Biomedical subjects

Gillian D Smith

Publications and source records attributed to Gillian D Smith.

4 recordsLinked to original sources

PubMed2006

Prevention of high-pressure injection injuries to the hand.

OBJECTIVES: To identify populations at high risk for, and the usual mechanisms of injury in, high-pressure injection injuries to the hand. METHODS: A case note review of a historical cohort of 76 patients, presenting with high-pressure injections injuries to the hand over a 12-year period, collected information including sex, age, hand dominance, and occupation of the patient and mechanism of injury, when documented. RESULTS: Eighty-two percent of these injuries were work-related, affecting mainly manual workers (84%), including 13 painters, 10 mechanics, 8 farmers, and 3 water blasters. The mechanism of injury, recorded in 63%, was most commonly a ruptured hose or inadvertent gun discharge during cleaning or use. CONCLUSIONS: Preventative measures could include a targeted safety program for equipment users, engineering improvements in gun and hose design, economic incentives, and workplace legislation.

Adult↗

PubMed2005

Convergence insufficiency: a treatable cause of problems in microsurgery.

Microsurgical training concentrates on the practical mechanisms of performing vessel anastomoses, with little attention given to medical problems that may adversely affect the trainee's performance. Undiagnosed vision problems are rarely considered in microsurgical training, and may not be manifested until other limiting factors, such as basic instrument and suture handling, are mastered. While vision problems tend to be diagnosed and treated immediately among ophthalmology trainees, visual and ocular pathology is poorly understood outside of that specialty. We present a case of a surgeon who had been performing microsurgery for 10 years with an undiagnosed binocular vision problem that consistently affected microsurgical proficiency. Once diagnosed, the problem responded to therapeutic exercises within weeks. We suggest ophthalmologic referral of any surgeon who has unexplained problems with microsurgical technique (especially problems involving stereoscopic vision) to exclude a treatable visual cause.

Adult↗

PubMed2005

Slipper cast management of emergency foot problems.

Foot conditions are frequently seen in the emergency department. In many cases, although weight bearing is painful, it is not precluded, per se. When a soft dressing does not provide sufficient support, a below knee walking cast may be applied. We present an alternative dressing that may be of benefit in selected foot injuries. The dressing is fashioned with cast padding, foam sheeting and plaster. It is designed and molded to fit like a slipper. The plaster slipper has distinct advantages in that it is comfortable, lighter for the patient, and avoids the problem of ankle stiffness. We believe that this option is underused in the emergency setting.

Ankle↗

PubMed2005

Fiberglass cast application.

Plaster of Paris has been largely superceded for casting in orthopedic departments by synthetic cast materials. Despite its weight, its relative brittleness, its unpopularity with patients, and its messiness in application, plaster of Paris remains the mainstay of casting in the emergency department. This is due to a combination of economic reasons, the belief that synthetic casts leave less room for swelling and its relative ease of application compared to synthetic materials. We present a technique for synthetic cast application that avoids the problems of the rapidly setting cast and therefore allows the time for less experienced hands to produce a well-fitting cast or splint. We believe that this option, which allows the patient to have a lighter synthetic cast, rather than the traditional plaster of Paris cast, will be welcomed by both the patient and physician.

Casts, Surgical↗