World journal of surgery
-
World journal of surgery · Oct 2008
Outcome analysis of blood product transfusion in trauma patients: a prospective, risk-adjusted study.
Studies have confirmed adverse outcome associated with transfusion of packed red blood cells (PRBCs) in trauma; however, little data are available regarding other blood product transfusion, such as fresh frozen plasma (FFP) and platelets. The objective of this study was to examine risk-adjusted outcome in trauma with stratification by blood product type. ⋯ There is a dose-dependent correlation between blood product transfusion and adverse outcome (increased mortality and infection) in trauma patients.
-
World journal of surgery · Oct 2008
Evaluation of the outcome of complete sinus excision with reconstruction of the umbilicus in patients with umbilical pilonidal sinus.
Umbilical pilonidal sinus is a cause of umbilical discharge. In this study, the outcome of complete excision of the umbilical sinus with umbilical reconstruction is considered. Adult patients with umbilical pilonidal sinus who had not undergone any previous surgeries were operated on using a technique that involves complete excision of the sinus after eversion of the umbilicus followed by reconstruction of the umbilicus. ⋯ Only four patients had wound drainage after operation, and all required drainage of the wound. No recurrence was observed during the follow-up period, and all patients were satisfied with the appearance of their umbilicus. The technique of complete sinus excision and umbilical reconstruction is an effective and acceptable method for treating umbilical pilonidal sinus and may be recommended for primary treatment of this disease.
-
Surgical education for medical students in Australia and New Zealand is provided by 19 universities in Australia and 2 in New Zealand. One surgical college is responsible for managing the education, training, assessment, and professional development programs for surgeons throughout both countries. The specialist surgical associations and societies act as agents of the college in the delivery of these programs, the extent of which varies among specialties. ⋯ Trainees' progress is assessed by workplace-based assessment and formal examinations, including an exit examination. The sustained production of sufficient competent surgeons to meet societal needs encompasses many challenges including the recruitment of appropriate graduates and the availability of adequate educational and clinical resources to train them. Competence-based training is an attractive educational philosophy, but its implementation has brought its own set of issues, many of which have yet to be resolved.
-
Japanese students must pass very competitive entrance examinations to enter medical school after graduating from high school at the relatively young age of 18. There are currently 80 medical schools in Japan, with approximately 7700 students graduating annually. Since 2004, after passing the National Medical Board Examination, all medical graduates are required to complete a 2-year period of clinical training to become medical practitioners. ⋯ General surgery board certification is a prerequisite for subspecialty board certification. Notwithstanding these revisions, the number of surgery candidates is steadily declining because work conditions in the surgical profession are viewed as unfavorable. To regain some level of the previous attractiveness and glory of this specialty, surgeons need to receive significant incentives that counteract some of the downsides of the life of a surgeon.
-
World journal of surgery · Sep 2008
Meta AnalysisIntraoperative allogeneic red blood cell transfusion in ampullary cancer outcome after curative pancreatoduodenectomy: a clinical study and meta-analysis.
Allogeneic blood transfusion (ABT) containing packed red blood cells (RBCs) has a known immunosuppressive effect that may affect cancer metastases and recurrence. This study examined whether intraoperative allogeneic RBC transfusion is an independent risk factor of adverse outcome in patients with ampullary carcinoma after curative pancreatoduodenectomy. ⋯ The amount of intraoperative ABT is one of the important factors that adversely influenced survival in patients with ampullary cancer after curative pancreatoduodenectomy. Healing anemia preoperatively and careful dissection to minimize intraoperative bleeding as much as possible are mandatory for reducing risk of the intraoperative ABT.