Journal of the Royal College of Surgeons of Edinburgh
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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.
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J R Coll Surg Edinb · Aug 1996
Non-operative management of stab wounds to the abdomen with omental evisceration.
A consecutive series of 14 patients with anterior abdominal stab wounds and omental evisceration treated at the Kingston Public Hospital Jamaica over a 3-year period is presented. During this period 223 patients with abdominal stab wounds were seen of which 66 had omental evisceration. ⋯ Serial physical examination was the method used to select patients for conservative surgical management with the exclusion of patients with deteriorating clinical signs or peritonitis. Omental evisceration through an abdominal stab wound in a patient with stable clinical signs and without evidence of peritonitis is not an absolute indication for exploratory laparotomy.
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Cricothyrotomy is an important surgical technique. We studied the anatomy of the cricothyroid membrane in 13 adult fresh cadavers preserved at 45 degrees F and examined at 70 degrees F. The working dimensions of the cricothyroid membrane were measured for emergency cricothyrotomy and placement of an airway tube. ⋯ Eight subjects (62%) had an artery delineated transversely across the cricothyroid membrane. Two subjects (15%) had sclerosis of the cricothyroid joint. To promote the safe use of cricothyrotomy, the anatomy of the cricothyroid membrane is defined and clinically relevant data are presented.