International journal of surgery
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A total of 18 composite tissue allotransplants of the face have currently been reported. Prior to the start of the face transplant programme, there had been intense debate over the risks and benefits of performing this experimental surgery. This review examines the surgical, functional and aesthetic, immunological and psychological outcomes of facial transplantation thus far, based on the predicted risks outlined in early publications from teams around the world. ⋯ The overall early outcomes of the face transplant programme have been generally more positive than many predicted. This initial success is testament to the robust approach of teams. Dissemination of outcomes and ongoing refinement of the process may allow facial transplantation to eventually become a first-line reconstructive option for those with extensive facial disfigurements.
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Consequent to recent advances in surgical techniques and management, survival rate has increased substantially over the last 25 years, particularly in colorectal cancer patients. However, post-operative morbidity and mortality from colorectal cancer vary widely across the country. Therefore, standardised outcome measures are emphasised not only for professional accountability, but also for comparison between treatment units and regions. ⋯ Discrepancies in these models have led to the introduction of a specialty-specific POSSUM: the ColoRectal POSSUM (CR-POSSUM). CR-POSSUM only uses six physiological parameters and four operative measures for prediction of mortality. It is much simplified to allow ease of use.
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Randomized Controlled Trial
Local anaesthetic wound infiltration following paediatric appendicectomy: a randomised controlled trial: Time to stop using local anaesthetic wound infiltration following paediatric appendicectomy?
This study sought to determine the efficacy of post-operative wound infiltration with local anaesthetic following paediatric appendicectomy. ⋯ Wound infiltration with local anaesthetic following appendicectomy in children provides no additional benefit over regular simple analgesia. Its routine use represents dogmatic practise which ought to be challenged for this patient group.
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Comparative Study Clinical Trial
DRUJ instability after distal radius fracture: a comparison between cases with and without ulnar styloid fracture.
Because of the importance of the DRUJ in upper extremity function and the prevalence of distal radius fractures, either with or without ulnar styloid fracture, this study was designed to assess the relationship between ulnar styloid fracture and the incidence of DRUJ instability after treatment of distal radius fractures treated with ORIF (volar plate). ⋯ Our study demonstrated that untreated stable or minimally displaced ulnar styloid fracture accompanied by distal radius fracture, has no adverse effect on DRUJ stability following ORIF of the radius.