Health professionals are under increasing pressure to reduce costs while ensuring patient safety. As the number of vascular access devices (VADs) used in health care continues to increase, there is a need to reduce the complications of infection and occlusion associated with them. Needle-free devices (NFDs), also known as needleless connectors, have been available since the early 1990s and the type and variety of these devices has continued to develop. As well as the original aim of NFDs to maintain a closed system and to reduce the risk of needlestick injuries and blood spillage, NFDs are now designed with the aim of improving clinical outcomes by reducing the common complications of infection and catheter occlusion. As there are a number of NFDs available with specific designs, it is imperative that health professionals have an understanding of the different types and functions. This article provides an explanation of NFD design and functions and guidance and information about their benefits, as well as advice on preventing complications associated with their use.
Letter 1: Moving from open to laparoscopic appendicectomy (Br J Surg 2003; 90: 257-258) SirThe authors point out that the literature suggests there is a greater incidence of intra-abdominal abscess formation following laparoscopic appendicectomy. The papers do not report clearly whether an adequate wash out and drainage of the abdominal cavity was undertaken during the laparoscopic procedure. In patients with acute appendicitis and local peritonitis, wash out of the peritoneum with saline and drainage of the abdomen should be routine after laparoscopic appendicectomy. We have not observed intra-abdominal abscess formation following laparoscopic appendicectomy, which has been done routinely in our institution for the last 4 years.M. Riegler
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