Annals of the Royal College of Surgeons of England最新文献_第7页

Re: Cosmetic incision for paediatric muscle biopsy. 关于小儿肌肉活检的美容切口。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-07-31 DOI: 10.1308/rcsann.2024.0039

T Burge

引用次数: 0

A network meta-analysis of the timing of wound dressing removal. 关于伤口敷料去除时机的网络荟萃分析。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-07-31 DOI: 10.1308/rcsann.2023.0083

Rjks Hwang, D L Crook, C S Allan, S Sarkar

{"title":"A network meta-analysis of the timing of wound dressing removal.","authors":"Rjks Hwang, D L Crook, C S Allan, S Sarkar","doi":"10.1308/rcsann.2023.0083","DOIUrl":"https://doi.org/10.1308/rcsann.2023.0083","url":null,"abstract":"Introduction: Wounds are invariably dressed postoperatively but the evidence for the timing of dressing changes is limited. This meta-analysis evaluated whether the relative risk of wound infection varies depending on when dressings are changed.Methods: A frequentist random-effects network meta-analysis was conducted on the results of a systematic review of the MEDLINE®, Ovid®, Scopus®, Web of Science™ and PubMed® databases and the Cochrane Central Register of Controlled Trials performed in May 2023. Evidence quality was graded using the Confidence In Network Meta-Analysis tool.Results: A total of 4 studies were included with 878 patients. A significant increase in the relative risk of wound infection was found when dressings were left in situ for more than 4.5 days when compared with 48 hours (3.18, 95% confidence interval: 1.22-8.33). There were no significant differences in the relative risk of infection between the other groups. Model heterogeneity and inconsistency were insignificant (Cochran's Q: 0.44, p=0.51). The quality of the evidence was graded as generally very low and risk of bias evaluations showed it to be of high concern for bias.Conclusions: Late dressing changes significantly increase the risks of wound infection and changes at 48 hours minimise these risks. There was no advantage demonstrated for earlier dressing changes. Ensuring that dressings are changed appropriately can minimise patient harm and health service costs.","PeriodicalId":8088,"journal":{"name":"Annals of the Royal College of Surgeons of England","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854588","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}

引用次数: 0

Multidisciplinary management of orthopaedic trauma - are we adhering to the guidelines? 骨科创伤的多学科管理--我们遵守准则了吗？

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-07-31 DOI: 10.1308/rcsann.2024.0048

K Hutchinson, C B Bretherton, A Gmati, B Handley

{"title":"Multidisciplinary management of orthopaedic trauma - are we adhering to the guidelines?","authors":"K Hutchinson, C B Bretherton, A Gmati, B Handley","doi":"10.1308/rcsann.2024.0048","DOIUrl":"https://doi.org/10.1308/rcsann.2024.0048","url":null,"abstract":"Introduction: A multidisciplinary team (MDT) approach to polytrauma patients minimises morbidity and mortality. This project assesses the extent to which British Orthopaedic Association Standards for Trauma guidelines for the management of the frail Orthopaedic patient are currently being met.Methods: A retrospective analysis was performed of all Trauma and Orthopaedic patients in multiple medical institutions over a 2-week capture period from 1 March 2022 until 14 March 2022 inclusive. Data collected included age, sex, injury, length of stay and dates of speciality input.Results: A total of 1,050 patients were included from 27 hospitals. The median age was 80 years, with 560 (53.3%) of all fractures being neck of femur fractures. Of the 1,050 patients, 870 (82.9%) were managed operatively. The median number of different speciality involvements was 3; 645 (61.4%) had an orthogeriatric (OG) review. In major trauma centres (MTC), 93.3% had OG input, compared with 66.3% in non-MTC. The speciality with the greatest input was Radiology, with Plastics having the lowest input.Conclusion: A standardised MDT approach is needed to optimise care and recovery in orthopaedic trauma patients. The difference in results regarding speciality involvement is substantial and needs to be addressed to minimise disparities in care received by this vulnerable cohort of patients.","PeriodicalId":8088,"journal":{"name":"Annals of the Royal College of Surgeons of England","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854592","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}

引用次数: 0

Penile tourniquet: the Wharton tourniquet. 阴茎止血带：沃顿止血带。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-07-31 DOI: 10.1308/rcsann.2024.0045

S Nour, G H Lafford, S M Wharton

引用次数: 0

Process and outcome differences in the care of patients undergoing elective and emergency right hemicolectomy. 择期和急诊右半结肠切除术患者的护理过程和结果差异。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-07-31 DOI: 10.1308/rcsann.2024.0056

J Banks, A Rashid, T R Wilson, C P Challand, M J Lee

{"title":"Process and outcome differences in the care of patients undergoing elective and emergency right hemicolectomy.","authors":"J Banks, A Rashid, T R Wilson, C P Challand, M J Lee","doi":"10.1308/rcsann.2024.0056","DOIUrl":"https://doi.org/10.1308/rcsann.2024.0056","url":null,"abstract":"Introduction: Up to 30% of patients with colorectal cancer present as an emergency and have worse outcomes than elective patients. Compared with left-sided cancers, malignancies arising in the right colon are significantly under-researched. We sought to compare cancer care quality and clinical outcomes between emergency and elective presentations of right-sided colon cancer (RCC).Methods: This multicentre, retrospective study included all patients who underwent operative management for a RCC, from 1 April 2017 to 31 March 2022. Data were collected from electronic patient records, and host and tumour factors as well as outcomes between emergency and elective cohorts were compared.Results: Overall, 806 patients (median age 72 years) were included. Some 175 patients (22%) presented as an emergency: 140 in obstruction and 35 with tumour perforation, compared with 1 patient with tumour perforation in the elective group (p < 0.001). The emergency group had higher rates of postoperative complications (59.1% vs 20.0%, p < 0.001), increased 90-day mortality (13.7% vs 1.3%, p < 0.001) and a longer hospital stay (5 vs 10 days, p < 0.001). From the emergency cohort only 29.2% of eligible patients received adjuvant chemotherapy and in multivariate regression analysis emergency presentation was associated with a decreased likelihood of receiving adjuvant chemotherapy (odds ratio 0.26 [0.14-0.47], p < 0.001).Conclusions: Both short- and long-term outcomes after emergency presentation of RCC are poor, with inadequate access to subsequent chemotherapy. Strategies addressing emergency presentations of left-sided tumours have moved towards temporisation and elective surgery. Delaying major resectional surgery for optimisation may improve outcomes and access to adjuvant therapies for RCC.","PeriodicalId":8088,"journal":{"name":"Annals of the Royal College of Surgeons of England","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854594","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}

引用次数: 0

The 'hashtag' K-wires configuration for the management of severe comminuted patellar fracture: the combination of tension band technique and cerclage wiring. 用于治疗严重粉碎性髌骨骨折的 "hashtag "K线配置：张力带技术与Cerclage接线的结合。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-07-31 DOI: 10.1308/rcsann.2024.0044

N E Koukoulias, A V Vasiliadis, S Savvidou, T Dimitriadis

引用次数: 0

A simple technique for checking nipple height in breast reduction and mastopexy. 乳房缩小术和乳房整形术中检查乳头高度的简单技术。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-07-31 DOI: 10.1308/rcsann.2024.0042

Ye Ru Chin, David Oliver

引用次数: 0

Modified patella tendon plication in ambulant children with cerebral palsy. 在行动不便的脑瘫儿童中采用改良髌腱植入术。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-07-31 DOI: 10.1308/rcsann.2024.0052

A M Khan, Y Alkhalfan, A Afsharpad, M Kokkinakis

引用次数: 0

The open access juggernaut and another bastion falls. 开放存取的巨轮和另一个堡垒倒下了。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-07-31 DOI: 10.1308/rcsann.2024.0055

D Batura

引用次数: 0

Intra-abdominal rhabdomyosarcoma in a paediatric patient presenting as acute appendicitis. 一名表现为急性阑尾炎的儿童腹腔内横纹肌肉瘤。

IF 1.1 4区医学

Annals of the Royal College of Surgeons of England Pub Date : 2024-07-31 DOI: 10.1308/rcsann.2024.0065

M C Moolamannil, H Khan, S Karim

引用次数: 0