International journal of surgery
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Venous thromboembolism (VTE) is the most common preventable cause of hospital-related mortality. There are major inadequacies internationally in administering appropriate prophylaxis. Our initial aim was to show whether our local effectiveness of administration was equally poor. With local inadequacy confirmed, our second aim was to design, implement and evaluate the efficacy of a new VTE protocol nested within a surgical clerking proforma. ⋯ Implementation of a VTE protocol as part of a clerking proforma for acute surgical admissions is a simple and effective way of ensuring that surgical patients receive appropriate thromboprophylaxis. A similar strategy could be employed to broaden the scope of the National Institute of Clinical Excellence (NICE) guidelines to address VTE prevention in all hospitalised patients.
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We report a case of an iatrogenic foreign body in the airway. An 80-year-old patient who had undergone major head and neck surgery several weeks early presented as an inpatient with a persistent cough and recurrent chest infections. ⋯ This foreign body presented indolently as it was cannulated. We suggest that in such patients, readers should be aware of this possible underlying iatrogenic cause of respiratory complications.
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Inter-hospital transfer of trauma patients in a developing country: a prospective descriptive study.
There is no standardised protocol for the transfer of injured patients in Jamaica, a process that is well known to be potentially hazardous. We undertook this study to evaluate the inter-hospital transfer process of injured patients in this developing country. ⋯ The transfer of injured patients is not being performed in a manner consistent with modern medical practice. There is urgent need for implementation of a standardised protocol for the transfer of such patients in Jamaica.
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Laparoscopic appendicectomy is gradually being accepted as a procedure of choice in the management of suspected acute appendicitis. (in female of childbirth and obese patients, working class, children and elderly). The aim of this study is to assess the feasibility and safety of laparoscopic appendicectomy for perforated appendicitis and to assess our simple technique to reduce postoperative infective complications of perforated appendicitis. ⋯ Perforated appendicitis can be managed effectively and safely using a laparoscopic technique. Timing of intervention and operative technique which includes four abdominal quadrants copious irrigation is important to prevent postoperative intra-abdominal abscesses.