Annals of the Royal College of Surgeons of England
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The evidence for and against the prophylactic use of anticonvulsants and antibiotics in head injury is reviewed. There is a lack of blinded placebo-controlled trials in this area. On balance there is no compelling evidence to support the use of either anticonvulsant or antibiotic prophylaxis in head injury, with the possible exception of antibiotic prophylaxis in compound depressed skull fractures and penetrating brain injuries.
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The efficient use of operating lists is important to clear waiting lists and because they are expensive to run (at 1988 prices, 151 pounds per hour). Of general surgical theatre session time, 49% is used for performing operations, but no survey of orthopaedic theatre sessions has been published. In light of this we surveyed 151 elective orthopaedic lists at three hospitals. ⋯ During lists, turnover times were quicker if a consultant surgeon was present (P = 0.0022). We conclude that more efficient use of elective orthopaedic theatre sessions is possible and could be achieved if more detailed preparation was undertaken by the anaesthetic, theatre and surgical staff concerned. If a consultant surgeon is present the list is likely to proceed with fewer delays.
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Research projects culminating in a higher surgical degree are now an almost inevitable part of training in general surgery. However, little information exists on the trainees' experience of research. Fifty-nine general surgical trainees (39 registrars and 20 senior registrars) from the North East Thames region completed a confidential questionnaire which addressed various aspects of surgical research. ⋯ A one-year period of structured training in research methods with the emphasis on educational content, rather than the production of a thesis, would be a popular alternative. There was a highly significant correlation between the degree of satisfaction with project supervision and the subsequent impression of the value of research (Spearman's rho = 0.54, p < 0.001) stressing the crucial role of the research supervisor. Significant variability in satisfaction with research supervision was noted between the various research centres in the region suggesting a need for closer external monitoring of research posts.
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Ann R Coll Surg Engl · Mar 1994
An audit of the effect of a 24-hour emergency operating theatre in a district general hospital.
The recent introduction of a 24-hour emergency theatre for General Surgery provided an opportunity to audit its effect on emergency operating in a District General Hospital. Prior to its introduction much of the emergency operating was determined by theatre availability rather than clinical need. ⋯ This had benefits for the patients in reducing their waiting time and also for the junior surgeons by increasing their sleep. A survey of the Region indicated that very few hospitals provided adequate emergency theatre facilities.