ANZ journal of surgery
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ANZ journal of surgery · Aug 2005
Use of a single silastic chest drain following thoracotomy: initial evaluation.
It is standard practice to use multiple large bore semi-rigid chest tubes to drain the pleural cavity following thoracic procedures. These can cause pain and discomfort at the insertion site. ⋯ The use of a single, small silastic chest drains following thoracotomy may be safe and effective in draining both fluid and air, though an additional tube may be necessary for persistent leaks.
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ANZ journal of surgery · Aug 2005
Predictors of mortality, length of stay and discharge destination in blunt trauma.
The present study explored a range of variables to identify predictors of mortality and morbidity and to develop prediction models based on these variables. ⋯ The present study identified key predictors of mortality and morbidity (length of hospital stay and discharge destination). The newly developed mortality model out-performed published trauma scoring methods. However, further development and trial of the new prediction models is required before implementation as definitive audit and benchmarking tools could be recommended.
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ANZ journal of surgery · Aug 2005
Does off-pump coronary artery bypass grafting beneficially affect renal function?
Off-pump coronary artery bypass grafting (CABG) has been reported to beneficially affect renal function, but this remains to be confirmed. The purpose of the present paper was to study the effects of off-pump CABG on renal function and analyse predictors of postoperative renal impairment in patients who received off-pump CABG. ⋯ Off-pump CABG provides better renal protection than on-pump CABG. However, perioperative renal function should be closely monitored in patients who have left ventricular dysfunction or who undergo multivessel grafting, even when off-pump CABG is performed.
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ANZ journal of surgery · Aug 2005
Biography Historical ArticleSurgical accountability in the 1880s: the death of Susan Nixon.
Susan Nixon died in 1881 following a surgical error. Her surgeon, Dr W. E. ⋯ The surgical misadventure that resulted in Mrs Nixon's death became a public scandal, which gained currency through both parliamentary debate and the popular press. The purpose of referring to this case is to explore the mechanisms of accountability that surgeons faced in the 1880s--a decade of rapid change in the practice of surgery. The response of late nineteenth century society to surgical error and the resultant reaction of the medical profession have resonances that are relevant to surgeons practising today.
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Following press reports of patients catching fire or receiving chemical burns in the operating theatre, a review was conducted on the flammability of skin antiseptics. The purpose of the paper was to clarify confusion regarding povidine-iodine (Betadine), which had been reported as being flammable, and also to determine the use of alcohol-based solutions in the Hunter Area Health Service. A risk assessment was conducted and risk reduction strategies outlined. ⋯ Operating theatre fires continue to be a major risk for patient safety. In order to reduce this risk, the strategies outlined here should be followed.