3D Printed N-95 Masks During the COVID-19 Pandemic: Lessons Learned.

Early in 2020, the pandemic resulted in an enormous demand for personal protective equipment (PPE), which consists of face masks, face shields, respirators, and gowns. At our institution, at the request of hospital administration, the Lifespan 3D Printing Laboratory spearheaded an initiative to produce reusable N95 masks for use in the hospital setting. Through this article, we seek to detail our experience designing and 3D printing an N95 mask, highlighting the most important lessons learned throughout the process. Foremost among these, we were successful in producing a non-commercial N95 alternative mask which could be used in an era when N95 materials were extremely limited in supply. We identified five key lessons related to design software, 3D printed material airtightness, breathability and humidity dispersal, and ability for communication. By sharing our experience and the most valuable lessons we learned through this process, we hope to provide a helpful foundation for future 3D-printed N95 endeavors.

Perspectives on endovascular training in traditional 5+2 vascular surgery fellowship training programs.

This study aimed to compare expectations and experiences of fellows to those of faculty in vascular surgery fellowship programs with regard to endovascular training. Anonymous surveys were sent to fellows (n = 235) and program directors (n = 147), with 79 fellows and 65 faculty members responding. Fellows noted higher expectations of their endovascular skills prior to starting fellowship than the faculty group reported expecting. Faculty assessed fellows' pre-training endovascular skills at a significantly lower level than the fellows' self-assessment. Fellows were significantly less satisfied with the structured aspects of endovascular training than the faculty believed them to be. Only 3% of fellows vs. 32% of faculty felt that the presence of an endovascular simulator affected how residents ranked fellowship programs during the match. In conclusion, incoming fellows in vascular surgery fellowship programs have high expectations of themselves, but may overestimate their actual pre-training endovascular skills. Fellows desire more structured endovascular training, which is not recognized by faculty. Endovascular simulators are valued, but may not be a significant draw in the match process.

Interventions on the superficial venous system for chronic venous insufficiency by surgeons in the modern era: an analysis of ACS-NSQIP.

OBJECTIVE: To evaluate patient characteristics, practice patterns, and outcomes for patients treated for chronic venous insufficiency (CVI). BACKGROUND: Chronic venous insufficiency is a common problem treated using open or endovascular methods by physicians from a number of surgical and nonsurgical specialties. METHODS: Patients treated for CVI in the American College of Surgeons National Surgical Quality Improvement Program data set (2005-2011) were identified. Analyses were based on open surgical treatment (open surgery of varicose vein [OSVV]) versus endovenous ablation (EVA), specialty of treating surgeon, and by the presence of venous ulceration (VU). Preoperative patient characteristics and intraoperative measures were examined, and multivariate logistic regression analyses were performed for the postoperative outcomes of superficial surgical site infection (sSSI) and deep venous thrombosis (DVT). RESULTS: A total of 4366 patients were identified. Patients undergoing EVA were older (53.3 vs 51.8 years; P < .001), had higher body mass index (BMI; 29.9 vs 29.0; P < .001), and more commonly presented with VU (20.9% vs 13.3%; P < .001). Vascular surgeons were more likely than general surgeons to treat patients with VU (17.0% vs 13.4%; P = .017). Patients with VU had higher BMI (32.2 vs 28.8; P < .001), were older (57.9 vs 51.4 years; P < .001), and more likely to be diabetic (9.0% vs 4.7%; P < .001). Factors associated with sSSI were OSVV (adjusted odds ratio [AOR] 2.56; 95% confidence interval [CI] 1.19-5.50; P = .016), obesity (AOR 2.16; 95% CI 1.10-4.24; P = .025), and VU (AOR 2.56; 95% CI 1.19-5.50; P = .016). Patients undergoing OSVV had significantly lower odds of DVT when compared to EVA (AOR 0.52; 95% CI 0.28-0.97; P = .040). CONCLUSIONS: The OSVV, obesity, and VU increase the odds of sSSI after procedures treating CVI. Patients in these categories should be monitored closely for signs of infection in the perioperative period. Patients undergoing EVA have higher odds of postoperative DVT, suggesting that routine screening after EVA for DVT may be justified.