ANZ journal of surgery
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ANZ journal of surgery · Jul 2008
Predictors of post-traumatic stress disorder following major trauma.
Post-traumatic stress disorder (PTSD) is a common sequel to physical trauma, but there is disagreement regarding the predictors of this condition. This study aims to examine the role of physical, psychosocial and compensation-related factors in the development of PTSD following major trauma. ⋯ Post-traumatic stress disorder after major trauma was not related to measures of injury severity, but was related to other factors, such as blaming others for the accident and the processes involved in claiming compensation.
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Surgeons and anaesthetists are involved in Pain Medicine, as they have a responsibility to contribute to postoperative pain management and are often consulted about longer-term pain problems as well. A large component of persistent pain after surgery can be defined as neuropathic pain (NP). Nerves are injured during surgery and pain can persist after the surgical wound has healed. ⋯ The aim of this article was to appraise the prevention, diagnostic work-up, the physical and particularly the pharmacological management of post-surgical NP and to provide a glimpse of advances in the field. It is a practical approach to post-surgical NP for all surgeons and anaesthetists. The take-home message is that prevention is better than waiting for post-surgical NP to become persistent.
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ANZ journal of surgery · Jun 2008
Commentary: how surgical audits can be used to promote the update of surgical evidence.
Evidence-based medicine (EBM) is an important advance in health care. The Australian Safety and Efficacy Register of New Interventional Procedures - Surgical (ASERNIP-S), the Royal Australasian College of Surgeons, has been at the forefront of promoting EBM in surgery by developing systematic reviews and managing surgical audits. ⋯ Surgical audits can be used: (i) to assess practice trends and the impact of systematic reviews or clinical guidelines on treatment practice, (ii) to identify the disparities in the uptake of evidence, and (iii) to promote further research on how to bridge evidence-practice gaps and to overcoming possible barriers for the evidence uptake. The information gathered through the audit data assessment on evidence-uptake can be used to improve evidence dissemination and identify possible barriers to the uptake of evidence.