Biomedical subjects

W Yinusa

Publications and source records attributed to W Yinusa.

5 recordsLinked to original sources

PubMed2004

Prescription error in an orthopaedic practice.

A retrospective review of 17,833 prescription items was undertaken at the National Orthopaedic Hospital, Lagos, Nigeria with the aim of determining the prevalence and types of prescription error. The percentage prescription error was 4.5 with type C (minor nuisance) being the most common prescription error. Incomplete prescription was the reason for these errors in 71% of cases. Our results revealed that the higher the professional status of the prescriber, the lower the prescription error. Even though the errors were recognised and corrected at the dispensing point, there was no indication that the prescriber was informed of his mistakes. We suggest, amongst others, regular clinical meeting of Doctors and Pharmacists where various aspects of rational drug could be discussed.

Drug Prescriptions↗

PubMed2003

Glove punctures in orthopaedic surgery.

From February 2001 to May 2001, 792 latex gloves used in 100 operations from three orthopaedic sub-specialties (paediatrics, hand and spine) were tested for puncture by a water infusion test. Sixty-nine gloves from 45 operations were punctured, giving an overall glove perforation rate of 8.7% (69/792) and an operative perforation rate of 45% (45/100). The hand operations had the lowest operative perforation rate (19.4%) while the spine operations had the highest (63.6%). The glove perforation rate increased in bony procedures (60% versus 22.5%), in procedures with major instrumentation (66% versus 18%) and in more lengthy procedures. The thumbs and the left index finger had more punctures than other parts. In addition, the glove perforation rate for single gloving was 9.6% (53/552) while that for the inner glove of double gloving was 0.8% (1/120). Based on these findings, we would like to recommend double gloving and regular glove changing in these high-risk surgeries.

Equipment Failure↗

PubMed2003

Problems of amputation surgery in a developing country.

We studied prospectively 87 patients who underwent extremity amputation in the National Orthopaedic Hospital in Lagos in 1995-1996. Trauma from road traffic accident was the most common indication (34/87) with peripheral vascular disease being the least encountered (2/87). Traditional bonesetters' gangrene accounted for 9/87 cases in circumstances that were largely avoidable. Our study revealed that amputation is still being performed as a life-saving procedure, as 44/87 patients presented with gangrene of a limb. The nonavailability of special investigations such as Doppler ultrasound, arteriography, and CT scan was responsible for a delay in definitive treatment in 28 cases. Poor prosthetic services and the absence of a well-coordinated amputee clinic were responsible for some of the unsatisfactory results. We believe that the availability of specialized diagnostic tools and facilities for microvascular surgery, together with a multidisciplinary approach to the management of the amputee, would considerably change the current gloomy picture of amputation in developing countries such as Nigeria.

Adolescent↗

PubMed2003

Incidence of glove failure during orthopedic operations and the protective effect of double gloves.

OBJECTIVE: To determine the usefulness of double gloves in protecting against the exposure of surgical team members' hands to blood. METHODOLOGY: Five-hundred-ninety-six gloves were studied during 71 orthopedic operations using the water-loading test (filling a glove with water and occluding its cuff tightly to identify leaking points). RESULTS: In all, 73 glove perforations occurred, but only nine resulted in exposure to blood (blood touching the skin). The incidence of glove perforation was 12% (73/596), and overall exposure (blood touching the skin) per operation was 13% (9/71). The latter would have been 87% (62/71) but for the use of double gloves. Sixteen percent of the perforations in double gloves were in the inner gloves, while 84% were in the outer gloves. Exposure of surgeons was reduced from 54% to 10%, first assistants from 27% to 3%, and second assistants from 7% to 0 (p < 0.02, df = 2) by double-gloving. Significantly more perforations occurred during operations on bone, compared with soft tissue operations, p < 0.0001, RR = 4 (95% CL 1.87-8.55). The most common sites of glove perforation were the index finger (47%), thumb, and the palm region: 14% each. More glove perforations occurred in nondominant hands. CONCLUSION: Double-gloving offers additional protection to surgeons and assistants by preventing hand exposure to blood intraoperatively.

Equipment Failure↗

PubMedDate not supplied

Extremity gunshot injuries in civilian practice: the National Orthopaedic Hospital Igbobi experience.

A combined retrospective and prospective study of Gunshot Injuries (GSI) that presented to the National Orthopaedic Hospital, Igbobi (NOHL) between 1991 and 1995 was undertaken with the aim of determining the characteristics of these injuries in Lagos, Nigeria. 232 patients with 281 gunshot wounds and 212 gunshot fractures were seen during this period. 68.9% of patients in the study were in the age group 21-40 years with a mean age at presentation of 32.46 +/- 11.21 years. The male to female ratio was 9:1. 87 (37.5%) presented within 6 hours of injury. Armed robbery dominated the events surrounding the shootings with high velocity weapon (HVW) accounting for 47% of the cases. While the femur was the commonest single bone to be fractured the treatment of fractures generally was largely conservative as only 5 fractures were eventually treated by open reduction and internal fixation. Wound infection was the commonest complication (25%) with amputation being performed in 5.6% of cases. This study does not confirm the belief that high velocity weapon causes greater morbidity than low velocity weapon. Even though the average duration of hospitalisation was 33.5 +/- 23.4 days, we advise that for our present state of development gunshot fractures should not be primarily treated with internal fixation.

Adolescent↗