International journal of surgery
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Blunt abdominal trauma (BAT) is a leading cause of morbidity and mortality. Rapid diagnosis and treatment with the Advanced Trauma Life Support guidelines are vital, leading to the development of Focused Assessment with Sonography in Trauma (FAST). ⋯ Patients with false negative scans, requiring therapeutic laparotomy is concerning. In unstable patients FAST may help in triaging and identifying those requiring laparotomy. Negative FAST scans do not exclude abdominal injury. Further randomised control trials are recommended if the role of FAST is to be better understood.
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Routine pre-operative cross-matching of two units of packed red cells (PRC) is current practice in most hospitals for patients undergoing elective laparoscopic colorectal surgery (LCS). ⋯ G&S is sufficient to allow safe & cost-effective operative practice in laparoscopic colorectal surgery.
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Biography Historical Article
A pioneer in medicine and surgery: Charles Sédillot (1804-1883).
Professor Charles Sédillot (1804-1883) is one of the pioneers of modern medicine, surgery, anaesthesiology, histopathology and infectiology. Unfortunately, he remains unknown outside of the circles of French military medicine historians. He was the first surgeon in the world to offer techniques such as coxofemoral dislocation and internal urethrotomy, thus becoming a pioneer in endoscopic surgery. ⋯ Long before the description put forth by Semmelweiss (1818-1865), he foresaw and understood the existence and action of microorganisms, which he termed microbes, in the development of postoperative infections. For his work, he was honoured by his peers in France but remained unknown beyond the borders of his homeland. Here, we present a succinct report of the considerable accomplishments of the life and work of this outstanding physician and surgeon.
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C-reactive protein (CRP) has been used as an indicator of postoperative complications in abdominal surgery. Its short half-life makes it a reliable marker of the systemic inflammatory response secondary to a surgical procedure or to the appearance of complications, rapidly returning to normal values with the recovery of the patient. ⋯ According to these results, an early and persistent elevation of CRP after colorectal surgery with anastomosis, is a marker of anastomotic leakage. A cut-off value > 140 mg/L on POD3 maximizes sensitivity and specificity.
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Weight loss is the most commonly used metric in comparing outcomes after bariatric surgery. This is frequently presented in the form of percentage of excess weight loss (%EWL). Patients' weight is measured at several time points prior to surgery. The time point selected as the preoperative weight can have significant effects upon the measurement of %EWL. This study aimed to investigate whether there was any standardization in the selection of preoperative weight amongst UK bariatric surgery healthcare professionals. ⋯ Variation in the measurement of the preoperative weight will lead to variations of calculated %EWL between different bariatric units or even between different disciplines in the same unit. This will make comparison of published outcome data difficult. This study highlights the urgent need for standardization.