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Biomedical subjects

Peter J Robb

Publications and source records attributed to Peter J Robb.

6 recordsLinked to original sources
PubMed2005

Successful treatment of MRSA otorrhoea: a case report.

Infection with methicillin-resistant Staphylococcus aureus (MRSA) is increasing. It may be community or hospital acquired and is characteristically difficult to eradicate. Here we report a case of a two-year-old girl who sustained a traumatic tympanic membrane perforation following a minor burns injury. She was seen as an out-patient in a burns unit and subsequently developed MRSA otorrhoea. This was treated with a two-week course of fusidic acid topical drops. At three-week follow up the tympanic membrane had healed and the infection had healed completely. Fusidic acid is safe and effective in the treatment of MRSA otorrhoea. We need to maintain vigilance in the treatment of otorrhoea, as MRSA may become an increasingly common pathogen in the future.

Administration, Topical↗
PubMed2005

Day-case adenoidectomy: outcomes are improved using suction coagulation and prophylactic anti-emetic treatment.

In 2004, the Department of Health published 10 High Impact Changes across the NHS. Of these, the first was treating day surgery as the norm for elective operations, releasing up to half a million in-patient beds each year. Adenoidectomy is an operation commonly performed in children for upper respiratory tract obstruction and as part of the surgical management of otitis media with effusion. Many surgeons consider the traditional curettage adenoidectomy as an unsatisfactory operation because it is performed blind, and is associated with varying reported levels of post-operative bleeding. Concern about the risk of bleeding and the frequent occurrence of post-operative nausea and vomiting have discouraged many surgeons from adopting adenoidectomy as a day-case procedure. We have audited the management and discharge of a cohort of 72 children undergoing traditional curettage adenoidectomy. Based on the results, we have completed the audit loop, by managing a second cohort of 77 children by suction coagulation adenoidectomy. An anaesthetic protocol has been designed to reduce post-operative nausea and vomiting, and facilitate same day discharge from hospital. The rate of post-operative nausea and vomiting fell from 21 to 1.3%, and the post-operative bleeding from 9.7% to nil. Discharge on the day of operation rose from 40.3 to 100%. Our audit confirms that these measures permit safe, day-case adenoidectomy.

Adenoidectomy↗
PubMed2003

Aseptic surgical technique and postgrommet otorrhoea.

Myringotomy and grommet insertion is one of the most common operations performed in Europe today, with an estimated 70,000 being carried out annually in Britain alone [Lancet 1 (1984) 835]. Otorrhoea is a common postoperative complication. There is controversy about the degree to which surgical asepsis should be maintained during the operation. This prospective study of 35 patients (70 ears) undergoing grommet insertion was carried out to evaluate the efficacy of two differing degrees of surgical asepsis. Using each patient as their own control a grommet was inserted into one ear with the surgeon wearing sterile gloves and masks, and the other wearing only clean non-sterile gloves. Discharge in the first 14 days occurred in five ears, three cases belonging to the former group and two to the latter. The results indicate that there is no significant difference in the incidence of postoperative otorrhoea using either of the above methods, and demonstrate that this operation may be performed in a safe but more cost-efficient manner.

Adolescent↗