Surg J R Coll Surg E
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In 2003 the National Patient Safety Agency (NPSA) advised side marking for avoiding errors and reducing incorrect side surgery. This survey aimed to ascertain whether or not, these 'best practice' guidelines are currently being implemented by ophthalmic surgeons in Scotland and, if not, the reasons for this, and also to ascertain surgeons' attitudes towards marking. ⋯ Guidelines are not consistently being implemented in their entirety by eye surgeons in Scotland. In order to improve compliance and improve patient safety, we suggest a risk-stratified approach in side marking based on individual patient factors that may encourage wider acceptance, without compromising patient safety.
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Breast cancer-related lymphoedema (BCRL) is a chronic swelling of the upper limb following surgery to axillary lymph nodes. This clinical literature review considers the risk factors that have been identified for the development of BCRL: the extent of surgery to the breast and the axilla, radiotherapy, nodal status, infection and patient characteristics such as BMI and patient age. The management of BCRL is primarily conservative, but the evidence for pharmacological and surgical approaches is also considered.
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Surg J R Coll Surg E · Apr 2009
The necessity of routine post-thoracostomy tube chest radiographs in post-operative thoracic surgery patients.
Chest radiographs are routinely performed post-operatively in thoracic surgery patients, in particular after the removal of thoracostomy tubes. From observation of our practice, we hypothesised that chest radiographs did not need to be performed routinely post-operatively and after removal of thoracostomy tubes. ⋯ We feel our data support the hypothesis that it is not necessary to perform routine chest radiographs in thoracic surgery patients post-operatively and after post-operative thoracostomy tube removal. It would be better to monitor these patients clinically and only request chest radiographs on the basis of deterioration in recorded observations or clinical findings.
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Surg J R Coll Surg E · Apr 2009
The impact of pre-operative assessment clinics on elective surgical case cancellations.
Pre-operative assessment clinics prepare patients for elective procedures. Little is known about their impact on elective case cancellations. We investigated whether a pre-operative assessment clinic would reduce surgical case cancellations. ⋯ When we analysed the data in terms of the reason for cancellation, we found that cancellations for medical, but not patient reasons were significantly reduced following pre-assessment (p = 0.013 and p = 0.180, respectively). The data suggest that establishment ofa pre-operative assessment clinic reduces elective case cancellations. In particular we found a significant reduction in cancellations for medical reasons.