Annals of the Royal College of Surgeons of England
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Retained sponges and instruments (RSI) due to surgery are a recognised medical 'never event' and have catastrophic implications for patients, healthcare professionals and medical care providers. The aim of this review was to elucidate the extent of the problem of RSI and to identify preventative strategies. ⋯ Vigilance among operating theatre personnel is paramount if RSI is to be prevented. Prospective multicentre trials to assess efficacy of new technologies aiding manual counting should be undertaken if this medical error is to be eliminated completely.
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Ann R Coll Surg Engl · Mar 2013
Comparative StudyEffect of cotton padding on the setting properties of plaster slabs.
Plaster of Paris (PoP) impregnated bandages have been used to maintain the position of bones and joints for over a century. Classically, wool dressing is applied to the limb before the PoP, which can then be moulded to the desired shape. A modification of this practice is to wrap the PoP bandages circumferentially in cotton before wetting and applying to the patient in an attempt to reduce inhalation of plaster dust and reduce mess. However, this may affect the water content of the cast and therefore also its setting properties and strength. This study compared the setting properties of PoP casts when used with and without cotton wrapping. ⋯ The initial decrease in strength and stiffness of the cast wrapped in cotton may comprise the ability of the backslab to hold the joint or bone in an optimal position. Any modification of the standard plaster slab application technique should allow for the potential adverse effects on the plaster setting properties.
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Ann R Coll Surg Engl · Mar 2013
Case ReportsTraumatic diaphragmatic hernia: delayed presentation with tension viscerothorax--lessons to learn.
Diaphragmatic rupture is a serious complication of thoracoabdominal trauma. The condition may be missed initially. ⋯ His diaphragmatic injury passed unnoticed, to present two years later with left tension viscerothorax, a rarely reported and hardly recognised entity. Nasogastric tube insertion aborted the emergency situation and the hernia was repaired successfully in a semielective setting.
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Ann R Coll Surg Engl · Mar 2013
Cardiopulmonary exercise testing as a predictor of complications in oesophagogastric cancer surgery.
An anaerobic threshold (AT) of <11 ml/min/kg can identify patients at high risk of cardiopulmonary complications after major surgery. The aim of this study was to assess the value of cardiopulmonary exercise testing (CPET) in predicting cardiopulmonary complications in high risk patients undergoing oesophagogastric cancer resection. ⋯ This study has shown a correlation between AT and the development of cardiopulmonary complications although the discriminatory ability was low.