The British journal of oral & maxillofacial surgery
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Br J Oral Maxillofac Surg · Jul 2012
ReviewLitigation in National Health Service oral and maxillofacial surgery: review of the last 15 years.
Litigation claims are increasing in medicine but we know of little detailed analysis of those published concerning oral and maxillofacial surgery (OMFS) despite information being freely available from the NHS Litigation Authority (NHSLA) under the Freedom of Information Act. We obtained information from the NHSLA on clinical and non-clinical negligence claims in OMFS from April 1995 to August 2010, and analysed the data with outcomes and a further breakdown of subspecialty. During the period 318 claims relating to OMFS were registered. ⋯ The total amount paid out was in excess of £5 million, and the highest claim (more than £300,000) during the period was for misdiagnosis of an oral cancer. Litigation in OMFS is increasing, as is the number of cases that necessitate compensation by the NHSLA. We discuss the trends and implications.
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Br J Oral Maxillofac Surg · Jun 2012
ReviewTraumatic brain injury: review of current management strategies.
Head injury is a common condition with a high morbidity and mortality. Serious intracranial haematomas require early recognition and evacuation to maximise chances of independent outcomes. ⋯ Evidence for the treatment of cerebral perfusion pressure, and management of hyperventilation, osmotherapy, tracheostomy, and leakage of cerebrospinal fluid (CSF) has accumulated during the last decade and is important in the management of patients in all clinical settings. Since head injury is commonly associated with maxillofacial injuries, this review will be relevant to all who deal with this aspect of trauma.
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Br J Oral Maxillofac Surg · Apr 2012
Meeting the psychological needs of patients with facial disfigurement.
Those with congenital or acquired disfigurement are faced with the challenges of social reactions and their own psychological responses to looking different. There is no simple linear relation between the degree of disfigurement and the degree of experienced distress. ⋯ Decision-making about surgery, including that for those seeking aesthetic surgery, should take account of these complex factors to understand the patient's needs, ensure informed consent, and avoid unnecessary or ill-timed surgery. All those working with patients with disfigurement should have an understanding of their psychosocial needs, and there should be access to an identified member of staff such as a clinical nurse specialist with counselling skills, and a recognised referral route to a psychologist or liaison psychiatrist.