Let’s talk postoperative care—Join Dr. Katharine Caldwell for a discussion with expert acute and critical care surgeon Dr. Isaiah Turnbull. This episode of the Washington Manual of Surgery Podcast will focus on postoperative care and is a companion to Chapter 3 of the 9th edition of the bestselling Washington Manual of Surgery.  

Dr. Isaiah Turnbull reviews the management of common post-operative problems. Key points include handling hypotension, tachycardia, and fever in post-operative patients, the importance of clinical assessment for infections, and insights from the STOP-IT trial on antibiotic duration. The episode also emphasizes the need for proper imaging and laboratory investigations to diagnose and manage necrotizing soft tissue infections effectively. Tune in for expert advice crucial for surgical trainees. 

Guest Host: Katharine Caldwell, MD – general surgery resident at WashU Medicine and associate editor of the Washington Manual of Surgery  

Guest: Isaiah Turnbull, MD, is an associate professor in the Department of Surgery at WashU Medicine. Dr. Turnbull’s specialty is in acute and critical care surgery and his research interests include medical and surgical training burnout, and how this issue compromises training, clinical efficacy, and quality assurance. 

Notes:

LRINEC Score

• Wong CH, Khin LW, Heng KS, Tan KC, Low CO. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. Crit Care Med. 2004 Jul;32(7):1535-41. doi: 10.1097/01.ccm.0000129486.35458.7d. PMID: 15241098.
• Fernando SM, Tran A, Cheng W, Rochwerg B, Kyeremanteng K, Seely AJE, Inaba K, Perry JJ. Necrotizing Soft Tissue Infection: Diagnostic Accuracy of Physical Examination, Imaging, and LRINEC Score: A Systematic Review and Meta-Analysis. Ann Surg. 2019 Jan;269(1):58-65. doi: 10.1097/SLA.0000000000002774. PMID: 29672405.

STOP-IT

• Sawyer RG, Claridge JA, Nathens AB, Rotstein OD, Duane TM, Evans HL, Cook CH, O'Neill PJ, Mazuski JE, Askari R, Wilson MA, Napolitano LM, Namias N, Miller PR, Dellinger EP, Watson CM, Coimbra R, Dent DL, Lowry SF, Cocanour CS, West MA, Banton KL, Cheadle WG, Lipsett PA, Guidry CA, Popovsky K; STOP-IT Trial Investigators. Trial of short-course antimicrobial therapy for intraabdominal infection. N Engl J Med. 2015 May 21;372(21):1996-2005. doi: 10.1056/NEJMoa1411162. Erratum in: N Engl J Med. 2018 Feb 15;378(7):686. doi: 10.1056/NEJMx180006. PMID: 25992746; PMCID: PMC4469182.

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The Washington Manual of Surgery Podcast is a companion to the Washington Manual of Surgery (9th Edition). For more comprehensive surgical education, pick up a copy of the Washington Manual of Surgery: https://bit.ly/41xJ0aQ

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For more information about the Department of Surgery at WashU Medicine, visit https://surgery.wustl.edu/ and follow us on social media.

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