Vascular techniques

Mohamad Fadzly Mohamad Yusof

This document discusses the management of acute limb ischemia through thrombectomy or embolectomy. It provides details on: 1) Recognizing acute limb ischemia and starting heparin treatment while relieving pain and checking limb viability. 2) Performing an embolectomy by making a small arteriotomy above the bifurcation to insert a Fogarty catheter and remove the embolus. 3) Closing the arteriotomy with interrupted sutures and continuing heparin and warfarin treatment while monitoring for complications.

Management of abdominal vascular injury

Bashir BnYunus

This document discusses the management of abdominal vascular injuries. It covers the epidemiology, anatomy, presentation, investigations, surgical approaches, challenges, and complications of abdominal vascular injuries. Resuscitation and damage control techniques are emphasized. Exposure and control of the aorta, inferior vena cava, and iliac vessels are described in detail. Primary repair or ligation are the main repair options, with endovascular techniques also playing a selective role. Mortality rates are high and prompt diagnosis and management are critical due to the risk of exsanguinating hemorrhage.

Endovascular surgery

Anil Meetei

Dr. Anil Meetei presented on endovascular surgery and its various procedures and techniques. Endovascular surgery involves minimally invasive procedures using catheters and instruments inserted into blood vessels. Some key procedures discussed included balloon angioplasty, stenting, atherectomy to remove plaque, thrombolysis to treat clots, and filters to prevent pulmonary embolism. Factors such as device sizing, access points, imaging, and complications were also reviewed.

Saphenous Vein Harvesting

This document discusses saphenous vein harvesting for coronary artery bypass grafting (CABG). It covers the anatomy of the saphenous vein, techniques for harvesting including open and endoscopic methods, tips for avoiding complications, and postoperative care. The saphenous vein is commonly used as a graft due to its accessibility and handling properties, though the internal mammary artery is preferred due to better long-term patency rates. Care must be taken during harvesting to avoid intimal injury, nerve damage, and ensure hemostasis and wound closure to prevent infection.

Vascular trauma

1. The document discusses various types of vascular injuries including sharp, blunt, transection, laceration, and contusion injuries. 2. Signs of vascular injury in the extremities include pain, pallor, pulselessness, perishing cold, paresthesia, paralysis and the "P's". Complications can include bleeding, ischemia, and complications from vascular injury. 3. Evaluation of vascular injuries involves assessment of signs like hard or soft pulses, Doppler, CT angiography, and possible urgent exploration and repair in cases of threatened limbs with paresthesia and paresis.

G03 vascular injury

Claudiu Cucu

Vascular injuries require prompt evaluation and treatment to prevent limb loss from hemorrhage or ischemia. Physical exam and Doppler are initial steps to detect hard signs of injury warranting arteriography or surgery. Soft signs may be managed non-operatively with serial imaging. Scoring systems help determine limb salvability in mangled extremities based on injury mechanism, ischemia time, age, and hemodynamics. Revascularization generally precedes fixation to restore blood flow, though temporary shunts allow staged procedures. Close coordination between specialties optimizes limb salvage.

This document is an introduction to the European Manual of Medicine: Vascular Surgery. It provides a brief history of vascular surgery in Europe, highlighting pioneers from different countries. It also discusses the development of atherosclerosis and the role of lipids in peripheral arterial disease. The introduction aims to give context to the manual and orient the reader to the scope and content covered.

Seminar on basic principles of endovascular surgery

Biswajit Deka

- Endovascular surgery uses catheter-guided devices to restore blood flow in occluded vessels by delivering thrombolytic agents directly to clots or removing clots mechanically. - The technique was pioneered in the 1950s-1980s through developments like the Seldinger technique for arterial access using guidewires, methods for extracting thrombus using balloon catheters, and introducing balloon angioplasty and stents. - Key devices used in endovascular procedures include guidewires, catheters, balloons, stents, and stent grafts, each with characteristics suited to their purpose like accessing vessels, delivering thrombolytic agents, dilating stenoses, scaffolding vessels, and excluding aneurys

Stapling devices in surgery

Ankita Singh

This document summarizes the history and development of stapling devices in surgery from 1908 to present day. It begins with early stapling instruments developed in Hungary in the early 1900s and progresses through key innovations such as disposable, sterile cartridges; linear, circular, and hemorrhoidal staplers; adoption of titanium staples; and development of laparoscopic staplers. The document also discusses tissue properties, biomechanics of stapling, factors that influence optimal staple formation such as precompression time, and evidence that stapling results in fewer leaks and strictures compared to hand-sewn anastomoses.

Minimal invasive cabg

Deep Chandh

The document discusses various techniques for coronary artery bypass grafting (CABG), including conventional on-pump CABG using cardioplegic arrest and cardiopulmonary bypass (CPB), and minimally invasive techniques like off-pump CABG (OPCAB) and mid-cabinal CABG (MIDCAB) without use of CPB. It summarizes the technical concepts of different graft conduits, procedures like MIDCAB using stabilization devices, and clinical trials comparing on-pump CABG to off-pump techniques. The largest trial found no difference in major cardiovascular outcomes between on-pump and off-pump CABG, though off-pump was associated with less bleeding, transfusions, and acute kidney injury

Surgicaldrainsand their types

Faryal Tebani

Surgical drains have several purposes and types. They help evacuate fluids from surgical sites to prevent infection and allow wounds to heal. Common types include closed suction drains like Jackson-Pratt drains and open drains like Penrose drains. Placement, securing, and care of drains is important to avoid complications like infection, displacement, or blockage. Drains are removed once drainage decreases significantly or they are no longer needed.

TAPP : tips,tricks & technique

piyushpatwa

Coronary Artery Bypass Graft (CABG) Surgery

Muhammad Eimaduddin

Lower Limb Vascular Trauma

Saeed Al-Shomimi

This document provides an overview of lower limb vascular trauma, including: - It accounts for 80% of all vascular trauma cases, with the lower extremities involved in two-thirds of patients. - Presentation can include hard signs like active bleeding or soft signs like pulse deficits. Complications include thrombosis, embolization, and rupture. - Diagnosis involves clinical examination, pulse oximetry, Doppler ultrasound, duplex ultrasound, and angiography. - Management includes immediate hemorrhage control, volume resuscitation, operative strategies like suturing, grafting or shunting, and damage control techniques like ligation if needed. Case examples from the author's experience are also summarized.

Endovascular Prep Basic

Staplers in Surgery

Vinod Badavath

Principles of liver resection.pptx

thubelihlezenda

Emergency Thoracotomy

SCGH ED CME

This document discusses emergency thoracotomy for traumatic injuries. It outlines indications for the procedure including hemodynamic instability from penetrating chest injuries or cardiac tamponade. Steps of the procedure are described including a clamshell incision and interventions like controlling hemorrhage, cardiac massage, and aortic clamping. Contraindications include prolonged downtime or signs of unsurvivable injuries. Studies show improved survival in penetrating injuries with signs of life when thoracotomy is performed in the ED. Proper training and equipment are needed to perform this critical lifesaving procedure.

Arterial trauma

This document discusses extremity vascular injuries, which can result in limb loss or death if not properly treated. The most common causes are road traffic injuries. Clinical features include signs of active bleeding, ischemia, pain, pallor, and pulse absence. Imaging like duplex scans and angiography can help diagnose the injury. Early surgical repair of damaged blood vessels is needed to restore blood flow. Complications include compartment syndrome, which requires fasciotomy to reduce pressure. Close monitoring is also needed after reperfusion to watch for systemic effects. With proper emergency treatment and surgery, many extremities can be saved from amputation.

Aortic SURGERY Intro

SREE GOKULAM MEDICAL COLLEGE AND RESEARCH FOUNDATION

Critical limb ischemia. povd . dr mnr

Critical limb ischemia refers to severe reduced blood flow in the limbs that puts the extremities at risk for gangrene and amputation. It is usually caused by advanced peripheral artery disease resulting from atherosclerosis. There are two main types - acute limb ischemia which is a surgical emergency requiring urgent revascularization to prevent amputation, typically due to an embolism or thrombosis; and chronic limb ischemia which is caused by progressive atherosclerosis and not an emergency but requires treatment to prevent limb loss. Medical management focuses on risk factor modification through smoking cessation, tight blood pressure and glucose control, and lipid lowering therapy, while exercise is recommended to improve symptoms.

Vascular trauma

This document summarizes the assessment and treatment of vascular trauma. It discusses the history of vascular surgery, mechanisms of injury, initial assessment and treatment focusing on controlling bleeding and ischemia. Signs of arterial injury are outlined. Surgical management may involve angiography, open exploration, repair, bypass or ligation. Compartment syndrome is a risk and location of injury impacts outcomes. Treatment of venous and carotid trauma is also addressed.

Aiod

Mai Parachy

This document discusses surgical bypass options for aorto-iliac occlusive disease (AIOD). It defines AIOD and describes the standard TASC classification system. The main indications for surgical intervention are claudication or chronic limb-threatening ischemia. Surgical bypass options described include aortoiliac endarterectomy, aortobifemoral bypass, femorofemoral bypass, axillofemoral bypass, and obturator bypass. Postoperative patency rates for different procedures are provided.

Bowel anastomosis

Asif Ansari

This document discusses intestinal anastomosis, which involves creating a connection between intestinal loops or ends. Intestinal anastomosis is commonly performed for elective and emergency cases involving conditions like cancer, infections, or obstructions. The key factors for a successful anastomosis are minimal contamination, good blood supply, and tension-free apposition of the intestinal ends. The document compares hand-sewn and stapled techniques, noting that while staplers are faster, studies have found no difference in outcomes between the two methods. Proper patient factors and surgical technique are more important than the specific method used.

Laparoscopic inguinal hernia repair (TAPP)

Dr-Maryam Khan

This document provides information on direct and indirect inguinal hernias, including their anatomy and symptoms. It also describes the laparoscopic procedure for treating inguinal hernias, including positioning the patient, dissecting the hernia sac, placing mesh to cover the defect, and post-operative care. The laparoscopic approach has advantages over open surgery such as smaller incisions, less tissue disruption, and less post-operative pain, though it requires practice to learn.

Colorectal surgery and stomas

meducationdotnet

Abdominal surgery and stomas are discussed, including: - Common abdominal procedures for colorectal cancer like right/left hemicolectomy and anterior resection are described. - Complications of surgery like anastomotic leaks and paralytic ileus are also covered. - Stomas, specifically ileostomies and colostomies, are defined as ways to divert feces after removal of part of the colon and rectum. Differences between ileostomies and colostomies and potential complications are outlined.

Percutaneous Coronary Intervention

Ladi Anudeep

Percutaneous coronary intervention (PCI) is a non-surgical procedure used to treat narrowed coronary arteries of the heart. During PCI, a catheter is inserted through the groin or arm and threaded to the blocked artery. A deflated balloon at the catheter's tip is inflated to flatten the plaque against the artery wall. In some cases, a stent is placed to keep the artery open. PCI aims to restore blood flow, relieve chest pain, and reduce the risk of heart attack. Patients typically recover within a day but are advised to limit activity for 1-2 weeks.

Aneurysm

Khemsagar Patel

This document provides an overview of aortic aneurysms. It begins with definitions and classifications of aneurysms based on location, morphology, and etiology. Abdominal aortic aneurysms are discussed in more detail, including risk factors, natural history if left untreated, methods of diagnosis using imaging modalities, and treatment options of open surgical repair versus endovascular repair. Complications of each treatment method are also summarized. The document aims to cover the historical aspects, epidemiology, pathophysiology, clinical presentation, diagnostic evaluation and management principles of aortic aneurysms.

What's hot

Vascular surgery

Mi rincón de Medicina

Seminar on basic principles of endovascular surgery

Biswajit Deka

Stapling devices in surgery

Ankita Singh

Minimal invasive cabg

Deep Chandh

Surgicaldrainsand their types

Faryal Tebani

TAPP : tips,tricks & technique

piyushpatwa

Coronary Artery Bypass Graft (CABG) Surgery

Muhammad Eimaduddin

Lower Limb Vascular Trauma

Saeed Al-Shomimi

Endovascular Prep Basic

Staplers in Surgery

Vinod Badavath

Principles of liver resection.pptx

thubelihlezenda

Emergency Thoracotomy

SCGH ED CME

Arterial trauma

Aortic SURGERY Intro

SREE GOKULAM MEDICAL COLLEGE AND RESEARCH FOUNDATION

Critical limb ischemia. povd . dr mnr

Vascular trauma

Universidad Nacional del Altiplano

Aiod

Mai Parachy

Bowel anastomosis

Asif Ansari

Laparoscopic inguinal hernia repair (TAPP)

Dr-Maryam Khan

Colorectal surgery and stomas

meducationdotnet

What's hot (20)

Vascular surgery

Seminar on basic principles of endovascular surgery

Stapling devices in surgery

Minimal invasive cabg

Surgicaldrainsand their types

TAPP : tips,tricks & technique

Coronary Artery Bypass Graft (CABG) Surgery

Lower Limb Vascular Trauma

Endovascular Prep Basic

Staplers in Surgery

Principles of liver resection.pptx

Emergency Thoracotomy

Arterial trauma

Aortic SURGERY Intro

Critical limb ischemia. povd . dr mnr

Vascular trauma

Aiod

Bowel anastomosis

Laparoscopic inguinal hernia repair (TAPP)

Colorectal surgery and stomas

Similar to Vascular techniques

Percutaneous Coronary Intervention

Ladi Anudeep

Aneurysm

Khemsagar Patel

ANGIOPLASTY.pptx

Sailee Pomendkar

Angioplasty is a minimally invasive medical procedure used to unblock blood vessels, most commonly the coronary arteries. During balloon angioplasty, a balloon-tipped catheter is used to compress plaque and widen the artery. Stent angioplasty involves placing a small metal mesh tube called a stent to maintain artery patency. Angioplasty is used to treat conditions like coronary artery disease and angina. Patients typically stay in the hospital for 1-2 days after angioplasty and can return to normal activities after a week of limited physical exertion and gradual exercise. While angioplasty has benefits over alternatives like bypass surgery, risks include pain, bleeding, and artery rupture.

L15 calcaneus

Claudiu Cucu

Fractures of the calcaneus can cause long-term disability if not treated properly. While the best treatment method is controversial, operative treatment via open reduction internal fixation may provide better outcomes than non-operative treatment by restoring anatomy and preventing malunion. However, operative treatment also carries risks of wound complications. Treatment must be individualized based on the injury pattern, patient characteristics, and surgeon experience to weigh the risks and benefits of operative versus non-operative management.

Endovascular Aortic Aneurysm Repair

Huthayfa Ghanem

The document discusses endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms. It presents a case of a 62-year-old male undergoing EVAR for a 5.5cm AAA. EVAR involves deploying a graft via catheter to exclude the aneurysm from blood flow. Complications can include endoleaks, where blood leaks outside the graft but within the aneurysm sac. The main types of endoleaks are type I (inadequate seal at graft ends), type II (collaterals inside the sac), and type III (graft component disruption). EVAR has advantages over open repair like less invasiveness but risks like increased reintervention rates.

Anastomosis surgery

ZahraMobasher1

CSOM SURGERIES

Dr Harjitpal Singh

This document discusses different surgical procedures for chronic suppurative otitis media (CSOM), including cortical mastoidectomy, combined approach tympanoplasty (CAT), and canal wall down procedures like radical and modified radical mastoidectomy. It outlines the objectives, indications, surgical steps, and key points for cortical mastoidectomy and CAT. These intact canal wall surgeries aim to eradicate disease while preserving the ear canal. Canal wall down procedures are indicated for more extensive disease and create a common cavity in the mastoid, middle ear, and ear canal.

$Scaphoid fractures$ $Scaphoid fractures$

Scaphoid fractures

DrAbdulSuhail

This document discusses the nonunion of scaphoid fractures, including causes, diagnosis, consequences, and management approaches. It notes that the incidence of scaphoid fracture nonunion ranges from 5-50% depending on studies. Diagnosis involves clinical examination, repeat x-rays, bone scans, and MRI. Consequences include degenerative changes and avascular necrosis. Management depends on fracture stability and can include prolonged immobilization, electrical stimulation, osteosynthesis using K-wires, screws, or plates, bone grafting, and salvage procedures like proximal row carpectomy. The author advocates early surgical fixation and vascularized bone grafting in some cases to improve healing outcomes.

Amputation Topic Orthopaedics Presentation

AIIMS JODHPUR

This document provides information about amputation indications, surgical principles, and post-operative care. It discusses various types of amputations for both lower and upper limbs. The main indications for amputation include peripheral vascular disease, trauma, malignancy, infection, burns, and frostbite. The surgical principles focus on choosing an amputation level for optimal function, creating adequate skin and muscle flaps, and hemostasis. Post-operative care involves pain management, rigid dressings, physiotherapy, and prosthetic training to prevent complications like infection, contractures, and phantom limb pain.

Osteotomies around the hip

Drkabiru2012

The document discusses osteotomies around the hip, including pelvic and proximal femoral osteotomies. It covers indications, classifications, principles, techniques for various osteotomies like Salter, Steel, Ganz, Pemberton, Dega, Chiari, Schanz, Lorenz, and femoral osteotomies for conditions like slipped capital femoral epiphysis, Perthes disease, congenital coxa vara and non-unions. Post-operative principles and complications of osteotomies are also discussed.

Av fistula.pptx

Pradeep Pande

This document provides tips and instructions for using a PowerPoint presentation (PPT) on arteriovenous fistula (AVF). The PPT includes blank slides for key topics where the presenter can elicit student responses. It recommends showing blank slides first to engage students before providing information. The PPT covers AVF demographics, etiology, pathophysiology, clinical features, investigations, management, and prevention. It is designed for active learning through multiple revisions of blank and filled slides. The document also provides links to access the full PPT collection.

Principles of amputation

Aminu Umar

This document outlines principles of amputation, beginning with definitions and a brief history. It discusses indications for amputation including the 3 D's (dead, dying, or damn nuisance limb) and covers pre-operative, intra-operative, and post-operative principles and considerations. Complications are addressed as well as amputation in children. Prosthetics and rehabilitation goals are also summarized. The document provides an overview of best practices and factors to consider for successful amputation outcomes.

Plastia mitral 2012

Ankle arthrodesis anterior approach and trans fibular approach which is better

BipulBorthakur

This document compares the anterior approach and trans fibular approach for ankle arthrodesis surgery. It details the surgical techniques for both approaches and presents the results of a study comparing clinical outcomes for 60 patients undergoing one of the two procedures. The anterior approach provided better exposure of the ankle joint but carried a higher risk of neurovascular injury. The trans fibular approach resulted in less wound complications and slightly better hindfoot alignment, though it required additional fixation of the fibula. Overall, both approaches showed similar improvements in pain and function scores with a slightly faster time to fusion for the trans fibular approach.

Extra cranial aneurysms

Ronald Mbiine

An extracranial aneurysm is a permanent dilatation of an artery outside the skull. The document defines and classifies different types of aneurysms including aortic, carotid, iliac, and popliteal aneurysms. Abdominal aortic aneurysms are the most common type and usually occur below the renal arteries due to atherosclerosis. They may be asymptomatic, symptomatic but unruptured, or ruptured with high mortality. Treatment involves surveillance of small aneurysms and surgery such as open repair or endovascular stent grafting for larger or symptomatic aneurysms to prevent rupture.

$Surgical approach intercondylar/ supracondylar humerus fracture$ $Surgical approach intercondylar/ supracondylar humerus fracture$

Surgical approach intercondylar/ supracondylar humerus fracture

Khadijah Nordin

This document discusses the surgical approach for intercondylar/supracondylar humerus fractures using a chevron osteotomy. It describes the posterior surgical approach as being safer and providing better visualization of the articular surface compared to anterior approaches. The key steps of the posterior approach are outlined, including a midline skin incision, raising subcutaneous flaps, isolating the ulnar nerve, preparing the osteotomy site with saw and chisel, performing the chevron-shaped osteotomy, reducing and fixing the joint fragments, and coupling the fragments to the metaphysis. Complications of the procedure are also listed.

Marfan syndrome

Margaret Pagington

This document discusses Marfan Syndrome in a patient. It describes tests that revealed the patient has mitral valve prolapse, aortic dissection, and aortic dilation causing aortic regurgitation. Based on these results and the patient's family history, he was diagnosed with Marfan Syndrome according to clinical guidelines. The patient requires surgery to repair the aortic dissection and replace his aortic valve. After surgery, he will need to take beta blockers long-term to prevent blood clots.

Vascular.ppsx

OmarAhmedSaleh2

This document discusses atherosclerosis and aneurysms of the aorta and iliac arteries. It describes a postmortem specimen showing the aorta and iliac arteries affected with multiple white patches and ulcerations due to atherosclerosis. Complications of atherosclerosis include chronic and acute ischemia from vessel narrowing as well as aneurysm formation from weakening of the arterial walls. Another specimen shown is an abdominal aortic aneurysm containing thrombi on the wall, which is a common complication of atherosclerosis and hypertension and poses risks of rupture or distal embolism.

Meniscal Injuries

Salman Syed

This document discusses meniscal injuries of the knee. It provides information on meniscal anatomy, vascular supply, types of tears including longitudinal, horizontal, and bucket handle tears. It outlines signs and symptoms of meniscal tears including joint line tenderness. Physical exam tests like McMurray's test and MRI are discussed for diagnosis. Treatment options including non-surgical management for small peripheral tears versus surgical options like partial meniscectomy, meniscal repair, and allograft transplantation are summarized. Post-operative rehab and potential complications are also briefly mentioned.

Hip Periprosthetic Fracture.pptx

Ahmed Ashour dr.

This document discusses hip periprosthetic fractures that occur around the stem of a total hip arthroplasty. It describes risk factors, classifications, evaluations, and treatments for these fractures. For acetabular fractures, the Letournel classification is used and treatment depends on stability and motion. For femoral fractures, the Vancouver classification is based on fracture site, stem stability, and bone quality. Types A, B1, B2, and C fractures are described along with appropriate fixation methods like plates, screws, cables or cerclage wires depending on the specific situation.

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Vascular emergencies tcd sjh 2017

This document discusses the presentation, diagnosis, and treatment of vascular emergencies. It notes that abdominal aortic aneurysm, ischemia due to occlusion or embolism, and arterial trauma are common vascular emergencies. Imaging and consultation with vascular surgery is recommended to determine if the patient requires open surgery, endovascular aneurysm repair (EVAR), or other procedures. Immediate transfer to the operating theater is important for ruptured aneurysms to increase chances of survival. Both open surgical repair and newer endovascular techniques are covered.

Beyond consent

1) The document discusses the evolving standards for informed consent in medical procedures, moving from a professional standards approach to a reasonable patient standard that requires disclosure of all material risks. 2) Ensuring patient understanding of medical procedures and risks is challenging, as multiple factors like timing, education level, and context can influence comprehension. 3) Effective consent requires an ongoing process of discussion tailored to individual patient needs that incorporates written information, multimedia tools, and shared decision making to build trust and understanding.

Rcsi global surgery (final)

The document discusses COSECSA's efforts to address the shortage of surgeons in East, Central and Southern Africa. It notes that over 5 billion people lack access to safe and affordable surgery. COSECSA has worked to enhance surgical training programs, increase the number of examinations, and build infrastructure like the East and Central African Journal of Surgery. Through partnerships with organizations like RCSI, it has helped train over 1,600 surgeons who have an 84% retention rate in Africa. COSECSA aims to continue developing sustainable indigenous training initiatives to address the large unmet need for surgical services in the region.

Challenges in the diabetic foot 2016

This document discusses the challenges in treating diabetic foot problems. It notes that neuropathy, deformity, trauma, ulceration, infection, ischemia and limb loss are common complications. A thorough assessment is needed to determine if the foot problem is neuropathic, ischemic, involves osteomyelitis, Charcot neuroarthropathy or a combination. Treatment depends on the underlying issues but may include offloading, antibiotics, debridement, revascularization procedures like angioplasty or bypass. Multidisciplinary care with specialists like vascular surgeons is important for managing the complex challenges of the diabetic foot.

Diabetic Foot 2016

This document discusses diabetic foot management and prevention. It covers neuropathy, vascular disease, infection risk and treatment options. Sensory testing like monofilaments can identify high-risk patients. Imaging and tests like ABI, toe pressures and oximetry evaluate vascular status. A multidisciplinary approach is needed to address structural, neurological and vascular issues. Treatment may include offloading, wound care, antibiotics, revascularization or amputation depending on the specific patient presentation and risk factors.

Faculty of radiologists 2015

The document describes a new surgical training pathway that aims to address issues with the traditional model. The key aspects of the new pathway include: 1) Earlier and more standardized selection of trainees based on multiple criteria including aptitude tests, interviews, and past performance. 2) Structured progression of trainees based on ongoing competency-based assessments rather than time served. Assessments include online evaluations, logbooks, exams, and skills assessments. 3) Matching of trainees to specialized surgical programs in the second year based on performance and preference. This aims to provide more certainty around specialty choices earlier in training.

Establishing a Foot protection Clinic

This document summarizes the work of Sean Tierney and the Diabetic Foot Protection Service at Tallaght Hospital in Dublin, Ireland. The service was established in the 1990s to address the high rates of lower limb amputation among diabetic patients through a multidisciplinary team approach. The team includes vascular surgery, orthotics, nursing, podiatry and other specialties. Through risk assessment, imaging, offloading, infection treatment and revascularization procedures when needed, the service aims to heal foot ulcers and prevent amputation. Outcomes data shows reductions in amputation rates and hospital bed days used since establishing the coordinated care model.

Peripheral vascular disease 2015

This document discusses peripheral arterial occlusive disease (PAOD), including its presentation and differential diagnosis, assessment and management of cardiovascular risk, and methods for managing symptoms and preventing limb loss. It addresses PAOD as a predictor of cardiovascular disease and its real risks, such as limitation on exercise quality of life, risk of limb loss, and increased global health risk. The document outlines treatments for PAOD that can reduce global risk, provide symptom relief, and treat symptoms, including exercise, drug therapy, endovascular procedures, open surgery, and techniques for limb salvage.

Providing a lymphoedema service

This document discusses lymphedema, including its classification, diagnosis, assessment, grading, and treatment options. It classifies lymphedema as primary or secondary and notes the prevalence among vascular clinic patients. Treatment options discussed include skin care, compression garments, manual lymphatic drainage, multilayer bandaging, pneumatic compression devices, drug therapy, laser therapy, and surgical options like liposuction and lymphatic reconstruction. Integrated multidisciplinary care is emphasized as most effective for managing this chronic condition long-term.

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The document discusses leg ulcers, their causes, and vascular assessment. The major causes of leg ulcers are venous disease (81%), arterial disease (10%), mixed arterial and venous disease (7%), diabetic neuropathy (1%), and malignancy (1%). Venous ulcers are typically recurrent and painless, showing signs of venous hypertension like haemosiderin and lipodermatosclerosis. Arterial ulcers present with a history of claudication and reduced ABIs. Treatment involves compression therapy for venous ulcers and vascular surgery for arterial insufficiency or venous reflux. Differential diagnosis of leg ulcers considers etiology like vasculitis, neuropathy, or infection.

Acute limb ischaemia

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The document discusses various issues in abdominal aortic aneurysm (AAA) management, including screening, surveillance, predicting operative risk, and choosing between open repair and endovascular aneurysm repair (EVAR). It provides details on screening criteria in different countries, predictors of mortality for open repair, outcomes from EVAR clinical trials showing lower reintervention rates compared to open repair, and types of endoleaks after EVAR. The document also describes fenestrated and branched endografts for more complex aneurysm anatomies and notes there are still unresolved issues regarding EVAR indications.

Diabetic foot 2015

The document discusses diabetic foot disease and prevention. It notes that diabetic foot ulcers and amputations pose a major global health burden. Effective prevention requires risk assessment of patients' structural foot issues, sensation, and vascular status. Those at highest risk require regular screening, education on foot care, and customized treatment like offloading or revascularization depending on their specific issues. Ongoing management may involve wound care, infection treatment, or novel vascular interventions to help avoid amputation.

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The document discusses the case of a 62-year-old man who experienced a transient ischemic attack. It summarizes the diagnostic workup, including imaging and vascular testing, to determine if the patient had a stroke and the location of any blockages. The document then reviews the evidence and guidelines for treatment of carotid artery disease, including whether the patient is a surgical candidate. Overall, the key information provided is on evaluating and treating patients who experience transient ischemic attacks or minor strokes due to carotid artery disease.

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The document discusses various issues related to venous disease including varicose veins, chronic venous hypertension, and leg ulcers. It summarizes guidelines for referring patients for treatment of varicose veins as well as results from the Edinburgh Vein Study. The document also discusses how varicose veins negatively impact quality of life and how surgical treatment can improve quality of life. Treatment options for varicose veins, superficial thrombophlebitis, and venous ulcers are presented.

Pcs sligo 2013

This document outlines the requirements and guidelines for the Professional Competence Scheme operated by the Royal College of Surgeons in Ireland (RCSI). Surgeons must complete a minimum of 50 credits each year from activities in several categories: external activities (20 credits), internal activities (20 credits), personal learning (5 credits), research and teaching (2 credits), and one audit (12 credits). Credits are earned by participating in various professional development and quality improvement activities. Surgeons record their activities and hours in an online portal, and may be audited to ensure compliance with the scheme's requirements.

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Effective communication skills are essential for high quality medical practice. Communication skills should be assessed separately from clinical skills as they require a structured approach distinct from a busy clinical agenda. Communication skills can be assessed using simulated patient encounters, with a focus on information gathering, explanation and relationship building. The Calgary-Cambridge model provides a framework for teaching and assessing key components of the medical consultation.

Wound management Association Ireland 2011

The document discusses various topics related to chronic wounds including: 1) Surgical interventions and trials showing benefits of compression therapy and surgery for venous disease. 2) Factors that can cause ulcers like venous disease, arterial disease, diabetes, and infection. Tests to assess these factors are discussed. 3) Treatments addressed include compression therapy, antibiotics, wound dressings, biopsy, excision and grafting, and surgery for venous and arterial issues.

Introduction