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A J Gibbons

Publications and source records attributed to A J Gibbons.

At least 19 recordsLinked to original sources
PubMed2006

Use of mini-implants in orthognathic surgery.

We report a case in which mini-implants were used for intraoperative maxillomandibular fixation and for postoperative elastic traction in the treatment of a 20-year-old woman with mandibular prognathism.

Adult↗
PubMed2005

Results of the centralisation of adult emergency oral and maxillofacial surgical services at the University Hospital, Birmingham.

In 2001, the oral and maxillofacial surgical (OMFS) services for adults in Birmingham were centralised at the Selly Oak site of the University Hospital and the OMFS department was given access to the emergency operating theatre every day. We examined the effects of this on the emergency workload during the 6 months after centralisation and compared it with the emergency workload at the University Hospital during the 6 months before centralisation. The number of adult patients who attended the University Hospital as emergencies increased from 242 in the 6 months before centralisation to 545 in the subsequent 6 months (an increase of 127%). Of the latter 164 (30%) were admitted and operated on, 138 (84%) within 24h of admission. Despite the large increase in the number of patients, 102 (74%) were operated on during normal working hours. After centralisation, all operations were done on multidisciplinary emergency lists compared with only 55% before centralisation. Centralisation did not reduce the access of patients to the emergency service and conformed with the guidelines of the National Confidential Enquiry into Perioperative Deaths (NCEPOD).

Adult↗
PubMed2005

Advice given in community pharmacies to patients with possible oral carcinoma.

We compared advice given by community pharmacy staff in Worcestershire to a proxy consulter on behalf of a patient with a longstanding oral ulcer, presumed to be an oral cancer. If patients seek advice in this way the quality of the advice given is dependent on whether the respondent is a pharmacist or a community pharmacy assistant.

Consultants↗
PubMed2004

Risk management.

Explore the source record for details and available documents.

Adult↗
PubMed2004

Blood transfusion requirements in bimaxillary osteotomies.

The over-ordering of cross-matched blood to cover operations can result in blood shortages and is costly; it can never be free of risk. Current published guidelines recommend cross-matching 2 units of blood for bimaxillary orthognathic procedures with an additional 2 units if combined with a genioplasty. We reviewed the records of 115 consecutive cases of simultaneous bimaxillary osteotomies at Morriston Hospital over a 5-year period (January 1996 to December 2000). Ordering and use of blood were investigated and the cost analysed. Blood loss was minimised using a strategy of controlled moderate hypotension and meticulous haemostasis. Nine patients were given transfusions of blood but five of these were deemed inappropriate. No predisposing factors for transfusion were identified. We recommend that the tariff for ordering blood for bimaxillary osteotomies should be revised to a "group and save" with antibody screen, providing that a 30-min indirect antibody cross-match is available.

Adolescent↗
PubMed2004

The CRABEL score--setting standards in maxillofacial medical note-keeping.

The CRABEL score (developed by Crawford, Beresford and Lafferty) was introduced for auditing medical note-keeping at Morriston Hospital in June 2001. Guidelines detailing the scoring system were issued to all clinicians in the maxillofacial unit. An auditor selected two sets of medical notes from each consultant's firm, giving an initial allocation of 100points/firm (50 points for each set of notes). The notes of the most recent in-patient admission were analysed using the CRABEL marking sheet to give a score out of 100 for each firm. The audit was repeated at 3-month-intervals. CRABEL scores within the maxillofacial unit improved from 70 to 97. The CRABEL score is simple, reliable and repeatable. It is a successful and objective measure for audit and for improvement in the quality of note-keeping. We propose that it be adopted in maxillofacial units throughout the United Kingdom.

Humans↗