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From 50% Mortality to Zero

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21 Mar 2013

A presentation at the annual President’s Meeting at Britain’s oldest surgical Royal College today highlights recent advances which have seen the treatment of devastating conditions historically associated with 50% mortality rates reduced to virtually zero. The Royal College of Surgeons of Edinburgh (www.rcsed.ac.uk); later this month opening its first centre of operations in Birmingham to cater for the 80% of its members based in England and Wales; will see a number of presentations on topics relevant to surgery and patient safety during its prestigious President’s Meeting, which this year is on the theme of “Emergency Care in the 21st Century”.

It’s been estimated that any given day, over 600 people in the UK will be in hospital suffering from intestinal failure (a condition where the gut fails to function adequately) and needing to be fed intravenously for more than 28 days. These patients become dependent on long-term care and suffer a poor quality of life, unable to feed themselves normally or use the bathroom. A steady rise year on year in the number of these problems can be linked not just with trauma (accidents, knife wounds etc) but also with an increasingly older and frail population undergoing more complex surgical procedures - such as for cancer – for which they would have previously been deemed unfit. In addition, advances in emergency treatment mean that if life-threatening problems do develop, patients are more likely to survive but remain dependent on round-the-clock help.

The “Emergency Care in the 21st Century” conference’s keynote lecture on this subject is delivered by Professor Gordon Carlson from the National Intestinal Failure Centre in Salford. Protocols developed by the specialised unit, which is funded by NHS England, are resulting in the world’s best record in the treatment of these conditions. According to Professor Carlson;

“Severe acute intestinal failure, especially when combined with infection in patients with an open abdomen, has usually been associated with considerable mortality, with death rates over 50% reported within the last 20 years and even now, despite advances in critical care medicine, the most recent statistics still show death rates in excess of one in four. I’m delighted to present how we have developed a dedicated multidisciplinary approach for the treatment of these challenging conditions over more than 30 years, refining therapies for patients in situations which would have previously been regarded as untreatable.”

Salford’s Intestinal Failure team, comprising half a dozen bowel experts working together, currently has the world’s best results in treating this type of patient, with zero mortality from complex reconstructive surgery for intestinal failure in the last three years. It attracts and trains visiting health professionals from all over the world (USA, New Zealand, Europe), some of whom have now begun to establish similar units, implementing treatment protocols developed in the UK.

According to the Royal College of Surgeons of Edinburgh President Mr. Ian Ritchie;

“Critical care surgery interests every surgeon because, at some point in our careers, dealing with emergencies forms an integral part of our work. The work carried out by Professor Carlson and his colleagues in Salford is a significant achievement and an important  development in the continuing aim of all those who work in healthcare to develop processes and procedures which will improve the treatment of patients.  At our meeting this year we will be covering a host of subjects relating to emergency surgery, many of which have broader implications across healthcare as a whole, such as the debate around specialisation vs generalisation in surgical training; A&E provision; and pre-Hospital care. I’m delighted with the calibre of presentations which will be delivered and the expertise which will be showcased at this exciting event.”


“Emergency Care in the 21st Century” is taking place Friday 21 March at the Royal College of Surgeons of Edinburgh. For information about this conference please visit http://presmeeting.rcsed.ac.uk/


About The Royal College of Surgeons of Edinburgh

RCSEd was first incorporated as the Barber Surgeons of Edinburgh in 1505, and is the oldest surgical corporation in the world with memberships approaching 25,000 professionals in over 100 countries worldwide. The College promotes the highest standards of surgical and dental practice through its interest in education, training and examinations, its liaison with external medical bodies and representation of the modern surgical and dental workforce. It is also home to the UK’s only Faculty of Surgical Trainers, open to all those with an interest in surgical training regardless of College affiliation. Find RCSEd on Twitter www.twitter.com/RCSEd and on Facebook www.facebook.com/rcsed

The College is based at Nicolson Street, Edinburgh, EH8 9DW and can be reached on (0)131 527 1600 or mail@rcsed.ac.uk. In March 2014, a new base opened in Birmingham, catering to the 80% of the College’s UK membership who are based in England and Wales.

For all media enquiries please contact the Communications Team on +447467 485145 or email comms@rcsed.ac.uk 


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