In-office outpatient orthognathic surgery: review of 254 cases where the patients were discharged the same day.

This study was performed to present a single operator's experience of in-office (outside of a hospital setting) outpatient orthognathic surgery over a period of 12 years. A total of 254 surgeries were performed during this period. Average procedure times were comparable with published results from studies of similar material. The mean operating time for bimaxillary surgery (n = 21) was 3 hours and 11 minutes. Regarding single-jaw procedures, the mean operating time for Le Fort I osteotomy (n = 115) was 2 hours and 14 minutes and for bilateral sagittal split osteotomy (n = 118) was 2 hours and 1 minute. All patients were discharged from the office the same day, except one patient who was transported to the hospital after surgery due to an anaesthetic complication. This patient was discharged from the hospital later the same day. In this setting, outpatient orthognathic surgery is both safe and practical when careful attention is given to patient preparation and selection. Emergency phone contact with the surgeon in case of complications is important to avoid unnecessary hospitalization.

What attendance rate can be achieved for Pap smear screening? A case-control study of the characteristics of non-attenders and results of reminder efforts.

OBJECTIVE: To understand participation failures in a national Pap smear screening programme by studying characteristics of non-attenders and results of further reminder efforts. DESIGN: A case-control and an intervention study. SETTING: The community health centre in the town of Hafnarfjördur, Iceland. SUBJECTS: The target population comprised 2510 women aged 35-69, who were invited regularly every second year for cervical cancer screening. MAIN RESULTS: 2241 (89.3%) had attended screening during the preceding five years, 102 (4.1%) had never attended, and 167 (6.7%) had attended previously but not during the preceding five years. Women with a mental disorder and those who had never married were more likely not to attend. The most usual explanations given by non-attenders were that they did not like to participate, or they felt they did not need to, some of them because their uterus had been removed. Of the non-attenders 29 (10.8%) came for a Pap smear after repeated reminding efforts. CONCLUSIONS: Total participation rate in cervical cancer screening programmes in Iceland is high. When efforts are taken to lower the non-attendance rate it has to be kept in mind that many women are unwilling or unable to participate in such preventive measures.