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Bmj Usa: Minerva


BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E218

From BMJ USA 2003;April:232

Every surgeon's nightmare is to leave a swab or instrument inside a patient. So what are the risk factors? A case-control study of medical malpractice claims found that it's nine times more likely to happen during emergency surgery and four times more likely after an unplanned change in the procedure (New England Journal of Medicine 2003;348:229–235). Overweight patients (and their surgeons) are also at increased risk.

The risk of a surgical wound becoming infected is inversely correlated with the oxygen tension in the subcutaneous tissues. Providing supplementary oxygen during surgery reduces that risk. A study of 500 patients undergoing colon surgery found that only 5% of the patients given 80% oxygen developed wound infection compared with 11% of those given 30% oxygen. Supplementary oxygen also cut the rate of postoperative nausea and vomiting (Clinical Infectious Diseases 2002;35:1397–1404).

An incidentaloma is the name given to a totally asymptomatic non-functional tumor that is clinically and biochemically silent and has been discovered by chance. These tumors are found most often in the adrenal glands of patients being investigated with modern imaging techniques. The name seems to have enraged …

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