Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · Mar 2008
Review Case ReportsExtensor tendon injury to the index and middle finger secondary to Kirschner wire insertion for a distal radial fracture.
We describe a case with the highly unusual complication of attritional ruptures to both the extensor tendons to the index and middle finger following Kirschner wire placements for a distal radial fracture. This particular complication has never been previously described in the literature. We also review the literature, identifying certain techniques in the management of distal radial fractures with Kirschner wires which are considered to increase the risk of tendonous or neurovascular injury. Finally, recommendations are made that should reduce the complications of iatrogenic soft tissue injury associated with this very common procedure.
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Ann R Coll Surg Engl · Mar 2008
Wedding rings are not a significant source of bacterial contamination following surgical scrubbing.
Despite some evidence that the wearing of rings may increase the microbial load, there is currently nothing to suggest that viable bacteria remain following a standard surgical scrub. The aim of the study was to examine the distribution and type of microbial flora seen on the hands of doctors following a standard surgical scrub. ⋯ This preliminary study would suggest that a traditional band wedding ring is not a source of a bacterial load following a standard surgical scrub procedure and, as such, there is no requirement for their removal pre-operatively.
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Ann R Coll Surg Engl · Mar 2008
Comparative StudyThe dedicated emergency surgeon: towards consultant-based acute surgical admissions.
The management of an efficient acute surgical service with conflicting pressures of managing elective and emergency work, compounded by waiting list targets and the maximum 4-h wait for patients in accident and emergency poses a significant challenge. We assess the impact of appointing a dedicated emergency surgeon on the delivery of our emergency surgery service. ⋯ The appointment of a dedicated emergency surgery consultant has resulted in an increase in day-time consultant-supervised operating, shorter hospital stay for emergency admissions, improved training for surgical trainees, as well as providing potential financial savings for the trust.
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Ann R Coll Surg Engl · Mar 2008
Mobile phones, in combination with a computer locator system, improve the response times of emergency medical services in central London.
The aim of this study was to determine whether mobile phones and mobile phone locating devices are associated with improved ambulance response times in central London. ⋯ Since the introduction of the mobile phone locating system, there has been an improvement in ambulance response times. Mobile locating systems in urban areas across the UK may lead to faster response times and, potentially, improved patient outcomes.
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Ann R Coll Surg Engl · Mar 2008
Recent changes in the management of blunt splenic injury: effect on splenic trauma patients and hospital implications.
Management of blunt splenic injury has been controversial with an increasing trend towards splenic conservation. A retrospective study was performed to identify the effect of this changed policy on splenic trauma patients and its implications. ⋯ Non-operative management of blunt splenic trauma in adults can be performed with an acceptable outcome. Although CT is classed as the 'gold standard', initial imaging for detection and evaluation of blunt splenic injury, ultrasound can play a major role in follow-up imaging and potentially avoids major radiation exposure.