ABSTRACT
INTRODUCTION: Time delays resulting in prolonged ischemia have a significant impact on the successful reattachment of amputated body parts. No studies have addressed the issues surrounding delays from the time of the accident to the start of replantation surgery. The present paper identifies the bottlenecks that prolong the time before patients are able to gain access to a replant team. METHODS: A total of 50 patients underwent microsurgical replantation, because of traumatic amputation, at a university-based hospital from 1996 to 2003. The charts were analyzed to ascertain individual time intervals from the onset of injury until the beginning of replant surgery. RESULTS: The average length of time for patients who came directly to the replant centre was 3 h 40 min before surgery began. In contrast, for those referred from outlying hospitals, the elapsed time was 6 h 21 min. CONCLUSIONS: Two major bottlenecks were found. First, for patients who were referred from other health centres, delays were due to a lack of information as to where patients could receive appropriate replant surgery. Second, delays at the replant centre were primarily due to insufficient physical and human resources in the operating room.
ABSTRACT
A solid-state video camera is used as the focal plane detector in an underwater spectrometer system to acquire multiple spectra simultaneously within the water column. Signal-to-noise enhancement of the spectra is accomplished by use of a combination of frame averaging and dark field mapping so that the dynamic range of the individual frame can be increased from approximately 7 bits to > 13.5 bits. This method also removes the need for shuttering to determine the dark background or device cooling to reduce the dark current noise. The dark mapping algorithm is shown to be valid over a range of device temperatures so that the detector can vary freely with the ambient water temperature without loss in mapping accuracy. Despite observation times that can be up to an order of magnitude greater than cooled devices, the use of frame averaging and dark mapping eliminates the need for additional detector cooldown time and can provide a smaller, simpler, more power efficient, and robust design.
