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Thomas O, Ramsay A, Yiasemidou M, Hardie C, Ashmore D, Macklin C, Bandyopadhyay D, Bijendra Patel, Burke JR, Jayne D. The surgical management of cutaneous abscesses: A UK cross-sectional survey. Ann Med Surg (Lond) 2020; 60:654-659. [PMID: 33304582 PMCID: PMC7718210 DOI: 10.1016/j.amsu.2020.11.068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 11/24/2020] [Indexed: 12/20/2022] Open
Abstract
Aim Cutaneous abscesses are one of the most common acute general surgery presentations. This study aimed to understand the current practice in the management of cutaneous abscesses in the United Kingdom (UK), once the decision has been made that acute surgical incision and drainage (I&D) is required. Method General surgeons from across the UK were surveyed on their opinions on the optimum management of cutaneous abscesses. Outcomes measured included anaesthesia, incision technique, antibiotic administration, departmental abscess pathways, and post-drainage management. A combination of Likert scales, multiple-choice questions, and short answer questions were used. Comparisons were made of Likert scales between regions using a two-sample independent t-test. The survey was peer reviewed and distributed through the Association of Coloproctology of Great Britain and Ireland (ACPGBI) network between April and June 2018. Results Sixty-one responses were collected from surgeons throughout the UK. Of these respondents, 69% indicated that cutaneous abscesses would always or usually require a General Anaesthetic (GA) for treatment, and 82% indicated that abscesses were at least sometimes not treated until the next day due to a lack of resources. While 79% of surgeons stated that pus swabs are always or are usually taken, 44% of respondents never or rarely chased the results. The main indications for giving antibiotics were sepsis/systemically unwell patients, and cellulitis. 31% of responding centres had an abscess management protocol, and 82% of respondents confirmed that they would always pack the abscess wound post-operatively. Conclusion ‘Incision and drainage’ is currently the most widely used technique for the surgical management of cutaneous abscess. However, this study demonstrates the significant variability in the use of anaesthesia, antibiotics, packing and the use of protocols to guide and streamline patient management. There are no current NICE guidelines specifically covering cutaneous abscess management. There is significant practice variation in the management of cutaneous abscesses across the UK. Wound packing is still commonplace, despite guidelines recommending that there is evidence that it should be avoided. New recommendations on the use of antibiotics whilst treating cutaneous abscesses are yet to be taken up by most surgeons. Surgically managed cutaneous abscesses in the UK are preferably managed under a general anaesthetic.
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Affiliation(s)
- Owen Thomas
- Leeds Institute of Biomedical & Clinical Sciences, Clinical Sciences Building, St James's University Hospital, Leeds, LS9 7TF, UK
| | - Alistair Ramsay
- The John Golligher Colorectal Surgery Unit, St. James's University Hospital, Leeds Teaching Hospital Trust, Beckett Street, Leeds, LS9 7TF, UK
| | - Marina Yiasemidou
- Leeds Institute of Biomedical & Clinical Sciences, Clinical Sciences Building, St James's University Hospital, Leeds, LS9 7TF, UK
| | - Claire Hardie
- Leeds Institute of Biomedical & Clinical Sciences, Clinical Sciences Building, St James's University Hospital, Leeds, LS9 7TF, UK
| | - Daniel Ashmore
- Leeds Institute of Biomedical & Clinical Sciences, Clinical Sciences Building, St James's University Hospital, Leeds, LS9 7TF, UK
| | | | | | - Bijendra Patel
- Barts Health NHS Trust, Whitechapel Rd, London, E1 1FR, UK
| | - Joshua R Burke
- The John Golligher Colorectal Surgery Unit, St. James's University Hospital, Leeds Teaching Hospital Trust, Beckett Street, Leeds, LS9 7TF, UK.,Leeds Institute of Biomedical & Clinical Sciences, Clinical Sciences Building, St James's University Hospital, Leeds, LS9 7TF, UK
| | - David Jayne
- The John Golligher Colorectal Surgery Unit, St. James's University Hospital, Leeds Teaching Hospital Trust, Beckett Street, Leeds, LS9 7TF, UK.,Leeds Institute of Biomedical & Clinical Sciences, Clinical Sciences Building, St James's University Hospital, Leeds, LS9 7TF, UK
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Macklin C, O'Brien K, Hover D, Schwartz ME, Bolkhovsky V, Zhang X, Oliver WD, Siddiqi I. A near-quantum-limited Josephson traveling-wave parametric amplifier. Science 2015; 350:307-10. [DOI: 10.1126/science.aaa8525] [Citation(s) in RCA: 360] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 08/19/2015] [Indexed: 11/02/2022]
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Roch N, Schwartz ME, Motzoi F, Macklin C, Vijay R, Eddins AW, Korotkov AN, Whaley KB, Sarovar M, Siddiqi I. Observation of measurement-induced entanglement and quantum trajectories of remote superconducting qubits. Phys Rev Lett 2014; 112:170501. [PMID: 24836225 DOI: 10.1103/physrevlett.112.170501] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Indexed: 05/23/2023]
Abstract
The creation of a quantum network requires the distribution of coherent information across macroscopic distances. We demonstrate the entanglement of two superconducting qubits, separated by more than a meter of coaxial cable, by designing a joint measurement that probabilistically projects onto an entangled state. By using a continuous measurement scheme, we are further able to observe single quantum trajectories of the joint two-qubit state, confirming the validity of the quantum Bayesian formalism for a cascaded system. Our results allow us to resolve the dynamics of continuous projection onto the entangled manifold, in quantitative agreement with theory.
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Affiliation(s)
- N Roch
- Quantum Nanoelectronics Laboratory, Department of Physics, University of California, Berkeley, California 94720, USA
| | - M E Schwartz
- Quantum Nanoelectronics Laboratory, Department of Physics, University of California, Berkeley, California 94720, USA
| | - F Motzoi
- Department of Chemistry, University of California, Berkeley, California 94720, USA
| | - C Macklin
- Quantum Nanoelectronics Laboratory, Department of Physics, University of California, Berkeley, California 94720, USA
| | - R Vijay
- Department of Condensed Matter Physics and Materials Science, Tata Institute of Fundamental Research, Mumbai 400005, India
| | - A W Eddins
- Quantum Nanoelectronics Laboratory, Department of Physics, University of California, Berkeley, California 94720, USA
| | - A N Korotkov
- Department of Electrical Engineering, University of California, Riverside, California 92521, USA
| | - K B Whaley
- Department of Chemistry, University of California, Berkeley, California 94720, USA
| | - M Sarovar
- Scalable and Secure Systems Research (08961), Sandia National Laboratories, Livermore, California 94550, USA
| | - I Siddiqi
- Quantum Nanoelectronics Laboratory, Department of Physics, University of California, Berkeley, California 94720, USA
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Vijay R, Macklin C, Slichter DH, Weber SJ, Murch KW, Naik R, Korotkov AN, Siddiqi I. Stabilizing Rabi oscillations in a superconducting qubit using quantum feedback. Nature 2012; 490:77-80. [DOI: 10.1038/nature11505] [Citation(s) in RCA: 332] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 08/17/2012] [Indexed: 11/10/2022]
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Johnson JE, Macklin C, Slichter DH, Vijay R, Weingarten EB, Clarke J, Siddiqi I. Heralded state preparation in a superconducting qubit. Phys Rev Lett 2012; 109:050506. [PMID: 23006157 DOI: 10.1103/physrevlett.109.050506] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Indexed: 06/01/2023]
Abstract
We demonstrate high-fidelity, quantum nondemolition, single-shot readout of a superconducting flux qubit in which the pointer state distributions can be resolved to below one part in 1000. In the weak excitation regime, continuous measurement permits the use of heralding to ensure initialization to a fiducial state, such as the ground state. This procedure boosts readout fidelity to 93.9% by suppressing errors due to spurious thermal population. Furthermore, heralding potentially enables a simple, fast qubit reset protocol without changing the system parameters to induce Purcell relaxation.
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Affiliation(s)
- J E Johnson
- Department of Physics, University of California, Berkeley, 94720, USA
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Abstract
Clostridium septicum myonecrosis is associated with diabetes, colorectal and haematological malignancies. We present a case of metastatic myonecrosis in a diabetic patient with a perforated caecal tumour. The literature since 1989 is reviewed and 28 cases of Clostridium septicum myonecrosis are discussed.
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Affiliation(s)
- Matthew J Powell
- Mid Yorkshire NHS trust, Pinderfields General Hospital, Wakefield, Yorkshire, UK.
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