Abstract:
:Delay in operating on trauma patients leads to increased morbidity, mortality, length of hospital stay and overall cost. The urgency of operative intervention depends on the injury sustained. There are no published guidelines on what constitutes a reasonable delay between admission and operation. As part of the clinical governance in our unit, an audit was undertaken to examine the structure and process of trauma operating. Patients were allocated to groups defined by the Bath Orthopaedic Department, according to urgency of need for surgery. Group A: patients (for example, open fractures and dislocations) should have definitive treatment within 6 h of admission. Group B: patients (for example, hip fractures, long bone injuries and ankle fractures) should have operations on the day that they are presented to the consultant trauma meeting, or on the day that they are declared fit/ready for theatre. Group C: patients (for example, tendon injuries, simple hand fractures) should have operations within 5 days of presentation to the trauma meeting. Over 3 months, there were 401 acute orthopaedic admissions requiring surgery (61 group A, 277 group B, 63 group C). 78% of group A patients, 58% of group B patients and 86% of group C patients were operated on within the target times. In total, 137 out of 401 operations (34%) missed the targets set. 119 of these (87%) were delayed due to lack of available operating time. This was despite the fact that 59 operations (15% of total) were done on lists normally used for elective operating. Most of the other delays were due to the need for an appropriately experienced surgeon to be available. If these targets are to be achieved for the majority of patients, the trauma theatre must become more efficient, or more flexible time must be made available during evenings or weekends to clear the backlog of trauma operations.
journal_name
Ann R Coll Surg Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Lankester BJ,Paterson MP,Capon G,Belcher Jsubject
Has Abstractpub_date
2000-09-01 00:00:00pages
322-6issue
5eissn
0035-8843issn
1478-7083journal_volume
82pub_type
杂志文章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::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::It is often accepted by hospital staff that patients would prefer to be at home for the Christmas and Easter holiday periods. This is one of the reasons that elective surgery is reduced at these times. However there is very little evidence to prove whether this is true. To investigate this question 310 patients attend...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1997-03-01 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
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更新日期:1984-03-01 00:00:00
abstract::The 'vascular' aetiology of headache is questioned. An alternative hypothesis based on sensitisation of sensory nerve endings by neurogenic plasma extravasation is discussed. The development of drugs which selectively inhibit the release of vasoactive neuropeptides from perivascular sensory nerves may benefit patients...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章,评审
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更新日期:1993-07-01 00:00:00
abstract::Appendiceal intussusception is an rare diagnosis that may be found on imaging or at the time of surgery, as seen in this case of a 33-year-old female presenting with gastrointestinal symptoms. Images are presented with differential diagnosis as well as treatment options. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
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更新日期:2017-01-01 00:00:00
abstract:INTRODUCTION:Portal and mesenteric venous thrombosis is a rare but potentially serious complication after laparoscopic sleeve gastrectomy. There are no consistent studies that prove the safety and effectiveness of oral anticoagulant thromboprophylaxis with rivaroxaban after laparoscopic sleeve gastrectomy. The objectiv...
journal_title:Annals of the Royal College of Surgeons of England
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更新日期:2020-11-01 00:00:00
abstract::A prospective study of 825 consecutive patients with colorectal cancer presenting to three general surgeons in a district general hospital over a 10-year period are reported. In all, 735 patients had an operation and are grouped according to whether their operation was within 24 h of admission (n = 63), more than 24 h...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1993-09-01 00:00:00
abstract::This is a retrospective review of 80 intra-articular calcaneal fractures treated with open reduction and internal fixation by a specialist team under supervision of a single surgeon in a tertiary centre between 2005 and 2014. The fractures were evaluated with plain radiography and computed tomography, and graded using...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2016.0259
更新日期:2017-04-01 00:00:00
abstract::First reported two decades ago, isolated incisional recurrence of hepatocellular carcinoma is an extremely rare clinical entity. We present two cases of recurrence: one recurring over 10 years after initial resection, and the second presenting with a port site recurrence 3.5 years following laparoscopic radiofrequency...
journal_title:Annals of the Royal College of Surgeons of England
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doi:10.1308/rcsann.2017.0097
更新日期:2017-07-01 00:00:00
abstract::Extensive cephalic spread of solution occurred in three out of seven cases studied during coeliac plexus blockade. Spread on to cardiac nerves and plexus may be a factor in hypotension following this procedure. Incremental dosage and careful screening is recommended. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:INTRODUCTION:The aim of this study is to ascertain the accuracy of diagnostic ultrasound in the assessment of the occult abdominal and groin herniae. The authors have previously demonstrated its efficacy in diagnosing the type of clinical groin herniae but occult herniae provide a further diagnostic problem. PATIENTS ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588406X95110
更新日期:2006-03-01 00:00:00
abstract::This report describes the mortality in 100 liver resections performed in 96 patients for seven benign and 93 malignant liver tumours. Repeat hepatectomy was performed in four patients who developed recurrences after the first liver resection. Two patients died within 30 days. The first was a 67-year-old man who died o...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1995-03-01 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::Extraskeletal chondrosarcomas are rare and there is only one reported case of primary pancreatic chondrosarcoma. We report the case of a 34-year-old woman with a 6-month history of abdominal pain and distention. Radiological studies indicated a mass in the pancreas, and exploratory laparotomy revealed a tumour of the ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870810X12659688851672
更新日期:2010-04-01 00:00:00
abstract::A non-woven alginate dressing has been used on experimental, full and partial thickness wound models for periods up to 14 days, to assess its effects on wound healing. Histological evaluation has shown that it is an effective haemostat, generally well tolerated by body tissues. Good epidermal healing was seen on all w...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1987-07-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870811X582828
更新日期:2011-07-01 00:00:00
abstract:INTRODUCTION:Carpal tunnel decompression is the most commonly performed surgical procedure within a hand unit. Although very effective, the complications following the procedure can be significant. In an attempt to identify the causes of such complications, we assessed whether seniority of the surgeon impacts on outcom...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588407X232035
更新日期:2007-11-01 00:00:00
abstract::Groin vessels are most commonly used to obtain vascular access for angiography because of their size and accessibility. Haemostasis at the puncture site can be achieved with manual compression alone or by using a vascular closure device. We highlight the case of a 68-year-old woman who developed acute claudication in ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章,评审
doi:10.1308/147870811X591143
更新日期:2011-09-01 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::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: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::Ureteric obstruction is a rare consequence of inguinoscrotal hernias. We report the case of a 71-year-old man who presented with a left hemiscrotal swelling and ipsilateral hydronephrosis. Following investigations, he was found to have a sliding inguinal hernia involving the left ureter. His left inguinal hernia was r...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2016.0024
更新日期:2016-02-01 00:00:00
abstract::Congenital cholesteatoma is a rare entity. It arises from aberrant epithelial remnants left at the time of closure of the neural groove, between the 3rd and 5th week of embryonic life. Otoscopy typically shows a pearly white mass, medial to the intact tympanic membrane, primarily in the anterosuperior quadrant, withou...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870807X160425
更新日期:2007-03-01 00:00:00
abstract::We report the case of a patient presenting with a chronic groin sinus secondary to a tubal ligation clip migration (Filshie clip) 21 years after the laparoscopic sterilisation took place. Our case report adds to the small number of cases describing tubal clip migration with resultant local sepsis. Although this is a r...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870810X476638
更新日期:2010-01-01 00:00:00
abstract::It is timely to review the place of surgery in the treatment of thyroid disease when for some years endocrinologists, pharmacologists, and radiotherapists have made most of the running. This account falls naturally into three parts, simple, malignant, and toxic goitre. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1979-03-01 00:00:00
abstract::Rectus femoris origin injuries in adult athletes are uncommon. In the acute phase, conservative treatment seems to have a favourable outcome, with surgical repair reserved for unsuccessful cases only. However, a group of patients may develop chronic pain and disability after recovery from the acute phase due to heter...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588412X13171221589333
更新日期:2012-04-01 00:00:00
abstract:INTRODUCTION:This observational study investigated the incidence of distal radius fractures in children, to determine whether the rate is rising, the effect of seasonal variation on incidence and whether fracture type and rate of surgical intervention has changed, to help in determining costs for secondary care and to ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2019.0023
更新日期:2019-04-01 00:00:00
abstract::Percutaneous transluminal angioplasty (PTA) is often used for patients who would not previously have been treated, due for example, to their poor general condition or their symptoms being relatively mild. The approximate overall initial success and complication rates are 80% and 10%, respectively. Iliac angioplasties ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1992-07-01 00:00:00
abstract::Falls are the most common accident occurring to patients in hospital, especially those undergoing rehabilitation. The types, causes, and consequences of such falls are discussed in relation to the patients' age and underlying condition with reference to 386 accidents occurring over a 5-month period in a hospital with ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1981-11-01 00:00:00