The benefit of introducing a virtual trauma assessment clinic during a global pandemic.

Sars-CoV2/COVID-19 pandemic created a national emergency in Ireland. Our institution implemented a virtual trauma assessment clinic to reduce attendance to our district hospital which was stimulated by the development of 'safe-distanced' care. The audit aimed to evaluate the impact of our trauma assessment clinic on care provision and presentation to hospital.

Incidence of Symptomatic Venous Thromboembolism (VTE) in 8,885 Elective Total Hip Arthroplasty Patients Receiving Post-operative Aspirin VTE Prophylaxis.

Background: Venous thromboembolism (VTE) is a potentially reducible cause of morbidity and mortality in patients undergoing elective hip arthroplasty surgery. The balance of post-operative VTE prophylaxis and risk of post-operative haemorrhage remains at the forefront of surgeon's mind. The National Institute for Health and Care Excellence (NICE) published updated guidelines in 2018 which recommend the use of both mechanical and pharmacological methods in patients undergoing elective total hip arthroplasty (THA).

The Impact of Body Mass Index on Local Anaesthetic Inguinal Hernia Repair.

Background: Open mesh repair of inguinal hernia is acceptable and can be performed under local anaesthesia (LA). Individuals with high BMI (Body Mass Index) have often been excluded from LA repairs for varying reasons including safety concerns. Open repair of unilateral inguinal hernia (UIH) amongst individuals with different BMI groups was studied.

Virtual Fracture Clinics in Orthopaedic Surgery - A Systematic Review of Current Evidence.

Aims: Approximately 75% of fractures are simple, stable injuries which are often unnecessarily immobilised with subsequent repeated radiographs at numerous fracture clinic visits. In 2014, the Glasgow Fracture Pathway offered an alternative virtual fracture clinic (VFC) pathway with the potential to reduce traditional fracture clinic visits, waiting times and overall costs. Many units have implemented this style of pathway in the non-operative management of simple, undisplaced fractures.

Saving time in the fracture clinic: 2 weeks post-operative plain films following open reduction and internal fixation of distal radius fractures do not affect management.

Introduction: Distal radius fractures represent up to one in every sixth treated fracture. The majority of these are intra-articular and require operative management. Many recent studies advocate for the use of volar plating fixation.

The Effectiveness of Negative Pressure Wound Therapy Versus Conventional Dressing in the Treatment of Open Fractures: A Systematic Review and Meta-Analysis.

Objectives: To compare the efficacy of negative pressure wound therapy (NPWT) versus conventional dressings (CD) in the management of open fractures.

Data Sources: A systematic search of English articles in the PubMed/MEDLINE, Embase, and the Cochrane Library through April 2019 comparing NPWT versus CD in the management of open fractures.

Study Selection: Inclusion criteria were articles in English language, comparing NPWT with CD in skeletally mature individuals who had sustained an open fracture at any anatomical site, reporting on rates of deep infection, flap frequency, flap failure, nonunion, amputation, length of hospital, or intensive care unit stay.

A healthy decline in age- and sex- specific incidence of hip fractures in the elderly in the Republic of Ireland.

Aim: The number of patients sustaining hip fractures in the Republic of Ireland was expected to increase by 100% from 2004 to 2026. This has not been seen either in local or international literature. Our aim is to assess the age- and sex-specific incidence of hip fractures in patients over the age of 65 years and to determine whether the projected increase in incidence is mirrored in the reality of the Irish experience.

"90/90" Plating of proximal humerus fracture-a technical note.

Introduction: While locking plates have markedly improved fixation of proximal humerus fractures, a cohort of fractures remains difficult to treat. This cohort has been identified as fractures with marked medial comminution and varus deformity. Loss of reduction and fixation failure are the most frequently reported complications for this cohort.

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.