South African Journal of Surgery - Volume 42, Issue 1, 2004
Volume 42, Issue 1, 2004
Source: South African Journal of Surgery 42 (2004)More Less
Extracted from text ... 2 VOL 42, NO. 1, FEBRUARY 2004 SAJS SAJS Information wanted during heart recovery New research shows that patients would like more information from health care providers during recovery after cardiac surgery. Researchers from University Health Network and the University of Toronto recently reported on research in which they surveyed nearly 1 000 patients after hospital discharge. The survey indicated that patients would have a higher success rate in recovery if physicians provided more information and allowed more involvement. Donna E Stewart, MD, lead author of the study, said that disseminating more information to heart patients can increase patient satisfaction and lead to better preventive health behaviour. The investigators found that the most common areas in which patients wanted ..
Source: South African Journal of Surgery 42, pp 4 –5 (2004)More Less
Extracted from text ... Editorial SAJS 4 VOL 42, NO. 1, FEBRUARY 2004 SAJS The standard of care for abdominal gunshot wounds has traditionally been mandatory laparotomy. This was also the case for abdominal stab wounds until the beginning of the 1980s, by which time selective non-operative management (SNOM) had become an acceptable alternative for a selected group of patients. Adopting the same policy for gunshot wounds of the abdomen has created resistance due to certain dissimilarities between the two mechanisms of penetrating trauma. Approximately one-third of stab wounds to the abdomen are associated with significant injury, while the same is true for approximately 80% of gunshot wounds. This is because gunshots result in a greater degree ..
Source: South African Journal of Surgery 42, pp 5 –10 (2004)More Less
Extracted from text ... SAJS VOL 42, NO. 1, FEBRUARY 2004 5 CONGRESSES, 2004 NASA (Neurology Society of SA) KwaMaritane, 10 - 13 March SASA (SA Society of Anaesthesiologists) Sandton Convention Centre, 13 - 17 March Salmagundi (Dermatology Society of SA) Cape Town Convention Centre, 27 - 29 April ASSA-SAGES 2004 (combined Association of Surgeons of SA, SA Gastroenterology Society, SA Society of Endoscopic Surgeons, Vascular Society of SA, SA Gastrointestinal Nurses Society). Cape Town Convention Centre, 6 - 10 August SASMO (Educational Symposium - joint meeting of European School of Oncology and South African Society of Medical Oncology, 'Multidisciplinary Management of Upper Gastrointestinal Tumours') Sandton Convention Centre, 18 - 20 November Further information is available from ..
Source: South African Journal of Surgery 42, pp 7 –10 (2004)More Less
<I>Introduction.</I> The abuse of alcohol and drugs is a major public health problem and intoxication is one of the most important risk factors for violence and other causes of injury. The aim of the current study was to evaluate the prevalence of drug and alcohol use associated with injury in adult trauma patients in an inner city trauma unit in Johannesburg. <br><I>Methods.</I> A cohort of 105 adult trauma patients admitted to our university trauma unit and its allied medicolegal laboratory were studied in order to provide prospective data and enable us to correlate the prevalence and type of substance abuse with the demographics and injury patterns after major trauma. <br><I>Results.</I> Forty-five patients required resuscitation at the Johannesburg Hospital Trauma Unit (JHTU) and 60 patients were examined at the Johannesburg Medicolegal Laboratory (JMLL), giving a total of 105 patients. Blood alcohol concentration (BAC) was positive in 59% of the patients. The average BAC in the trauma unit patients was 37 mmol/l (0.17 g/dl) , more than three times the legal limit for driving. <br>Of the patients 43.7% were positive for urinary cannabis; women were statistically significantly more likely to have taken cannabis than men (p = 0.039). There was no difference in rates of exposure to cannabis or alcohol in patients who were the victims of interpersonal violence compared with the victims of accidents (p = 0.17). Only 3 patients had taken other drugs of abuse; 2 had taken Mandrax (methaqualone) and 1 amphetamine. <br><I>Conclusion.</I> Alcohol and cannabis are commonly misused by trauma patients in Johannesburg; the degree of misuse of other drugs appears to be low. Intoxication is a significant risk factor for violence and accidents and the resultant injuries are a massive burden on our society. Doctors have a responsibility to highlight the association between substance misuse and trauma and should also attempt to persuade individual trauma patients to reduce future alcohol consumption.
Source: South African Journal of Surgery 42, pp 11 –13 (2004)More Less
Penetrating abdominal trauma (PAT) is seen daily in our trauma ward. We present a retrospective study of the patients managed in our hospital (Polokwane Hospital, Limpopo) from January 1999 to March 2000. <br>Epidemiology, mechanism of injury, patterns of injury, management, morbidity and overall mortality were recorded for analysis. Morbidity and mortality were commonly associated with peritonitis and multiple organ dysfunction syndrome.
Use and care of an endotracheal / tracheostomy tube cuff - are intensive care unit staff adequately informed? : intensive careSource: South African Journal of Surgery 42, pp 14 –16 (2004)More Less
<I>Background.</I> There is an apparent high incidence of tracheal stenosis in the Bloemfontein area. The aim of this study was to determine intensive care unit (ICU) staff knowledge of the use and care of endotracheal and tracheostomy tube cuffs. <br><I>Methods.</I> One hundred and twelve qualified nurses, working in 11 different ICUs, were asked to complete an anonymous questionnaire regarding endotracheal / tracheostomy tube cuffs. <br><I>Results.</I> The results highlight the following three areas of concern: (i) there was an overall misconception in 38% of the respondents that the function of the cuff was to secure the tube in position in the trachea to prevent selfextubation; (ii) accurate regulation of cuff pressure was not routine practice in any of the ICUs; and (iii) only half of the respondents felt their training regarding cuff care management was sufficient. <br><I>Conclusions.</I> ICU staff had misconceptions regarding the function and care of endotracheal / tracheostomy tube cuffs. The concept of a higher cuff pressure for better stabilisation of the tube is probably an important factor that could have caused the increase in tracheal stenosis in the Bloemfontein area. Critical care nursing needs to emphasise the use of current techniques, discourage routine cuff deflation, and encourage collaboration with ICU physicians on standards of care. A protocol that could be used in the ICUs regarding the use and care of an endotracheal / tracheostomy tube cuff is proposed.
Source: South African Journal of Surgery 42, pp 17 –19 (2004)More Less
A 32-year-old patient was admitted with a communityacquired pneumonia. She had clinical evidence of AIDS and chest X-ray features consistent with pulmonary tuberculosis. While in the ward she developed an acute abdomen necessitating laparotomy, at which a diagnosis of abdominal tuberculosis was made. Sputum and intraoperative pus specimens grew a multiresistant <I>Nocardia brasiliensis</I>. Microbiological investigations for tuberculosis were negative. The patient died after a short ICU admission from multiple organ dysfunction syndrome.
Source: South African Journal of Surgery 42, pp 20 –31 (2004)More Less
Extracted from text ... Abstracts SAJS 20 VOL 42, NO. 1, FEBRUARY 2004 SAJS CLINICAL EVALUATION OF THE CHARCOT FOOT IN DIABETIC PATIENTS, REGARDING THE ARCHITECTURAL AND NEUROVASCULAR IMPAIRMENT Heerden-Van HM, Durand MC Department of Surgery, University of Pretoria Goal: To investigate the pathology of the Charcot foot in a diabetic patient, specifically the anatomical, neurological and vascular changes. Method: All the patients in the Diabetic Foot clinic were investigated prospectively (1997 - 2001). One hundred and eighty diabetic patients were compared to sixteen Charcot feet in diabetic patients. A neurovascular examination was done, and a footprint was taken with a Podotract. In the cases were both the posterior tibial artery and a. dorsalis pedis were absent, a Doppler ..
Author R. LakierSource: South African Journal of Surgery 42 (2004)More Less
Extracted from text ... 32 VOL 42, NO. 1, FEBRUARY 2004 SAJS Radiation Oncology for Cure and Palliation. By R. G. Parker, N. A. Janjan, M. T. Selch. Pp. xii + 282. 35 figs. Hardcover. US$ 149. Heidelberg: Springer, 2003. ISBN 3- 540-41401-0. This is one of the rather useful series of books on medical radiology published by Springer. Perhaps the most useful feature of this book is its conciseness. This is not an indication of a lack of substance. The title indicates the scope of the book and it fulfils its promise well, with an emphasis on the role of radiation in multidisciplinary treatment. The authors select and cover the subject matter well, ..
Author K.M. KuczkowskiSource: South African Journal of Surgery 42 (2004)More Less
Extracted from text ... Letter to the Editor SAJS To the Editor: I read with interest the article by Daponte et al.,1 which discusses the effect of maternal trauma on pregnancy outcome, and provides guidelines for obstetric and surgical management of pregnant trauma victims. Trauma in a parturient remains the leading cause of non-pregnancy-related maternal death, and maternal death remains the most common cause of fetal demise.2 The most common aetiologies of trauma in pregnancy include transportation accidents and falls. Sadly, the recent literature documenting surgical, obstetric and anaesthetic management of pregnant trauma victims is very limited. The pregnant trauma victim presents a unique spectrum of challenges to the health care team. However, pregnancy may not always ..