ANZ journal of surgery
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ANZ journal of surgery · Dec 2016
Multicenter StudyAntibiotic resistance in early periprosthetic joint infection.
Prophylactic antibiotics significantly reduce prosthetic joint infection (PJI) rates after hip and knee arthroplasty. However, rising antibiotic resistance has raised concerns over the adequacy of conventional prophylaxis. This study aimed to identify organisms causing PJIs in hip and knee arthroplasty secondary to perioperative contamination and their susceptibility to current prophylactic antibiotics. ⋯ The majority of bacteria causing early PJI are resistant to cefazolin. Whilst many organisms cultured were susceptible to vancomycin, there is currently insufficient evidence to justify its routine use as a prophylactic. However, when treating PJI in the early postoperative period, surgeons should be aware that most organisms will be methicillin-resistant, and the choice of empirical antibiotic treatment should reflect this.
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ANZ journal of surgery · Dec 2016
Are we meeting the British Society of Gastroenterology guidelines for cholecystectomy post-gallstone pancreatitis?
The aim of this study was to audit the current management of patients suffering with gallstone pancreatitis (GSP) at a university teaching hospital for compliance with the British Society of Gastroenterology (BSG) guidelines regarding cholecystectomy post-GSP. ⋯ Only 32.1% were treated as per BSG guidelines. About 19.8% (n = 21) of the patients suffered further morbidity as a result of a delayed operation and there is a clear difference between admitting speciality and the median time to operation.
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ANZ journal of surgery · Dec 2016
Catheter-related upper limb venous thrombosis in a tertiary hospital setting.
To determine the relative likelihood of upper limb venous thrombosis (ULVT) in patients with peripherally inserted central catheter (PICC) versus central venous catheter (CVC), compared with patients without a catheter, in a tertiary hospital setting. ⋯ Catheters predispose to the formation of ULVT. PICCs are more likely to be associated with ULVT than CVC and have shorter time to symptomatic clot. PE from ULVT is uncommon.
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ANZ journal of surgery · Dec 2016
Does a distal perfusion cannula reduce ischaemic complications of extracorporeal membrane oxygenation?
Extracorporeal membrane oxygenation (ECMO) provides support to patients with severe but reversible cardiac or pulmonary failure. Vascular complications of ECMO are well recognized. ⋯ Ischaemic complications of ECMO are common and occur despite the presence of a distal limb-perfusing cannula; however in our study the distal limb cannula was a limb-salvaging intervention in six patients. Prolonged time on ECMO is a risk factor for DVT, and a high index of suspicion must be maintained. Percutaneous insertion was associated with higher rates of bleeding and DVT.