Journal of the Royal College of Surgeons of Edinburgh
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Angola is one of the most heavily mined countries in the world. Despite the vast effort made to clear landmines, very few accurate figures for casualty rates are available. The town of Kuito in central Angola is surrounded by minefields left after the 22-month siege by the rebel UNITA forces. ⋯ Mortality from anti-personnel mines was 1.7% (1/60). Seventy per cent of all lower limb amputations in Kuito are performed as a result of landmine injury (53/76). Landmines exert a severe strain on already stretched surgical services, and a significant burden of morbidity on the population of Kuito.
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J R Coll Surg Edinb · Dec 1996
Day-case surgery in children under 2 years of age: experience in a district general hospital and survey of parental satisfaction.
One surgeon's experience of day-case paediatric surgery in a population aged less than 2 years at a district general hospital is reported. During a 6-year period from 1989 to 1994, 82 day-case operations were performed in 79 infants and young children. All children were managed by a multidisciplinary team including surgeon, paediatric anaesthetist and paediatric nurses. ⋯ A telephone survey of parents enquiring into satisfaction with all aspects of pre-, peri-, and post-operative care revealed that the procedures are well-accepted. The survey also showed that there was no increased utilization of primary health care professionals when day-case surgery is performed in this young age group. We conclude that paediatric day-case surgery is safe and well-tolerated by both infants and parents and is suitable for performance in non-specialist centres provided a team approach is adopted.
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J R Coll Surg Edinb · Dec 1996
The management of stab wounds to the chest: sixteen years' experience.
In a retrospective review of 16 years of admissions to a regional cardiothoracic unit, 76 patients were admitted with stab wounds to the chest. Of these wounds, 75% were managed conservatively with tube drainage and observation and 25% required surgical intervention. 5.2% were managed as emergency room thoracotomies, 15.8% as urgent procedures in the operating theatre and 4% as late procedures. The total mortality was 1.3% and was seen in the emergency room thoracotomy group (mortality 25%). The risk if sub-diaphragmatic injury in the presence of chest injury is highlighted.