Summary:Augmented reality (AR) is defined as “a technology that superimposes a computer-generated image on a user’s view of the real world, thus providing a composite view.”1 This case report describes how emerging AR telesurgery technologies may be used to facilitate international surgeon–surgeon collaboration and training. Here, we illustrate how a remote surgeon in Beirut, Lebanon, was able to offer assistance to a surgeon in Gaza, Palestine, during a complex hand reconstruction case following a bomb-blast injury in an 18-year-old male. We discuss the implications of AR technology on the future of global surgery and how it may be used to reduce structural inequities in access to safe surgical care.
Poor wound healing is an important surgical complication. At-risk wounds must be identified early and monitored appropriately. Wound surveillance is frequently inadequate, leading to increased rates of surgical site infections (SSIs). Although the literature demonstrates that risk factor identification reduces SSI rates, no studies have focused on wound management at a junior level. Our study assesses documentation rates of patient-specific risk factors for poor wound healing at a large district general hospital in the UK. It critically evaluates the efficacy of interventions designed to promote surveillance of high-risk wounds. We conducted a full-cycle clinical audit examining medical records of patients undergoing elective surgery over 5 days. Interventions included education of the multidisciplinary team and addition of a Wound Healing Risk Assessment (WHRA) checklist to surgical admissions booklets. This checklist provided a simple stratification tool for at-risk wounds and recommendations for escalation. Prior to interventions, the documentation of patient-specific risk factors ranged from 0·0% to 91·7% (mean 42·6%). Following interventions, this increased to 86·4-95·5% (mean 92·5%), a statistically significant increase of 117·1% (P < 0·01). This study demonstrates that documentation of patient-specific risk factors for poor wound healing is inadequate. We have shown the benefit of introducing interventions to increase risk factor awareness.
The CCTF (formerly named CCDS) held its 14th meeting on 20-22 April 1999. Following the discussions, seven Recommendations were adopted and submitted to the Comite International des Poids et Mesures (CIPM). The list is the following:1. Recommendation S 1 (1999): Mise-en-pratique of the definition of the second. 6. Recommendation S 6 (1999): Future global navigation satellite systems.
Recommendation S 7 (1999): On Two-Way Satellite Time and Frequency TransferAdditionally discussed were the present form of UTC and mostly the interest of preserving the leap second. The advantages and disadvantages of several options regarding the future use of leap seconds were compared. The CCTF, however, felt that it did not have the authority to propose any action. Then CCTF decided to ask the BIPM Director to write to the relating international bodies including IAU so as to draw their attentions to this issue while recommending the usage of TAI in case a time scale without discontinuity is needed. Also it was decided, in order to make more expedite the process, to ask the opinions of the various Commissions of the Scientific Unions.
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