Bilateral epiphora following the Kufner maxillary osteotomy.
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Biomedical subjects
Publications and source records attributed to C M Avery.
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An audit was performed to examine the time of administration of heparin and antibiotic prophylaxis to patients at risk of deep vein thrombosis, pulmonary embolism and post-operative wound infection. The records of 648 consecutive patients undergoing major surgery within a 12-month period were reviewed retrospectively. Heparin prophylaxis was given before surgery to only 30.9 per cent of patients undergoing elective procedures and in only 22.7 per cent of emergencies. Antibiotic prophylaxis was given before operation or at induction of anaesthesia to 82.1 per cent of patients undergoing elective procedures and in only 72.1 per cent of emergencies. It is concluded that administration of heparin and antibiotic prophylaxis is inadequate despite the provision of a written protocol.
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The technique of interdental wiring was compared with a small-plate osteosynthesis technique (SPO) in a prospective study of surgical glove perforations acquired during the treatment of mandibular fractures. Using the SPO technique there was a significant reduction in the incidence of skin penetrating injuries in the surgeon (P less than 0.005) and assistant surgeon groups (P less than 0.05). The reduction in the incidence of glove perforation in the assistant surgeon group was very highly significant in the SPO series (P less than 0.001). The reduction in the surgeon group was not significant. No difference was noted in the scrub nurse group. The small-plate osteosynthesis technique has the advantage of reducing the risk of intraoperative cross-infection transmitted by hand contamination or penetrating injury. The recommended precautions for preventing the transmission of blood-borne pathogens are reviewed.
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