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768 results on '"Stansby, G."'

163. Prediction Of Surgical Site Infections After Major Surgery Using Visible And Near-Infrared Spectroscopy.

Author

Back, Nathan, Cohen, Irun R., Lajtha, Abel, Lambris, John D., Paoletti, Rodolfo, Maguire, David J., Bruley, Duane F., Harrison, David K., Ives, Charlotte L., Harrison, D. K., and Stansby, G. S.

Abstract

Final results of an investigation into whether oxygen saturation of tissues (StO2, measured by spectrophotometry) could predict surgical site infections (SSI) after major abdominal surgery are presented StO2 was measured on the arm and wound site pre-operatively and then at 12, 24 and 48 hours post-operatively. A Whitland Research RM200 was employed as the visible lightguide spectrophotometer. StO2 measurements using this machine were designated SSO2 (skin SO2). A Hutchinson Inspectra® Model 325 was used for the near infrared spectroscopy (NIS) measurements. StO2 measurements using this machine were designated MSO2 (muscle SO2). Of 59 patients (38 males, 21 females), 42 healed uneventfully and 17 developed SSI. The overall infection rate was 28.8%. No significant differences were seen in wound SSO2 between outcome groups at any stage. At 12 hours there was a significant difference between the two groups with respect to mean wound MSO2 (A= 58.3+/-21.6%, B=42.2+/-16.6%, p=0.005, 95% confidence interval = 5.26, 26.98). A receiver operating characteristic curve showed that when a wound MSO2 of 53% was chosen as the threshold to classify potential infection a sensitivity of 71% and a specificity 73% (chi-squared test, p=0.002) was achieved. The use of the near-infrared spectrophotometry as a tool to predict wound infections should be further evaluated and advocated. [ABSTRACT FROM AUTHOR]

Published
2008
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164. Assessment of Oxygenation and Perfusion in the Tongue and Oral Mucosa by Visible Spectrophotometry and Laser Doppler Flowmetry in Healthy Subjects.

Author

Back, Nathan, Cohen, Irun R., Lajtha, Abel, Lambris, John D., Paoletti, Rodolfo, Kang, Kyung A., Harrison, David K., Bruley, Duane F., Singh, D.B., Stansby, G., and Harrison, D.K.

Abstract

Use of Visible Light Spectrophotometry (VLS) and Laser Doppler Flowmetry (LDF) is currently being studied by the authors to assess the viability of tissue margins in colon resection and to assess mucosal oxygenation in the colon. Thus, as a preliminary study it was necessary to evaluate whether there is any systematic inter-probe variability of the measurements by VLS and LDF. The oral mucosa was used as a model. Methods SO2 with VLS (Whitland Research RM200) and blood flow with LDF (Moor Instruments DRT4) were measured at 10 sites each on the tongue and oral mucosa of 10 healthy volunteers at 0, 6 and 24 hours using 3 different probes for VLS and 2 probes for LDF. Results The results showed that the SO2 measurements by VLS using the different probes on the tongue and mucosa were significantly correlated (P<0.05). SO2 values at 6 hours were significantly higher than at 0 and 24 hours (P<0.05) in all but one case. SO2 measurements were not correlated with LDF. LDF measurements by the 2 probes were correlated significantly (P<0.05) but the standard deviations were very large. Conclusions SO2 measurements on the oral mucosa are reproducible. Due to the large variations in LDF, VLS is likely to be the more clinically useful tool for identifying mucosal ischaemia [ABSTRACT FROM AUTHOR]

Published
2008
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169. Vascular 08

Author

Mohan, I.V., primary, Kan, Y.M., additional, and Stansby, G., additional

Published
2002
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199. Interpretation of patient-reported outcome measures for varicose vein surgery.

Author

Nesbitt, C., Wilson, W. R. W., Lees, T. A., and Stansby, G.

Subjects
QUALITY of life, VARICOSE veins, HEALTH outcome assessment, POSTOPERATIVE period, QUESTIONNAIRES, SCALE analysis (Psychology), VISUAL analog scale, PREOPERATIVE period, DATA analysis software, PATIENTS' attitudes, ADVERSE health care events, SURGERY
Abstract

Objectives: Since 2009 the National Health Service (NHS) has been collecting patient- reported outcome measures (PROMs) following varicose vein interventions. The objective of this manuscript was to interrogate the one-year PROMs data with respect to varicose vein intervention and to discuss its potential impact on the provision of service. Methods: We interrogated the one-year PROMs data with respect to potential impact on the provision of service. Results: In total, 37,521 varicose vein operations were performed during the study period (1April 2009-30 April 2010). A total of 15,808 preoperative questionnaires were completed and returned and 12,509 were linked to Hospital Episode Statistics episodes. A total of 8127 postoperative questionnaires were completed and linked to the preoperative questionnaires. For the EuroQuol (EQ) 5D questionnaire average preoperative score across the completed data-set was 0.773. The postoperative health gain was 0.094. Fifty-three percent of patients had improved postoperative scores, 33% reported no change, while 14% reported a reduction in their postoperative EQ-5D score. Pain/discomfort was the only domain where patients reported any negative symptoms; 72% (5390) reported pain/ discomfort preoperatively and 37% (2804) postoperatively. In total, 62.6% (4685) reported no pain/discomfort following surgery A total of 7167 complete, linked and eligible data- sets were observed for the Aberdeen Varicose Vein Questionnaire (AVVQ). The average preoperative score was 18.75. The average postoperative score was 10.76. This represented a reduction in symptom scores of one-half following intervention. The lowest improvements were witnessed in patients with the lowest preoperative scores (least severe symptoms). Additional postoperative questions highlighted the improvements conferred from varicose vein surgery with 90.3% of patients reporting an improvement in their problems from varicose veins following surgery and 85% describing their operative results as excellent, very good or good. Conclusion: These data have shown variable improvements following venous interventions. PROMs are likely to have significant implications for health care in the NHS on a number of levels including provision of funding and future planning of services. [ABSTRACT FROM AUTHOR]

Published
2012
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