Flap Anchoring Following Primary Breast Cancer Surgery Facilitates Early Hospital Discharge and Reduces Costs.

BACKGROUND: Routine drain placement after breast cancer surgery is standard practice. Anchoring the axillary and mastectomy flaps to the underlying chest wall with sutures has been advocated as a means of avoiding drainage following breast surgery. This study compares outcomes following flap fixation or routine drain placement and uniquely considers the economic implications of each technique.

Perioperative fluid restriction reduces complications after major gastrointestinal surgery.

The physiologic response to surgical trauma promotes sodium and water retention AND weight gain owing to perioperative fluid loading increases morbidity SO perioperative fluid restriction should reduce postoperative complications after gastrointestinal surgery.

Early management of atrial fibrillation in general surgical in-patients.

Background: It has been suggested that new-onset atrial fibrillation (AF) in non-cardiac surgical patients should trigger a thorough search for other morbidity. We reviewed our unit's management of new-onset AF to determine whether this target is achieved.

Methods: Patients under the care of a general surgeon who developed new-onset AF during their inpatient stay were identified from a prospectively maintained database of surgical in-patients.

Serum calcium slope predicts hypocalcaemia following thyroid surgery.

Background: Hypocalcaemia is the single commonest complication of thyroid surgery. Typically, serial calcium levels are performed post-operatively in order to detect hypocalcaemia, often requiring at least a 48-h stay. Our practice is to measure serum corrected calcium pre-operatively, 6 h post-operatively and 24 h post-operatively.