ABSTRACT
In recent years, due to the increasing population of ageing and obesity, the incidence rate of hernia is increasing year by year, which has become a social problem that needs to be focused. Although starting late, the hernia and abdominal wall surgery has developed rapidly in recent years in China, and many remarkable achievements have been made. The development of hernia and abdominal wall surgery is inseparable from the progress of medical technology, the continuous innovation of materials, the improvement of perioperative management concept and the improvement of registration and follow-up system. The authors investigate the relevant research at home and abroad in recent years, and summarize and prospect the materials science, the daytime surgery and the registration and follow-up system, in order to provide reference for the future development of hernia and abdominal wall surgery.
ABSTRACT
Under the background of performance evaluation in nationwide tertiary public hospitals and the DRGs reform, how to improve the efficiency of daytime surgery management is becoming a hotspot for hospital managers. Since July 2020, a tertiary general hospital applied the theory of incentive compatibility to guide the medical workers to consciously strive to achieve such management goals as improving the quantity and quality of daytime surgeries by constructing an organizational management system, increasing performance rewards for daytime surgical teams, rewarding advanced collectives and individuals, convening work coordination and promotion meetings, formulating penalty terms, and strengthening supervision of surgical quality and safety indicators. The implementation rate of daytime surgery in hospitals, the number of departments conducting daytime surgery, the number of covered diseases, and the satisfaction rate of inpatients had increased from 6.94%, 6 departments, 64 diseases, and 90.5% in 2019 to 24.08%, 21 departments, 125 diseases, and 95.0% in 2022, respectively. The incidence of daytime surgical bleeding, and readmissions within 15 days decreased from 0.6% and 0.5% in 2019 to 0.5% and 0.2% in 2022, respectively. The theory of incentive compatibility was in line with the development goals of daytime surgery in China, providing an optimal strategy for improving the management efficiency of daytime surgery according to local conditions.
ABSTRACT
BACKGROUND: Whether nighttime surgery will affect the safety and prognosis of patients has been controversial. OBJECTIVE: To compare the safety and prognosis of daytime surgery versus nighttime surgery in patients receiving total knee arthroplasty. METHODS: Data of 712 patients who received unilateral total knee arthroplasty from January 2015 to January 2018 in the Binzhou Medical University Hospital were retrospectively analyzed. Of the patients, 615 cases were treated by total knee arthroplasty during daytime hours (8:00-18:00) and the other 97 patients were treated by total knee arthroplasty during nighttime hours (18:01-7:59). The perioperative and postoperative conditions of the two groups of patients were compared. This study was approved by the Medical Ethics Committee of Binzhou Medical University Hospital, China (approval No. LW2016013). RESULTS AND CONCLUSION: (1) Perioperative period: The operation time in the nighttime surgery group was shorter than that in the daytime surgery group (P 0.05). (2) Prognosis: There was no significant difference in motion range and knee joint function KSS score between the two groups (P > 0.05). (3) The results showed that nighttime surgery did not increase the incidence of adverse reactions after total knee arthroplasty, and did not affect the prognosis of patients.