Dandenong and District Hospital – general surgery and colorectal surgery projects

Supervisor(s): Associate Professor Bruce Waxman
Location: Dandenong and District Hospital Academic Surgical Unit
Ph: 9554 8657
Email: Bruce.Waxman@monash.edu

Description:

1. Primary prevention of perineal problems: Elective caesarean section for the Primigravida: An informed choice
   A combined quantitative and qualitative research project, the former documenting perineal problems of urinary, sexual and defaecatory problems in primigravidas having vaginal delivery vs caesarean section and the latter a combined focus group and questionnaire to survey women’s attitudes to being provided information about the potential risk of vaginal delivery and being given a choice of either vaginal delivery or caesarean section.
   
   
2. Care of the critically ill surgical patient: Improving junior medical officers communication skills and ability to recognise signs of critical deterioration
   A qualitative study analysing the effectiveness of the RACS based CCrISP course and a quantitative analysis of the effectiveness of the course by determining abilities of junior medical officers to assess signs of clinical deterioration. A project combined with the Simulation Centre at the Monash Medical Centre, Moorabbin and RACS.
   
   
3. Disaster management and the surgeon
   Developing a database and register for surgeons an education and training program and promoting a greater awareness of the Medical Controller’s role in DISPLAN, following the aftermath of the Bali Bombings and the Tsunami Disaster Medical Responses, shortcomings have been recognised in the efficiency and response of Australian Medical Teams. The objectives of this project would be to assess the existing disaster management arrangements, develop a database of medical officers, particularly surgeons willing to be deployed and increasing the awareness of medical practitioners of the role of Medical Controller and DISPLAN. A project combined with DISPLAN Victoria.
   
   
4. Communication skills and surgeons: Hand over and communications between junior medical staff and consultants
   A qualitative study determining the different models of medical hand over between junior medical officers in surgical units and communications with consultants. The project would also evaluate the role of nurse practitioners providing after hours medical cover for junior medical officers.
   
   
5. Medical Officers’ careers in the Australian Defence Force: Past performance and recruitment potential
   A qualititative and quantitative study evaluating the careers and achievements of medical practitioners in the Australian Defence Force and the recruitment potential and particularly the problems of return of service obligation (ROSO). A combined project with the Australian Defence Force.
   
   
6. Medical Officers’ careers in the Royal Flying Doctor Service: Past performance and recruitment potential
   A qualititative and quantitative study evaluating the careers and achievements of 5 medical practitioners in the Royal Flying Doctor Service and the recruitment potential and particularly the problems of return of service obligation (ROSO). A combined project with the Royal Flying Doctor Service.
   
   
7. Pruritus Ani and the effect of incomplete wiping of the anus after defaecation
   A quantitative study analysing the wiping habits of a series of volunteers to evaluate the effectiveness of toilet paper wiping, an alcohol based wipe and a bidet on cleansing the perineal skin. It will be combined with a clinical series of patients suffering from pruritus ani and those with incontinence and the effectiveness of wiping the anus after defaecation.
   
   
8. Wound infection and colorectal surgery
   A quantitative analysis to access the effectiveness of various techniques in reducing wound infection, particularly the use of high inspired oxygen during the operation on wound infection rates. A randomised controlled trial comparing the use of high inspired oxygen in a series of patients having elective colorectal surgery in Southern Health.
   
   
9. Gender and outcome of surgery for large bowel cancer
   A quantitative analysis of the influence of gender on the prognosis of patients having elective surgery for large bowel cancer and exploring potential hypotheses for the tendency for females to have a better prognosis and how this may influence trials of different treatment regimens in large bowel cancer combined with the Anticancer Council of Victoria and Monash Institute Reproduction & Development.
   
   
10. Small bowel obstruction and the role of Gastrograffin meal and follow-through
    A quantitative analysis on long term follow up of patients having had small bowel obstruction and gastrograffin meal and follow through as to whether they may develop further small bowel obstructions requiring hospital admissions in the future.
    
    
11. Laparotomy, division of adhesions and the use of a physical barrier in preventing subsequent adhesions and managing chronic abdominal pain
    A quantitative analysis of patients undergoing surgery before the division of adhesions is only either with small bowel obstruction or chronic abdominal pain and the effectiveness of physical barriers viz. spray gel® and Seprafilm® in reducing the frequency of admissions to hospital with small bowel obstruction or chronic abdominal pain.
    
    
12. Division of abdominal adhesions and the irrigating scalpel: Evaluation of the effectiveness and morbidity associated with the use of the irrigating scalpel
    A quantitative study auditing the results of operations using the irrigating scalpel and an evaluation of the physiological basis of its effectiveness. This satellite project will be on the effect of irrigation solutions on rusting of surgical blades.
    
    
13. Irrigating anastomosis technique: Evaluation of its effectiveness and morbidity
    A qualitative study to assess the use of the irrigating anastomosis technique in increasing the efficiency of suture anastomosis and its effectiveness on anastomotic healing and wound infection. A quantitative audit to evaluate the effectiveness of this technique.
    
    
14. Defacatory problems after vaginal delivery
    Socially disabling problems arise from pelvic floor injury after vaginal delivery. The advent of physiological measurements of anorectal function has allowed the 52 improved assessment of these difficulties and subsequent planned approach to surgical management. This clinically based project aims to further refine the tools of assessment and monitoring of anorectal dysfunction and its subsequent planned management, and establishment of an education program for women in the child bearing age group.