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PubMed · 11183026

Consultant work patterns. Blade runners.

J Yates·M Harley·B Jayes
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Abstract

An analysis of the work of 182 consultant orthopaedic surgeons in two English regions found they averaged seven hours a week operating. A fifth were working below the minimum operating hours recommended by the British Orthopaedic Association. Orthopaedic teams are now seeing fewer outpatients and inpatients than 10 years ago, despite a 50 per cent increase in the number of consultants. The current situation raises serious concerns about appropriate use of specialists' time and operating theatres. Trusts should not appoint any more consultant orthopaedic surgeons until those they have operate for a minimum of eight hours a week.

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ConsultantsEfficiencyEnglandHumansMedical Staff, HospitalOrthopedicsPersonnel Staffing and SchedulingState MedicineTraumatologyWorkloadJournal Article

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J Yates, M Harley, B Jayes. 2000-04-27. Consultant work patterns. Blade runners.. https://pubmed.ncbi.nlm.nih.gov/11183026/

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PubMed2006

UK national survey of enucleation, evisceration and orbital implant trends.

AIM: To evaluate current clinical practice in the UK in the management of the anophthalmic socket; choice of enucleation, evisceration, type of orbital implant, wrap, motility pegging and complications. METHODS: All consultant ophthalmologists in the UK were surveyed by postal questionnaire. Questions included their practice subspecialty and number of enucleations and eviscerations performed in 2003. Specific questions addressed choice of implant, wrap, motility pegging and complications. RESULTS: 456/896 (51%) consultants responded, of which 162 (35%) had a specific interest in oculoplastics, lacrimal, orbits or oncology. Only 243/456 (53%) did enucleations or eviscerations. 92% inserted an orbital implant after primary enucleation, 69% after non-endophthalmitis evisceration, whereas only 43% did so after evisceration for endophthalmitis (50% as a delayed procedure). 55% used porous orbital implants (porous polyethylene, hydroxyapatite or alumina) as their first choice and 42% used acrylic. Most implants inserted were spherical, sized 18-20 mm in diameter. 57% wrapped the implant after enucleation, using salvaged autogenous sclera (20%), donor sclera (28%) and synthetic Vicryl or Mersilene mesh (42%). A minority (7%) placed motility pegs in selected cases, usually as a secondary procedure. 14% of respondents reported implant exposure for each type of procedure and extrusion was reported by 4% after enucleation and 3% after evisceration. CONCLUSIONS: This survey highlights contemporary anophthalmic socket practice in the UK. Most surgeons use porous orbital implants with a synthetic wrap after enucleation and only few perform motility pegging.

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