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Biomedical subjects

P M Lafferty

Publications and source records attributed to P M Lafferty.

9 recordsLinked to original sources
PubMed1998

Lichtenstein inguinal hernia repair in a primary healthcare setting.

BACKGROUND: Given the generally accepted poor outcome of inguinal hernia repair when using nylon darn, and the recent interest in low-tension mesh repair, an attempt was made to demonstrate the feasibility, outcome and patient perception of providing Lichtenstein inguinal hernia repair, using local anaesthesia, wholly within the primary healthcare sector. METHODS: A prospective study reviewed clinical outcome and patient perception in 100 adults referred with inguinal hernia only. No selection was made regarding age, sex, American Society of Anesthesiologists status or previous repairs. Recurrence, pain, infection, return to full function and associated complications were assessed at 24 h, 1 and 6 weeks, and 1 year. Local Community Health Councils assessed patient perception. RESULTS: In the first 100 patients (age range 21-83 (mean(s.d.) 60(14.7)) years; 58 of employable age; 92 men; ten recurrent hernias), no recurrences have occurred at 1 year. Infection rate was 3 per cent. Pain was maximal in the first 24-48 h (median visual analogue scale 5, range 0-10) and reduced rapidly (median 1) at 1 week. Mean time to return to work or full normal activity was 8 days. Some 85 operations were performed within 1 month of diagnosis. In all, 86 patients returned the patient satisfaction questionnaire and 98 per cent of these were 'very pleased' with the service. CONCLUSION: In highly motivated primary healthcare centres, inguinal hernia repair can be undertaken effectively, providing high patient satisfaction, minimal complications and low recurrence rates using the Lichtenstein technique.

Adult↗
PubMed1997

Balancing the curriculum: promoting aesthetic knowledge in nursing.

The view of nursing as both art and science is widely held within the profession; however, this belief is not reflected in nurse education where the artistic aspects of nursing practice continue to be overshadowed by the emphasis on the scientific, the technical and the objective. It is suggested that nursing knowledge can be considered within four fundamental types or patterns of knowledge: empirical, aesthetic, personal and moral, each interrelated and interlinked, with aesthetic knowledge argued to encompass the art of nursing. Nursing's dual identity as an art and science arguably requires a balance within the curriculum, therefore the promotion and acquisition of aesthetic knowledge seems a desirable aim. The development of strategies specifically designed to develop and incorporate such knowledge across the curriculum and to make it explicit presents a challenge for all nurse educators. This paper will examine aesthetic knowledge as essential to the art of nursing, and will consider the application of literature as a method through which this knowledge may be attained. The use of literature is suggested as facilitating an awareness of human predicaments universal to all, thus enabling the nurse to develop qualities of caring, empathy and compassion, indicated to be components of nursing's art form.

Curriculum↗
PubMed1991

Management of foreskin problems.

One hundred consecutive cases of boys with foreskin problems referred to local paediatric surgeons in the Edinburgh area were studied. Fifty five underwent circumcision and the remainder were managed more conservatively with or without the use of local or general anaesthetic. Although sometimes avoiding general anaesthetic, the more conservative methods involved more frequent visits to the clinic, a larger number of complications, and a longer follow up period. Despite the vogue for conservatism, circumcision still has an important part to play in the management of troublesome foreskins in children.

Anesthetics, Local↗
PubMed1990

The role of the paediatric surgeon in alleged child sexual abuse.

Two hundred ninety cases of alleged child sexual abuse (CSA) were reported in Edinburgh and the Lothian region over the 7-year period from 1982 through 1988. We have found an increase in the incidence of alleged CSA, which has resulted in greater involvement of the paediatric surgeon. CSA was found to be occurring with increasing frequency in younger children. The physical examination and the role of general anaesthesia are discussed together with the data about the collection of forensic material.

Adolescent↗
PubMed1990

Repair of coronal and subcoronal hypospadias: an 8-year retrospective study.

Twenty-three patients undergoing treatment for coronal and subcoronal hypospadias over an 8-year period were reviewed. A ventral skin tube inlay graft was used in all cases, and a comparison made between Nesbitt's button hole technique and three other procedures used for ventral skin cover. The button hole procedure was associated with fewer fistulae and provided acceptable cosmesis.

Humans↗
PubMed1990

A comparison of postoperative pain relief techniques in orchidopexy.

Fifty consecutive patients admitted to the Western General Hospital for orchidopexy, were randomly allocated to receive either a caudal bupivacaine block or peroperative wound instillation with bupivacaine, to provide postoperative analgesia. Bupivacaine wound instillation reduced the total operating time, gave more efficient postoperative pain relief in hospital and proved both inexpensive and simple in its application.

Adolescent↗
PubMed1989

Anterior abdominal wall defects.

A total of 48 infants with abdominal wall defects referred to the South West Regional Neonatal Surgical Centre over a period of six years were reviewed. There were 27 (56%) infants with gastroschisis and 21 (44%) infants with exomphalos. At the regional centre, four pregnancies with gastroschisis were terminated following a prenatal diagnosis, one child was stillborn, and one with exomphalos and trisomy 13 died soon after birth. Of the remaining 42 live births, the one year survival for babies born with a gastroschisis was 95% (21/22) and with an exomphalos was 81% (17/20). All deaths, except one, were due to factors other than the abdominal defect. The effect on outcome of prenatal diagnosis, parental counselling, in utero transfer, mode of delivery, and methods of surgical closure was reviewed.

Abdominal Muscles↗