Biomedical subjects

Clare Heal

Publications and source records attributed to Clare Heal.

6 recordsLinked to original sources

PubMed2006

Risk factors for wound infection after minor surgery in general practice.

OBJECTIVE: To determine the incidence of and risk factors for surgical site infections in general practice. DESIGN: Prospective, observational study of patients presenting for minor excisions. SETTING: Primary care in a regional centre, Queensland, October 2004 to May 2005. PARTICIPANTS: 857 patients were assessed for infection. RESULTS: The overall incidence of infection was 8.6% (95% CI, 3.5%-13.8%). Excisions from lower legs and feet (P = 0.009) or thighs (P = 0.005), excisions of basal cell carcinoma (P = 0.006) or squamous cell carcinoma (P = 0.002), and diabetes (P < 0.001) were independent risk factors for wound infection. CONCLUSION: Our results indicate the high-risk groups for surgery in a general practice setting, such as people with diabetes and those undergoing excision of a non-melanocytic skin cancer or excision from a lower limb. Recognition of these groups could encourage more judicial use of prophylactic antibiotics and use of other interventions aimed at reducing infection rates.

Adult↗

PubMed2006

Can sutures get wet? Prospective randomised controlled trial of wound management in general practice.

OBJECTIVE: To compare standard management of keeping wounds dry and covered with allowing wounds to be uncovered and wet in the first 48 hours after minor skin excision. DESIGN: Prospective, randomised controlled, multicentre trial testing for equivalence of infection rates. SETTING: Primary care in regional centre, Queensland, Australia. PARTICIPANTS: 857 patients randomised to either keep their wound dry and covered (n = 442) or remove the dressing and wet the wound (n = 415). RESULTS: The incidence of infection in the intervention group (8.4%) was not inferior to the incidence in the control group (8.9%) (P < 0.05). The one sided 95% confidence interval for the difference of infection rates was infinity to 0.028. CONCLUSION: These results indicate that wounds can be uncovered and allowed to get wet in the first 48 hours after minor skin excision without increasing the incidence of infection.

Adult↗

PubMed2006

Shared decision making and decision aids - a literature review.

Shared decision making (SDM) is a process within a patient centred consultation that involves both the patient and doctor discussing management options and agreeing on management decisions in partnership. Decision aids are designed to help patients understand the options relating to management for certain conditions and their possible benefits and potential adverse effects. We discuss the evolution and rationale behind SDM and the evidence relating to outcomes, the types of decision aids available, and research relating to their use.

Decision Making↗

PubMed2006

Minor skin excisions in general practice in North Queensland.

OBJECTIVE: To describe the demographics of patients presenting with skin cancer to general practitioners in rural North Queensland, the sites from which skin cancers are removed, and their histology. METHODS: Data was recorded from 1247 consecutive patients who attended for minor skin lesion excisions. RESULTS: Close to half (46.7%) of lesions excised were skin cancers. We excised more squamous cell carcinomas than basal cell carcinomas (0.74:1). Our number needed to treat (benign or dysplastic naevi excised per melanoma) was 8.4. Mean age for excision of melanoma, basal cell carcinoma and squamous cell carcinoma was 55, 60.9 and 63.8 years respectively. Relative tumour density was greatest in the face, scalp and neck region for all skin cancers. DISCUSSION: In this sample of Mackay GPs, there was a very high yield of skin cancers from all excisions. We could consider lowering our threshold for excision of pigmented lesions.

Adult↗

PubMed2005

A peer support program for international medical graduates.

International medical graduates (IMGs) form a significant part of the Australian general practice workforce. Many experience social and professional problems and perform poorly inThe Royal Australian College of General Practitioners Fellowship Examination. This article reports on a pilot program in Mackay, north Queensland that addressed some of these issues.

Family Practice↗

PubMed2002

Screening for chlamydia in general practice.

OBJECTIVE: To determine the prevalence of genital Chlamydia trachomatis infection in young patients presenting to general practitioners and to evaluate selective screening, based on risk factors, including gender. METHODS: A cross sectional survey of 508 consecutive patients aged 18-24, presenting to six general practices and one youth clinic in Mackay, North Queensland. We screened urine for chlamydia using Ligase chain reaction. RESULTS: Of 508 samples, 25 were positive (5%). The only factors with increased risks of infection were attendance at a youth clinic and recent change in sexual partner. It was as high in men as in women. CONCLUSION: Prevalence of chlamydia infection may be high enough to support screening of all patients aged 18-24, depending on cost effectiveness studies.

Adolescent↗