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Jahangiri M, Choobineh A, Malakoutikhah M, Hassanipour S, Zare A. The global incidence and associated factors of surgical gloves perforation: A systematic review and meta-analysis. Work 2022; 71:859-869. [PMID: 35253703 DOI: 10.3233/wor-210286] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Surgeon's hands are exposed to a range of chemical and physical stressors that influence the integrity of gloves. Thus, glove perforation facilitates pathogen transmission through the holes. Numerous studies have shown that glove perforation is of great importance, but there is still no complete consensus. OBJECTIVE This study aimed to investigate the safety conditions of surgical gloves based on the incidence of glove perforation among surgical teams. METHODS A literature review was conducted by searching PubMed, Embase, Scopus, ISI, and ProQuest databases. The incidence of glove perforation was reviewed in eight categories. A total of 580 articles were found in the initial search. RESULTS 109 articles containing 130 datasets were analyzed. The overall incidence of glove perforation was 14.44 %. Surgeons had the highest incidence of glove perforation (23.09 %). An increase in the duration of surgery increased the odds of perforation. It was found that 68.58% of the glove perforations were not identified by practitioners. CONCLUSION Despite major advances in the design of surgical gloves, the issue of safety and integrity of gloves has not improved. Due to the high incidence of surgical glove perforations, most of which had not been identified, it is imperative to consider strategies to minimize the incidence of perforation. The results of the present study can be used to integrate information related to the rate of perforation of surgical gloves in different surgeries.
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Affiliation(s)
- Mehdi Jahangiri
- Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Choobineh
- Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdi Malakoutikhah
- Department of Occupational Health Engineering, School of Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Soheil Hassanipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Asma Zare
- Department of Occupational Health Engineering, Sirjan School of Medical Sciences, Sirjan, Iran
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2
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van Ewijk LJ, van Riet TCT, van der Tol IGH, Ho JPTF, Becking AG. Power chains as an alternative to steel-wire ligatures in temporary maxillomandibular fixation: a pilot study. Int J Oral Maxillofac Surg 2021; 51:975-980. [PMID: 34509364 DOI: 10.1016/j.ijom.2021.08.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 06/28/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022]
Abstract
The aim of this study was to compare two techniques for temporary intraoperative maxillomandibular fixation (TIO-MMF) during orthognathic surgery: steel-wire ligatures versus power chains. Patients undergoing orthognathic surgery between October 2019 and March 2020 were included in a prospective cross-sectional study conducted in three participating hospitals. Data were collected using a standardized measurement form. A total of 44 patients were included, in whom TIO-MMF was applied 79 times. A statistically significant difference in intraoperative loss of stability of the segment relationship was found between steel-wire ligatures (11.4%) and power chains (0%). The mean application time of TIO-MMF differed significantly between steel-wire ligatures (99 seconds) and power chains (157 seconds) (P < 0.001). There was no statistical difference in occurrence of adverse events between the two techniques. This study found that the application of TIO-MMF with power chains is more stable compared to steel-wire ligatures. Steel-wire ligatures were significantly faster to apply, although the absolute difference (less than 1 minute) was small. Other possible advantages of the proposed technique are discussed. The results of this study suggest that power chains for the application of TIO-MMF in orthognathic surgery are a valuable alternative to steel-wire ligatures.
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Affiliation(s)
- L J van Ewijk
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands.
| | - T C T van Riet
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands.
| | - I G H van der Tol
- Department of Oral and Maxillofacial Surgery, Northwest Clinics, Alkmaar, The Netherlands.
| | - J P T F Ho
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands; Department of Oral and Maxillofacial Surgery, Northwest Clinics, Alkmaar, The Netherlands.
| | - A G Becking
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, The Netherlands; Department of Oral and Maxillofacial Surgery, MKA Kennemer & Meer and Spaarne Gasthuis, Haarlem, The Netherlands.
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Satpute AS, Mohiuddin SA, Doiphode AM, Kulkarni SS, Qureshi AA, Jadhav SB. Comparison of Erich arch bar versus embrasure wires for intraoperative intermaxillary fixation in mandibular fractures. Oral Maxillofac Surg 2018; 22:419-428. [PMID: 30302602 DOI: 10.1007/s10006-018-0723-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 09/26/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE Intermaxillary fixation (IMF) is a fundamental principle in the management of mandibular fractures but with recent advent of open reduction and internal fixation (ORIF), use of IMF is almost limited intraoperatively. Therefore, we compared the efficacy of Erich arch bar versus embrasure wires for intraoperative IMF in mandibular fractures. METHOD This prospective study was comprised of 50 patients with mandibular fractures who required ORIF with intraoperative IMF. Patients were categorized into two groups of 25 patients each: Erich arch bar technique was used for group A and embrasure wire technique for group B. Parameters were time taken for IMF, needle stick injury, occlusal stability, iatrogenic complications, and periodontal status of patients. STATISTICAL ANALYSIS Chi-squared test and unpaired t test analyses was run on IBM SPSS 21.0 version (2015) software. RESULT Mean time for placing embrasure wire (3.48 min) was significantly less than that for Erich arch bar (48.08 min). Needle stick injury rates to the operator as well as the assistants were significantly less when using the embrasure wire than the Erich arch bar. The Erich arch bar had significantly superior postoperative occlusion stability. Iatrogenic injury was more common when placing the Erich arch bar than the embrasure wire. Postoperative oral hygiene status was good in patients that received the embrasure wire. CONCLUSION Embrasure wire technique is a quick, easy, and reliable technique for minimally or moderately displaced fractured mandible and had better clinical outcomes than did patients that underwent the Erich arch bar technique.
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Affiliation(s)
- Ashish Shrikant Satpute
- Maharashtra Institute of Dental Sciences & Research, Dental College, M.I.T Medical Campus, Vishnathpurum, Latur, 413512, India.
| | - Syed Ahmed Mohiuddin
- Maharashtra Institute of Dental Sciences & Research, Dental College, M.I.T Medical Campus, Vishnathpurum, Latur, 413512, India
| | - Amol Madhukar Doiphode
- Maharashtra Institute of Dental Sciences & Research, Dental College, M.I.T Medical Campus, Vishnathpurum, Latur, 413512, India
| | - Sujay Sanjay Kulkarni
- Maharashtra Institute of Dental Sciences & Research, Dental College, M.I.T Medical Campus, Vishnathpurum, Latur, 413512, India
| | - Ahtesham Ahmad Qureshi
- Maharashtra Institute of Dental Sciences & Research, Dental College, M.I.T Medical Campus, Vishnathpurum, Latur, 413512, India
| | - Swapnil Bharat Jadhav
- Maharashtra Institute of Dental Sciences & Research, Dental College, M.I.T Medical Campus, Vishnathpurum, Latur, 413512, India
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Yaembut N, Ampornaramveth RS, Pisarnturakit PP, Subbalekha K. Dental Student Hand Hygiene Decreased With Increased Clinical Experience. JOURNAL OF SURGICAL EDUCATION 2016; 73:400-408. [PMID: 26861583 DOI: 10.1016/j.jsurg.2015.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 12/22/2015] [Accepted: 12/28/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate the effectiveness, related knowledge, attitudes, and practices of hand hygiene (HH) among dental students with different levels of clinical experience. DESIGN This was a cross-sectional analytical study. Bacterial samples on the participants' hands were obtained using a swab technique before and after handwashing, for oral surgical procedures. After culturing, the colony-forming units were counted. Self-reported questionnaires reflecting the knowledge, attitudes, and practices related to HH were completed by the participants. SETTING This study was performed in a primary oral health care institution, Faculty of Dentistry, Chulalongkorn University (Bangkok, Thailand). Bacterial samples and self-reported questionnaires were collected in the Department of Oral and Maxillofacial Surgery. Bacterial culture was performed in the Department of Microbiology. PARTICIPANTS The 120 participants comprised first, second, third-year clinical training students (CTs), and postgraduate dental students (PGs) (32, 34, 30, and 24 participants, respectively). RESULTS More than 99% of the bacteria were eliminated from the participants' hands after handwashing. Significantly higher numbers of bacteria were recovered from the hands of the PGs compared with those of the CTs, and the hands of the third-year CTs compared with those of the first-year CTs (p < 0.001), after HH. The first-year CTs had the highest attitude scores, whereas the PGs had the lowest practice scores. The knowledge scores were similar in all groups. CONCLUSION HH effectiveness, attitudes, and practices of dental students decreased as students gained more clinical experience, whereas knowledge did not. Our results suggest that HH instruction should be given throughout the duration of dental students' education.
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Affiliation(s)
- Nanmanas Yaembut
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | | | - Pagaporn P Pisarnturakit
- Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
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Chhabra N, Chhabra S, Thapar D. Evaluation of two different methods of arch bar application: a comparative prospective study. J Maxillofac Oral Surg 2015; 14:432-40. [PMID: 26028870 DOI: 10.1007/s12663-014-0658-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 07/01/2014] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To comparatively evaluate the efficacy of a pencil type wire twister and the normal wire twister in terms of various parameters during arch bars application. METHOD The study involved residents of the department enrolled in MDS course. Two study groups of 60 patients each were made by randomly selecting the patients from the outpatient department of Oral and Maxillofacial surgery who required arch bar application. Group A included the patients who underwent upper and lower arch bar application with the use of a pencil type twister and group B included patients who underwent arch bar application with a normal wire twister. All respondents were given a questionnaire after the completion of procedure involving the use of medical sharps. The paired samples t test was used for statistical analysis. RESULT Among group A, mean glove perforations, actual wire stick injuries, mean time taken to complete the procedure, mean wire breakage during the procedure was less than in group B. Comfort level of patients and Ease of operator while performing the procedure was more in group A than in group B. Frictional abrasion of the finger was not associated with the use of pencil type twister. Overall rating of the procedure was more in group A than group B. CONCLUSION The use of pencil type wire twister outweighs normal wire twister in various ways. It increases the overall efficacy of the operator during the procedure.
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Affiliation(s)
- Naveen Chhabra
- Department of OMFS, DAV Dental College and M.M General Hospital, Yamunanagar, 135001 Haryana India
| | - Shruti Chhabra
- Department of OMFS, DAV Dental College and M.M General Hospital, Yamunanagar, 135001 Haryana India
| | - Deepti Thapar
- Department of OMFS, DAV Dental College and Hospital, Yamunanagar, Haryana India
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Kuroyanagi N, Nagao T, Sakuma H, Miyachi H, Ochiai S, Kimura Y, Fukano H, Shimozato K. Risk of surgical glove perforation in oral and maxillofacial surgery. Int J Oral Maxillofac Surg 2012; 41:1014-9. [PMID: 22446068 DOI: 10.1016/j.ijom.2012.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 12/21/2011] [Accepted: 02/15/2012] [Indexed: 10/28/2022]
Abstract
Oral and maxillofacial surgery, which involves several sharp instruments and fixation materials, is consistently at a high risk for cross-contamination due to perforated gloves, but it is unclear how often such perforations occur. This study aimed to address this issue. The frequency of the perforation of surgical gloves (n=1436) in 150 oral and maxillofacial surgeries including orthognathic surgery (n=45) was assessed by the hydroinsufflation technique. Orthognathic surgery had the highest perforation rate in at least 1 glove in 1 operation (91.1%), followed by cleft lip and palate surgery (55.0%), excision of oral soft tumour (54.5%) and dental implantation (50.0%). The perforation rate in scrub nurses was 63.4%, followed by 44.4% in surgeons and first assistants, and 16.3% in second assistants. The odds ratio for the perforation rate in orthognathic surgery versus other surgeries was 16.0 (95% confidence interval: 5.3-48.0). The protection rate offered by double gloving in orthognathic surgery was 95.2%. These results suggest that, regardless of the surgical duration and blood loss in all fields of surgery, orthognathic surgery must be categorized in the highest risk group for glove perforation, following gynaecological and open lung surgery, due to the involvement of sharp objects.
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Affiliation(s)
- N Kuroyanagi
- Department of Maxillofacial Surgery, Aichi-Gakuin University School of Dentistry, Aichi, Japan
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Blood-borne viruses: are we taking them seriously? A survey of UK oral and maxillofacial surgeons. Br J Oral Maxillofac Surg 2011; 49:400-3. [DOI: 10.1016/j.bjoms.2010.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 06/08/2010] [Indexed: 11/23/2022]
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8
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Glove Perforations During Interventional Radiological Procedures. Cardiovasc Intervent Radiol 2009; 33:375-8. [DOI: 10.1007/s00270-009-9719-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2009] [Accepted: 09/14/2009] [Indexed: 11/26/2022]
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Kanjirath PP, Coplen AE, Chapman JC, Peters MC, Inglehart MR. Effectiveness of Gloves and Infection Control in Dentistry: Student and Provider Perspectives. J Dent Educ 2009. [DOI: 10.1002/j.0022-0337.2009.73.5.tb04732.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Preetha P. Kanjirath
- Department of Periodontics and Oral Medicine; School of Dentistry; University of Michigan
| | - Amy E. Coplen
- dental hygienist and a graduate student in the dental hygiene program; School of Dentistry; University of Michigan
| | - Jody C. Chapman
- predoctoral dental student; School of Dentistry; University of Michigan
| | - Mathilde C. Peters
- Department of Cariology and Restorative Dentistry; School of Dentistry; University of Michigan
| | - Marita Rohr Inglehart
- Department of Periodontics and Oral Medicine; School of Dentistry, and Adjunct Associate Professor of Psychology; Department of Psychology; College of Literature, Science, and Arts; University of Michigan
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Gaujac C, Ceccheti MM, Yonezaki F, Garcia IR, Peres MPSM. Comparative analysis of 2 techniques of double-gloving protection during arch bar placement for intermaxillary fixation. J Oral Maxillofac Surg 2007; 65:1922-5. [PMID: 17884516 DOI: 10.1016/j.joms.2006.06.311] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2006] [Revised: 04/26/2006] [Accepted: 06/09/2006] [Indexed: 11/16/2022]
Abstract
PURPOSE This study was conducted to comparatively evaluate, in a prospective and randomized manner, 2 techniques for providing double-gloving protection during arch bar placement for intermaxillary fixation. MATERIALS AND METHODS A total of 42 consecutive patients in whom application of an Erich bar was indicated for intermaxillary fixation were equally divided into 2 groups. In group 1, 2 sterile surgical gloves were used; in group 2, a nonsterile disposable inner glove was used under a sterile surgical glove. Wilcoxon, Mann-Whitney, Kruskal-Wallis, and binomial statistical tests were used to analyze the findings. RESULTS A total of 103 perforations were found in the outer gloves (47 in group 1 and 56 in group 2), along with 5 perforations in inner gloves in both groups (alpha = .01). No significant statistical difference was found between groups in terms of inner glove perforations (alpha = .05). The nondominant hand presented with 70.9% of the perforations, statistically significant to 1%. CONCLUSIONS Both double-gloving techniques were found to provide effective clinician protection. The use of a nonsterile disposable glove under the surgical glove is possible for less-invasive procedures, offering the same safety as using 2 sterile surgical gloves while decreasing operational costs. This method does not eliminate the need to change gloves when a perforation is suspected or noted during the surgery, however.
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Affiliation(s)
- Cristiano Gaujac
- Department of Oral and Maxillofacial Surgery, Clinics Hospital, University of São Paulo, São Paulo, Brazil.
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11
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Character BJ, McLaughlin RM, Hedlund CS, Boyle CR, Elder SH. Postoperative integrity of veterinary surgical gloves. J Am Anim Hosp Assoc 2003; 39:311-20. [PMID: 12755206 DOI: 10.5326/0390311] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A multicenter, prospective study was performed to document the incidence of defective gloves postoperatively in veterinary surgery and to correlate defects with a variety of influencing factors. Gloves were collected after surgical procedures performed by the small animal clinical services at two veterinary teaching hospitals and one institution's student surgery laboratories. Gloves were evaluated for defects using electrical resistance testing. The overall incidence of glove defects was 23.3%. Significantly more defects occurred in gloves used for nonsoft-tissue procedures and in gloves worn on the nondominant hand. Eighty-four percent of all defects occurred in procedures lasting >60 minutes. No differences were detected in the brands of gloves used nor among surgeons of different experience levels. The individuals performing the surgery were not able to accurately predict the presence of a defect in their gloves. Surgeons should remain alert for possible glove defects and consider measures such as changing gloves every 60 minutes or double-gloving to minimize potential complications.
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Affiliation(s)
- Ben J Character
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi 39762, USA
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Avery CM, Gallagher P, Birnbaum W. Double gloving and a glove perforation indication system during the dental treatment of HIV-positive patients: are they necessary? Br Dent J 1999; 186:27-9. [PMID: 10028739 DOI: 10.1038/sj.bdj.4800009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
AIM The aim of this study was to compare the incidence of glove perforation when double gloved or single gloved during the routine treatment of HIV-positive patients. In addition, a glove perforation indication system based on a double gloving technique was assessed. DESIGN Prospective, randomised and open study of glove perforation. METHODS 138 consecutive HIV-positive patients underwent routine dental treatment by senior dental staff and dental hygienists in a teaching hospital. Staff wore either single gloves (Regent Biogel D or standard surgical gloves) or double gloves (Regent 'Reveal' perforation indication system or standard surgical gloves). A subjective assessment of glove comfort, sensitivity and ease of donning was made using a visual analogue scale. RESULTS The incidence of glove perforation/procedure was low, 2.9%. There were no skin penetrating injuries, visible exposure to body fluids or unnoticed perforations. Double gloving was subjectively less comfortable and sensitive than single gloving (P < 0.0001). The glove perforation indication system did not increase the detection of intra-operative perforations. CONCLUSIONS There is unlikely to be any significant benefit from the use of a double gloving technique or perforation indication system during the routine dental treatment of HIV-positive patients.
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Affiliation(s)
- C M Avery
- Department of Oral and Maxillofacial Surgery, King's College Hospital, London
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