Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · Jan 1994
Randomized Controlled Trial Comparative Study Clinical TrialProlonged suction drainage prevents serous wound discharge after cardiac surgery.
A series of 180 patients was randomised to two groups after median sternotomy performed for cardiac surgery in order to evaluate the effect of suction drainage on serous wound discharge. In group A all wounds were drained using two conventional mediastinal drains, while in group B one suction drain and one conventional mediastinal drain were employed. Five patients developed serous wound discharge in group B compared with 14 in group A (chi 2, P < 0.02). There were no significant differences between the rates of major wound infection (group A, n = 1; group B, n = 1) or the incidence of postoperative pericardial effusion assessed by echocardiography (group A, n = 10; group B, n = 5).
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All 338 lower limb amputees under the care of one disablement services centre were asked to assess phantom pain severity at different times after amputation. Of 212 (63%) replies, 13 had died, 22 were non-limb wearers and 22 were unable to complete the questionnaire. In all, 176 useful replies were received--96 below-knee, 74 above-knee and 6 through-knee. ⋯ Phantom pain decreased with time, was present equally in traumatic and vascular amputees, and was related to the amount of preoperative pain (P < 0.005). Only 22% felt phantom pain had impaired their rehabilitation. Rehabilitation score was related to phantom pain severity at the time of questionnaire completion (P < 0.05), but not at other specified times after operation.
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Ann R Coll Surg Engl · Jan 1994
Intravenous sedation in accident and emergency departments: a nationwide survey.
Anonymous questionnaires regarding the practice of intravenous sedation were sent to all accident and emergency departments in England and Wales. The response rate was 63%. Intravenous sedation was used by 94% of the departments who replied. ⋯ In 16% of the units no monitoring was used routinely. ECG monitoring was carried out by 48% of the departments, non-invasive blood pressure monitoring by 67% and pulse oximetry by 65%. Our findings indicate there is a need for guidelines regarding patient selection, the choice of drugs and the monitoring of patients.