Determining what 'good' really looks like.

Rory Colville argues that improved veterinary communication alongside acceptance of first-opinion clinical guidelines could help the profession determine what 'good' looks like for each case.

Bleeding on the cutting edge: A systematic review of anticoagulant and antiplatelet continuation in minor cutaneous surgery.

Background: Anticoagulant and antiplatelet (AC/AP) use is common and practice surrounding AC/AP continuation or cessation peri-operatively for minor cutaneous surgery lacks evidence-based consensus.

Objective: To determine the risks of haemorrhagic and thromboembolic complications associated with the continuation or cessation of AC/AP therapy in minor cutaneous surgery.

Methods: A systematic literature search was conducted using PubMed, MEDLINE, Embase and CENTRAL, to identify all articles involving the use of AC/AP in patients undergoing minor cutaneous surgery, including skin grafts and local flaps.

A pilot investigation into the effects of different office chairs on spinal angles.

Purpose: To investigate the effects of four office chairs on the postural angles of the lumbopelvic and cervical regions.

Research Question: Which chair(s) produce an "ideal" spinal posture?

Methods: An experimental same subject design was used involving healthy subjects (n = 14) who conducted a typing task whilst sitting on four different office chairs; two "dynamic" chairs (Vari-Kneeler and Swopper), and two static chairs (Saddle and Standard Office with back removed). Data collection was via digital photogrammetry, measuring pelvic and lumbar angles, neck angle and head tilt which were then analysed within MatLab.

The mental rotation flap.

Two types of random pattern rotation flaps around the chin are described for the closure of small to moderate defects of the lateral chin. Over an 18 month period (September 2007-April 2008) three patients with a mean age of 74 years had skin cancers excised as an outpatient under local anaesthetic, leaving skin defects from 2.0×1.

Nailbed repair and patient satisfaction in children.

Introduction: We performed an audit to assess frequency of injury to the nail bed and outcomes after repair in a busy paediatric hand trauma clinic.

Subjects And Methods: This retrospective study examines 46 consecutive nail bed repairs over a 6-month period. All notes were reviewed for patient demographics, details of the injury including the operation and aftercare.

How happy are patients with their gynaecomastia reduction surgery?

Gynaecomastia reduction surgery is a common male cosmetic procedure. Our clinical experience suggested far lower rates of satisfaction than previously reported. Therefore we evaluated our patient group using a detailed questionnaire designed specifically to assess patient satisfaction with breast attributes and quality-of-life outcome following surgery.

Multidisciplinary management of head and neck sarcomas.

Background: Head and neck sarcomas are extremely rare. This article reviews the management and outcomes in a multidisciplinary clinic.

Methods: The records of 41 male and 19 female patients (mean age, 50 years) were reviewed.

Malignant peripheral nerve sheath tumour metastasising to the parotid gland.

Two rare cases of metastases from malignant peripheral nerve sheath tumours (MPNST) of the head and neck are described. The initial lesions were superficial, but despite early diagnosis and complete excision, they metastasised to the ipsilateral parotid gland. Both underwent further complete excision and neither metastatic lesion showed progression in grade.

What is the impact of breast augmentation on the Breast Screening Programme?

Aims: To identify the number of women with breast implants in the Newcastle Breast Screening Programme, it's additional workload and compare the number of screen detected cancers in the implant and non-implant group.

Methods: Retrospective 9 year review of all women with cosmetic breast augmentation who have joined the National Breast Screening Programme in Newcastle.

Results: The percentage of total screened attendances involving implants has increased from 61 (0.

Angiosarcoma of the breast after quadrantectomy and postoperative radiotherapy for carcinoma.

Angiosarcoma of the breast following conservation surgery and radiotherapy for carcinoma is rare. We report a case occurring after a latent period of 8 years, which required excision with a 5 cm margin and latissimus dorsi flap repair.

A small contact burn injury requiring upper limb amputation.

An elderly, demented, man was referred with a fairly small contact burn to the medial side of his left arm and forearm. The thermal injury had caused ischaemia of the forearm and hand. Thrombosis of the underlying brachial artery was suspected, and the only surgical option was amputation.

Coding plastic surgery operations: an audit of performance using OPCS-4.

Accurate coding is essential for local and national data reporting and for contracting. It is also integral to clinical governance. This study aimed to assess the accuracy of coding in Morriston Hospital plastic surgery theatres and coding office, to reaudit and address poor practice.

Hand surgery and quality of life.

The outcome in patients having surgery to the hand was assessed subjectively using a questionnaire that covered activities of daily living (ADL), hand pain and psychological well-being. The questionnaires were completed on average 6.9 months preoperatively and 20.