International journal of surgery
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Randomized Controlled Trial
Local anaesthetic wound infiltration following paediatric appendicectomy: a randomised controlled trial: Time to stop using local anaesthetic wound infiltration following paediatric appendicectomy?
This study sought to determine the efficacy of post-operative wound infiltration with local anaesthetic following paediatric appendicectomy. ⋯ Wound infiltration with local anaesthetic following appendicectomy in children provides no additional benefit over regular simple analgesia. Its routine use represents dogmatic practise which ought to be challenged for this patient group.
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Wrong-site surgeries (including wrong-site, wrong-person and wrong-procedure errors) remain the number one problem among adverse events of health care delivery. Patients and/or family members should be involved when possible to help prevent such errors. ⋯ The majority of participants reported good practices for avoiding wrong-site surgery mistakes before an operation. A significant improvement of post-training scores in the family member group was seen. The high satisfaction rating given by the participants after seeing the animation indicates that it was generally acceptable.
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Accurate handover of clinical information is imperative to ensure continuity of patient care, patient safety and reduction in clinical errors. Verbal and paper-based handovers are common practice in many institutions but the potential for clinical errors and inefficiency is significant. We have recently introduced an electronic templated signout to improve clarity of transfer of patient details post-surgical take. ⋯ Our results show that introduction of this electronic signout significantly reduced median length of stay from five to four days (P=0.047). No significant difference in ASA grades, time to first intervention or overall admission diagnosis was obtained between the two time periods. In conclusion, this is the first study to show that the introduction of electronic signout post-call was associated with a significant reduction in patient length of stay and provided better continuity of care than the previously used paper-based handover.
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We sought to assess the effects of aortic cross-clamp time (XCL) on outcome following cardiac surgery in low- and high-risk patients. ⋯ Prolonged cross-clamp time significantly correlates with major post-operative morbidity and mortality in both low- and high-risk patients. This effect increases with increasing XCL time. Prior knowledge on this effect can help in preventing some of these complications.