Abstract To investigate whether clinical or laboratory variables on admission of patients with odontogenic infections are associated with a severe clinical course and a prolonged hospital stay, we ...hypothesised that specific factors such as the serum concentration of C-reactive protein (CRP) may act as predictors of the duration of stay. We designed a prospective patient-oriented study that included all those treated for maxillofacial infections of odontogenic origin in the Oral and Maxillofacial Surgery Department of Northampton General Hospital between November 2013 and December 2014. A total of 71 were enrolled. We found that the concentration of CRP was a significant predictor of hospital stay (p = 0.01). Its measurement on admission can predict the likely duration of stay of these patients and enable beds to be managed more efficiently.
Scientific publications place much emphasis on postoperative outcomes such as recurrence, but little attention to patients’ satisfaction. The purpose of this evaluation was to find out patients’ ...reported outcomes after their initial consultation, treatment, and follow-up appointments for non-melanoma skin cancer of the head and neck. We used an adapted version of the European Organisation for Research and Treatment of Cancer (EORTC) validated questionnaire for patients’ satisfaction to collect data prospectively from consenting patients between September and December 2015. A total of 179 questionnaires were completed (initial consultation n=51, treatment n=74, and follow up n=54). Patients were most satisfied with the appointments for treatment (Kruskal–Wallis p<0.001, mean (SD) score 4.86/5 (0.15)), and 87% regarding the service as excellent. Patients were least satisfied with services and organisation of care compared with nurses and doctors (Kruskal–Wallis p<0.001). There seemed to be most satisfaction after the appointment for treatment. A possible explanation could simply be the relief of having finally had their cancer removed. Patients are also likely to show greater satisfaction with the clinical team because of the personal nature of the interaction that they experience during this aspect of their care.
Abstract In patient-centred medical practice, consideration of the patients’ expectations is vital to the planning and delivery of service. Modern medicine must use the continuing advances in ...information technology to disseminate knowledge and raise awareness among patients and the public. People increasingly use the Internet to search for information on health, and the online presence of an organisation or a profession is known to bring a wide range of benefits. We aimed to find out what patients expect from the website of an Oral and Maxillofacial Surgery (OMFS) unit and to assess the online presence of OMFS units in the United Kingdom. Results from 100 self-administered questionnaires showed that there were 18 common domains that patients would like to see on OMFS websites. When ranked according to the number of times they were mentioned, a map of the department was mentioned most and the complaints policy least. Of the 156 OMFS units in the UK, only 51% have websites and of these, 80% are in London. There were none in Wales and Northern Ireland. Only half of the websites contained information that related to patients’ expectations. Strategies to improve the content of websites for OMFS units and to improve their online presence are urgently needed.
The anterolateral thigh flap has gained popularity over the last few decades for the reconstruction of various surgical defects. The anatomy of the main perforating vessel of the anterolateral flap, ...the descending branch of the lateral circumflex femoral artery (dbLCFA), has been well described in the literature, however only one study has investigated its patency in patients with significant comorbidities. The aim of this study is to assess the degree of vascular stenosis of the dbLCFA in patients with multiple comorbidities.
A total of 128 sets of angiographic data were collected from 93 patients retrospectively over a 12-month period. The percentage stenosis of superficial femoral artery (SFA), LCFA, and dbLCFA was measured and converted into an established scoring system.
The rate of dbLCFA stenosis was 12.5%. Interestingly, 24.0% of patients without peripheral vascular disease (PVD) showed some degree of stenotic changes in the dbLCFA, whereas only 10.7% of those with PVD had some degree of stenosis. There was no correlation between dbLCFA stenosis and patient comorbidity. The SFA was significantly affected by smoking, hypercholesterolemia (p < 0.05), and diabetes mellitus (p < 0.01) CONCLUSIONS: This study shows that the dbLCFA is not affected by patient comorbidity including PVD when compared with medically fit controls. Even in individuals with severe disease of the superficial vascular system; there is often sparing of the deep system. Surgical reconstruction using the anterolateral thigh flap is a safe procedure for patients even with multiple comorbidities including significant PVD and no additional preoperative investigations are required.