The Surgical Care Practitioner role in Achilles tendon re-rupture: A case study

2021 ◽  
pp. 175045892110023
Author(s):  
Elda Julies ◽  
Tim Williams ◽  
Susan Hall
Keyword(s):  
Informed Consent ◽  
Achilles Tendon ◽  
Clinical Course ◽  
Treatment Options ◽  
Surgical Care ◽  
Surgical Team ◽  
Patient Journey ◽  
Practitioner Role

The value of a Surgical Care Practitioner to an orthopaedic team is demonstrated in this case study of a patient who presented with a re-ruptured Achilles tendon. It highlights the role the practitioner plays in the patient journey and illustrates it’s value throughout the clinical course from consultation through to discharge. The Surgical Care Practitioner, as a member of the extended surgical team can help to explain the diagnosis and associated treatment options, facilitate informed consent and provide expert procedural assistance to the surgeon. A Surgical Care Practitioner is ideally placed to answer patient queries and aid in rehabilitation.

The surgical care practitioner seeking consent: An appropriate delegate?

2018 ◽  
Vol 28 (10) ◽  
pp. 273-277
Author(s):  
Michael Nicholas
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Shared Decision Making ◽  
Care Pathway ◽  
Surgical Care ◽  
Recent Case ◽  
Health Board ◽  
Shared Decision ◽  
Surgical Team ◽  
Surgical Practice

Surgical care practitioners (SCPs) have become recognised as integral members of the surgical team in many healthcare establishments. Seeking informed consent either as the operating practitioner or on behalf of the surgeon, as their delegate, has becoming routine for many SCPs. Informed consent is a critical step in the patient’s care pathway and fundamental in fostering shared decision making and safer surgical practice. The relatively recent case of Montgomery v Lanarkshire Health Board has highlighted a need for those practitioners seeking informed consent to critically examine their practice and revisit the founding principles of the process.

scholarly journals Wrist fracture management and the role of surgical care practitioner through the patient’s journey

2021 ◽  
pp. 175045892097607
Author(s):  
Rojas Moya Desiree ◽  
Russell Kabir
Keyword(s):  
Emergency Services ◽  
Surgical Care ◽  
Wrist Fracture ◽  
Junior Doctors ◽  
Examination Technique ◽  
Legal Implications ◽  
Fracture Management ◽  
Surgical Options

The presentation of this case study involves an exploration of the patient's journey in detail after having a traumatic wrist fracture, which is recognised as one of the most common fractures encountered daily in emergency services by junior doctors and practitioners. However, this article not only analyses the medical guidance for this type of case, but also the importance of the surgical care practitioner role in trauma and orthopaedics. All practitioners attending patients in emergency services are required to develop a good knowledge of anatomy, physiology, patient’s examination technique, classifications and consequently being aware of the possible surgical options for treatment of the fracture. They will also need to fully understand the legal implications of consent to ensure safe practice.

scholarly journals 892 Emergency General Surgical Practice at a District General Hospital during COVID-19 Pandemic: Implementing Royal College of Surgeons Guidance

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
K Hashmi ◽  
S Khalid ◽  
K Raja ◽  
A Zaka ◽  
J Easterbrook
Keyword(s):  
Informed Consent ◽  
Royal College ◽  
Mortality Risk ◽  
General Surgery ◽  
Surgical Care ◽  
District General Hospital ◽  
Emergency General Surgery ◽  
Surgical Practice ◽  
Full Compliance ◽  
Type Of Surgery

Abstract Introduction COVID-19 pandemic had a significant impact on surgical practice across NHS. RCS released guidance on altering surgical practise during the pandemic to deliver safe surgical care in March, 2020. We present an audit conducted at a DGH comparing practice of emergency general surgery (EGS) with RCS guidance at the peak of COVID-19 pandemic. Method Consecutive patients undergoing EGS from 1st April to 15th May,2020. Data of demographics, ASA grade, comorbidities, type of surgery, hospital stay, informed COVID-19 pneumonia consent, complications and 30-day mortality were collected. Pre- and post-operative COVID-19 status was determined. Results Forty-four (n = 44) patients, mean age 47.5 and IQR (26-69). Male (55.8%) and females (44.2%). Preoperative COVID19 status was confirmed in around 79.1% patients. All (100%) patients who underwent CT imaging preoperatively had CT chest performed. Informed consent for COVID19 pneumonia was taken in 4.7% patients. 30-day mortality risk was 7% and complications risk was 4.7%. RR of 30-day mortality in preoperative COVID19 status positive patients was RR = 0.92 (CI 0.85-1.01) and for complications was RR = 0.95 (CI 0.88-1.02). Conclusions RCS guidance on managing and altering practice in EGS during COVID-19 pandemic is reliable, implementable, and measurable in a DGH setting. Simple improvements in consent process can achieve full compliance with RCS guidelines.

scholarly journals Successful Homoeopathic Treatment of Phyllodes Tumour: A Case Study

2021 ◽  
Vol 34 (02) ◽  
pp. 130-140
Author(s):  
Purnima Shukla ◽  
Purak Misra ◽  
Risabh Kumar Jain ◽  
Rajiv Kumar Misra
Keyword(s):  
Clinical Course ◽  
Research Centre ◽  
Subjective Improvement ◽  
Gradual Improvement ◽  
Conium Maculatum ◽  
Detailed Case ◽  
Phyllodes Tumour ◽  
Phyllodes Tumours ◽  
Over Time

AbstractPhyllodes tumours (PTs) of the breast are rare biphasic fibroepithelial neoplasm. They have potentiality to recur and metastasise. Majority of them follow a benign clinical course. We have treated one patient suffering from PT at the out-patient department of Sri Ram Medical & Homoeopathic Research Centre, Gorakhpur, India. After detailed case taking and repertorisation, first Conium maculatum and later on Phytolacca decandra and Calcarea fluorica were prescribed on the basis of individualisation to treat the case. Outcomes were assessed clinically every month for subjective improvement and objectively by ultrasonography reports at every 6-month interval. Gradual improvement was noted over time. The case has been assessed with MONARCH Inventory, which shows ‘definite’ association between the medicine and the outcome.

scholarly journals EFFECT OF PATHYA PALAN/ DIET, PANCHAKARMA AND AYURVEDA MEDICINE IN AAMVATA- A CASE STUDY

2021 ◽  
Vol 9 (8) ◽  
pp. 1908-1912
Author(s):  
Neerja R. Sharma ◽  
Preeti Preeti ◽  
Parvesh Kumari
Keyword(s):  
Female Patient ◽  
Lifestyle Modification ◽  
Treatment Options ◽  
Dietary Guidelines ◽  
Psychological Disturbances

The menopausal stage is the condition where a female wants to be at ease but if other ailments occur where she has to face continuous pain and agony make is more uncomfortable along with the psychological disturbances. The present case is a female patient who came with the symptoms of Aamavata (R.A.) in her menopausal age and was diagnosed with the same (Aamvata). She received Dietary guidelines along with lifestyle modification (Pathya Palan), Panchakarma therapy i.e. Vaitran Basti (medicated enema) for 7 days, Ruksha Swedana (dry sudation), Aamvatari Rasa, Trivrata Avleha, Ajmodadi churna, Giloy Satva for 1 month, later only Ajmodadi Churna and dietary guidelines for 2 months. The application of the Ayurvedic principle shows remarkable results in this case where other treatment options are limited. Keywords: Aamvata, R.A., Pathya Palan

scholarly journals NON-SPECIFIC ULCERATIVE COLITIS AND COVID-19, A CASE STUDY

2021 ◽  
Vol 5 (1) ◽  
pp. 89-92
Author(s):  
Z. P. Lemeshevskaya ◽  
◽  
M. V. Pavlukevich ◽  
N. I. Procopchik ◽  
◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Clinical Case ◽  
Clinical Laboratory ◽  
Clinical Course ◽  
Medical Documentation ◽  
Atypical Form ◽  
History Of ◽  
Hematoxylin And Eosin ◽  
Somatic Diseases

Background. COVID-19 infection keeps changing our understanding of its clinical course when associated with various somatic diseases. Objective. To present a clinical case of a patient with non-specific ulcerative colitis (NUC) and COVID-19 infection. Material and methods: medical documentation, general clinical, laboratory and instrumental data as well as histological examination of bioptates stained with hematoxylin and eosin that were obtained during colonoscopy. Results. The article presents a case history of a patient with manifestations of severe total NUC developed in association with the subclinical form of COVID-19 infection, the former being the cause of death in concomitant pathology. Conclusions. This clinical case describes a variant of an unfavorable outcome of NUC, one of the reasons for the manifestation of which was the atypical form of COVID-19 infection, which became a trigger for an autoimmune inflammatory process in the intestine. The accumulation of new knowledge about the features of the pathogenesis and manifestations of both pathologies will make it possible to improve the effectiveness of treatment and predict the course and outcomes of combined pathology.

scholarly journals TREATMENT OPTIONS FOR NEGLECTED ACHILLES TENDON RUPTURED: WETHER SPONTANEOUS HEALING IS POSSIBLE?

2018 ◽  
Vol 24 (2) ◽  
pp. 59-69
Author(s):  
A. P. Sereda
Keyword(s):  
Surgical Treatment ◽  
Achilles Tendon ◽  
Treatment Outcomes ◽  
Plantar Flexion ◽  
Treatment Options ◽  
Tendon Healing ◽  
Spontaneous Healing ◽  
Minimal Incision ◽  
Better Than

The paper considers cases of spontaneous healing of achilles tendon with elongation. In such condition the tendon defect is not palpable, active plantar flexion is preserved and patients are complaining for strength diminution.Purpose— to study features of spontaneous achilles tendon healing with elongation and to analyze the shortening tenoplasty option as a procedure primarily aimed at restoration of strength for gastrocnemius-soleus complex.Material and Methods.The paper presents features and outcomes of surgical treatment of 25 patients who underwent a shortening tenoplasty of various types: crimping (3 patients), Z-type (2 patients), oblique (1 patient) and transverse (19 patients).Results.No re-ruptures or other serious complications were observed in the patients of the present study. Treatment outcomes were evaluated by j. leppilahti scale in 304,7±8,9 days after the procedure. postoperative leppilahti scores were statistically significantly better than prior to surgery — 82,4±5,6 and 62,2±7,7, respectively, (p<0,0001). Conclusion. Shortening tenoplasty can be indicated in cases of spontaneous achilles tendon healing with elongation. at relatively early stages of the injury with rather elastic scars the crimping tenoplasty can be applied.  At later stages a resection shortening tenoplasty is recommended through a minimal incision with transverse resection of tendon and removal of scar block. 

The 7th French Airborne Forward Surgical Team experience of surgical support to the population of a low-income country: a prospective study on 341 patients with short-term follow-up

2018 ◽  
Vol 164 (6) ◽  
pp. 423-427 ◽  
Author(s):  
Yvain Goudard ◽  
C Butin ◽  
C Carfantan ◽  
G Pauleau ◽  
E Soucanye de Landevoisin ◽  
...  
Keyword(s):  
Low Income ◽  
Elective Surgery ◽  
Surgical Care ◽  
Host Population ◽  
Surgical Team ◽  
Low Income Country ◽  
Operative Outcomes ◽  
Surgical Teams ◽  
A Prospective Study

BackgroundThe 7th Airborne Forward Surgical Team (FST) has deployed to Chad in 2015 and 2016, in support of French military forces. Humanitarian surgical care is known to represent a significant part of the surgical activity in such missions, but to date limited data have been published on the subject.MethodsAll surgical patients from a civilian host population treated by the FST during these missions have been prospectively included. Indications, operative outcomes and postoperative outcomes were evaluated.ResultsDuring this period, the FST operated on 358 patients. Humanitarian surgical care represented 95% of the activity. Most patients (92.7%) were operated for elective surgery. Emergencies and infectious diseases represented, respectively, 7.3% and 9.1% of cases. The mean length of stay (LOS) was three days (2–4), and the median follow-up was 30 days (22–34). Mortality rate was 0.6% and morbidity was 5.6%. Parietal surgery had no significant complication and had shorter LOS (p<0.001). Emergent surgeries were more complicated (p<0.01) and required more reoperations (p<0.05). Surgical infectious cases had longer LOS (p<0.01).ConclusionsHumanitarian surgical care can be provided without compromising the primary mission of the medical forces. Close surveillance and follow-up allowed favourable outcomes with low morbidity and mortality rates. Humanitarian care is responsible for a considerable portion of the workload in such deployed surgical teams. Accounting for humanitarian care is essential in the planning and training for such future medical operations.

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