Surg J R Coll Surg E
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Surg J R Coll Surg E · Oct 2009
Two week rule referral for patients with colorectal cancer below the age of 50; are we being ageist?
The TWR system was introduced in July 2000. The purpose of this study was to investigate whether patients below the age of 50 years with colorectal cancer (CRC) are experiencing delays in treatment. ⋯ Patients with symptoms of CRC below the age of 50 years may face referral and diagnostic delay if not referred via the TWR system; many of these would be eligible if age was not a deciding factor.
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Surg J R Coll Surg E · Aug 2009
Letter Randomized Controlled TrialThe needle catcher--a safer way to suture.
The needle catcher is a novel surgical instrument which has been developed in Belfast in conjunction with Queen's University Belfast that aims to reduce suture needle exposure and increase operator safety during suturing. The instrument was used to close wounds in 20 patients presenting to A&E in the Royal Group of Hospitals and to the plastic surgery service in the Ulster Hospital. This letter includes a technical description of the instrument, evaluation of needle exposure, comments from users, evaluation of the needle catcher and a discussion on the need for additional protection for medical staff in surgical based specialties where there is frequent exposure to blood, open wounds and sharps.
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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.