Abstract P6-16-03: Surgical management of DCIS during the UK Sloane audit project

Author(s):  
Cliona Clare Kirwan ◽  
Sheila Stallard ◽  
Senthurun Mylvaganam ◽  
Bridget Hilton ◽  
Karen Clements ◽  
...  
2009 ◽  
Vol 91 (5) ◽  
pp. 417-419 ◽  
Author(s):  
Adam J Brooks ◽  
Arul Ramasamy ◽  
David Hinsley ◽  
Mark Midwinter

INTRODUCTION In the UK, general surgical specialist trainees have limited exposure to general surgical trauma. Previous work has shown that trainees are involved in only two blunt and one penetrating trauma laparotomies per annum. During their training, nearly half of trainees will not be involved in the surgical management of liver injury, 20% will not undertake a trauma splenectomy and only a quarter will see a trauma thoracotomy. Military general surgical trainees require training in, and exposure to, the surgical management of trauma and specifically military wounding patterns that is not available in the UK. The objective of this study was to determine whether operative workload in the sole British surgical unit in Helmand Province, Afghanistan (Operation HERRICK) would provide a training opportunity for military general surgical trainees. PATIENTS AND METHODS A retrospective theatre log-book review of all surgical cases performed at the Role 2 (Enhanced) treatment facility at Camp Bastion, Helmand Province on Operation HERRICK between October 2006 and October 2007, inclusive. Operative cases were analysed for general surgical trauma, laparotomy, thoracotomy, vascular trauma and specific organ injury management where available. RESULTS A total of 968 operative cases were performed during the study period. General surgical procedures included 51 laparotomies, 17 thoracotomies and 11 vascular repairs. There were a further 70 debridements of general surgical wounds. Specific organ management included five cases of liver packing for trauma, five trauma splenectomies and four nephrectomies. CONCLUSIONS A training opportunity currently exists on Operation HERRICK for military general surgical specialist trainees. If the tempo of the last 12 months is maintained, a 2-month deployment would essentially provide trainees with the equivalent trauma surgery experience to the whole of their surgical training in the UK NHS. Trainees would gain experience in military trauma as well as specific organ injury management.


2020 ◽  
Vol 26 (6) ◽  
pp. 1-4
Author(s):  
Melissa Loh ◽  
Karthikeyan Iyengar ◽  
William YC Loh

The effect of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on the NHS in the UK has been profound and unprecedented. Many surgical specialities, including dentistry, throughout the country have not been exempt from this effect. As there are many aerosol-generating procedures and aerosol-generating exposures in surgical specialities, there has been a substantial cancellation of elective treatment. This has been in part because of the limited availability of personal protective equipment for surgeons as this is being use elsewhere by clinicians to aid the reduction of viral spread in the community. As the UK is preparing to emerge from the ‘lockdown’ during the pandemic, restarting elective surgical and dental treatment is an expected challenge. This article looks at the possible roadmap to recovery of elective surgical management and dentistry, taking into consideration possible predicted further peaks and troughs of COVID-19 infections.


2017 ◽  
Vol 11 (1) ◽  
pp. 58-61 ◽  
Author(s):  
Alexios Tsiotras ◽  
R Daron Smith ◽  
Ian Pearce ◽  
Kieran O’Flynn ◽  
Oliver Wiseman

These guidelines have been developed by the British Association of Urological Surgeons to give a framework to clinicians, based primarily in the UK, for the management of patients presenting acutely with ureteric colic. They have been developed by consensus with reference to the American Urological Association/Endourological Society guidelines on the surgical management of stones and the European Association of Urology guidelines on urolithiasis, and adapted to the logistics of those practicing within the National Health Service. Grades of recommendation and levels of evidence are based upon the system adopted by the European Association of Urology.


2020 ◽  
Vol 25 (04) ◽  
pp. 402-406
Author(s):  
Soha Sajid ◽  
James Gill ◽  
Adrian Chojnowski ◽  
Rohit Singh

Background: Avocados are increasingly being consumed due to the nutritional benefits they provide. Avocado related hand injuries reflect their increasing popularity. Most injuries occur in attempting to de-stone the fruit. This is a prospective cohort study reviewing hand injuries sustained from preparing the fruit. Methods: Data was prospectively collected from three centres across United Kingdom (UK) over a 4-year period. The data was analysed for patient demographics, nature and zone of injury and management required. Results: A total of 35 patients and 42 injuries were included in the study. The median age of patients presenting with these injuries was 33 years, with majority of injuries occurring in the 21–30 age group. Most (88%, n = 31) of patients were male. Majority (85%, n = 36) of injuries happened during the de-stoning of the fruit. All injuries occurred in the non-dominant hand, with 70%, (n = 30) of wounds being sustained in zone 3. All injuries required surgical management and needed between 1 to 6 follow up outpatient visits. Vital structures such as tendons, digital nerves, pulleys and joint capsule were frequently implicated and required exploration or repair. Conclusions: Avocado related hand wounds are serious injuries with an associated morbidity. They frequently sustained by young patients. They usually require surgical management and may need numerous outpatient attendances. Caution and public education should be advocated on the preparation of avocados. This is the largest study to date that has reviewed the surgical management of avocado hand injuries.


2019 ◽  
Vol 12 (2) ◽  
pp. e226530 ◽  
Author(s):  
Jeremy Nettleton ◽  
Hugh Crawford-Smith ◽  
Anthony Adimonye ◽  
Faith McMeekin

Juvenile gangrenous vasculitis of the scrotum is a rare entity, of which to our knowledge we describe the first documented case in the UK. It follows a typical disease course, demonstrated by an 18-year-old male who presented with three necrotic scrotal lesions; proceeded by 3 days of fever, pharyngitis and lethargy. Previous cases have been managed successfully with systemic steroids. On this occasion, surgical debridement was made of the necrotic areas under antibiotic cover and complete resolution was achieved with excellent wound healing and no evidence of recurrence. This case report discusses the importance of disease recognition and the merits of surgical management. We also add to the debate as to whether this disease is a variation of pyoderma gangrenosum or a distinct entity itself within the pantheon of scrotal gangrene.


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