ANZ journal of surgery
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ANZ journal of surgery · Mar 2014
Intra-abdominal hypertension in the current era of modern trauma resuscitation.
This study aimed to determine the incidence and outcome of post-traumatic (PT) intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) after the advances in haemostatic resuscitation. ⋯ With current practice of minimal fluid resuscitation and liberal use of damage control strategies among trauma patients, the IAH was common transient phenomena but the incidence of ACS is remarkably low.
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ANZ journal of surgery · Mar 2014
Computed tomography in acute abdominal pain: an overused investigation?
The use of computed tomography (CT) for the evaluation of patients presenting to the emergency department (ED) with acute abdominal pain has increased. We set out to investigate its effectiveness. ⋯ Abdominal CT scans frequently changed the clinical diagnosis and patient disposition. Twenty-three per cent of patients had no identifiable cause on CT scan for their acute abdominal pain.
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ANZ journal of surgery · Jan 2014
Comparative StudyIncreasing breast reconstruction rates by offering more women a choice.
Breast reconstruction (BR) following mastectomy for breast cancer is safe and has high rates of patient satisfaction, yet only around 12% of Australian women undergo BR. This study presents BR rates and outcomes from a specialist practice that discusses reconstruction options with all women medically suitable for BR. ⋯ A BR rate of 41%, over three times the national average, was achieved when BR was discussed with all patients. This significant gain in BR rate was not accompanied by a commensurate increase in adverse outcomes, providing evidence that expanding the indications for BR to women who were previously not considered eligible is a valid option.
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ANZ journal of surgery · Jan 2014
Practice GuidelineEvidence-based review for patients undergoing elective hip and knee replacement.
The objective of this study was to evaluate the evidence for different interventions in the preoperative, perioperative and post-operative care for people undergoing elective total hip (THR) and knee (TKR) replacement surgery. ⋯ There was a deficiency in the quality of the evidence supporting key aspects of the continuum of care for primary THR/TKR surgery. Consequently, recommendations were limited. Prioritization and funding for research into areas likely to impact clinical practice and patient outcomes after elective joint replacement surgery are the next important steps.