A case series of rapid prototyping and intraoperative imaging in orbital reconstruction.

In Christchurch Hospital, rapid prototyping (RP) and intraoperative imaging are the standard of care in orbital trauma and has been used since February 2013. RP allows the fabrication of an anatomical model to visualize complex anatomical structures which is dimensionally accurate and cost effective. This assists diagnosis, planning, and preoperative implant adaptation for orbital reconstruction. Intraoperative imaging involves a computed tomography scan during surgery to evaluate surgical implants and restored anatomy and allows the clinician to correct errors in implant positioning that may occur during the same procedure. This article aims to demonstrate the potential clinical and cost saving benefits when both these technologies are used in orbital reconstruction which minimize the need for revision surgery.

Rapid prototyping technology in orbital floor reconstruction: application in three patients.

Rapid prototyping entails the fabrication of three-dimensional anatomical models which provide an accurate and cost-effective method to visualize complex anatomical structures. Our unit has been using this to assist in the diagnosis, planning, and preoperative titanium plate adaptation for orbital reconstruction surgery following traumatic injury. The aim of this article is to demonstrate the potential clinical and cost-saving benefits of this technology.

The Effect of a Keratin Hydrogel Coating on Osseointegration: An Histological Comparison of Coated and Non-coated Dental Titanium Implants in an Ovine Model.

Bioactive substances may be used to enhance the rate and quantity of bone healing during osseointegration of titanium dental implants. A pilot observational study was undertaken to assess a novel keratin hydrogel in six adult sheep utilising the femoral condyles as the surgical site to assess osseointegration. Implants and osteotomy sites were coated with the keratin gel prior to implant placement (test implants) whereas the opposite knee received unmodified control implants in each animal. Fifty 3.5 mm × 7 mm Neoss dental implants were surgically implanted with a range of 3-5 Neoss dental implants placed per surgical site in each knee and allowed to heal for 5 days or 2, 4, 8, 12 and 16 weeks prior to the sheep being sacrificed. Of the 50 placed implants, 24 were used for this study and analysed via resin-embedded, undemineralised sections from test and control implants to assess the range of healing around the unloaded dental implants. These dental implants were analysed using histomorphometric methods for the best 3 consecutive threads on each side and the percentage of bone to implant contact (%BIC) was used to determine the degree of osseointegration between test and control dental implants at each time point. All implants appeared osseointegrated at the time of sacrifice. One each of the pairs of control implants at 2, 4 and 12 weeks demonstrated minimal integration histologically, with %BIC <10 %. No test implants had %BIC <35 % at any time point. Mean %BIC for test implants was higher than controls at all time points except 5 days and 2 weeks. The range from 2 to 16 weeks healing was 39.7 % [SD 25.5 %] to 85.4 % [14.2 %] for test implants and 35.6 % [43.4 %] to 46.6 % [23.1 %] for controls. %BIC appeared to increase earlier in the test implants (from 4 weeks onwards) compared to controls. After 16 weeks, %BIC was almost twice as great in test implants as controls. This pilot observational study suggests that keratin hydrogel may promote earlier osseointegration around titanium dental implants. Further cross-sectional studies with larger sample sizes are warranted. The most marked difference between test and control implants was seen after 4 weeks. It is recommended that future studies in this model focus on healing after 4 weeks.

Sickness presenteeism in a New Zealand hospital.

AIMS: The aim of this study was to assess the attitudes of hospital clinical staff to acute personal illness. METHODS: A self-reported questionnaire was developed. Four hundred clinical staff employed by the district health board (DHB) who met the inclusion criteria who were randomly selected. Data were collected and analysed using SPSS software. Ethical approval was obtained from the Lower South Regional Ethics Committee and from the DHB Health Research Office. RESULTS: Doctors were more likely to exhibit sickness presenteeism (SP)--i.e. working despite being sick--than any other occupational group at the DHB. Two main reasons were given for not taking sick leave: staff did not believe they were unwell enough to justify taking leave and they did not want to increase the workload of others. The majority of study participants would not contact anyone for advice about whether to take leave. CONCLUSION: This study provides evidence that SP, especially in doctors, is prevalent in the DHB and is similar to findings from elsewhere. Low rates of clinical staff contacting someone for advice on coming to work whilst ill could be targeted to improve infection control.