arthroplasty, Replacement, Hip ; Case-Control Studies ; Cost-Benefit Analysis ; Humans ; Povidone-Iodine/therapeutic use ; Preoperative Care/methods ; Skin ; Surgical Wound Infection/prevention & control
    Chemical Substances Anti-Infective Agents, Local ; Povidone-Iodine (85H0HZU99M) ; 2-Propanol (ND2M416302)
    Language English
    Publishing date 2022-06-16
    Publishing country France
    Document type Journal Article ; Randomized Controlled Trial
    ISSN 1877-0568
    ISSN (online) 1877-0568
    DOI 10.1016/j.otsr.2022.103355
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Limb reconstructive surgery in austere settings: use of flaps in French forward surgical facilities.

    Barbier, O / Ollat, D / Rigal, S / Versier, G

    Medecine et sante tropicales

    2016  Volume 26, Issue 2, Page(s) 137–141

    Abstract: Introduction: Military surgeons deployed abroad must achieve soft tissue coverage under austere conditions.: Hypothesis: A non-specialized surgeon can achieve soft tissue coverage with good results.: Material and method: This is a retrospective ... ...

    Title translation Chirurgie reconstructrice des membres en situation précaire : utilisation des lambeaux dans les structures chirurgicales de l'avant françaises.
    Abstract Introduction: Military surgeons deployed abroad must achieve soft tissue coverage under austere conditions.
    Hypothesis: A non-specialized surgeon can achieve soft tissue coverage with good results.
    Material and method: This is a retrospective study of all patients who underwent soft tissue coverage in French forward surgical units between 2003 and 2013.
    Results: In all, 81 flaps were constructed. Open fractures (39%) were the leading indication, followed by osseous infections (35%). Most flaps were for legs (70%) and hands (25%). Only pedicle flaps were used. The success rate was 91%.
    Discussion: Flaps can be constructed by orthopedic surgeons who are not specialized in reconstructive surgery, in austere settings and with good results. This procedure must be part of a global strategy of limb reconstruction, especially in cases of bone and joint infection. Pedicle flaps, especially muscular, appear more reliable and are to be preferred. The training of the surgeons deployed abroad must include flap surgery.
    Language English
    Publishing date 2016-05-01
    Publishing country France
    Document type Journal Article
    ISSN 2261-2211
    ISSN (online) 2261-2211
    DOI 10.1684/mst.2016.0573
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Could the orthopaedic surgeon deployed in austere setting perform flaps on the leg?

    Barbier, O / Ollat, D / Pasquier, P / Rigal, S / Versier, G

    Acta orthopaedica Belgica

    2017  Volume 83, Issue 1, Page(s) 35–39

    Abstract: The orthopaedic military surgeons deployed in operations are led to perform soft tissue coverage on the lower limb. The purpose of this study was to evaluate if flaps performed by surgeons' non-specialist in reconstructive surgery are associated with ... ...

    Abstract The orthopaedic military surgeons deployed in operations are led to perform soft tissue coverage on the lower limb. The purpose of this study was to evaluate if flaps performed by surgeons' non-specialist in reconstructive surgery are associated with good outcome. All patients operated for a flap on the leg in French Forward Surgical Team deployed in theatre of operations between 2003 and 2013 were retrospectively reviewed. Forty-nine patients were included, for a total of 54 flaps' procedures. Indications were open fractures in 25 cases and osseous infections in 29 cases. No flap was performed on French soldiers. All the flaps were pedicle. Outcome was favourable for more than 90% of flaps with no statistical difference between muscular and fasciocutaneous flap and with regard to the indication. In conclusion, an orthopaedic surgeon deployed in austere setting with significant good outcome can perform reconstructive surgery with legs' flaps.
    MeSH term(s) Adolescent ; Adult ; Aged ; Bone Diseases, Infectious/surgery ; Child ; Child, Preschool ; Fractures, Open/surgery ; France ; Humans ; Leg ; Middle Aged ; Military Personnel ; Mobile Health Units ; Orthopedics ; Reconstructive Surgical Procedures ; Retrospective Studies ; Surgical Flaps ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2017-03
    Publishing country Belgium
    Document type Journal Article
    ZDB-ID 210367-9
    ISSN 0001-6462 ; 1784-407X
    ISSN 0001-6462 ; 1784-407X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: When the tendon autograft is dropped accidently on the floor: A study about bacterial contamination and antiseptic efficacy.

    Barbier, O / Danis, J / Versier, G / Ollat, D

    The Knee

    2015  Volume 22, Issue 5, Page(s) 380–383

    Abstract: Background: Inadvertent contamination of the autograft can occur during anterior cruciate ligament (ACL) reconstruction if the autograft is dropped on the floor during surgery. A study was undertaken to determine the incidence of contamination when a ... ...

    Abstract Background: Inadvertent contamination of the autograft can occur during anterior cruciate ligament (ACL) reconstruction if the autograft is dropped on the floor during surgery. A study was undertaken to determine the incidence of contamination when a graft is dropped on the operating room floor and the efficacy of antimicrobial solutions to decontaminate it.
    Methods: Samples from 25 patients undergoing ACL reconstruction with a hamstring tendon were sectioned and dropped onto the floor. Cultures were taken after immersion in antiseptic solutions (a chlorhexidine gluconate solution (group 1), a povidone-iodine solution (group 2), and a sodium hypochlorite solution (group 3)). A fourth piece (group 0) was cultured without being exposed to any solution. Cultures of a floor swab were taken at the same time.
    Results: The floor swab cultures were positive in 96% of cases. The rate of contamination was 40% in group 0, 8% in group 1, 4% in group 2, and 16% in group 3. There was a significant difference between groups 1 and 2 and group 0 (p<0.05) but not between groups 3 and 0.
    Conclusions: Immersing a graft dropped on the floor during surgery in a chlorhexidine gluconate solution or povidone-iodine solution significantly reduces contamination of the graft. Soaking of the hamstring autograft in one of these solutions is recommended in the case of inadvertent contamination.
    Clinical relevance: Laboratory investigation (level 2).
    MeSH term(s) Aerococcus/isolation & purification ; Anterior Cruciate Ligament Reconstruction ; Anti-Infective Agents, Local ; Autografts/microbiology ; Chlorhexidine/analogs & derivatives ; Disinfectants ; Disinfection ; Floors and Floorcoverings ; Humans ; Immersion ; Intraoperative Complications ; Operating Rooms ; Povidone-Iodine ; Prospective Studies ; Pseudomonas/isolation & purification ; Sodium Hypochlorite ; Staphylococcus/isolation & purification ; Tendons/microbiology ; Tendons/transplantation
    Chemical Substances Anti-Infective Agents, Local ; Disinfectants ; Povidone-Iodine (85H0HZU99M) ; Sodium Hypochlorite (DY38VHM5OD) ; chlorhexidine gluconate (MOR84MUD8E) ; Chlorhexidine (R4KO0DY52L)
    Language English
    Publishing date 2015-10
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1200476-5
    ISSN 1873-5800 ; 0968-0160
    ISSN (online) 1873-5800
    ISSN 0968-0160
    DOI 10.1016/j.knee.2014.07.027
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