Perioperative antibiotic prophylaxis use in modern orthopaedic procedures is well established. Studies have shown significant reduction in risk of post-operative infections. However, as effectiveness of these antibiotics is dependent on achieving high serum and tissue concentrations that exceed the minimum inhibitory concentrations of infective organisms for operation duration, the timing of prophylaxis is crucial. Although, optimal timing for administering prophylaxis varies in the literature, 30 to 60 minutes prior to skin incision or inflation of tourniquet is considered best standards. To audit our practice of timing of administration of perioperative prophylactic antibiotics in trauma and orthopaedic procedures.Introduction
Objectives
We reproduced a frequently cited study performed at our University Hospital that was published in the British Medical Journal in 1981 assessing the extent of “snow and ice” fractures during the winter period. As per the original study, four days of snow and ice were identified as well as two control periods when snow and ice wasn't recorded; four days within the same year, with a similar amount of sunshine hours, and four days one calendar year later. The distribution of fractures according to age and sex in addition to the anatomical location were examined in relation to the presence of snow and ice as well as comparisons with the index study 33 years ago.Background
Methods
Patients with hand injuries frequently present to Emergency Departments. The ability of junior doctors to perform an accurate clinical assessment is crucial in initiating appropriate management. To assess the adequacy of junior doctor hand examination skills and to establish whether further training and education is required.Background
Objectives
The incidence of bleeding following primary TKR has increased with the use of chemical thromboprophylaxis. Our aim was to compare Clexane, Apixaban and Rivaroxaban in terms of frequency and volume of bleeding episodes, need for blood transfusion, return to theatre and incidence of VTE events. Between February and May 2014, a consecutive series of 132 primary TKRs were studied prospectively. The wound dressings of these patients were assessed daily to look for signs of bleeding and classified into: Mild (< 50p size coin), moderate (> 50p size coin) or Severe (blood seeping through the dressing). Follow up was up to minimum of 30 days post discharge.Background
Methods
Increasing number of studies investigating surgical patients have reported longer length of stay (LOS) in hospital after an operation with higher ASA grades. However, the impact of Body Mass Index (BMI) on LOS in hospital post Total Knee Replacement (TKR) remains a controversial topic with conflicting findings in reported literature. In our institution, we recently adopted a weight reduction program requiring all patients with raised BMI to participate in order to be considered for elective TKR. This has prompted us to investigate the impact BMI has on LOS compared to the more established impact of ASA grade on patients following Primary TKR.Background
Objectives
