the coverage of soft- tissue defects of the hand specially volar side needs special consideration. although certain local flaps have been described and used for resurfacing the palm, extensive injury requires distant or free flaps for coverage. abdominal pedicle flap has been traditionally used for extensive hand injuries, however there is no doubt that one of the ideal tissues for resurfacing ...

Function Its purpose was to treat patients whose degree of subnormality was such that operative procedures with local anaesthesia and sedation would be difficult and rarely successful. Full general anaesthesia with endotracheal intubation and throat pack made it possible for the most intractable patient to have the necessary treatment completed in one visit. The theatre is equipped with all the...

nearest kidney transplant unit as many potential donors as are available. In doing this doctors will need to enlarge their vision from concern for the patients under their own care to include other patients who may otherwise die. From this survey it seems that a sustained campaign is required to improve the communication between doctors and nurses caring for potential donors and those working i...

The management of infections in surgical intensive care unit patients poses specific challenges. Although the overall approach to the patient is no different from other patients, diagnosis is often problematic. As in other infections, multidrug resistance is increasingly described, and changes in pharmacokinetics may require different dosing strategies. Also the need for source control adds a l...

CriticalCareNurse Vol 33, No. 1, FEBRUARY 2013 71 Maxwell Mirel is a registered nurse and Tonja Hartjes is a clinical nurse educator in the surgical/cardiothoracic intensive care unit at Malcolm Randall Veterans Affairs Medical Center, Gainesville, Florida. For questions related to this article, contact Tonja Hartjes at [email protected]. Surgical critical care typically focuses on curativ...

Pattern of admissions in a general surgical unit was studied from January 1980 to July 1981. Of 1021 cases admitted 697 were non-emergency and 324 were emergency admissions. Trauma and Appendicitis were the most common surgical emergencies, whereas Hernias, Anorectal conditions and diseases of the Gall bladder were the most frequent non-emergency admissions. The length of hospital stay in relat...

Retrospective study was conducted in surgical intensive care unit (ICU) in Clinical Hospital Center Zagreb in 2005. The aim of study was to create guidelines for empirical antibiotic therapy of sepsis in ICU for unknown causative agent based on antimicrobial susceptibility of causative bacteria. Thirty-two patients with severe sepsis were included in study and from medical records their clinica...

The traditional on-call system for the management of acute general surgical admissions is inefficient and outdated. A new model, Acute Surgical Unit (ASU), was developed at Nepean Hospital in 2006. The ASU is a consultant-driven, independent unit that manages all acute general surgical admissions. The team has the same make up 7 days a week and functions the same every day, including weekends a...

Cases of hospital acquired pneumonia occurring during the 1st 12 months of Medico-Surgical ICU (Intensive care unit, MSICU) in operation were evaluated retrospectively to determine its incidence, common causative pathogens, outcome and radiological patterns with the new hospital setting providing a unique relatively aseptic environment. Among the 920 admitted patients, 73 episodes of nosocomial...

Background Unplanned extubations can result in serious complications. Objectives To determine characteristics of patients and nurses and risk factors that affect extubations. Methods A retrospective exploratory design was used. Ramsay Sedation Scale scores, need for reintubation, time between intubation and extubation, use of sedation and analgesia in the preceding 48 hours, and use of restrain...