The aim of this study was to develop, implement, and evaluate a standardized perioperative enhanced recovery after surgery (ERAS) clinical care pathway in microsurgical abdominal-based breast reconstruction.Development informed by the latest ERAS guideline for reconstruction. Key features included shortened preoperative fasting, judicious fluids, multimodal analgesics, early oral nutrition, Foley catheter removal, ambulation. There were 3 groups women cohort study: (1) traditional historical...

Abstract Background Rural provider-to-provider telehealth is growing globally. It used to both facilitate equitable access specialist healthcare services for those living in rural and remote areas provide support place-based providers. There limited research on the implementation of these services, especially an emergency or inpatient hospital setting. The Western Australia Country Health Service (WACHS) Command Centre one such example. First implemented 2012, a geographical area covering...

The objective of this study is to evaluate the cost-effectiveness a postoperative clinical care pathway for patients undergoing major head and neck oncologic surgery with microvascular reconstruction. This comparative trial prospective treatment group managed on historical prior implementation. Effectiveness outcomes evaluated were total hospital days, return OR, readmission ICU rate pulmonary complications. Costing perspective was from government payer. 118 included in study. All...

Large defects secondary to oral cancer resection are reconstructed with microsurgical free flaps. Pulmonary complications in these patients common. Postoperative mobilization is recommended decrease respiratory complications; however, many microsurgeons reluctant adopt early protocols due the perceived risk of flap compromise. The purpose this study was determine incidence pneumonia among undergoing and immediate reconstruction compare complication between mobilized (<4 days postoperative)...

Pulmonary complications are common after major head and neck oncologic surgery with microsurgical reconstruction associated increased mortality morbidity. Clinical care pathways evidence-based tools that reduce unnecessary practice variation ultimately improve patient outcomes. In this study, the authors evaluate effectiveness of a comprehensive pathway on reducing postoperative pulmonary hospital length stay in patients undergoing carcinoma resection free flap reconstruction.Fifty-five...

Background: Some women with breast implants express concern about the safety of implants, fearing possibility implant-associated anaplastic large cell lymphoma (BIA-ALCL) and implant-related illness. Methods: A qualitative analysis was performed to examine perceived challenges, barriers, worries experienced by these women. Convenience sampling used elicit responses from members Canadian BIA-ALCL Facebook advocacy groups. Three independent coders read reread transcripts, using thematic...

To summarize current Canadian practice patterns in the diagnosis of and interventions for inhalation injuries (INHI).A 10-question survey regarding INHI was sent to medical directors all 16 burn centres across Canada.The response rate 50%. Fibreoptic bronchoscopy is required only four (50%). The departments intensive care, plastic surgery, otolaryngology respirology are involved performing fibreoptic 87.5%, 37.5%, 12.5% centres, respectively. Intubation most often based on physical...

<sec> <title>BACKGROUND</title> Delivery of health care utilizing telehealth is a recognized and rapidly evolving domain in the delivery Emergency Medicine. Research suggests positive impact for patients presenting emergency care, however, regional challenges acute telemedicine have not been studied. The WA Country Health Service (WACHS) Telehealth (ETS) commenced operation 2012 Western Australian departments (EDs). WACHS ETS serves 87 remote WACHS-run hospitals as well 10 non-WACHS...

The purpose of this study is to gather the practices and perceptions among upper extremity surgeons regarding use musculoskeletal ultrasound for diagnostic therapeutic intervention.

Telehealth is a recognized and rapidly evolving domain in the delivery of emergency medicine. Research suggests positive impact telehealth patients presenting for care; however, regional challenges acute telemedicine have not been studied. The WA Country Health Service (WACHS) established Emergency (ETS) 2012 to provide other technology-enabled services Western Australian hospitals clinics. WACHS ETS supports 87 rural remote WACHS-operated as well 10 non-WACHS health clinics via...

Large diaphragmatic defects present a reconstructive challenge, often necessitating the use of synthetic materials. We report our experience reconstructing large using human acellular dermal matrix (HADM). Patients unable to undergo primary repair from 2009 2013 were reconstructed HADM. A chart review was performed investigate immediate and late post-operative outcomes. Construct stability assessed with repeat imaging. In addition, literature identify studies in which HADM had been used for...

The purpose of this study was to describe the impact using a multidisciplinary hand clinic on (1) waitlists for urgent operative pathologies and (2) volume referrals seen by plastic surgery.A retrospective data analysis all new Peter Lougheed Centre in Calgary, Alberta, performed. Data were collected from 6 months before after introduction model (ie, between January 2017 2018). Demographics database, including wait times, triage type, triaged each discipline.Prior model, 81% (n = 591)...

I nhalation injury (INHI) is a comorbid factor that increases the risk of mortality in burn victims (1-3).The combination INHI and associated with complex pathophysiological alterations including increased pulmonary microvascular permeability prolonged cardiac depression ovine models (4,5).In Canadian study, Tredget et al (6) reported prolongs hospital stay independent age size.In spite clinical significance INHI, there has been lack academic progress management this field.Palmieri (7)...

The Western Australia (WA) Acute TeleStroke Programme commenced incrementally across regional WA during 2016-2017. Since the introduction of Programme, there has been monitoring service outputs, including patient access to tertiary stroke specialist advice and reperfusion treatment; however, impact consultation with a via telehealth (videoconferencing or telephone) on effectiveness cost-effectiveness care drivers not systematically evaluated.The aim case study was examine transient ischaemic...

Articular cartilage damage has been a longstanding challenge in hand surgery. Because of its limited ability to heal on own and predictable impact bone resulting degenerative osteoarthritis, surgical intervention is often mandated, through arthrodesis or implant arthroplasty. In this article, we revisit the perichondrial arthroplasty, two-stage joint resurfacing technique using autologous rib perichondrium. It indicated for posttraumatic osteoarthritic changes with without stiffness...

Autophagy is a cellular housekeeping process by which proteins and damaged organelles are targeted for engulfment autophagosomes ultimately culminating in degradation within the lysosomes. Chronic inflammation has been shown to disrupt normal physiological homeostasis leading increased risk of cardiovascular disease, type 2 diabetes mellitus muscle atrophy. The purpose this study was investigate whether disrupts activation autophagy C2C12 myotubes. Myoblasts were grown 10% fetal bovine serum...