International journal of surgery
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Pediatric injuries pose a significant health burden in sub-Saharan Africa, though historic data are too scarce to appreciate the extent of the problem. The purpose of this study is to utilize a comprehensive database to describe the epidemiology of pediatric injuries at a tertiary hospital in Malawi. ⋯ This study revealed patterns of injury based upon age, gender, location, and season. Our results may prove useful to stakeholders in injury prevention for designing, evaluating, and implementing programs to improve public safety in children in Malawi and similar resource poor nations.
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Comparative Study
Accuracy of clinical coding from 1210 appendicectomies in a British district general hospital.
The primary aim of this study was to assess the accuracy of clinical coding in identifying negative appendicectomies. The secondary aim was to analyse trends over time in rates of simple, complex (gangrenous or perforated) and negative appendicectomies. ⋯ Clinical coding for negative appendicectomy was unreliable. Negative rates may be higher than suspected. This has implications for the validity of national database analyses. Using this form of data as a quality indictor for appendicitis should be reconsidered until its quality is improved.
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Biography Historical Article
A pioneer in medicine and surgery: Charles Sédillot (1804-1883).
Professor Charles Sédillot (1804-1883) is one of the pioneers of modern medicine, surgery, anaesthesiology, histopathology and infectiology. Unfortunately, he remains unknown outside of the circles of French military medicine historians. He was the first surgeon in the world to offer techniques such as coxofemoral dislocation and internal urethrotomy, thus becoming a pioneer in endoscopic surgery. ⋯ Long before the description put forth by Semmelweiss (1818-1865), he foresaw and understood the existence and action of microorganisms, which he termed microbes, in the development of postoperative infections. For his work, he was honoured by his peers in France but remained unknown beyond the borders of his homeland. Here, we present a succinct report of the considerable accomplishments of the life and work of this outstanding physician and surgeon.
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There is still significant risk of patients developing surgical site infection (SSI) following orthopaedic surgery due to growing demand for joint surgery in high-risk patients and increasing complexity of procedures. The higher rate of SSI seen in high-risk procedures and also in high-risk patients is of concern as the development of infection can be a very serious complication of orthopaedic surgery and has implications for patient morbidity, length of hospital stay (LOS), resource utilisation and healthcare costs. This article provides an overview of the efficacy of prophylactic and therapeutic application of resorbable gentamicin-containing collagen implants (GCCI) in the prevention of SSI following orthopaedic surgical procedures. ⋯ This review demonstrates that prophylactic use of GCCI can have a positive effect on wound healing in a range of orthopaedic surgical procedures and in high-risk patients. GCCI may also have a role to play in the treatment of osteomyelitis.
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Colorectal cancer (CRC) is one of the leading causes of cancer death all over the world and right-sided colon cancer represents approximately 15% of all cases of CRC. Laparoscopic colectomies produce advantages in short-term outcome compared to open procedures and have recently benefited by a long term oncologic validation. This study was designed to compare the short- and medium-term surgical outcomes of totally laparoscopic (TLRC) and laparoscopic-assisted right colectomy (LARC) for neoplasia, hypothesizing they may be at least similar. ⋯ Although more appropriate indications must be set by future studies, we encourage the choice of a TLRC for the treatment of cancer of the right colon. TLRC is actually a feasible and safe technique, which has resulted in an encouraging short-term outcome, low incidence of major complications and preservation of oncologic principles, without affecting operative times.