Journal of the Royal College of Surgeons of Edinburgh
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J R Coll Surg Edinb · Apr 1993
Removal of metal implants after fracture surgery--indications and complications.
In a study of 297 internal fixation operations for fractures or joint injuries performed during 1982, a second operation for implant removal was undertaken in 42% of cases. Significant complications occurred following the second procedure in 19%. Implants which were retained did not give rise to appreciable problems. It is suggested that implants should only be removed when there are clear clinical indications for doing so.
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J R Coll Surg Edinb · Feb 1993
Randomized Controlled Trial Clinical TrialBupivacaine infiltration after haemorrhoidectomy.
The effect of a locally infiltrated solution of bupivacaine was studied in 30 patients undergoing haemorrhoidectomy. A standard Milligan-Morgan haemorrhoidectomy, with preoperative infiltration of adrenaline solution (1:200,000), was performed. ⋯ There was no significant difference between the groups with respect to visual analogue pain scores, analgesic requirement, time to first bowel action or duration of hospital stay. Bupivacaine as a local infiltration in this situation does not confer analgesic effect into the postoperative period.
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J R Coll Surg Edinb · Oct 1992
Acute epiglottitis in adults: a potentially lethal cause of sore throat.
The diagnosis, management and outcome in 12 adults with acute epiglottitis was reviewed. Painful dysphagia was a universal symptom and respiratory distress affected eight patients, six of whom required urgent airway intervention. All patients received parenteral antibiotics, ten received steroids and four received adrenaline. ⋯ Indirect laryngoscopy is the investigation of choice and this is preferable to neck radiology. Two patients died and it is stressed that this condition must be distinguished from other more common causes of a severe sore throat. The patient should be managed in a unit with the facilities and expertise to effect acute airway intervention.
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J R Coll Surg Edinb · Feb 1992
Early experience with the Bower percutaneous endoscopic gastrostomy tube.
Percutaneous endoscopic insertion of gastrostomy tubes is a technique becoming more widely used in the UK. It allows insertion of a gastrostomy tube without laparotomy, under local anaesthesia and sedation, and so operative insertion may eventually become a rarity. We report on our successful early experience with a new gastrostomy tube (Bower PEG) which does not require endoscopy if eventual removal is required, and describe the methods of insertion and removal.