ANZ journal of surgery
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Decision making is an integral part of surgical practice and is a skill that is as important as the ability to operate. Sound decision making is the result of acquiring 'surgical wisdom', which is achieved through learning, experience and reflection. This paper reviews the processes of surgical decision making with respect to choosing the correct procedure and deciding when to operate, and how operative decisions are made, together with the factors that influence our surgical decisions.
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ANZ journal of surgery · Nov 2009
Cerebral gunshot wounds: a score based on three clinical parameters to predict the risk of early mortality.
To provide a score to predict the risk of early mortality after single craniocerebral gunshot wound (GSW) based on three clinical parameters. ⋯ Three immediately obtainable clinical parameters were evaluated and a score for predicting the risk of early mortality after a single craniocerebral GSW was established.
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ANZ journal of surgery · Nov 2009
Pilot study of operative fixation of fractured ribs in patients with flail chest.
Flail chest is a serious injury in trauma with a significant mortality rate, and long-term pain and disability. Traditionally, management has consisted of internal pneumatic splinting, leading to prolonged periods of mechanical ventilation, and its attendant complications. The aim of this study was to assess the safety of operative fixation of broken ribs in flail chest using absorbable prostheses. ⋯ This pilot study of operative fixation of broken ribs in patients with flail chest, using absorbable plates and screws, has shown the technique to be safe and effective. On the basis of these results, a prospective randomized trial has commenced at The Alfred Hospital, comparing this management strategy with conservative management.