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Biomedical subjects

A W McCombe

Publications and source records attributed to A W McCombe.

13 recordsLinked to original sources
PubMed1992

Managing swabs in the operating theatre: a new method.

The swab count has traditionally used a swab rack. A new alternative 'bag' method involves placing used swabs in batches of five into plastic bags which are sealed and stored in a bin. A randomized prospective study was carried out to compare these two methods. Twenty consecutive ear, nose and throat cases were randomized to rack or bag collection. Swab-related activities were divided into three categories and analysed by formal time-and-motion criteria. Blood contamination of operating theatre and circulating personnel was recorded. The time involved in all three swab-related activities was significantly less using the bag technique. There was no theatre blood contamination using this method, but significant contamination occurred using the rack. Circulating theatre personnel were minimally contaminated in two cases using the bag method but were grossly contaminated in all ten cases using the rack method. The bag technique is therefore safe and time efficient.

Equipment Contamination↗
PubMed1992

A comparison of laser cautery and sub-mucosal diathermy for rhinitis.

A randomized prospective trial was conducted to compare the efficacy of laser cautery against sub-mucosal diathermy to the inferior turbinates in 29 patients with rhinitis. Laser diathermy was performed using an arthroscopic fitment to a CO2 laser. Subjective and objective measurement of airway obstruction were performed, using a linear analogue scale and a nasal peak inspiratory flow meter, before operation and at 3 days and 6 weeks afterwards. In both groups there was a similar and significant improvement in subjective scores at 6 weeks (SMD from 3.6 to 1.8, P less than 0.01; laser from 3.9 to 2.1, P less than 0.001), but only the laser group was significantly better at Day 3 (SMD from 3.6 to 3.5, n.s.; laser from 3.9 to 3.0, P less than 0.05). In addition, there was significantly more general subjective morbidity at Day 3 in the SMD group (P less than 0.01). The objective scores improved equally in both groups but were not significant. We conclude that laser cautery of the inferior turbinate is a superior alternative to SMD for the treatment of rhinitis.

Adult↗
PubMed1991

Meningitis from canine Pasteurella multocida following mastoidectomy.

A case of Pasteurella multocida meningitis, following a mastoidectomy is presented. The association of close contact with pets, many of which harbour Pasteurella multocida as part of their normal buccal flora. This case confirms the potential benefit of taking an ear swab prior to mastoid surgery and in seeking an appropriate 'pet' history.

Adult↗
PubMed1990

Inter-arytenoid glottic bar following intubation.

Inter-arytenoid glottic bar is a rare complication of prolonged endotracheal intubation. We present two such cases and their treatment. The aetiology of this complication is multifactorial and involves local factors--local trauma, movement of the endotracheal tube within the larynx, infection, and anatomical influences--together with systemic factors such as in our two cases. The relative importance of these factors is discussed. A comment is also made on the use of a pre-operative topogram and the importance of an ENT assessment in patients with airway problems following prolonged intubation.

Adolescent↗
PubMed1989

The long-term results of electric fire hand burns in children.

An 11-year retrospective series of 95 deep, electric fire hand burns in children was studied and the epidemiology, treatment and operative management analysed. From this series a group of 14 patients was recruited to assess the long-term results of this injury. At long-term follow-up (mean 14.4 years) the recorded parameters included range of movement, hand sensation, power and size. Photographs were taken and any subjective problems noted. Analysis of these data showed a marked variation in range of movement, sensation, size and appearance of the injured hands. Despite this, complaints about cosmetic results or any restriction of activities were rare. In conclusion, these injuries are particularly destructive but with appropriate surgical management, albeit protracted, and despite imperfect cosmetic results, excellent function can be obtained in the growing hand.

Burns, Electric↗
PubMed1989

Skin stapling of wounds in the accident department.

In a randomized prospective study of 100 consecutive patients presenting to the accident and emergency department with superficial lacerations, staples and sutures were compared for skin closure. Acceptability of the methods by staff and patients, and end results were similar. Staples were more expensive than sutures, but were significantly quicker, simpler to use and safer. They are, therefore, particularly suitable for use in a busy accident and emergency department.

Attitude of Health Personnel↗
PubMed1988

Torsion of scrotal contents in children.

One hundred and forty consecutive cases of torsion of scrotal contents were reviewed retrospectively. There were 95 cases of torsion of the testicular appendage and 45 cases of testicular torsion. Testicular torsion was more common on the left and patients tended to present earlier with more systemic upset in the form of vomiting, abdominal and groin pain than patients with torsion of a testicular appendage. Pathognomic features of examination were an elevated or ectopic testis in 50% of cases of testicular torsion and a palpable tender blue nodule in 21% of cases of torsion of a testicular appendage. We believe that it is often possible to distinguish between these two conditions and, where this is possible, a trial of conservative management is justified for torsion of a testicular appendage.

Adolescent↗
PubMed1988

Gastric lipoma and intussusception in a child.

Gastroduodenal intussusception and gastric lipoma are exceedingly rare conditions in childhood. We report the first case of intussusception due to a gastric lipoma in this age group.

Child, Preschool↗