Biomedical subjects

David M Ricketts

Publications and source records attributed to David M Ricketts.

5 recordsLinked to original sources

PubMed2005

The effects of injection of bovine vaccine into a human digit: a case report.

BACKGROUND: The incidence of needlestick injuries in farmers and veterinary surgeons is significant and the consequences of such an injection can be serious. CASE PRESENTATION: We report accidental injection of bovine vaccine into the base of the little finger. This resulted in increased pressure in the flexor sheath causing signs and symptoms of ischemia. Amputation of the digit was required despite repeated surgical debridement and decompression. CONCLUSION: There have been previous reports of injection of oil-based vaccines into the human hand resulting in granulomatous inflammation or sterile abscess and causing morbidity and tissue loss. Self-injection with veterinary vaccines is an occupational hazard for farmers and veterinary surgeons. Injection of vaccine into a closed compartment such as the human finger can have serious sequelae including loss of the injected digit. These injuries are not to be underestimated. Early debridement and irrigation of the injected area with decompression is likely to give the best outcome. Frequent review is necessary after the first procedure because repeat operations may be required.

Accidents, Occupational↗

PubMed2005

Keeping plaster casts dry: what works?

Plaster casts are commonly used in the management of fractures. The mechanical properties of plasters are adversely affected by water. There are a number of commercial products available to allow patients to continue to shower and swim by protecting the plaster. The aim of this study was to compare these products with a plastic bag and elastic band. Each protector was tested in a shower, immersed in a swimming pool and worn while swimming. The volume of water intrusion was measured. There was no significant difference between a plastic bag and the commercially available products. We do not recommend the use of commercially available plaster protectors for showering or swimming: a plastic bag and elastic band is a cheaper and more convenient device.

Activities of Daily Living↗

PubMed2005

Where to split plaster casts.

Plaster casts are often split to accommodate swelling following injury. This is not influenced by the axis of the split. The aim of this study was to compare the mechanical properties of plasters split along different axes. Full plasters were applied to mannequin forearms, and then split along dorsal, volar, radial or ulnar sides. Following this the plasters were loaded in a dorsal direction. We found that of all the axes tested, the dorsal split was the best for maintaining fracture reduction (p = 0.001).

Casts, Surgical↗

PubMed2005

Satisfaction levels in orthopaedic out-patients.

INTRODUCTION: It is important that patients are satisfied with an out-patient consultation. This ensures compliance with treatment and attendance for follow-up. The aim of this study was to identify factors regarding out-patient consultation associated with patient satisfaction. METHODS: A two-part questionnaire identifying expectations of, and subsequent satisfaction with, a new out-patient consultation was completed by 106 out-patients. RESULTS: There was no correlation between not seeing the clinician anticipated and reduced satisfaction (P = 0.17). Using more information sources was associated with less satisfaction (P = 0.02). Patients were less satisfied if their expectations of either treatment or outcome were changed. CONCLUSIONS: Meeting patients' expectations is an essential part of effective communication. The use of specialist physiotherapists and general practitioners with a special interest is an effective way of seeing more new patients.

Communication↗

PubMed2005

Short-listing for orthopaedic specialist registrar posts--what is important?

INTRODUCTION: Competition for specialist registrar (SpR) posts in orthopaedics is high. The aim of the current study was to provide evidence-based advice for applicants applying for SpR posts in orthopaedics. METHODS: The short-listing forms of 273 applicants for orthopaedic SpR posts in South Thames (West) were reviewed. The experience of short-listed candidates was compared with those that were not. RESULTS: We have shown a high chance of being short-listed between 5 and 6 years after qualification with a sharp fall off either side of this. It is clear that a wide range of appropriate experience is more important than high volume and low quality experience in orthopaedics alone. CONCLUSION: Candidates who plan ahead and gain a broad experience have a better chance of progressing in an orthopaedic career. Good, early career advice is essential to achieve this.

Career Mobility↗