Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland最新文献

{"title":"Scottish Open Fractures of Tibia (SOFT) audit; a multi-centre retrospective review of ortho-plastic management of tibial shaft fractures at major trauma centres (MTCs) in Scotland.","authors":"J E Dixon, I A Rankin, S Rangarajan, J Brennan, A Varma, D W Shields, I M Stevenson","doi":"10.1016/j.surge.2025.01.006","DOIUrl":"https://doi.org/10.1016/j.surge.2025.01.006","url":null,"abstract":"<p><strong>Aims: </strong>Open fractures of the tibia are associated with significant complications, for which attempts have been made to standardise and optimise their management. In the UK, this standard is the British Orthopaedic Association Standards for Trauma (BOAST) guidelines. The Scottish Open Fracture of Tibia (SOFT) Audit is a national review of open tibial shaft fractures across all four Scottish Trauma Networks, which aims to provide a definite review of ortho-plastic care for open tibial shaft fractures in Scotland.</p><p><strong>Methods: </strong>A retrospective audit of all adult patients who sustained open tibial shaft fractures in Scotland from June 2021 to June 2023 was performed. The primary outcome measure was compliance with BOAST guidelines. Secondary outcome measures included infection, return to theatre, soft-tissue failure, and amputation.</p><p><strong>Results: </strong>196 open tibial shaft fractures were identified. Common complications included infection (24 %), return to theatre (17 %), soft-tissue failure (9.7 %) and amputation (7.1 %). Complete compliance with BOAST guidelines was documented in 8.8 % of cases. Significant variation was seen between geographical regions of Scotland. No significance was seen between compliance to BOAST guidelines and any of the secondary outcome measures. Multivariate analysis identified Grade 3 Gustilo-Anderson injuries as significantly associated with post-operative infection, post-operative infection significantly associated with return to theatre, and return to theatre significantly associated with soft-tissue failure and/or amputation.</p><p><strong>Conclusion: </strong>This study demonstrates in Scotland there is scope for improvement in cohesion with national guidance including timing of antibiotic delivery, combined ortho-plastics approach, and soft-tissue cover within 72 h of definitive fixation.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress in the etiology and minimally invasive therapy of hallux valgus.","authors":"YongJia Zhu, Ming Gao, Haowen Tan JiaPeng Yan, HongFei Zhang","doi":"10.1016/j.surge.2025.01.005","DOIUrl":"https://doi.org/10.1016/j.surge.2025.01.005","url":null,"abstract":"<p><p>Hallux valgus (HV) is the most common foot deformity. It has various pathogenic factors that make its pathogenesis challenging to understand. As the disease progresses, patients experience amplified pain and decreased activities, significantly affecting their quality of life. At present, clinics offer several conservative and surgical treatments that must be selected based on patient condition and disease progression. Surgical treatment is frequently the only method available to patients with HV to delay disease progression and correct the deformity after conservative treatment fails. In recent years, minimally invasive surgical treatments have gained significant attention and developed rapidly due to their well-known advantages, such as safety, efficiency, and quick recovery time. The number of literature that provides a systematic review of the subject must be increased. This review tracks recent advancements, summarizing the etiological mechanism, epidemiology, diagnosis, and treatment of HV. In addition, it emphasizes typical surgical therapies and focuses on the progress of minimally invasive treatment from the first generation to the current fourth generation. This review will serve as a systematic basis for the clinical treatment of HV and provide a reference material for future research.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An evaluation of the stocks of target-controlled infusion (TCI) pumps in Irish departments of anaesthesia and an assessment of the stocks' ability to support transition to more environmentally sustainable general anaesthesia practice.","authors":"Kim O'Brien, Marguerite Nyhan, Dónal Ó Cróinín","doi":"10.1016/j.surge.2025.01.004","DOIUrl":"https://doi.org/10.1016/j.surge.2025.01.004","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embracing change: The potential of artificial intelligence in transforming surgical practice.","authors":"Kaiser O'Sahil Sadiq","doi":"10.1016/j.surge.2025.01.002","DOIUrl":"https://doi.org/10.1016/j.surge.2025.01.002","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ergonomic challenges in surgical practice.","authors":"Amir Farah","doi":"10.1016/j.surge.2025.01.003","DOIUrl":"https://doi.org/10.1016/j.surge.2025.01.003","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Where do we go from here? The personal impact of adverse events and complications in surgeons: Results from a cross-sectional study.","authors":"S O'Meara, E Doherty, K Walsh","doi":"10.1016/j.surge.2025.01.001","DOIUrl":"https://doi.org/10.1016/j.surge.2025.01.001","url":null,"abstract":"<p><strong>Objective: </strong>Medical error is an inevitable part of modern healthcare, with a potential harmful impact for the patient and the surgeon. The phenomenon of negative personal responses for healthcare workers in the aftermath of adverse events is described as the \"second casualty\" and can involve significant physical and psychological distress. We present results from a cross-sectional survey of surgeons and their experience in the aftermath of adverse events or complications.</p><p><strong>Subjects and methods: </strong>Following ethical approval an anonymous online survey was distributed to all training and consultant surgeons in the Republic of Ireland. Data collected included basic demographics, personal response to an adverse event, coping strategies, contributing factors and perception of potential support structures.</p><p><strong>Results: </strong>A total of 110 responses were received representing surgeons with a broad range of experience and specialty. Eighty-nine percent (n = 98) of surgeons described negative psychological symptoms in the aftermath of adverse events. The predominant responses were anxiety, guilt and low mood. Sixty-seven percent (n = 74) reported that their training did not prepare them for the personal impact of events but found informal peer and family support to be beneficial and were open to the implementation of formal support structures.</p><p><strong>Conclusion: </strong>Surgeons suffer in the aftermath of negative outcomes and feel unprepared to manage the personal consequences. Institutions and representative bodies must step forward to change culture and develop supports for surgeons in the aftermath of adverse events and complications.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New technologies for future of surgery in Ireland: An RCSI working Group report 2024.","authors":"Alice Moynihan, Debbie Killeen, Ronan Cahill, Ashokkumar Singaravelu, David Healy, Carmel Malone, Enda Mulvany, Fergal O'Brien, Paul Ridgway, Kieran Ryan, Mary Barry, Donal Brennan, John Caird, Camilla Carroll, Calvin Coffey, Kevin Conlon, Kevin Cronin, Orla Cullivan, Aiden Devitt, Claire Donohoe, John Doris, Tom Gallagher, Michael Gilbride, Niall Hardy, Helen Heneghan, Arnold Hill, John Hinchion, Michael Kerin, Debbie Killeen, Aoife Lowery, Kevin McElvanna, Alison McHugh, Nathaniel McHugh, Ozanan Meireles, Alice Moynihan, Enda Mulvany, Peter Neary, Fergal O'Brien, Sharjeel Paul, Megan Power Foley, Nicola Raftery, Darragh Rice, Paul Ridgway, Fiachra Rowan, Kieran Ryan, Patrick Sheahan, Laura Viani, Danilo Vukanic, Mark Wilson","doi":"10.1016/j.surge.2024.11.012","DOIUrl":"https://doi.org/10.1016/j.surge.2024.11.012","url":null,"abstract":"<p><strong>Introduction: </strong>Surgery is a cognitive discipline whose practitioners characteristically use technology during operations for patients. With accelerating technological innovation throughout society and healthcare, we sought to develop a shared position for Irish surgery via a commissioned work programme by the Royal College of Surgeons in Ireland.</p><p><strong>Methods: </strong>Using Stanford design principles, representative clinical specialty and academic leads and higher trainee representatives across 15 specialties were surveyed regarding sentiments, perspectives and concerns regarding now and near future technology in clinical practice, career considerations and training/education. Selected participants proceeded to semi-structured interview as deeper dive including use-case exemplar development with narrative thematic analysis.</p><p><strong>Results: </strong>New technologies matter to surgeons and surgical practice for patients as evidenced by the high level of engagement and rich perspectives provided. However there is concern, particularly among academic groups, that Irish Surgery could be better positioned for the opportunities inherent in new technologies and better prepared strategically regarding stakeholder (surgical units, healthcare institutions, universities and especially management, health service executive and government) alignment. Investment levels are felt to be insufficient to maximally leverage new technology effectively including training investment where new ways of learning are needed as technologies such as artificial intelligence and data and analytics become more important to surgical practice beyond the current prioritisation of robotics and biomaterials.</p><p><strong>Conclusion: </strong>While there is high engagement, clear ambition and confidence with role of new technologies in the now and near future of Irish Surgery, there is opportunity to demonstrate leadership and synergise stake holders for better healthcare.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Talent Drain in Neurosurgery.","authors":"Lia Ubillus Peña, Yaritza La Torre, Carlos Gonzales Fernández, Gonzalo Jair Callahuanca-Flores, Irving Gabriel Calisaya-Madariaga","doi":"10.1016/j.surge.2024.12.005","DOIUrl":"https://doi.org/10.1016/j.surge.2024.12.005","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rise and fall of \"marginal gains\" - Lessons for surgery?","authors":"Connor Boyle, Calum Arthur, Steven Yule","doi":"10.1016/j.surge.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.surge.2024.12.004","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positive and negative framing of complication risk and long-term outcomes influences decision-making in hip and knee arthroplasty.","authors":"Alex B Boyle, Cass R Sunstein","doi":"10.1016/j.surge.2024.12.006","DOIUrl":"https://doi.org/10.1016/j.surge.2024.12.006","url":null,"abstract":"<p><strong>Background: </strong>The framing effect has been demonstrated in a variety of settings. This study aimed to determine whether framing of complication risk in total hip arthroplasty (THA) and long-term patient satisfaction rates in total knee arthroplasty (TKA) influences patient decision-making and 'worry' using hypothetical vignettes.</p><p><strong>Methods: </strong>Two cross-sectional survey studies were undertaken, one based on a THA vignette and one based on a TKA vignette. Participants were randomized into a positive-framing or negative-framing group and asked to read the vignette. They were then asked to indicate whether they would proceed with surgery, and to self-report their degree of 'worry' about surgery. For the THA vignette, the positive-framing group was informed '98 % of people will have no major complications' while the negative-framing group was informed that '2 % of people will have a major complication'. For the TKA vignette, the positive-framing group was informed '80/100 of people will be happy … once they have recovered' and the negative-framing group was informed '20/100 people will be unhappy … once they have recovered'. The vignettes were otherwise identical. The primary outcome was the decision to proceed with surgery. The secondary outcome was self-reported 'worry' about surgery.</p><p><strong>Results: </strong>For the THA vignette (622 individuals) 294/310 (95 %) indicated they would proceed with surgery in the positive-framing group while 275/312 (88 %) indicated they would proceed with surgery in the negative-framing group (p = 0.0037). For the TKA vignette (623 individuals), 302/311 (97.1 %) indicated they would proceed with surgery in the positive-framing group and 280/312 (89.7 %) indicated they would proceed with surgery in the negative-framing group (p = 0.0003). Self-reported 'worry' differed based on positive or negative framing in both surveys.</p><p><strong>Conclusions: </strong>Framing of complication risk and long-term outcomes influences patient decision-making and 'worry' in a THA and TKA vignette. This has implications for shared decision-making and informed consent.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}