ANZ journal of surgery
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ANZ journal of surgery · Sep 2013
Randomized Controlled Trial Comparative StudySingle-dose antibiotic prophylaxis is effective enough in colorectal surgery.
The aim of this study was to investigate the hypothesis that prevention of surgical site infection (SSI) is equally effective when patients receive single-dose (SD) or three-dose antibiotic prophylaxis with second-generation cephalosporin and metronidazole in elective colorectal surgery. ⋯ SD antibiotic prophylaxis with second-generation cephalosporin and metronidazole is equivalent to a three-dose prophylaxis for preventing SSI in elective colorectal surgery. But further study would be needed to clarify this because of the small number of participants.
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Thromboembolism is a common cause of morbidity and mortality in patients with colorectal cancer, but thromboprophylaxis (TP) is underutilized. Current guidelines do not make specific recommendations for colorectal cancer patients and provide minimal guidance for the ambulatory setting, although emerging evidence suggests TP may be warranted during chemoradiotherapy or in the extended post-operative phase. A survey of Australasian colorectal surgeons was therefore performed to assess current TP practice and attitudes. ⋯ More data on thromboembolism risk during various treatment phases are required and should be promulgated in tumour-specific guidelines. Logistical barriers to adopting TP in the ambulatory setting should be addressed.
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ANZ journal of surgery · Sep 2013
Oncoplastic breast surgery: a regional Australian 2012 fellowship experience.
Oncoplastic breast surgery (OBS) is a developing subspecialty, although many countries are struggling with how to incorporate training in OBS as part of the established breast surgery subspecialization pathways. UK and Brazil have surged ahead with established formal training programmes, whereas countries such as Australia still rely on ad hoc training by interested surgeons. Our aim was to review the possibility of including regional training centres with appropriate OBS expertise into a future formal training programme in OBS. ⋯ Current British Association of Surgical Oncology (BASO) guidelines specify recommendations regarding BASO Level I and II OBS training, experience and exposure. Based on the experience during the fellowship presented in this audit, we discuss the merits of using regional Australian hospitals like Port Macquarie Base Hospital to make up the cohort of BASO Level I units to provide the core foundation experience in OBS to the next generation of Australian oncoplastic breast fellows.
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ANZ journal of surgery · Sep 2013
Randomized Controlled Trial Comparative StudyProspective randomized controlled trial comparing dynamic hip screw and screw fixation for undisplaced subcapital hip fractures.
Neck of femur fractures (NOFFs) are a common cause of morbidity and mortality in our community. Minimally displaced intracapsular fractures are treated with internal fixation by a two-hole dynamic hip screw (DHS) or three partially threaded cancellous screws. Data to support the superiority of one are limited. This prospective randomized controlled trial compares outcomes with these two fixation methods. ⋯ This study found no difference in outcomes between DHS and cancellous screws in the treatment of subcapital NOFFs in a fit, independent population, but we found a high level of physical decline in previously fit, independently ambulating patients. A large, multicentre trial will be required to differentiate between these two fixation methods.