ANZ journal of surgery
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The study investigates the hypothesis that testicular torsion is over-diagnosed by emergency department (ED) doctors. Diagnoses made by ED doctors are compared with those made by a surgical registrar or specialist and the review outcome by a surgical registrar or specialist on diagnosis and management is evaluated. ⋯ Less experienced examiners suspect testicular torsion more frequently than surgical registrars or specialists. Review of the patient by an experienced examiner should allow for more accurate initial diagnoses and spare some children unnecessary surgical procedures.
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ANZ journal of surgery · Jan 2002
ReviewVirtual reality simulators: current status in acquisition and assessment of surgical skills.
Medical technology is currently evolving so rapidly that its impact cannot be analysed. Robotics and telesurgery loom on the horizon, and the technology used to drive these advances has serendipitous side-effects for the education and training arena. The graphical and haptic interfaces used to provide remote feedback to the operator--by passing control to a computer--may be used to generate simulations of the operative environment that are useful for training candidates in surgical procedures. ⋯ It is also necessary to determine--by repeated trials--whether a given simulation actually measures the performance parameters it purports to measure. This trains the spotlight on what constitutes good surgical skill, and how it is to be objectively measured. Early results suggest that virtual reality simulators have an important role to play in this aspect of surgical training.
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ANZ journal of surgery · Jan 2002
Retrospective study on the need of intensive care unit admission after major head and neck surgery.
The present article aims to study the pattern and need of Intensive Care Unit admission after major head and neck operations. ⋯ The present study showed that it is safe and cost-effective to discharge the majority of patients after major head and neck operations back to a specialist ward for nursing care.
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ANZ journal of surgery · Jan 2002
Randomized Controlled Trial Clinical TrialEffectiveness of intra-operative wound infiltration with long-acting local anaesthetic.
Postoperative pain relief is of importance to both patients and surgeons. One of the simpler techniques is infiltration of the surgical incision with long acting local anaesthetic. The literature is confusing, with numerous reports attesting to the value of this approach and a similar number disputing the demonstrable benefits. ⋯ Intraoperative wound infiltration with bupivacaine is widely employed as a method of minimizing postoperative pain. This study was unable to demonstrate a benefit of employing the technique in terms of a reduction in the patient's perception of pain. By having each patient act as their own control, we have avoided one of the major deficiencies of previous studies, namely, interpatient variability in assessment and perception of pain.
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ANZ journal of surgery · Dec 2001
Predicted impact on Victoria's ambulance services of a new major trauma system.
In 1999, a new major trauma system was proposed for the state of Victoria, Australia. The guidelines for the new system were aimed at delivering major trauma cases to definitive trauma care in the least time possible. The aim of the present study was to analyse the potential effect of this system on Victoria's ambulance services. ⋯ The present study demonstrated that most of the impact of a new trauma system on Victoria's ambulance services could be readily absorbed into the current workload. However, it also highlighted areas affected disproportionately within the ambulance services; in particular, air retrieval. Such studies are important to enable the effective implementation of new trauma systems.