ANZ journal of surgery
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Patients undergoing infrainguinal bypass surgery have reduced baseline tissue oxygen tension and high rates of wound infections. The hypoxaemia worsens during surgery, potentially reducing the ability to combat bacterial lodgement. We investigated whether high-dose perioperative oxygen administration to patients undergoing infrainguinal arterial surgery results in increased tissue oxygenation. ⋯ The administration of high-dose oxygen to vascular surgical patients undergoing lower-limb arterial surgery results in increased tissue oxygen concentrations when perfusion is not reduced by the presence of arterial clamps. These results suggest the administration of high-dose oxygen intraoperatively may be beneficial in reducing wound infections, but further research is required.
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ANZ journal of surgery · Jun 2007
Biography Historical ArticleLooking both ways: the Jamieson Memorial Lecture, 2006.
The Jamieson Memorial Lecture, delivered annually to the Neurosurgical Society of Australasia, commemorates the life and work of a leading Australasian neurosurgeon, Dr Kenneth Grant Jamieson (1925-1976), of Melbourne and Brisbane. He was the first specialist neurosurgeon to be appointed to the Brisbane General Hospital, the Brisbane Children's Hospital and the newly established Princess Alexandra Hospital in Queensland, jointly in 1956. He went on to serve as President of the Neurosurgical Society of Australasia (1971-1973) and as a Councillor of the Royal Australasian College of Surgeons from 1971 until his death. ⋯ Such an approach needs special attributes if pioneering advocacy for improvement is to be both directed and ultimately successful. The attributes needed to be a medical historian-futurist are summarized in the themes of (i) perspective; (ii) courageous resilience and optimism; (iii) evangelistic enthusiasm; and (iv) the skills of creativity that are needed for innovation. One audit of history suggests that much can be achieved if such qualities are possessed or can be developed by those who also 'look both ways'.
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ANZ journal of surgery · Jun 2007
Clinical TrialPreoperative beta-blocker use reduces atrial fibrillation in off-pump coronary bypass surgery.
Atrial fibrillation (AF) after coronary artery bypass graft surgery constitutes the most common sustained arrhythmia and results in many complications. The purpose of this study was to assess the effects of prophylactic use of beta-blockers against atrial fibrillation in off-pump surgery patients in the early postoperative period. ⋯ Low-dose postoperative beta-adrenergic blockade is valuable for patients who receive these medications before off-pump coronary artery bypass grafting procedures and may be beneficial against AF in all patients.
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ANZ journal of surgery · Jun 2007
ReviewMechanical compression in the prophylaxis of venous thromboembolism.
Venous thromboembolism (VTE) is an important cause of morbidity and mortality in a substantial number of the Australian community. There exists a considerable range of potential prophylactic measures aimed at reducing the risk of VTE. These antithrombotic regimens include pharmacological interventions and mechanical techniques to counteract venous stasis including graduated compression stockings and intermittent pneumatic compression (IPC) devices. ⋯ In moderate-risk patients when pharmacological prophylaxis is contraindicated, IPC can be used as an alternative. High-risk patients should receive both mechanical and pharmacological prophylaxis to reduce their relative risk. Until further evidence becomes available, the specific type of IPC unit chosen will generally be determined by ease of use, availability and cost.