Current trends in antibiotic prophylaxis for laryngectomy in the UK – a national survey

2015 ◽  
Vol 129 (1) ◽  
pp. 63-67 ◽  
Author(s):  
R Harris ◽  
E Ofo ◽  
D Cope ◽  
I Nixon ◽  
R Oakley ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Total Laryngectomy ◽  
Current Practice ◽  
Salvage Surgery ◽  
Pharyngocutaneous Fistula ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Current Trends ◽  
National Guidance ◽  
The Uk

AbstractBackground:With the increasing use of chemoradiotherapy protocols, total laryngectomy carries increasing risks such as pharyngocutaneous fistula. There is little reference to the use of antibiotic prophylaxis in salvage surgery. This study aimed to determine the current practice in antibiotic prophylaxis for total laryngectomy in the UK.Method:A questionnaire was designed using SurveyMonkey software, and distributed to all ENT-UK registered head and neck surgeons.Results:The survey revealed that 19 surgeons (51 per cent) follow a protocol for antibiotic prophylaxis in primary total laryngectomy and 17 (46 per cent) follow a protocol in salvage total laryngectomy. Only 11 (30 per cent) use anti-methicillin-resistant Staphylococcus aureus agents in their antibiotic prophylaxis. The duration of prophylaxis varies considerably. Nineteen surgeons (51 per cent) revealed that their choice of antibiotic prophylaxis reflected non-evidence-based practices.Conclusion:There appears to be little evidence-based guidance on antibiotic prophylaxis in primary and salvage total laryngectomy. The survey highlights the need for more research in order to inform national guidance on antibiotic prophylaxis in primary and salvage total laryngectomy.

scholarly journals A review of pharyngeal mucosal closure technique in total laryngectomy

2018 ◽  
Vol 5 (1) ◽  
pp. 145
Author(s):  
Gopu Govindasamy ◽  
Subbiah Shanmugam ◽  
Arul Murugan
Keyword(s):  
Medical Records ◽  
Total Laryngectomy ◽  
Salvage Surgery ◽  
Pharyngocutaneous Fistula ◽  
Closure Technique ◽  
Carcinoma Of The Larynx ◽  
The Impact ◽  
Salvage Laryngectomy ◽  
Radiotherapy Failure ◽  
Hospital Center

<p class="abstract"><strong>Background:</strong> The purpose of this retrospective analysis was to review our single institute based experience with the pharyngocutaneous fistula following total laryngectomy and to determine the impact of pharyngeal closure technique in the development of PCF in our patients.</p><p class="abstract"><strong>Methods:</strong> The medical records of the patients, who underwent total laryngectomy for squamous cell carcinoma of the larynx and hypopharynx in Government Royapettah Hospital, center for oncology between January 2010 and December 2017, were retrospectively reviewed.  </p><p class="abstract"><strong>Results:</strong> 26 patients were included in the study of which 25 were male and 1 was female. Mean age of the patients were 58 years. Horizontal closure was done in 9 patients (35%) and T closure was done in 17 patients (65%). PCF was observed in 1 of 9 patients in horizontal closure. Remaining 17 patients underwent T closure of whom 8 patients developed PCF (p=0.06). Eight out of 18 patients (44%) developed PCF after salvage surgery after radiotherapy failure, Remaining 8 patients underwent primary laryngectomy for advanced stage cancers with cartilage involvement, of whom 1 patient developed PCF (12.5%) (p=0.11). In salvage laryngectomy (n=18), 1 of 6 cases developed PCF in horizontal closure and 7 of 12 cases in T closure technique (p=0.09).</p><p class="abstract"><strong>Conclusions:</strong> The incidence of fistula in our study was 34%. Horizontal closure was associated with decreased incidence of PCF when compared to ‘T’ closure of the defect. Prior radiotherapy had increased incidence of PCF.</p>

Antibiotic Prophylaxis for Percutaneous Tracheostomy: A Survey of Current Practice in the UK

2010 ◽  
Vol 11 (1) ◽  
pp. 31-33
Author(s):  
Sameer Hanna-Jumma ◽  
David Higgins ◽  
John Kinnear ◽  
Melanie Wright
Keyword(s):  
Antibiotic Prophylaxis ◽  
Current Practice ◽  
Percutaneous Tracheostomy ◽  
The Uk

Vapours, gargles, darts and bougies: Victorian ENT treatments

2012 ◽  
Vol 126 (11) ◽  
pp. 1159-1163 ◽  
Author(s):  
J Montgomery ◽  
A Robertson
Keyword(s):  
Silver Nitrate ◽  
Lead Acetate ◽  
Evidence Based ◽  
National Formulary ◽  
Fourth Edition ◽  
Scotch Pine ◽  
Evidence Based Practices ◽  
Crown Prince ◽  
The Uk ◽  
Non Surgical Treatment

AbstractBackground:Sir Morell Mackenzie (1837–1892), the pre-eminent early laryngologist in the UK, is nowadays perhaps better remembered for his role in the management of the Crown Prince of Germany in 1887, than for his major contribution to the development of laryngology as a specialty. In this article we focus upon his text The Pharmacopoeia of the Hospital for Diseases of the Throat (fourth edition), and attempt a comparison of Victorian ENT treatments with today's management of ENT diseases.Treatments:Some of these Victorian treatments bear a resemblance to modern day practices. Others have not withstood the test of time, in particular: silver nitrate sticks for syphilitic ulcers of the larynx (not epistaxis); nebulised sulphuric acid, which was used as a stimulant; nasal bougies, including scotch pine and lead acetate; chloroform vapour for the treatment of hay fever; ‘London paste’, a non-surgical treatment for the reduction of the tonsils, (which was perhaps the Victorian equivalent of coblation); and zinc chloride darts, which were plunged into intractable goitres.Conclusion:Some of these remedies bear no resemblance to today's evidence-based practices, while other treatments (such as silver nitrate) are still in common use. In Victorian times, however, Mackenzie's books were widely read throughout Europe and were the standard references for a specialty in its infancy. The Pharmacopoeia was published in 1872, and major advances in medicine have been made since then. We have no way of knowing which treatments in today's British National Formulary will still be in use in 140 years.

Social Justice Principles, the Law and Research, as Bases for Inclusion

2008 ◽  
Vol 32 (1) ◽  
pp. 109-124 ◽  
Author(s):  
Phil Foreman ◽  
Michael Arthur‐Kelly
Keyword(s):  
Social Justice ◽  
Evidence Based ◽  
Policy And Practice ◽  
Evidence Based Practices ◽  
School Settings ◽  
The Usa ◽  
Research Findings ◽  
Inclusive Policy ◽  
The Uk ◽  
Students With A Disability

Educational policies for students with a disability in Australia, the USA, the UK and in most western countries stipulate that inclusive placement should be an option available to parents. This article examines three principal drivers of inclusion: social justice principles, legislation, and research findings, and considers the extent to which each of these has impacted on inclusive policy and practice. The article considers the research base for inclusion, and examines the extent to which the policy and practice of inclusion is supported by evidence. It concludes with some suggestions for a research agenda that focuses on the particular contextual challenges and complexities faced in Australasian school settings, whilst recognising international directions in the identification of evidence‐based practices.

Self-Regulation and the Writing Process: Enhancing the Performance of Students With Language and Learning Difficulties

2009 ◽  
Vol 16 (1) ◽  
pp. 28-36 ◽  
Author(s):  
Gary A. Troia
Keyword(s):  
Writing Process ◽  
Self Regulation ◽  
Learning Difficulties ◽  
Evidence Based ◽  
Struggling Learners ◽  
Evidence Based Practices

Abstract This article first provides an overview of components of self-regulation in writing and specific examples of each component are given. The remainder of the article addresses common reasons why struggling learners experience trouble with revising, followed by evidence-based practices to help students revise their papers more effectively.

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