Analysis of the surgical activity in the Dermatology Department of Fuenlabrada University Hospital, Madrid, Spain, between 2005 and 2010: determination of the standard operating times.

OBJECTIVES: To analyze the characteristics of the dermatologic surgery lists and to compare different indicators of surgical productivity. MATERIALS AND METHODS: This was a retrospective, descriptive study of the routine surgical activity undertaken in the Dermatology Department of Fuenlabrada University Hospital, Madrid, Spain, between January 2005 and December 2010. Data about the procedures performed and about the surgical lists were analyzed and an analysis was made of operating room occupancy. Surgical productivity was analyzed using standard operating times (SOTs) and surgical scheduling adequacy values (SA1 and SA2). Variables were recorded as relative frequencies. Covariance and the Pearson linear correlation index were used for comparisons. RESULTS: The study period included a total of 11,481 surgical sessions, of which 71% were minor surgery and the remainder were major outpatient surgery. A mean of 9.7 operations were performed in each session and the overall operating room occupancy was 71.9%. Four SOT descriptors (minor surgery, multiple minor skin lesions, nail surgery, and malignant tumors with primary closure) were sufficient to classify 86.7% of the operations performed. The operating room down-time was 0.15 SOT (9minutes) in 91.3% of operations. The mean SA1 index was 1.20. Overall surgical productivity measured using the SA2 index was 96.46%. The Pearson correlation showed a statistically significant relationship between the increase in the number of patients per surgical session, the reduction in operating room occupancy, and the increase in SA2 operating room productivity. CONCLUSIONS: The application of SOT descriptors enables us to quantify the complexity of the operations included in the surgical waiting list and to obtain indicators for the evaluation of surgical activity, improving efficiency in surgical time management.

Analysis of operating room activities in the dermatology department at Hospital Universitario de Fuenlabrada (2005-2010).

OBJECTIVE: To analyze data corresponding to patients who underwent dermatological surgery in an operating room. MATERIAL AND METHODS: This was a descriptive, retrospective study of operating room activities in the dermatology department of Hospital Universitario de Fuenlabrada in Madrid between January 2005 and December 2010. We analyzed the relative frequency of a range of patient and procedure-related variables, as well as substitution and cancellation rates, the proportional risk of complications, and operating room efficiency. RESULTS: In the period analyzed, 11,516 patients underwent surgery: 9351 required minor surgery, 1998 major ambulatory surgery, and 167 surgery requiring hospitalization. Simple excision was the most common procedure (64.7%), and in the majority of cases (85%), the condition was benign. The mean number of patients treated per day was 9.7, and mean operating room efficiency was 71.9%. CONCLUSIONS: Accurate record-keeping is essential for analyzing operating room activities and comparing results with those from other centers. The analysis of patterns over time shows the effect of changes made on different indicators. In our case, a decrease in operating room efficiency was seen with an increase in the number of patients per day undergoing surgery.

Congenital Harlequin syndrome as an isolated phenomenon: A case report and review of the literature.

UNLABELLED: Harlequin syndrome (HS) is a rare autonomic disorder due to a hemifacial cutaneous sympathetic denervation. It is characterized by unilateral diminished sweating and flushing of the face even though after heat or prolonged exercise. It is typically acquired. Congenital cases only represent a 6% of all individuals with HS. All congenital HS cases reported so far showed a concomitant Horner syndrome, probably due to a stellate ganglion involvement. HS represents an uncommon autonomic disorder due to a hemifacial cutaneous sympathetic denervation. It is clinically characterized by a dramatic alteration in facial appearance: ipsilateral denervated pale and dry half from the other intact red and moist half. CONCLUSION: We present, to the best of our knowledge, the first case of a patient with a congenital HS as an isolated phenomenon.