Utilising over the scope endoclips previously has been thought to be limited by the size of defect. Our experience details novel combination techniques that allow for quick resolution and the expeditious commencement of further management such as chemotherapy. These clips also proved to be cost-effective in our centre, utilising less inpatient and outpatient resources than alternative management plans.

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Journal clubs are a valued source of teaching for medical professionals. We launched a novel podcast delivered journal club utilising commonly used social media applications to drive asynchronous discussion around key topics. This design uses commonly accessible freeware and can be customised to suit the cohort of participants. We demonstrate changes of practice achieved through the journal club discussion, a sustained response of contributors, links to external papers and links to external media to augment the discussion. We are hoping to launch this intervention at our sister sites and assess over a longer time frame to demonstrate sustainability and validity of this teaching intervention.

The aim of this study was to compare the effect of tourniquet time less than or in excess of 120 minutes on foot surgery wound healing. Null hypothesis: A tourniquet time of over 120 minutes will not affect wound healing in foot surgery.Design, Setting, Participants and Method: A retrospective comparative cohort analysis was performed on 96 patients undergoing complex hindfoot surgery in a large central teaching hospital. Fifty-five patients receiving tourniquet pressure for >120 minutes and 41 receiving <120 minutes of tourniquet pressure were identified from electronic case records. The primary outcome was surgical wound healing. Secondary outcomes were discharge date and complication rate.Results: There was no significant difference in reported time for wounds to heal in the <120-minute or >120-minute cohort. There were no other significant differences in secondary clinical outcomes and no significant variations in patient demographics. Conclusion:This study suggests that tourniquet times from 2 to 3 hours in foot and ankle surgery with pressures up to 300 mmHg are not associated with a significant effect on wound healing.