Canadian journal of surgery. Journal canadien de chirurgie
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Today's acute care surgery (ACS) service model requires multiple handovers to incoming attending surgeons and residents. Our objectives were to investigate current handover practices in Canadian hospitals that have an ACS service and assess the quality of handover practices in place. ⋯ Handover skills must be taught in a systematic fashion. Improved resident communication will likely decrease loss of patient information and therefore improve ACS patient safety.
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We conducted a 3-decade clinical review of prophylaxis for wound infection and postoperative intra-abdominal abscess after open appendectomy for pediatric ruptured appendicitis. ⋯ Over a 35-year period of open appendectomy for pediatric ruptured appendicitis, wound infection was least frequent in patients who received prophylactic peritoneal wound drain, and postoperative intra-abdominal abscess was least frequent in those who received prophylactic SC antibiotic powder and IV antibiotics.
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Operating rooms (ORs) are estimated to generate up to one-third of hospital waste. At the London Health Sciences Centre, prosthetics and implants represent 17% of the institution's ecological footprint. To investigate waste production associated with total knee arthroplasties (TKAs), we performed a surgical waste audit to gauge the environmental impact of this procedure and generate strategies to improve waste management. ⋯ Level IV, case series.
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The median orthopedic surgery wait time in Canada is 33.7 weeks, thus alternative treatments for pathologies such as lumbar disc herniations (LDH) are needed. We sought to determine whether transforaminal epidural steroid injections (TFESIs) alleviate or merely delay the need for surgery. ⋯ Transforaminal epidural steroid injections are an important treatment tool, preventing the need for surgery in 56% of patients with LDH.