ANZ journal of surgery
-
ANZ journal of surgery · Jul 2003
Improving the evidence-base in surgery: evaluating surgical effectiveness.
This second of two articles about clinical epidemiology reviews the generation and synthesis of evidence for the effectiveness of surgical procedures. While well-designed randomized controlled trials of surgical procedures are considered the 'gold standard' of evaluation design, they may achieve high internal validity at the expense of external validity (generalizability). Improving the -evidence-base in surgery likely will require a comprehensive approach to surgical outcomes assessment, involving both improvements in the quality and quantity of randomized controlled trials as well as recognition of the complementary role of alternate study designs.
-
Subspecialization in general surgery is being encouraged by various surgical societies. The aim of this study was to view attitudes of Royal Australasian College of Surgeons (RACS) trainees to subspecialization in surgery, in particular, breast -surgery. ⋯ Breast surgery is an unpopular subspecialty for RACS trainees. Breast surgery is likely to experience increasing -problems with recruitment unless the skill base is reviewed and revised in line with the aspirations and needs of today's trainees.
-
Acute spinal cord injury is a serious concern in football, particularly the rugby codes. This Australia-wide study covers the years 1986-1996 and data are compared with those from a previous identical study for 1960-1985. ⋯ The rugby codes must be made safer by appropriate preventative strategies and law changes. In particular, attention is necessary for tackle injuries in rugby league and players out of regular position in scrummage. Compensation for injured players is grossly inadequate. There is an urgent need to establish a national registry to analyse these injuries prospectively.
-
The transfer of critically injured patients in a rural Australian setting presents a unique challenge to medical services due to the constraints of distance and time. The purpose of this study is to analyse which injuries are being transferred, how they occur, pretransfer intervention, transfer methods and transfer times. ⋯ This data produces a realistic framework of how major trauma in rural areas is treated in Western Australia. It highlights some areas of good practice, such as transfer methods and escorts, but also highlights problem areas such as transfer times and pretransfer intervention.
-
ANZ journal of surgery · Jun 2003
Comparative StudyNasal fractures: a study comparing local and general anaesthesia techniques.
The objective of the present study was to examine the outcome of nasal fracture reduction under both local anaesthesia and general anaesthesia techniques. ⋯ Both LA and GA appear to be acceptable and satisfactory methods of anaesthesia in the reduction of simple displaced nasal fracture.