In this Fellowship I will capitalise on my role as Professor of Surgery and Public Health at Monash University, Director of the National Trauma Research Institute, and a surgeon at The Alfred Hospital, to lead a program of research that improves our understanding of what works in trauma care and trauma systems, uses scientific strategies to ensure research makes a difference to practice and policy, and supports further research that seeks to understand how research can best be used to improve in ....In this Fellowship I will capitalise on my role as Professor of Surgery and Public Health at Monash University, Director of the National Trauma Research Institute, and a surgeon at The Alfred Hospital, to lead a program of research that improves our understanding of what works in trauma care and trauma systems, uses scientific strategies to ensure research makes a difference to practice and policy, and supports further research that seeks to understand how research can best be used to improve injured peoples' lives.Read moreRead less
Perioperative Beta-blockade To Prevent Cardiac Morbidity In High-risk Patients Undergoing Surgery (The POISE Study)
Funder
National Health and Medical Research Council
Funding Amount
$189,625.00
Summary
Non-cardiac surgery is associated with significant risk of complications and death, particularly in elderly patients who are known to have heart disease, or who have risk factors for it (ie smoking, high blood pressure). About 11% of the Australian population are currently taking medications for heart disease or high blood pressure and about 80% have at least one risk factor for heart disease. As more than 2 million Australians have general anaesthesia for non-cardiac surgery every year, a subst ....Non-cardiac surgery is associated with significant risk of complications and death, particularly in elderly patients who are known to have heart disease, or who have risk factors for it (ie smoking, high blood pressure). About 11% of the Australian population are currently taking medications for heart disease or high blood pressure and about 80% have at least one risk factor for heart disease. As more than 2 million Australians have general anaesthesia for non-cardiac surgery every year, a substantial group of patients are therefore at risk of an adverse outcome following surgery. Despite the magnitude of this problem, however, few studies have established treatments to decrease the risk of complications and death following surgery. Beta-blockers are a group of drugs which have been used for decades in the treatment of heart disease and high blood pressure. Beta-blockers are known to improve the way the heart copes with the stress of surgery. They decrease the heart rate, make the heart more efficient at using energy and reduce the likelihood of imbalance between oxygen supply and demand. Some previous studies showed that beta-blockers may reduce the risk of heart attack and death for up to 2 years after surgery. However, other studies have shown no effect of beta-blockers on outcome. These previous studies have involved small numbers of patients who may not represent the broader population having surgery. We therefore propose to undertake a large trial to definitively answer the question about whether beta-blockers improve the outcome after non-cardiac surgery in patients with, or at risk of, heart disease. Even if the effect of beta-blockers is relatively modest, because such large numbers of patients with heart disease have surgery, the overall effect on the rate of complications and death in the population could be very significant. The results of this study could have major implications for the success of, and cost of, surgery worldwide.Read moreRead less
The Neurovascular Territories Of The Human Body: Anatomic Study And Clinical Applications
Funder
National Health and Medical Research Council
Funding Amount
$186,650.00
Summary
A Melways Roadmap of the anatomy of the large and small nerves, arteries and veins of the human body is underway and will take a further three years to complete. The aim is to evolve or modify Reconstructive Plastic Surgery techniques taking tissue from a hidden site and, where possible, include a nerve supply with the transplant so that feeling can be restored to skin flaps and function to transferred muscle. The fundamental objective is to improve the quality of the patients life. We have alre ....A Melways Roadmap of the anatomy of the large and small nerves, arteries and veins of the human body is underway and will take a further three years to complete. The aim is to evolve or modify Reconstructive Plastic Surgery techniques taking tissue from a hidden site and, where possible, include a nerve supply with the transplant so that feeling can be restored to skin flaps and function to transferred muscle. The fundamental objective is to improve the quality of the patients life. We have already completed a thorough examination of the following regions: (i) head and neck (ii) forearm (iii) leg These have received international acclaim and awards. We are currently examining: (i) hand and foot (ii) thigh and buttock. Still to be commenced: (i) arm and shoulder (ii) torso (iii) back. Reconstructive surgery involves the treatment and the reconstruction of defects throughout the whole human body. These defects may arise in any member of the family. With modern reconstructive techniques a problem can often be solved in one operation thus avoiding multiple operations and long periods of hospitalisation which can be devastating to both patient and family. These new techniques nevertheless have demanded a reappraisal of the basic sciences, especially the anatomy of the blood and nerve supply to the potential transplant. This is essential so that they can be designed with not only precision and safety but in such a way that there is minimal disability at the donor site. As well as restoring shape and form, the patient can have tremendous improvement in quality of life and independence if function is also restored. In order to provide function (feeling and movement) a working nerve supply must be included in the reconstruction. Therefore our research must continue to investigate the complex patterns of nerve supply to tissues of the body and correlate this information with the blood supply which is needed to keep the tissue alive.Read moreRead less