ANZ journal of surgery
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ANZ journal of surgery · Jan 2014
Comparative StudyIncreasing breast reconstruction rates by offering more women a choice.
Breast reconstruction (BR) following mastectomy for breast cancer is safe and has high rates of patient satisfaction, yet only around 12% of Australian women undergo BR. This study presents BR rates and outcomes from a specialist practice that discusses reconstruction options with all women medically suitable for BR. ⋯ A BR rate of 41%, over three times the national average, was achieved when BR was discussed with all patients. This significant gain in BR rate was not accompanied by a commensurate increase in adverse outcomes, providing evidence that expanding the indications for BR to women who were previously not considered eligible is a valid option.
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ANZ journal of surgery · Jan 2014
Practice GuidelineEvidence-based review for patients undergoing elective hip and knee replacement.
The objective of this study was to evaluate the evidence for different interventions in the preoperative, perioperative and post-operative care for people undergoing elective total hip (THR) and knee (TKR) replacement surgery. ⋯ There was a deficiency in the quality of the evidence supporting key aspects of the continuum of care for primary THR/TKR surgery. Consequently, recommendations were limited. Prioritization and funding for research into areas likely to impact clinical practice and patient outcomes after elective joint replacement surgery are the next important steps.
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ANZ journal of surgery · Jan 2014
Clinical TrialCan POSSUM accurately predict post-operative complications risk in patients with abdominal Crohn's disease?
Although the majority of patients with Crohn's disease (CD) are young, they are often seriously ill when surgery is required. The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) is a risk prediction scoring system estimating 30-day complications. The primary endpoint was to evaluate POSSUM efficacy in this subgroup. The secondary endpoint was to determine any potential correlation between POSSUM, Harvey-Bradshaw Index (HBI), length of stay (LOS) and anastomotic leak. ⋯ POSSUM is precise in predicting post-operative complications in patients with abdominal CD. POSSUM correlates with HBI.
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ANZ journal of surgery · Jan 2014
Patent Blue V dye anaphylaxis: experience of Australian and New Zealand surgeons.
Patent Blue V dye (PBVD) can cause severe anaphylaxis. For sentinel node biopsy (SNB) in breast cancer patients, controversy exists as to the utility of PBVD in addition to lymphoscintigraphy. This survey assessed Australian and New Zealand breast surgeons' experience of anaphylaxis with PBVD. ⋯ Australian and New Zealand breast surgeons' reported that the anaphylaxis rate from PBVD was 0.15%. The majority of surgeons continued to use PBVD to facilitate SNB.