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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXVIII | Pages 23 - 23
1 Jun 2012
Crane EOT Reid GT McCracken JA Martin DJ
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NHS Greater Glasgow & Clyde has six hospitals that provide an inpatient trauma service, but only two have facilities to receive patients by helicopter. The Southern General Hospital contains regional Neurosurgical and Spinal Injuries services and attracts the majority of major trauma delivered by helicopter. This study explores the impact that Emergency Medical Retrieval (EMRS) and Air Ambulance services have on the Trauma & Orthopaedic department at our Hospital.

We examined the period 1st January 2010 to 31st December 2010 identifying Trauma & Orthopaedic admissions brought to our hospital by the Emergency Medical Retrieval and Air Ambulance services. These patients were identified from records kept by our Trauma Nurse Practitioner and an additional search of the hospital admissions database. Details of the admissions were extracted from this database, clinical records and various electronic patient records. Patients admitted to other departments were excluded from the study.

48 admissions (30 male, 18 female) were identified. Age ranged from 16-87 years. 16 patients had multiple injuries. 8 required High-Dependency or Intensive Care admission and there was 1 death in our cohort. 21 patients required surgery. In total, these patients required approximately 52.5 hours of operative time. These patients accounted for 373 inpatient days with an average hospital stay of 7.7 days (1-36 days). In addition, 25 patients have required a total of 35 outpatient appointments to date.

This study quantifies the significant impact on inpatient and outpatient Trauma & Orthopaedic services from helicopter derived admissions. Some patients admitted under Neurosurgery and Spinal Injuries also undergo surgery, but were not included in the study, representing an additional workload. We believe this study supports an argument for additional investment in this growing trauma service, especially given the recent expansion of EMRS to cover the whole of Scotland.


Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_II | Pages 330 - 330
1 Jul 2008
Martin DJ Patil S Byrne D Leach WJ
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Aim: We have carried out a prospective study to compare duplex ultrasonography and transcutaneous oxygen tension as predictors of wound healing after knee arthroplasty.

Methods and Materials: 53 patients were included in the study. All underwent pre-operative duplex scans of their lower limbs. In addition, transcutaneous oxygen tension measurements were made adjacent to the proposed incision pre-operatively and on days 1, 3 and 7 post knee arthroplasty. Wound healing was assessed using the ASEPSIS wound score.

Results: 4 wounds had evidence of delayed wound healing. Duplex ultrasonography was a poor predictor of such problems; however there was a significant correlation between pre-operative transcutaneous oxygen tension and post-operative wound scores.

Conclusion: Pre-operative transcutaneous oxygen tension measurement is a better predictor of wound healing after knee replacement surgery than duplex ultrasonograph, and may be a useful adjunct to the investigation of patients at risk of wound problems post knee arthroplasty.