RESUMO
We report a case of severe anterior cervical hyperostosis presenting with dysphagia.
Assuntos
Vértebras Cervicais/diagnóstico por imagem , Hiperostose/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Transtornos de Deglutição/etiologia , Fluoroscopia , Humanos , Hiperostose/complicações , Hiperostose/cirurgia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
We present an unusual case of haematogenous osteomyelitis in the diaphysis of the tibia of an adult leading to a subacute presentation with an extracortical abscess. Fluid from the abscess grew methicillin resistant Staphylococcus aureus (MRSA) on culture; MRSA with the same antibiogram had been grown from the patient's blood seven years earlier following a bowel resection. Drainage of the abscess and curettage of the bone lesion together with appropriate antibiotic therapy led to resolution of the osteomyelitis.
Assuntos
Abscesso/cirurgia , Staphylococcus aureus Resistente à Meticilina , Osteomielite/cirurgia , Infecções Estafilocócicas/cirurgia , Abscesso/patologia , Adulto , Humanos , Imageamento por Ressonância Magnética , Masculino , Dor Musculoesquelética/microbiologia , Osteomielite/patologia , Infecções Estafilocócicas/patologia , TíbiaRESUMO
The World Health Organisation Surgical Safety Checklist (WHO SSC) is a validated tool for reducing in-patient surgical morbidity and mortality. It is not performed universally with full compliance. Two audit cycles were completed at two different trauma and orthopaedic units and compliance was measured. Site 1 was found to have a significantly lower compliance with the team-brief (p<0.001). Following a change in practice the compliance significantly increased (p>0.00001) at Site 1. The team de-brief was found to be consistently poorly complied with. We recommend regular audit of compliance and change in practice for all surgical units, and suggest national monitoring to ensure the benefits of the WHO checklist are applied to all in-patient surgery.