Abstract：
:INTRODUCTION In our regional spinal injuries unit, complex pressure ulcer reconstruction is facilitated by a monthly multidisciplinary team clinic. This study reviews a series of the more complex of these patients who underwent surgery as a joint case between plastics and other surgical specialties, aiming to provide descriptive data as well as share the experience of treating these complex wounds. MATERIALS AND METHODS Patients operated on as a joint case from 2010 to 2014 were identified through a locally held database and hospital records were then retrospectively reviewed for perioperative variables. Descriptive statistics were collected. RESULTS 12 patients underwent 15 procedures as a joint collaboration between plastic surgery and other surgical specialties: one with spinal surgery, 12 with orthopaedic and two with both orthopaedic and urology involvement. Ischial and trochanteric wounds accounted for 88% of cases with five Girdlestone procedures being performed and 12 requiring soft-tissue flap reconstruction. Mean operative time was 3.8hours. Four patients required high-dependency care and 13 patients received long-term antibiotics. Only three minor complications (20%) were seen with postoperative wound dehiscence. DISCUSSION The multidisciplinary team clinic allows careful assessment and selection of patients appropriate for surgical reconstruction and to help match expectations and limitations imposed by surgery, which are likely to influence their current lifestyle in this largely independent patient group. Collaboration with other specialties gives the best surgical outcome both for the present episode as well as leaving avenues open for potential future reconstruction.
journal_name
Ann R Coll Surg Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Thomson CH,Choudry M,White C,Mecci M,Siddiqui Hdoi
10.1308/rcsann.2016.0227subject
Has Abstractpub_date
2017-02-01 00:00:00pages
169-174issue
2eissn
0035-8843issn
1478-7083journal_volume
99pub_type
杂志文章,评审abstract：INTRODUCTION:Involvement of regional lymph node is a critical sign in prognosis of gastric cancer. Radiological techniques are commonly used to evaluate the extension of gastric cancer. But their sensitivity and specificity are low especially in the early stage. Our aim was to assess the value of gastric lymphoscintigr...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588406X149200
更新日期：2006-11-01 00:00:00
abstract：INTRODUCTION:Introducing laparoscopic colorectal surgery is a challenge to the whole surgical team. It is usual for an assistant to hold the laparoscope and be responsible for the surgeon's view of the operative field and a lack of expertise in the assistant can add significant difficulties. The EndoAssist is a robotic...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588409X392162
更新日期：2009-07-01 00:00:00
abstract：INTRODUCTION:The main barriers to short stay thyroidectomy are haemorrhage, bilateral recurrent laryngeal nerve palsy causing respiratory compromise and hypocalcaemia. This study assessed the safety and effectiveness of thyroidectomy as a 23-hour stay procedure. METHODS:All patients undergoing total or completion thyr...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588414X13814021679997
更新日期：2014-05-01 00:00:00
abstract：:Although the operating microscope was introduced more than 50 years ago, its use was at first confined to otolaryngology and, later, to ophthalmology. More recently its use in the development of microvascular techniques has led to spectacular advances in the field of replantation and reconstructive surgery. The organi...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 历史文章,杂志文章
doi：
更新日期：1976-03-01 00:00:00
abstract：:Gross enlargement of the male breast with skin redundancy and ptosis cannot be effectively managed by subcutaneous mastectomy alone. A technique is described in which the excess breast tissue and skin are excised along a design which allows the nipple-areolar complex, mounted on a vertical deepithelialised pedicle, to...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1989-07-01 00:00:00
abstract：:The salient steps of a 20-year programme of research into the nature of burn disease are described. By burn disease we mean the late mortality and morbidity following burns. We have isolated a burn toxin which is derived from a thermal polymerization of cell membrane lipoproteins within the dermis and have studied its...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1974-11-01 00:00:00
abstract：:In a prospective study of 100 patients presenting with acute right hypochondrial pain and diagnosed clinically by a qualified surgeon as having acute cholecystitis, we have shown that the diagnostic error can be considerable. Twenty-five of these patients were found to have a different diagnosis on subsequent investig...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1986-01-01 00:00:00
abstract：INTRODUCTION:Surgical skills courses are an important part of learning during surgical training. The assessments at these courses tend to be subjective and anecdotal. Objective assessment using multiple choice questions (MCQs) quantifies the learning experience for both the organisers and the participants. MATERIALS A...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588408X242097
更新日期：2008-03-01 00:00:00
abstract：:The outcome of loop ileostomy closure was evaluated in 40 patients who had previously undergone restorative proctocolectomy. A standard operative technique was used which incorporated a circumstomal incision, non-resectional reconstruction and primary skin closure. Thirty-six patients (90%) enjoyed an uncomplicated re...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1990-07-01 00:00:00
abstract：:Changes in anal pressure have been monitored during the induction of anaesthesia. Falls in pressure accompany loss of consciousness following bolus doses of commonly used intravenous and inhalational anaesthetic agents. Subsequent rises in pressure towards pre-anaesthetic levels are usually associated with the time ta...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1988-03-01 00:00:00
abstract：:The history of the technique of promoting dissolution of retained gallstones in the biliary tree is briefly reviewed. Present methods are described in detail and our own experience recorded. We have treated six patients with retained calculi by means of heparinized saline and sodium cholate infusions of the common bil...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1977-03-01 00:00:00
abstract：:A patient presented with a recurrent incarcerated inguinoscrotal hernia requiring urgent surgery. The defect was through the gap in the mesh left originally for the cord structures. As a result, a modified funnel repair was performed. An innovative approach was adopted that was best suited to tackling and reducing the...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588414X13946184903081
更新日期：2014-11-01 00:00:00
abstract：:As part of a waiting list initiative, magnetic resonance imaging (MRI) scans were arranged for 69 patients waiting for knee arthroscopy. All patients had a clinical diagnosis of a meniscal tear. With 11 non-attenders, 58 scans were performed. Of the patients scanned, 35 had demonstrable meniscal tears, and five patien...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1996-09-01 00:00:00
abstract：OBJECTIVE:The objective of this study was to describe the impact of a 'fast-track' unit, combined with a computerised system for information collection and analysis, on the clinical practice and finance of a cardiothoracic department over the first 12 month period of its application. METHODS:Within 12 months, starting...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：2000-01-01 00:00:00
abstract：:Two years individual experience of spine and joint tuberculosis in the North West Frontier of Pakistan is summarised. The problems of treating a population that presents late in the course of the disease, and of coping with an added influx of highly affected Afghans, feature prominently in surgical practice. ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1984-03-01 00:00:00
abstract：:The successful treatment of major burns depends upon accurate and early fluid replacement in the first 36 h. A burns calculator has been designed, based upon the Muir and Barclay formula, which should facilitate the estimation of fluid requirements in burned patients and therefore improve their immediate management in...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1982-09-01 00:00:00
abstract：:This study suggests that appendicectomy should be routinely performed at laparoscopy for suspected acute appendicitis and that this can be achieved with minimal morbidity. ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1999-07-01 00:00:00
abstract：INTRODUCTION:The retrojugular approach for carotid endarterectomy (CEA) has been reported to have the advantages of shorter operative time and ease of dissection, especially in high carotid lesions. Controversial opinion exists with regard to its safety and benefits over the conventional antejugular approach. METHODS:...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章,meta分析,评审
doi：10.1308/003588414X13814021679357
更新日期：2014-04-01 00:00:00
abstract：INTRODUCTION:The purpose of this study was to explore the effectiveness of two chitosan formulations, Omni-Stat® granules and Celox Gauze®, in a model of major hepatic injury in the presence of clotting dysfunction. MATERIALS AND METHODS:Major hepatic injuries in moderately heparinised swine were treated with either O...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588410X12699663903593
更新日期：2010-10-01 00:00:00
abstract：:Malignant peripheral nerve sheath tumours (MPNSTs) are a rare but aggressive form of soft tissue sarcoma with few reported cases in the anatomic location seen with the case presented here. This case involves a 23-year-old man presenting with a soft tissue mass under the mandible found to be a MPNST, which was investig...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2017.0060
更新日期：2017-05-01 00:00:00
abstract：:Three hundred and forty consecutive patients received successful spinal anaesthesia with 0.5% plain bupivacaine. A small randomised study of 40 of these cases showed little difference between 3.5 and 3 ml; however, analysis of its use in 200 patients receiving 3.5 ml (mean block T10.5 +/- 1 segment) and 100 receiving ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1983-01-01 00:00:00
abstract：:Erdheim-Chester disease is a rare infiltrative histiocytic disorder with around 800 cases being reported worldwide. Patients most commonly present with skeletal pain, but the condition has been shown to affect multiple other organs. We describe a rare presentation in which the disease infiltrated the sinuses and affec...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2019.0130
更新日期：2020-02-01 00:00:00
abstract：INTRODUCTION:Incisional hernia is a common complication of laparoscopic colorectal surgery. Extraction site may influence the rate of incisional hernias. Major risk factors for the development of incisional hernias include age, diabetes, obesity and smoking status. In this study, we investigated the effect of specimen ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588414X14055925058274
更新日期：2015-01-01 00:00:00
abstract：:A high incidence of complications related to bleeding was observed after open prosthetic inguinal hernia repair. The site of injection of low-dose heparin into the abdominal wall was thought to be a possible causal factor for these complications. The wound complication rate after repair of primary unilateral inguinal ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,多中心研究
doi：
更新日期：1998-01-01 00:00:00
abstract：:Pseudoaneurysm is a rare complication of surgery or trauma around the knee. A 30-year-old man presented 10 days following anterior cruciate ligament repair with a 2 cm pulsatile swelling on the medial side of the knee. Angiography demonstrated a pseudoaneurysm of the medial inferior genicular artery. Surgical explorat...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：2000-05-01 00:00:00
abstract：INTRODUCTION:Osteoarthritis of the trapeziometacarpal joint (TMJ) is a common condition causing significant disability. Conservative treatments include intra-articular steroid injections. PATIENTS AND METHODS:This clinical, observational study prospectively reviewed the longevity of benefit of steroid injections into ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,评审
doi：10.1308/003588410X12699663905078
更新日期：2010-11-01 00:00:00
abstract：INTRODUCTION:Most women who have screening mammography and undergo subsequent open biopsy following an indeterminate core biopsy result are eventually found to have benign disease. However, a significant number have malignant disease and the rate of malignancy in such cases may be influenced by various factors. This s...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588412X13171221498460
更新日期：2012-03-01 00:00:00
abstract：:Little is known about the outcome after pancreatic debridement in the district general hospital (DGH) setting and the debate about centralisation of pancreatic surgical services continues. We retrospectively reviewed our experience over 2 years, looking particularly at mortality, morbidity and cost. Of 12 cases treate...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章,评审
doi：10.1308/003588402760452394
更新日期：2002-09-01 00:00:00
abstract：:A randomised, double-blind study was conducted to assess the influence of intra-articular and subcutaneous prilocaine with adrenaline on postoperative pain in day case arthroscopy of the knee. The time to first dose of oral analgesia postoperatively was significantly prolonged in those patients receiving prilocaine bu...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1990-11-01 00:00:00
abstract：:A series of 20 infants undergoing general anaesthesia for pyloromyotomy were studied in a randomised, blind and controlled trial to determine the postoperative behavioural and cardiorespiratory effects of wound infiltration of bupivacaine. Ten infants received bupivacaine (0.6 ml/kg, 0.25% = 1.5 mg/kg) injected intrad...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1990-09-01 00:00:00
