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Nolan GS, Dunne JA, Lee AE, Wade RG, Kiely AL, Pritchard Jones RO, Gardiner MD, Abbassi O, Abdelaty M, Ahmed F, Ahmed R, Ali S, Allan A, Allen L, Anderson I, Bakir A, Berwick D, Sarala BBN, Bhat W, Bloom O, Bolton L, Brady N, Campbell E, Capitelli-McMahon H, Cassell O, Chalhoub X, Chalmers R, Chan J, Chu HO, Collin T, Cooper K, Curran TA, Cussons D, Daruwalla M, Dearden A, Delikonstantinou I, Dobbs T, Dunlop R, El-Muttardi N, Eleftheriadou A, Elamin SE, Eriksson S, Exton R, Fourie LR, Freethy A, Gardner E, Geh JL, Georgiou A, Georgiou M, Gilbert P, Gkorila A, Green D, Haeney J, Hamilton S, Harper F, Harrison C, Heinze Z, Hemington-Gorse S, Hever P, Hili S, Holmes W, Hughes W, Ibrahim N, Ismail A, Jallali N, James NK, Jemec B, Jica R, Kaur A, Kazzazi D, Khan M, Khan N, Khashaba H, Khera B, Khoury A, Kiely J, Kumar S, Patel PK, Kumbasar DE, Kundasamy P, Kyle D, Langridge B, Liu C, Lo M, Macdonald C, Anandan SM, Mahdi M, Mandal A, Manning A, Markeson D, Matteucci P, McClymont L, Mikhail M, Miller MC, Munro S, Musajee A, Nasrallah F, Ng L, Nicholas R, Nicola A, Nikkhah D, O'Hara N, Odili J, Oudit D, Patel A, Patel C, Patel N, Patel P, Peach H, Phillips B, Pinder R, Pinto-Lopes R, Plonczak A, Quinnen N, Rafiq S, Rahman K, Ramjeeawon A, Rinkoff S, Sainsbury D, Schumacher K, Segaren N, Shahzad F, Shariff Z, Siddiqui A, Singh P, Sludden E, Smith JRO, Song M, Stodell M, Tanos G, Taylor K, Taylor L, Thomson D, Tiernan E, Totty JP, Vaingankar N, Toh V, Wensley K, Whitehead C, Whittam A, Wiener M, Wilson A, Wong KY, Wood S, Yeoh T, Yii NW, Yim G, Young R, Zberea D, Jain A. National audit of non-melanoma skin cancer excisions performed by plastic surgery in the UK. Br J Surg 2022; 109:1040-1043. [DOI: 10.1093/bjs/znac232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022]
Abstract
A national, multi-centre audit of non-melanoma skin cancer excisions by plastic surgery.
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Affiliation(s)
- Grant S Nolan
- Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Trust , Fulwood, Preston , UK
| | - Jonathan A Dunne
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
| | - Alice E Lee
- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
| | - Ryckie G Wade
- Leeds Institute for Medical Research, University of Leeds , Leeds , UK
- Department of Plastic and Reconstructive Surgery, Leeds Teaching Hospitals NHS Trust , Leeds , UK
| | - Ailbhe L Kiely
- Department of Plastic and Reconstructive Surgery, Royal Preston Hospital, Lancashire Teaching Hospitals NHS Trust , Fulwood, Preston , UK
| | - Rowan O Pritchard Jones
- Department of Plastic and Reconstructive Surgery, Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust , Prescot , UK
| | - Matthew D Gardiner
- Department of Plastic and Reconstructive Surgery, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Wexham , Slough , UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , UK
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- Department of Plastic and Reconstructive Surgery, Charing Cross and St Mary’s Hospitals, Imperial College Healthcare NHS Trust , London , UK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , UK
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Richards K, Sethu C, Tiernan E. Phalangeal fracture leading to digital amputation, sustained during manipulation for Dupuytren's disease as part of clostridial collagenase treatment. Ann R Coll Surg Engl 2019; 101:e102-e104. [PMID: 30855178 DOI: 10.1308/rcsann.2019.0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Collagenase injection was approved in Europe for use in the treatment of Dupuytren's disease in 2011. Reported adverse effects include skin tears, swelling, pain and complex regional pain syndrome. Here, we present a case of a rare complication of phalangeal fracture following treatment with collagenase clostridium and the resultant digital amputation. An 81-year-old man was treated for a 25-year history of progressively disabling Dupuytren's disease of his left middle and ring fingers. Nine days post-manipulation he presented with persistent pain and swelling and was diagnosed with a displaced fracture of the proximal phalanx of his ring finger. Following discussion of surgical options and potential outcome, he elected to undergo amputation of the digit. He has experienced good treatment results in his middle finger and has no significant functional impairment as a result of this complication. Those offering collagenase injection in the management of Dupuytren's disease should be aware of this potential complication and it should be included in the consent process.
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Affiliation(s)
- K Richards
- Burns and Plastic Surgery Department, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust , Birmingham , UK
| | - C Sethu
- Plastic and Reconstructive Surgery Department, Salisbury District Hospital, Salisbury , Salisbury , UK
| | - E Tiernan
- Plastic and Reconstructive Surgery Department, Salisbury District Hospital, Salisbury , Salisbury , UK
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Tiernan E, Casey P, O'Boyle C, Birkbeck G, Mangan M, O'Siorain L, Kearney M. Relations between Desire for Early Death, Depressive Symptoms and Antidepressant Prescribing in Terminally Ill Patients with Cancer. J R Soc Med 2017; 95:386-90. [PMID: 12151487 PMCID: PMC1279962 DOI: 10.1177/014107680209500803] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Some patients with advanced cancer express the wish for an early death. This may be associated with depression. We examined the relations between depressive symptoms and desire for early death (natural or by euthanasia or physician-assisted suicide) in 142 terminally ill patients with cancer being cared for by a specialist palliative care team. They completed the Hospital Anxiety and Depression Scale questionnaire and answered four supplementary questions on desire for early death. Only 2 patients expressed a strong wish for death by some form of suicide or euthanasia. 120 denied that they ever wished for early release. The desire for early death correlated with depression scores. Depressive symptoms were common in the whole group but few were on antidepressant therapy. Better recognition and treatment of depression might improve the lives of people with terminal illness and so lessen desire for early death, whether natural or by suicide.
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Affiliation(s)
- E Tiernan
- Our Lady's Hospice, Harold's Cross, Dublin 6W, Ireland.
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Abstract
Intraarticular phalangeal fractures are difficult to treat. The advantages of using dynamic external fixation devices include distraction of impacted fracture fragments and reduction in joint stiffness by allowing early joint mobilization. Previous reports have concentrated on pilon fractures and dorsal fracture dislocations affecting the proximal interphalangeal joint. We report our experience using a dynamic external spring fixator in the management of 15 patients with a variety of fracture patterns affecting the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints. In three cases the device spanned two adjacent joints. Long-term follow-up has shown excellent range of joint movement and no major complications. We consider that this device is an effective tool in the management of a range on complex intraarticular phalangeal fractures.
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Affiliation(s)
- D Johnson
- Department of Plastic and Reconstructive Surgery, Salisbury District Hospital, Odstock, Salisbury, Wiltshire SP2 8BJ, UK.
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Lunny B, Tiernan E. To hydrate or not at the end of life. Ir Med J 2012; 105:165. [PMID: 22973649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Sarwar U, Nicolaou M, Khan MS, Tiernan E. Air-freshener burns: a new paradigm in burns etiology? Int J Prev Med 2011; 2:291-3. [PMID: 22174972 PMCID: PMC3237275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 06/19/2011] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES We report a rare case of burns following the use of automated air-fresheners. METHODS We present a case report with a brief overview of the literature relating to burns associated with air-fresheners. The mechanism and treatment of these types of injuries are also described. RESULTS A 44 year-old female was admitted under the care of the burns team following burns secondary to an exploding air-freshener canister. The patient sustained burns to the face, thorax and arms resulting in a seven-day hospital admission. The burns were treated conservatively. CONCLUSIONS To our knowledge this is one of the few documented cases of burns as a result of air-fresheners. As they become more ubiquitous, we anticipate the incidence of such cases to increase. As such, they pose a potential public health concern on a massive scale.
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Affiliation(s)
- Umran Sarwar
- S1 Plastic Surgery, Salisbury District Hospital, Salisbury, England, United Kingdom.,Correspondence to: Umran Sarwar, Department of Burns and Plastic Surgery, Salisbury District Hospital, Salisbury, England, United Kingdom.
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Geary P, Tiernan E. Management of split skin graft donor sites – results of a national survey. J Plast Reconstr Aesthet Surg 2009; 62:1677-83. [DOI: 10.1016/j.bjps.2008.07.036] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2007] [Revised: 02/27/2008] [Accepted: 07/24/2008] [Indexed: 11/28/2022]
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Affiliation(s)
- H Chave
- Department of General Surgery, Salisbury District Hospital, UK
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Wright TC, Widdowson D, Khan M, Tiernan E, Hormbrey E. A cost-effective training tool for flexor tendon repair: Pig's trotters. J Plast Reconstr Aesthet Surg 2006; 59:107-8. [PMID: 16482802 DOI: 10.1016/j.bjps.2005.06.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
The training of surgeons has traditionally been an apprenticeship. In recent times it has become increasingly difficult for trainees to acquire operative skills. The acquisition and refinement of these technical skills by the surgical trainee are central to surgical teaching. Much work has been done looking into the theories of motor skill learning, working on the assumptions that if they are understood then tests may be developed to be used as skill predictors. Two schools of thought exist as to the use of neuropsychological factors in learning fine motor skills but all agree that practice and instructional feedback are essential for the correct acquisition of these essential surgical skills. With the current climate of shortened training and new guidelines its even more important to understand skill acquisition and assist in the learning of new surgical skills.
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Affiliation(s)
- M S Khan
- Department of Plastic Surgery, Salisbury District Hospital, Salisbury
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Tiernan E, O'Connor M, O'Siorain L, Kearney M. A prospective study of preferred versus actual place of death among patients referred to a palliative care home-care service. Ir Med J 2002; 95:232-5. [PMID: 12405498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
In this first such study in an Irish setting, patients referred to a Hospice Home Care Team were asked where they would prefer to die, and were then followed until death to determine actual place of death, and factors that influenced same. Over 80% expressed a preference to die at home. Almost 50% of those who expressed a preference for a home death actually died there. Of those admitted to hospital or hospice to die, uncontrolled symptoms and inability of family to cope were the main reasons precipitating admission. On closer assessment, it was felt that a significant minority of those admitted could have been cared for at home had additional resources been available in the community. Facilitating choice in place of care for the dying is acknowledged government policy and, as such, greater resources should be made available to community health and social services to support ongoing care at home.
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Affiliation(s)
- E Tiernan
- Department of Palliative Medicine, Our Lady's Hospice, Harold's Cross, Dublin.
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Tiernan E, Casey P, O'Boyle C, Birkbeck G, Mangan M, O'Siorain L, Kearney M. Relations between desire for early death, depressive symptoms and antidepressant prescribing in terminally ill patients with cancer. J R Soc Med 2002. [PMID: 12151487 PMCID: PMC1279962 DOI: 10.1258/jrsm.95.8.386] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Some patients with advanced cancer express the wish for an early death. This may be associated with depression. We examined the relations between depressive symptoms and desire for early death (natural or by euthanasia or physician-assisted suicide) in 142 terminally ill patients with cancer being cared for by a specialist palliative care team. They completed the Hospital Anxiety and Depression Scale questionnaire and answered four supplementary questions on desire for early death. Only 2 patients expressed a strong wish for death by some form of suicide or euthanasia. 120 denied that they ever wished for early release. The desire for early death correlated with depression scores. Depressive symptoms were common in the whole group but few were on antidepressant therapy. Better recognition and treatment of depression might improve the lives of people with terminal illness and so lessen desire for early death, whether natural or by suicide.
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Affiliation(s)
- E Tiernan
- Our Lady's Hospice, Harold's Cross, Dublin 6W, Ireland.
| | - P Casey
- Department of Adult Psychiatry, University College Dublin, Mater Misericordiae
Hospital, Dublin 7, Ireland
| | - C O'Boyle
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin 2,
Ireland
| | - G Birkbeck
- National Research Agency Ltd, 14 Stoneview Place, Dun Laoire, Co. Dublin,
Ireland
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Tiernan E, Kearney M, Lynch AM, Holland N, Pyne P. Effectiveness of a teaching programme in pain and symptom management for junior house officers. Support Care Cancer 2001; 9:606-10. [PMID: 11762971 DOI: 10.1007/s005200100269] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The objectives of this study were (i) to assess the level of knowledge with respect to pain and symptom management among doctors in their first year after graduation and (ii) to measure the impact of a structured teaching programme on their level of knowledge. All 34 newly qualified junior house officers in one teaching hospital were offered a six-session teaching programme in pain and symptom management. A multiple-choice questionnaire was used to assess their level of knowledge at the beginning and at the end of a 6-month period over which the teaching sessions took place. Attendance at and satisfaction with the programme were high. There was a significant improvement in the level of knowledge at the end of the programme, with the greatest improvement in those who attended most sessions. The low scores recorded for the questionnaire administered before the teaching programme suggest that there is a critical need for improved education in palliative care amongst newly qualified doctors. We have shown that a simple in-service case-based teaching programme can meet this need effectively.
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Affiliation(s)
- E Tiernan
- Department of Palliative Medicine, St Vincent's University Hospital, Dublin, Ireland.
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Shakespeare PG, Tiernan E, Dewar AE, Hambleton J. Using the pulsed dye laser to influence scar formation after breast reduction surgery: a preliminary report. Ann Plast Surg 2000; 45:357-68. [PMID: 11037155 DOI: 10.1097/00000637-200045040-00002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Many patients undergoing bilateral breast reduction surgery develop problems. Foremost among these problems is scar hypertrophy and its attendant symptoms. Although there is as yet no firm prognostic indicator for hypertrophy, scars that become hypertrophic often have a particular blood vessel pattern, observable by transcutaneous microscopy, showing vessels that lay transversely across the incision line with minimal crosslinks between them. Hypertrophic scars that develop in incision lines become wide, with the final width of the scar dependent on the maximum thickness during the growth stages before maturation and resolution. Close monitoring of scars forming in the incision line using the transcutaneous microscope detected this aligned vessel pattern before overt hypertrophy was seen. Use of the Pulsed Dye Laser caused disruption in the vessel pattern, appeared to inhibit additional hypertrophic development, and promoted early maturation of scars.
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Affiliation(s)
- P G Shakespeare
- Laser Clinic, Odstock Centre for Burns and Plastic Surgery, Salisbury District Hospital, UK
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Tiernan E. Depression in terminally ill cancer patients. Ir Med J 1998; 91:47-8. [PMID: 9617025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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O'Broin ES, O'Donnell M, O'Donovan D, Tiernan E, Lawlor DL, Eadie PA. Absorbable skin graft staples: a clinical trial using Graftac-X. Br J Plast Surg 1996; 49:485-7. [PMID: 8983555 DOI: 10.1016/s0007-1226(96)90038-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Skin stapling devices are a quick, effective method for securing skin grafts in burns patients. Removal of staples can be painful, often requiring a general anaesthetic. This problem has led to the recent development of absorbable staples which extrude with time. A prospective controlled clinical trial was performed on 20 burns patients comparing absorbable skin tacks with stainless steel staples. An area of at least 50 cm2 was grafted in each patient, half of which was secured with absorbable tacks and half with stainless steel staples. Each patient therefore acted as his/her own control. The presence of infection, haematoma and graft take using a grided cellophane sheet were assessed at one week. Infection and excess scarring at tack sites were assessed at one month. A statistically significant difference was not found between either group. In our hands absorbable skin staples have proven to be a reliable method of securing skin grafts.
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Affiliation(s)
- E S O'Broin
- National Burns Unit, St James's Hospital, Dublin, Ireland
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Hobby JL, Tiernan E, Mayou BJ. The 'Pinocchio' nasal deformity due to cavernous lymphangioma. J R Soc Med 1995; 88:535P-536P. [PMID: 7562857 PMCID: PMC1295340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The 'Pinocchio' or 'Cyrano' nose is a rare condition in which deformity of the nasal tip is produced by an underlying soft tissue tumour. Previously reported cases have been due to either capillary or cavernous haemangiomas (angiolipomas). The deformity is the cause of much teasing in children. There has been debate as to whether surgical intervention is indicated, as a proportion of cases will regress spontaneously. We report a case of 'Pinocchio' nose with a lymphangioma of the nasal tip which is previously undescribed and review the options for management.
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Affiliation(s)
- J L Hobby
- Department of Plastic Surgery, St Thomas' Hospital, London, England, UK
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Abstract
The rotation design was applied to fasciocutaneous flap repair of lower limb defects to produce a functional and aesthetic result superior to that obtained by the transposition design. A prospective, consecutive series of 21 patients is reported, 14 males and 7 females, ranging in age from 17 to 81 years (mean 43 years). The primary defects, 8 traumatic, 12 cutaneous malignancy excisions, and 1 radionecrotic ulcer, ranged in size from 3.5 x 3 cm to 10 x 8 cm (mean 6.6 x 5 cm). The rotation fasciocutaneous flap base ranged from 5 to 25 cm (mean 12 cm), and the radius ranged from 4.5 to 20 cm (mean 9 cm). The inclusion of a back-cut at the flap base permitted direct donor-site closure in all but one patient, obviating the need for a split-thickness skin graft and avoiding the otherwise inevitable significant contour defect. Postoperative bed rest ranged from 3 to 7 days (mean 5 days). Three minor and no major complications occurred, and there was complete survival of all flaps. The results in this series indicate a role for the rotation fasciocutaneous flap in the management of traumatic and excisional defects in the lower limb. It has proved reliable, gives good aesthetic results, and reduces treatment costs.
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Affiliation(s)
- C Healy
- Department of Plastic Surgery, University College of London Medical School, England
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Abstract
Hot tar adheres to skin and produces burns of variable depth. Removal of the tar is not essential but it improves patient comfort and allows early assessment of the underlying tissue damage. Butter is readily available and is an effective method of removing the adherent tar.
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Affiliation(s)
- E Tiernan
- Department of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, Cambridge, UK
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Abstract
An unusual case of bilateral ureteric obstruction and hydronephrosis due to pancreatic pseudocyst formation, after an episode of acute pancreatitis is reported. All abnormalities resolved with conservative management. Possible reasons for such ureteric obstruction include periureteric fat necrosis by pancreatic enzymes and compression by the inflammatory mass.
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Affiliation(s)
- G E Gibson
- Department of Medicine, Regional Hospital, University College, Cork, Ireland
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Tiernan E, White S, Henry C, Murphy K, Twomey C, Hyland M. Do elderly patients mind how doctors address them? Ir Med J 1993; 86:73. [PMID: 8473145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
A survey was carried out in the Geriatric Unit at Cork Regional Hospital to determine how elderly patients would like to be addressed by their doctor. Two hundred patients over the age of 65 were given a Questionnaire asking them to state their preference. Only a minority (4.5%) expressed a definite preference for the formal mode of address. The remainder either did not mind (38%) or preferred to be addressed by their first name (57.5%). We concluded that most elderly patients do have a preference and this should be established on admission.
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Affiliation(s)
- E Tiernan
- Dept of Geriatric Medicine, Regional Hospital, Cork
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Tiernan E, White S, Henry C, Murphy K, Twomey C, Hyland M. Do elderly patients mind how doctors address them? J Ir Med Assoc 1993; 86:73. [PMID: 11654233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
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Finucane P, Nicklason F, Dewar R, Woodhead JS, MacMahon M, Kelleher BP, Dockrell D, O’Broin SD, Ryder RJW, Walsh JB, Coakley D, Hegarty V, Hassan J, Yanni G, Whelan A, Feighery C, Bresnihan B, Keane J, Chan F, Over J, Finnucane P, Liston R, Clinch D, Scott T, Moloney B, Tiernan E, White S, Murphy K, Henry C, Twomey C, Hyland CM, Gregg ME, Beringer TRO, Henderson SA, Finlay OE, Murphy NM, Boreham CAG, Mollan RAB, Gilmore DH, Browne JP, O’Boyle CA, McGee HM, O’Malley KM, Joyce CRB, Mulkerrin E, Hampton D, Donovan K, Penney M, Sykes D, O’Neill D, Surmon D, Wilcock GK, O’Mahony D, Rowan M, Feely J, Lyons RA, McCarthy R, Murphy S, Rajan L, Fielding JF, Clements L, Cherot E, Greenough WB, West KP. Irish gerontological society. Ir J Med Sci 1992. [DOI: 10.1007/bf02942385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Affiliation(s)
- E Tiernan
- Department of Plastic Surgery, Addenbrooke's Hospital, Cambridge
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Abstract
This study was designed to compare the effectiveness of two approaches to urinary catheter management in controlling postoperative urinary dysfunction in 110 patients following abdominoperineal resection or low anterior bowel resection. Patients, stratified by sex and surgical procedure, were randomly assigned to either straight gravity drainage or a 6-day progressive catheter clamping program. The bladder training program following abdominoperineal resection reduced significantly the urinary dysfunction rate in women but not in men. Marked differences in dysfunction rates were related to type of surgery, gender, and surgeon. Etiology of postoperative voiding dysfunction in various groups is discussed.
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