The British journal of surgery
-
Randomized Controlled Trial Clinical Trial
Economic analysis of VenUS I, a randomized trial of two bandages for treating venous leg ulcers.
The study investigated the cost-effectiveness of four-layer and short-stretch compression bandages for treating venous leg ulcers. ⋯ On average, four-layer bandaging was associated with greater health benefits and lower costs than short-stretch bandaging.
-
Multicenter Study
Chronic pain after open mesh and sutured repair of indirect inguinal hernia in young males.
Chronic pain is common after herniorrhaphy, but the effect of surgical technique (mesh versus non-mesh repair) and the social consequences of the pain have not been established. The aim of this study was to analyse chronic postherniorrhaphy pain and its social consequences in young males operated on for an indirect inguinal hernia with a Lichtenstein mesh repair, Shouldice or Marcy (annulorrhaphy) repair. ⋯ Chronic pain is common after primary inguinal hernia repair in young males, but there is no difference in the pain associated with open mesh and non-mesh repair.
-
Multicenter Study
Prospective survey of factors affecting risk discussion during consent in a surgical specialty.
The Department of Health in the UK has developed new consent guidance but without clear recommendations on how the incidence and severity of a given risk should influence its discussion during the process of obtaining informed consent. Plastic surgery is a litigation-prone specialty that offers a paradigm for assessing attitudes to consent. ⋯ There was a wide variation of opinion as to how frequently a major risk must occur before it is likely to be conveyed to a patient during the process of consent. The findings suggest that recent change in case law has yet to disseminate fully in one surgical specialty, with the potential for the challenge that consent is not 'informed'.
-
The occurrence of in-transit metastases in patients with a tumour-positive sentinel node varies greatly between centres and it has been suggested that the incidence is high in this patient group. ⋯ Sentinel node biopsy was associated with a higher risk of in-transit metastases. This finding does not support the routine use of sentinel node biopsy in the management of melanoma.