ANZ journal of surgery
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ANZ journal of surgery · Oct 2013
Clinical TrialDoes an Acute Surgical Model increase the rate of negative appendicectomy or perforated appendicitis?
The clinical outcomes from suspected appendicitis depend on balancing the rate of negative appendicectomy (NA) with perforated appendicitis (PA). An Acute Surgical Model (ASM) was introduced at Geelong Hospital (GH) in 2011 involving a dedicated emergency general surgery theatre list every business day giving greater access to theatre for general surgeons. The aim of this study was to evaluate the effect of the ASM at GH on the management of appendicitis, in particular the NA and PA rates. ⋯ The introduction of the ASM at GH has not significantly altered the rate of NA or PA. The NA rate at GH is comparable to other published UK and Australian series.
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ANZ journal of surgery · Oct 2013
Smokers know little of their increased surgical risks and may quit on surgical advice.
Smoking cessation before surgery improves perioperative outcomes and some smokers may quit if undergoing surgery. Quitting smoking in community settings is influenced by physician quit advice and knowledge of smoking hazards, but there are few data on whether this applies in perioperative settings. ⋯ Improving patient knowledge of the perioperative risks of smoking and increased physician advice to quit may improve smoking abstinence at surgery.
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Monash Medical Centre introduced the acute surgical unit (ASU) in July 2011. The ASU is modelled on the concept of acute care surgery (ACS). This study reviews the impact of the ASU on the outcomes in an appendicectomy population. ⋯ We conclude that implementation of an ACS model does not lead to objective differences in outcome for patients after appendicectomy. However, the ACS model significantly decreased the number of operations performed after-hours.
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ANZ journal of surgery · Oct 2013
Biography Historical ArticleAustralia's female military surgeons of World War I.
The war service of Lilian Violet Cooper, the first female surgeon of the Royal Australasian College of Surgeons, is well recognized. Not so well known however, are the other pioneering female doctors who also undertook work as military surgeons during World War I. ⋯ These women operated in London, in Egypt and on the frontlines of the Macedonian campaign. While none of these other women became Fellows of the Royal Australasian College of Surgeons, their war efforts deserve recognition.
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ANZ journal of surgery · Oct 2013
Alvarado score: a guide to computed tomography utilization in appendicitis.
Although useful in evaluation of suspected appendicitis, not all patients require computed tomography (CT) evaluation. Clinical stratification of patients who benefit from CT evaluation is essential. We utilize the Alvarado score (AS) to stratify patients with suspected appendicitis into subgroups who benefit from CT evaluation and propose an objective algorithm with AS guiding CT utilization. ⋯ In suspected appendicitis, patients who benefit from CT evaluation are those with the AS ranging from 4 to 8. We propose a management algorithm with the AS guiding the necessity for CT evaluation.