International journal of surgery
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Comparative Study
Peri-operative antibiotic prophylaxis: adherence to guidelines and effects of educational intervention.
This study was aimed to determine the propriety of perioperative antimicrobial prophylaxis, to evaluate the effects of a training intervention on correction. ⋯ Although this educational intervention study achieved improvements in indications, choice, and dosing of surgical antimicrobial prophylaxis, it failed to improve prolonged use and total compliance rate, and to lower the costs sufficiently. It will probably provide better results by means of compulsory measures for surgeons to comply with available protocols and guidelines, as well as education programs, in order to change the antibiotic utility habits on surgical prophylaxis and to achieve accurate prophylactic administrations.
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Caring for patients in traditionally designed, large teaching hospitals is often frustrating. Attempts at decreasing internal costs and inpatient length of stay are universally undertaken in order to address dwindling reimbursement, and patient care becomes more specialized and fractionated. These attempts have proven to be myopic, at best, and injurious to patient care and professional job satisfaction, at worst. This manuscript attempts to characterize the operational processes of our university operating room facility as well as make suggestions for operational improvements that can be applied to all hospitals. ⋯ Nowhere in the hospital is this drive for cost containment and increased patient volume more evident than in the operating theatre. Long-term improvements must embrace radical reduction of OR costs and increased operative patient through-put, (i.e. per 8 h day; per fiscal year) by re-engineering the processes of operative patient care. In the end, the ultimate goal of safe and high-quality patient care must not be compromised.
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Case Reports
Case series and literature review: popliteal artery injury following total knee replacement.
We present a case series and literature review of injury to the popliteal vessels during total knee replacement (TKR). This is rare but may be limb-threatening with devastating consequences for the patient. An individual surgeon will see few cases. ⋯ Incidence remains steady. More careful surgical technique may be the most effective preventative measure. Ongoing awareness is therefore essential for early diagnosis and management of this rare but serious complication.
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Comment Letter Meta Analysis
Complementary and alternative medicine (CAM) and cancer: the kind face of complementary medicine.
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To ascertain the influence of images depicting different qualities of pain on unselected outpatient pain clinic consultations. ⋯ The results suggest that introducing a focus of images of pain into unselected pain consultations can facilitate discussion and lead to more fruitful dialogue between patients and clinicians.