Sample M+M Matrix
The M+M Matrix for April 18, 2002
Surgical Morbidity and Mortality Conference
Cedars-Sinai Medical Center, Los Angeles
Six matrices were developed at the surgical morbidity and mortality conference of April 18, 2002.
1. Peritracheal bleeding
- Surgical anatomy of the peritracheal area
- Operative causes of bleeding
- Immediate postoperative causes of bleeding
- Delayed bleeding; the Herald bleed
- Preoperative workup for peritracheal bleeding
2. Tracheostomy techniques
- Percutaneous methods
- Open tracheostomy
- Relative morbidity and mortality of each technique; bleeding
- Long-term complications of tracheostomy; stenosis
3. Tracheo-innominate fistulae
- Incidence
- Presentation
- Causes
- Operative management; approaches
4. Colocutaneous fistulae
- Management
- Etiologies; ischemia, enterotomy, drain erosion
- Likely causes during mobilization for a colostomy
5. Drains
- Types
- Management of the sump drain
- The global view, or "What am I draining, and what is the risk of manipulating this drain?"
- Histological findings resulting from 40 cm Hg wall suction
6. Exigent stomal bleeding
- Workup
- Role of colonoscopy
- Risks of colonoscopy
- Pseudo-aneurysms of colonic vasculature
- Role of the red-cell labeled scan or "The Parallel Universe of Gastrointestinal Bleeding."
- Surgical complications of stomal creation
- Role of angiography; diagnosis, embolization
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