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Biomedical subjects

D C Jacobsen

Publications and source records attributed to D C Jacobsen.

6 recordsLinked to original sources
PubMed1980

The pursuit of excellence in graduate surgical education. Visions of the Arizona experience.

The unique experiment in graduate surgical education is described. The premise is set forth that there exists a discipline called human biology worthy of formal graduate study, most logically carried out in a department of surgery. Study in this program was specifically goal-oriented rather than time-oriented, with goals individually tailored to each student. Emphasis was on flexibility of progression, individual achievement, original thought an rigorous logical analysis of fundamental problems in surgical biology. The purpose of such a program was to produce life-time students of human biology rather than mere residents hurdling a demoralizing obstacle. Although long-term data are not available, the conviction of those who participated in the experiment is that such a purpose was and can be uniquely fulfilled. Wilder acceptance of these principles should lead to higher standards of surgical care.

Arizona↗
PubMed1979

Central vessel trauma.

During a 24 month period, 30 patients were treated for central vessel trauma (CVT). Injured vessels included all of the major arteries and veins in the chesk, neck and abdomen except the infrarenal aorta. Overall survival was 70 per cent. Experience with specific injuries is reviewed with commentary on surgical access to difficult areas including the thoracic outlet, suprarenal aorta and inferior vena cava. Common factors in the nine deaths are reviewed with the findings that cardiac arrest at any time during pre- or intraoperative management is uniformly lethal; emergency thoracotomy for control of bleeding carries an expectedly high mortality; cross-clamping of the descending thoracic aorta to control hemoperitoneum has a limit of tolerance of about one hour, and prolonged shock, whether compensated or profound is poorly tolerated and is associated with a high mortality.

Abdominal Injuries↗
PubMedDate not supplied

Simplified perioperative management in vertical banded gastroplasty.

Vertical Banded Gastroplasty (VBG) is the most commonly performed weight loss operation in the United States and is of proven adjunctive benefit in the treatment of morbid obesity. In an attempt to reduce the hospital related complications associated with morbidly obese patients we simplified the perioperative management of 244 patients undergoing VBG. Our goals were early feeding, early ambulation and a short hospital stay. Neither nasogastric tube nor Foley catheter was used after surgery. Mean postoperative stay was 3.24 +/- 0.8. Forty-one patients (16.8%) developed significant complications. Only two of these had a nosocomial complication (0.8%). The remaining 39 patients had technical complications not related to the protocol of simplified perioperative care. Short hospital stay and simplified perioperative management are feasible and safe for the large majority of patients undergoing VBG and may, in fact, significantly decrease the nosocomial morbidity common to this type of patients.

Adult↗