ANZ journal of surgery
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Cat bites are the second most common mammalian bites. Cat bites of the hand in particular represent a potentially devastating problem in terms of wound infection and long-term disability if not treated appropriately. The purpose of the present study is to give an overview of demographics, management and follow up of the patients with cat bite injuries of the hand treated at the Royal Hobart Hospital. ⋯ Appropriate early treatment of cat bites of the hand is the key to success. Treatment with antibiotics, surgical drainage, debridement and copious irrigation, and use of corticosteroids in some cases, proved to be effective. Hand elevation and intensive physiotherapy after a short period of immobilization is critical. We believe that prophylactic antibiotics should be given even in case of a minor infection following cat bites of the hand. Clear guidelines for clinical recognition of infection, hospital admission and management are provided in our study.
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ANZ journal of surgery · Oct 2004
Randomized Controlled Trial Clinical TrialRandomized trial of a pain control infusion pump following inguinal hernia repair.
Continuous ambulatory analgesia following various surgical procedures is gaining popularity. The purpose of the present paper is to evaluate this form of analgesia following open anterior inguinal hernia repair by way of a pain control infusion pump (PCIP). ⋯ The PCIP provided safe and adequate analgesia following inguinal hernia repair. It provided effective analgesia especially when patients were mobilizing. This has implications for earlier discharge from hospital and associated cost-savings.
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ANZ journal of surgery · Sep 2004
Resources for managing trauma in rural New South Wales, Australia.
Trauma bypass is not always appropriate in the management of rural trauma because of the large distances and travel times. Rural hospitals in New South Wales, Australia are an essential component of the statewide integrated trauma system. The present study profiles the trauma resources of base hospitals in rural New South Wales. ⋯ Formal responses to major trauma in rural base hospitals in New South Wales are often restricted by a lack of specialist medical personnel. Nevertheless, the majority of hospitals have the resources to manage major trauma.
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ANZ journal of surgery · Aug 2004
Randomized Controlled Trial Comparative Study Clinical TrialTreatment of partial-thickness burns: a prospective, randomized trial using Transcyte.
The purpose of the present study was to compare the effectiveness of three burns dressings (TransCyte, a bio-engineered skin substitute; Biobrane; and Silvazine cream (silver sulphadiazine and 0.2% chlorhexidine)), in treating children with partial-thickness burns. The primary objective was to determine the days until > or =90% re-epithelialization. The secondary objectives were to evaluate the number of wounds requiring autografting and the number of dressing changes/local wound care required. ⋯ When used in partial-thickness burns in children, TransCyte promotes fastest re-epithelialization and required less overall dressings then Biobrane or Silvazine. Patients who received Silvazine or Biobrane require more autografting than those treated with TransCyte.
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ANZ journal of surgery · Aug 2004
Randomized Controlled Trial Clinical TrialManagement of postoperative urinary retention: a randomized trial of in-out versus overnight catheterization.
There has been no consensus on the best catheterization strategy for the management of postoperative urinary retention. A prospective randomized trial was undertaken to establish the best practice guidelines for the management of postoperative urinary retention. The authors also evaluated the contemporary incidence of urinary retention following different categories of general surgery and examined risk factors associated with its occurrence. ⋯ Postoperative urinary retention should be managed by in-out catheterization. Indwelling catheterization for 24 h appeared to bestow no additional benefits. The incidence of urinary retention increases with age, anorectal procedures and the use of spinal anaesthesia.