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Biomedical subjects

A C Campbell

Publications and source records attributed to A C Campbell.

At least 19 recordsLinked to original sources
PubMed2006

Do check X-rays influence the management of patients who have undergone hip fracture fixation using image intensifier guidance?

OBJECTIVE: To determine if postoperative check X-rays influence the management of patients who have undergone hip fracture fixation using image intensifier guidance and the possible economic impact. A fractured neck of femur is the commonest fracture sustained in the UK amongst the elderly population, with internal fixation commonly carried out under image intensifier guidance, producing high quality intraoperative images. In the postoperative period, patients often receive a subsequent check X-ray, although recent evidence has suggested little additional information is gained. METHODS: We examined the X-rays of 100 patients who underwent internal fixation (using image intensifier guidance) for a fractured neck of femur. RESULTS: Twenty-four patients received a postoperative check X-ray, although none of these patients had their management altered by this subsequent X-ray. CONCLUSION: If these check X-rays are avoided, there is a potential saving of over 2000 sterling pound in our hospital and 38,800 sterling pound in Scotland per annum.

Adult↗
PubMed2006

Vetted access to day case hand surgery.

This prospective study was undertaken in the day surgery unit of Monklands Hospital, Airdrie. The consultant hand surgeon screened all general practitioner referrals between September 1998 and July 2002, and suitable patients referred for minor hand procedures were listed directly on to the day-case waiting list without an initial review in outpatient department. The main end points in this study were accuracy of diagnosis, the appropriateness of surgical treatment plan, patient acceptability and the impact of direct listing on waiting times and attendance. There was agreement in clinical diagnosis in 92%, and the choice of treatment plan was judged to be appropriate in 96% cases. The overall patient acceptability was 90%. This one-visit system not only cuts down on the patients waiting time from initial referral up to surgery but also reduces the number of hospital visits for the patients.

Adolescent↗
PubMed2005

Role of topical antibiotics in hip surgery. A prospective randomised study.

BACKGROUND: The effectiveness of topical antibiotics has been shown well enough in vitro to justify strong consideration of their use in orthopaedic procedures. We carried out a randomised prospective trial to study the role of topical chloramphenicol ointment application on postoperative wounds following surgeries for hip fractures. METHODS: One hundred cases with fracture neck of femur were enrolled in the study. They were randomized into two treatment groups: one group had chloramphenicol ointment applied at the surgical site at the end of procedure and 3rd day postoperatively, while the control group did not. The wound was checked on the 3rd, 6th, 12th and 30th days postoperatively, by a tissue viability nurse on the guidelines issued by the Scottish Centre for Infection and Environmental Health (SCIEH). RESULTS: We had 12 cases with superficial infection of which 8 belonged to control group. The risk of developing wound infection, however, was not significant with and without the use of chloramphenicol ointment (relative risk 0.430, 95% confidence interval (CI) 0.120-1.544). Using multivariate analysis, no association was found between wound infection and age, gender, type of fracture or type of surgical procedure. Smoking was found to be the only factor significantly associated with infection, with the relative risk for current smokers compared with former/non-smokers being 7.29 (95% CI 1.62-32.67). CONCLUSION: Awareness is needed amongst the general public about the ill effects of smoking. There was reduction in the incidence of wound infection with the use of topical antibiotic ointment. However, this was not statistically significant to recommend its use in routine practice. A larger study should provide useful information on the role of topical antibiotic and its effect on postoperative wound infection.

Administration, Topical↗
PubMed2005

Balloon flexor sheathplasty: one-stage grafting at 19 years.

The technique of dilatation of a flexor sheath to allow one-stage grafting was recently described and named balloon flexor sheathplasty [J. Hand Surg. 27B (2001) 487-488]. The scope of this procedure is not yet known and the application after significant delay has not been described. We report a case where balloon flexor sheathplasty allowed return of useful function after an interval of 19 years.

Adult↗
PubMed2005

Do creatine kinase (CK) levels influence the diagnosis or outcome in patients with compartment syndrome?

We report a retrospective study in patients with compartment syndrome with the aim to analyse: 1) whether the level of rise in CK levels is a useful marker to the presence of compartment syndrome and; 2) whether an early fasciotomy assists in lowering of the elevated CK levels. The results of our study suggest that although raised CK levels are not diagnostic, they are a useful adjunct in making a diagnosis, and hence CK estimation should be done in all patients with suspected compartment syndrome. Moreover, an early fasciotomy (< 12 hours) has a statistically significant influence in lowering elevated CK levels, confirming the view that the earlier the decompression, the lesser the muscle damage.

Adult↗
PubMed2005

Femoral neck fractures complicating metal-on-metal resurfaced hips: a report of 2 cases.

Metal-on-metal hip resurfacing arthroplasty is increasingly popular for younger patients with advanced hip disease. Intra-operative or immediate postoperative femoral neck fracture after metal-on-metal hip resurfacing is a well-described technical complication, ranging from 0% to 1.5%. We report 2 cases of late femoral neck fracture occurring 8 and 15 months following the index operation, with a review of the literature. We recommend that patient selection should be of prime importance before embarking on metal-on-metal surface hip replacement to avoid such complications.

Accidental Falls↗
PubMed2005

Acetabular augmentation using a second cup during revision hip arthroplasty: an unusual case report.

Acetabular wedge augmentation is a useful technique and is recommended in situations where cup revision is likely to be excessively difficult. Numerous augmentation designs that improve the stability of the hip are now available in the market. Occasionally, however, these devices are not readily available, particularly if problems such as instability and dislocation are not anticipated preoperatively. We report our experience in treating such a case, using an augment cut from a second cup with a follow-up for 30 months. Though there is no substitute for proper preoperative planning, awareness of this procedure is helpful as unexpected problems do arise in revision acetabular surgery.

Acetabulum↗
PubMed2002

Cement restriction technique in dynamic hip screw revisions.

When revising dynamic hip screw fixation to arthroplasty, the defect left by the lag screw in the proximal femur poses a problem for cement containment, with the potential for sub-optimal cementation. We recommend the use of a bioresorbable cement restrictor as a simple and effective means to overcome this problem.

Absorbable Implants↗
PubMed2002

Flexor sheath dilatation with a Fogarty catheter.

The use of a Fogarty catheter to dilate a constricted flexor sheath is described. This relatively atraumatic method of dilating a constricted flexor sheath, may sometimes allow a one-stage rather than a two-stage tendon graft procedure.

Adult↗
PubMed2001

A single blind, prospective, randomized trial comparing n-butyl 2-cyanoacrylate tissue adhesive (Indermil) and sutures for skin closure in hand surgery.

Fifty patients underwent a variety of hand operations and were randomized for wound closure either with tissue adhesive (Indermil) or sutures. The two treatment groups had similar demographic characteristics and similar outcomes at the 2 and 6 week postoperative assessments which were performed by a designated tissue viability nurse blinded to the method of closure. Five minor wound dehiscences occurred: three in the adhesive group and two in the suture group. No infection occurred in either group. In conclusion, the study demonstrates tissue adhesive is as effective as suture in this type of hand surgery.

Adult↗
PubMed2001

Spontaneous bifocal Clostridium septicum gas gangrene.

Clostridium septicum gas gangrene (myonecrosis) is an acutely painful and rapidly fatal infection occurring in the absence of trauma. Urgent surgery is essential both to control pain and to ensure survival. Most patients who develop this infection have an underlying malignancy and clinicians should be aware of this association. We present a case of bifocal myonecrosis which to our knowledge has not been reported previously.

Aged↗
PubMed2001

Escape and aggregation responses of three echinoderms to conspecific stimuli.

In marine invertebrates, waterborne chemical stimuli mediate responses including prey detection and predator avoidance. Alarm and flight, in response to damaged conspecifics, have been reported in echinoderms, but the nature of the stimuli involved is not known. The responses of Asterias rubens Linnaeus, Psammechinus miliaris (Gmelin), and Echinus esculentus Linnaeus to conspecifics were tested in a choice chamber against a control of clean seawater (no stimulus). All three species showed statistically significant movement toward water conditioned by whole animals or homogenate of test epithelium. P. miliaris and E. esculentus displayed a statistically significant avoidance reaction, moving away from conspecific coelomic fluid, gut homogenate, and gonad homogenate. A. rubens was indifferent to conspecific coelomic fluid, pyloric cecum homogenate, and gonad homogenate but moved away from cardiac gut homogenate. P. miliaris was indifferent to gametes, but the other two species were significantly attracted to them. No species showed preference for one particular side of the chamber during trials to balance water flow. These echinoderms can distinguish between homogenates of conspecific tissues that might be exposed when a predator damages the test, and those that may emanate from the exterior surface during normal activities.

Animals↗
PubMed1999

Development of a performance assessment capability in the waste management programs of the U.S. Nuclear Regulatory Commission.

The U.S. Nuclear Regulatory Commission (NRC) staff has developed a performance assessment capability to address three programmatic areas in nuclear waste management: high-level waste, low-level waste, and decommissioning of licensed facilities (license termination). The NRC capability consists of: (1) methodologies for performance assessment; (2) models and computer codes for estimating system performance; (3) regulatory guidance in various forms, such as regulations, Branch Technical Positions, and Standard Review Plans; and (4) a technical staff experienced in executing and evaluating performance assessments for a variety of waste systems. Although the tools and techniques are refined for each programmatic area, general approaches and similar issues are encountered in all areas.

Government Agencies↗
PubMed1999

The bilobed flap in treatment of mucous cysts of the distal interphalangeal joint.

The bilobed flap has many uses in the field of plastic and reconstructive surgery. We describe its use in achieving skin cover following excision of mucous cysts in six digits in six patients, with a minimum follow up of 1 year. There were no postoperative complications. No cyst has recurred and cosmesis has been excellent in all cases.

Aged↗