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operating theatre

Claire E Webster, Jon Clasper, Daniel J Stinner, Joseph Eliahoo, Spyros D Masouros
Background: Throughout history, traumatic amputation of the lower extremity has been a notable feature of all conflicts involving explosive incidents. Even at the close of the recent conflicts in Afghanistan, there were deaths that were deemed "potentially survivable." The purpose of this study is to characterize lower extremity blast injury and to determine if their amputation levels and associated injury characteristics correlate with a higher risk of mortality. Methods: the UK Joint Theatre Trauma Registry (JTTR) was interrogated to identify all lower extremity traumatic amputations sustained in both Iraq and Afghanistan between January 2003 and the end of UK operations in August 2014...
March 14, 2018: Military Medicine
Laurent Mathieu, Michel Levadoux, Emmanuel Soucany de Landevoisin, Tarun J McBride Windsor, Sylvain Rigal
INTRODUCTION: Noncombat-related hand injuries are common in current theatres of operations. Crushing is one of the most frequent mechanisms that may cause traumatic amputations of digits. In the military setting, management of these digital amputations is challenging regarding limitation in microsurgical means in medical treatment facilities and aeromedical evacuation delays out of the combat zone. METHODS: Two cases of digital replantation performed in French forward surgical units are described...
2018: SICOT-J
S-M Lee, K Gordon, R McMillan, F Crystal, P Acher
Introduction Transurethral resection of the prostate has remained the most common operation for bladder outlet obstruction in the UK, but it is associated with potential morbidity and median two-day length of hospital stay. Holmium laser enucleation of the prostate (HoLEP) provides an alternative procedure. Provision of day-case HoLEP would improve patient care through increased efficiency. We assessed the feasibility and safety of day-case HoLEP and examined predictive factors for increased length of hospital stay...
March 15, 2018: Annals of the Royal College of Surgeons of England
H S Thakkar, I Yardley, D Kufeji
Introduction In 2015, the Royal College of Surgeons of England (RCS) commissioned the East Midlands Clinical Network to develop a set of guidelines for the management of paediatric torsion. Two quality measures identified were the provision of surgery locally where possible and 100% of explorations within three hours. We sought to assess the adherence to these quality measures within our referral network. Materials and methods Retrospective data were collected for all paediatric scrotal explorations performed within our centre between January 2014 and July 2016...
March 15, 2018: Annals of the Royal College of Surgeons of England
Benjamin R Poh, Paul A Cashin, Daniel G Croagh
INTRODUCTION: Traditional teaching dictates that it may not be prudent to take the jaundiced patient to theatre for emergency laparoscopic cholecystectomy as they may experience worse outcomes following surgery. METHODS: A prospective cohort of 104 patients undergoing emergency laparoscopic cholecystectomy was stratified into two groups using a serum total bilirubin of above 50 μmol/L (2.9 mg/dL) to define the jaundiced group. Primary outcomes were morbidity and mortality rate...
March 14, 2018: World Journal of Surgery
Anne-Marie Reid, Jeremy M Brown, Julie M Smith, Alexandra C Cope, Susan Jamieson
CONTEXT: For medical education researchers, a key concern may be the practicalities of gaining ethical approval where this is a national or local requirement. However, in qualitative studies, where the dynamics of human interaction pervade, ethical considerations are an ongoing process which continues long after approval has been granted. Responding to ethical dilemmas arising 'in the moment' requires a reflexive approach whereby the researcher questions his/her own motivations, assumptions and interests...
March 13, 2018: Perspectives on Medical Education
Randa A Abdallah, Sameh M Ragab, Maher Z Hassanin
OBJECTIVE: To investigate the safety and efficacy of two topical blood stopper modulators; Ankaferd blood stopper (ABS) and feracrylum 1% solution (FS) during adenoid surgery. STUDY DESIGN: Prospective randomized trial. METHODS: Two hundred and twenty five consecutive pediatric adenoid patients aged from 9 months to 2 years old were studied. Patients were randomly allocated into two haemostatic groups; (ABS, FS) and normal saline (control group)...
March 10, 2018: European Archives of Oto-rhino-laryngology
Olivia Sonneborn, Charne Miller, Leon Head, Rachel Cross
BACKGROUND: Operating theatre services can be heavily relied upon during mass casualty disaster events, which require nurses to have adequate training and education of hospital disaster management plans to respond appropriately. The evidence-base of disaster preparedness in the acute setting is limited, particularly with regard to operating theatre nurses. OBJECTIVES: Explore operating theatre nurse's disaster knowledge of their role in a mass casualty event, and identify the preferred mode of disaster education and training to improve disaster preparedness...
February 21, 2018: Nurse Education Today
Thomas Krasemann, Felix Berger, Petru Liuba, John Thomson
A modern catheter laboratory for the treatment of children with CHD should be in close proximity to the paediatric ICU, operating theatres, and imaging facilities. Space requirements and equipment for an up-to-date catheter laboratory are discussed. The document was endorsed by the council of the Association of European Paediatric and Congenital Cardiologists.
March 9, 2018: Cardiology in the Young
Ann Lögde, Gudrun Rudolfsson, Roma Runesson Broberg, Anna Rask-Andersen, Robert Wålinder, Erebouni Arakelian
The lack of specialist nurses in operating theatres is a serious problem. The aim of this study was to describe reasons why specialist nurses in perioperative care chose to leave their workplaces and to describe the process from the thought to the decision. Twenty specialist nurses (i.e. anaesthesia, NA, and operating room nurses) from seven university- and county hospitals in Sweden participated in qualitative individual in-depth interviews. Data were analysed by systematic text condensation. We identified four themes of reasons why specialist nurses quitted their jobs: the head nurses' betrayal and dismissive attitude, and not feeling needed; inhumane working conditions leading to the negative health effects; not being free to decide about one's life and family life being more important than work; and, colleagues' diminishing behaviour...
March 6, 2018: International Journal for Quality in Health Care
Steve Slott
Steve Stott, managing director of Medical Air, discusses the many benefits of ultraclean ventilation systems in the 21st century operating theatre environment, explaining that the development of ever-more advanced and 'flexibly designed' UCV canopies has enabled them to be installed in a wide range of theatres, extending the variety of surgeries that can be undertaken, while helping to minimise the risk of surgical site infection.
June 2017: Health Estate
René Fahrner, Falk Rauchfuss, Hubert Scheuerlein, Utz Settmacher
BACKGROUND: There are numerous causes of hepatic gas formation that range from serious pathologies to incidental findings, including mesenteric infarction, liver abscess, inflammatory bowel disease or minimally invasive hepatic interventions. CASE PRESENTATION: We report a case of a 50-year-old man who was admitted to the emergency room after a car accident. The clinical examination and further diagnostics revealed a craniocerebral injury with a fracture of the skull, concomitant soft tissue lesions and subarachnoidal bleeding...
March 2, 2018: BMC Surgery
Jeni Stevens, Virginia Schmied, Elaine Burns, Hannah G Dahlen
PROBLEM: Providing skin-to-skin contact in the operating theatre and recovery is challenging. BACKGROUND: Barriers are reported in the provision of uninterrupted skin-to-skin contact following a caesarean section. AIM: To explore how health professionals' practice impacts the facilitation of skin-to-skin contact within the first 2h following a caesarean section. METHODS: Video ethnographic research was conducted utilising video recordings, observations, field notes, focus groups and interviews...
February 26, 2018: Women and Birth: Journal of the Australian College of Midwives
Joel Wl Lau, Tao Yang, Kyaw Kyar Toe, Weimin Huang, Stephen Ky Chang
Surgical traineeship has traditionally been based on a master apprentice model where learning takes place in the operating theatre. This approach has changed over the past few years with greater emphasis on surgical training taking place within the surgical skills laboratory. We developed a high fidelity simulator, the Image-guided Robotic Assisted Surgical simulator (IRAS) with an incorporated robotic guidance feature. The robot system is developed to mimic the process of an experienced surgeon physically holding a trainee's hands to demonstrate maneuvering of the laparoscopic instruments...
January 2018: Annals of the Academy of Medicine, Singapore
Ahmet Ali Tuncer, Elif Emel Ayar Erten
Objective: In this study, thermocautery, plastic clamping, and conventional (open surgical) circumcision techniques were compared in terms of their complications. Methods: Male patients who underwent circumcisions between May 2014 and May 2015 in two separate pediatric surgery clinics were retrospectively analyzed using the hospital registry system. These patients were evaluated in terms of age, accompanying pathologies, anesthesia techniques, complication rates, duration of surgery, and circumcision techniques...
November 2017: Pakistan Journal of Medical Sciences Quarterly
L McCadden, C G Leonard, W J Primrose
BACKGROUND: Oesophageal disorders and osteonecrosis of the jaw are recognised complications of the commonly prescribed medication bisphosphonate. Despite these diagnoses being seen comparatively frequently within the ENT clinic, osteonecrosis of the external ear is a less well reported complication. METHODS: The current literature is reviewed and our experience with six cases of bisphosphonate-related ear canal osteonecrosis is presented. RESULTS: Six cases were identified as suffering from ear canal osteonecrosis as a result of bisphosphonate treatment...
February 28, 2018: Journal of Laryngology and Otology
H Tafazal, P Spreadborough, D Zakai, N Shastri-Hurst, S Ayaani, M Hanif
Introduction There is an increasing trend towards day case surgery for uncomplicated gallstone disease. The challenges of maximising training opportunities are well recognised by surgical trainees and the need to demonstrate timely progression of competencies is essential. Laparoscopic cholecystectomy provides the potential for excellent trainee learning opportunities. Our study builds upon previous work by assessing whether measures of outcome are still affected when cases are stratified based on procedural difficulty...
March 2018: Annals of the Royal College of Surgeons of England
N Rudarakanchana, M Hamady, S Harris, E Afify, Rgj Gibbs, C D Bicknell, M P Jenkins
Objective Despite centralisation of the provision of vascular care, not all areas in England and Wales are able to offer emergency treatment for patients with acute conditions affecting the aorta proximal to the renal arteries. While cardiothoracic centres have made network arrangements to coordinate care for the repair of type A dissections, a similar plan for vascular care is lacking. This study investigates early outcomes in patients with ruptured suprarenal aortic aneurysm or dissection (rSRAD) transferred to a specialist centre...
February 27, 2018: Annals of the Royal College of Surgeons of England
Shehan Wickramasinghe, Boris Ruggiero, Liang Low
INTRODUCTION: Acute wrap failure post fundoplication is a rare but recognized complication and can be due to patient factors, disease factors and surgical factors. Herniation of the stomach into the thorax can mimic a pneumothorax clinically and radiologically and thus lead to bad outcomes for patients. PRESENTATION OF CASE: We report the case of a 20-year-old male who presented to the emergency department with progressively worsening upper abdominal pain, nausea and vomiting followed by acute onset dyspnoea, six days post a laparoscopic repair of a small hiatus hernia and a Nissen fundoplication...
February 17, 2018: International Journal of Surgery Case Reports
Senthurun Mylvaganam, Elizabeth J Conroy, Paula R Williamson, Nicola L P Barnes, Ramsey I Cutress, Matthew D Gardiner, Abhilash Jain, Joanna M Skillman, Steven Thrush, Lisa J Whisker, Jane M Blazeby, Shelley Potter, Christopher Holcombe
INTRODUCTION: The 2008 National Mastectomy and Breast Reconstruction Audit demonstrated marked variation in the practice and outcomes of breast reconstruction in the UK. To standardise practice and improve outcomes for patients, the British professional associations developed best-practice guidelines with specific guidance for newer mesh-assisted implant-based techniques. We explored the degree of uptake of best-practice guidelines within units performing implant-based reconstruction (IBBR) as the first phase of the implant Breast Reconstruction Evaluation (iBRA) study...
February 7, 2018: European Journal of Surgical Oncology
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