Burn dressings play a vital role in protecting the patient from infection and aiding in the wound healing process. At present, the best burn wound dressing remains unknown. This study aimed to assess the efficacy of honey versus silver sulfadiazine dressing (SSD) for the treatment of superficial and partial thickness burns. We performed a systematic review and meta-analysis using the PubMed, MEDLINE and Embase databases to find relevant randomised control trials (RCTs) for inclusion. The outcomes measures included complete burn wound healing time, the proportion of wounds rendered sterile and subjective pain relief associated with the respective dressing type. This review was completed in line with PRISMA guidelines and has been registered with PROSPERO (Study ID: CRD42022337433). All studies in the English language that assessed honey versus SSD for patients with superficial or partial thickness burns were included. Quality and risk of bias assessments were performed using the Cochrane RoB2 tool. Seven studies were identified: totalling a population of 582 patients. From three studies, meta-analysis showed no significant difference in complete wound healing time (p = 0.06). Meta-analysis from five studies highlighted an overall significant difference favouring honey dressing in the proportion of wounds rendered sterile at day 7 post-injury (OR 10.80; 95% CI [5.76, 20.26]; p < 0.00001; I2 = 88%). We conclude that honey dressings may be as or more effective than SSD in the treatment of superficial and partial thickness burn injuries. However, due to the low quality of available studies in this field, further research is necessary to establish the optimum burn dressing. Ideally, this should be conducted in the form of prospective three-arm RCTs in accordance with the CONSORT statement.
Funding Acknowledgements Type of funding sources: None. Background Covid-19 pandemic has had a profound impact on healthcare service delivery. Acute cardiovascular care however remains a priority despite the pandemic. Patients presenting with non-ST elevation MI (NSTEMI) have been poorly characterised during the pandemic. Methods We conducted a retrospective study of patients diagnosed with NSTEMI during the peak of the pandemic between April-May 2020 at our tertiary centre in the UK. Data was collected from electronic patient clinical records including time from admission to angiography, length of stay, mortality, prescription of secondary prevention pharmacotherapy and referral to cardiac rehabilitation. We compared this data to the same time period in 2019. Results As can be seen from Table 1, in 2020, the mean age, median time to angiography and length of stay were all significantly lower than the control period of 2019. Prescription of secondary prevention medication (Aspirin, P2Y12 inhibitor, Beta-blocker, Statin and ACEi/ARB) and referral to cardiac rehabilitation also improved in 2020, however neither was statistically significant. During the 2020 period, 1 patient died due to late presentation NSTEMI and multi-organ failure. There were 3 deaths in 2019: complications following coronary bypass surgery, upper GI bleed and a subarachnoid haemorrhage. Conclusion Our results show that the mean age of the patients presenting with NSTEMI during the peak of Covid-19 pandemic was younger suggesting that elderly patients failed to present. Compared to 2019, there was significant improvement in patient treatment times with a significantly shorter stay in hospital, probably as a result of the reduction in elective activity allowing un-restrained access to the catheter labs. We also saw improvement in prescription for secondary prevention and referral to cardiac rehabilitation services during this time suggesting that there may have been improved focus on these aspects of care again. Table 120192020p-valueAge (years)71.2 ± 12.265.0 ± 12.1p < 0.01Number of NSTEMI patients5659p = NSNumber of NSTEMI patients undergoing angiography5053p = NSMedian time to angiography (hours)68.614p < 0.01Median length of stay (days)5 (IQR 2:8)2 (IQR 1:4)p < 0.01Referral to cardiac rehabilitation77.4%84.5%p = NSPrescription of secondary prevention medication69.8%72.4%p = NSTable 1- Comparison of NSTEMI patients in 2019 and 2020Abstract Figure. Box and whisker plot for hospital stay
Introduction Surgical conferences are invaluable events for healthcare professionals; they provide opportunities to engage with upcoming scientific discoveries, network professionally with peers as well as expand learning through lectures and workshops. For medical students, conferences provide an opportunity to expand understanding beyond the undergraduate curriculum in an interactive manner. COVID-19 has caused disruption to the organisation and attendance of in-person conferences (IPCs). Virtual conferences (VCs) offer a viable solution, allowing delegates to attend from the comfort of their own homes. Method The aim of our study was to evaluate an organised VC and explore the perceived benefits and limitations of VCs compared to IPCs. A virtual one-day trauma & orthopaedics (T&O) conference was organised involving lectures, workshops, poster, and oral presentations. Anonymous questionnaire forms were distributed to delegates following the conference to assess the aims of our paper. Results From 106 responses, 96.2% rated the conference as ‘Excellent’ or ‘Good’ with 92.5% stating that it increased their passion for T&O surgery. Based on a five-point Likert scale (5= strongly agree, 1= strongly disagree), mean score of agreement for preferring VCs to IPCs was 3.30(± 1.24). Key advantages of the VC were a lower cost (70.8%) and not having to travel (77.4%), whereas the main limitation was the inability to participate in hands-on workshops (84.9%). Conclusions Despite the success of our VC, delegate feedback indicates a mixed response comparing VCs to IPCs. We share our findings to encourage similar events to be organised and for other specialties.
Applying to core surgical training has always been a competitive and ambitious path with many applicants reaching out to expensive courses or literature to guide them through the application process. The COVID-19 outbreak heightened the difficulty and severed connections to previous support tools for foundation doctors interested in pursuing a surgical career during the pandemic. In the East Midlands, we identified this weakness and aimed to create a conduit to support our trainees through their application process.The Surgical Buddies Scheme was created in September 2020. This scheme involved connecting current Core Surgical Trainees (CST) doctors with keen Foundation doctors interested in applying to CST. The intermediary, buddy scheme organisers matched juniors with the tutors based on shared interest and location.26 foundation doctors (FY) joined the scheme across seven sites. The FY two doctors were given priority and were matched up with 22 CST doctors. Feedback forms were distributed to collect qualitative and quantitative data regarding their participation. The Feedback summary forms showed that the most common used contact platform was zoom (35.7%) and texting for additional support (35.7%). The average hours of contact spent were 4.2 hours. The qualitative feedback data from the FY doctors showed all their initial pre-scheme objectives were met.Effective leadership led to the initializing and distribution of a Buddy network system to offer a one-to-one contact between applicant and tutor. The initiative of the original scheme led to a large team of tutor collectively supporting and guiding our cohort of applicants.The success of the scheme was recognized by the Nottingham University Hospital (NUH)NHS trust Postgraduate Medical Education Team (PMED). The scheme expanded into a specialty specific NUH Peer Support Scheme. The CST application ideology has been extended to internal medical training, Psychiatry and General Practitioner training schemes.
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