Creating COVID-19 surge capacity at an elective surgical centre: a model for perioperative care.

We provide an initial, brief description of safe relocation of our emergency surgical services from a tertiary teaching hospital to a satellite secondary hospital during the COVID-19 pandemic. The reconfiguration created increased theatre and critical care bed capacity at the tertiary site, while enabling lower acuity emergency services in a repurposed, designated COVID free hospital. The described model can be applied to situations mandating surge capacity at tertiary hospitals, in high income countries.

Paraspinal desmoid fibromatosis after lumbar epidural analgesia.

A 14-year-old girl with cerebral palsy presented for bilateral lower limb surgery for spasticity. A lumbar epidural catheter was sited under general anaesthesia on the third attempt and used intra-operatively with good effect. A local anaesthetic infusion was used for postoperative analgesia but was noted to be leaking under the dressing with a patchy, unilateral block.

Daptomycin for the treatment of osteomyelitis associated with a diabetic foot ulcer.

 This report describes a case of Staphylococcus aureus osteomyelitis associated with a chronic foot ulcer that was successfully treated with surgical debridement and 6 weeks of daptomycin therapy. Daptomycin was chosen because of its excellent activity against the causative organism and the patient's history of penicillin allergy. Its tolerability and ease of administration also facilitated long-term outpatient management.