Asunto(s)
Fracturas Óseas , Fracturas Abiertas , Humanos , Angiografía por Tomografía Computarizada , Diagnóstico por Imagen , Extremidad Inferior/diagnóstico por imagen , Extremidad Inferior/cirugía , Fracturas Óseas/diagnóstico por imagen , Fracturas Óseas/cirugía , Fracturas Abiertas/diagnóstico por imagen , Fracturas Abiertas/cirugía , Estudios RetrospectivosRESUMEN
BACKGROUND: Since the earliest use of microscopes in surgery, several modifications have been made to improve the ergonomics of movement and posture, increase the resolution, and expand the visual field. The three-dimensional microscopes are latest innovation in this field. Despite the wider use of 3D microscopes in other specialities, their use in the reconstructive microsurgery in the United Kingdom is still limited. Reconstructive microsurgeons are highly skilled surgeons that are trained to operate utilising the microscope for long hours. This poses an occupational risk with a specific pattern of work-related conditions. AIMS AND METHODS: We aim in this report to demonstrate our experience utilising 3D microscopes in small cohort of patients matched to a control of patients operated utilising the traditional microscopes. Patients were matched by age, comorbidities, oncologic procedures. This was complemented by a survey completed by the operating surgeons. RESULTS: Nine patients were included in each group. There was no significant difference in operative or ischemia time and no significant post-operative complications in both groups. The surgeons reported better ergonomics, improved staff engagement, and a better teaching experience when utilising the 3D microscopes compared to traditional microscopes. CONCLUSION: The utilisation of the 3D microscopes in reconstructive microsurgery has shown to provide comfort, improve ergonomics of movement and posture without significant clinical implications in this series.
Asunto(s)
Microcirugia , Procedimientos de Cirugía Plástica , Ergonomía , Humanos , Microscopía , Microcirugia/métodos , PosturaAsunto(s)
Publicaciones Periódicas como Asunto , Procedimientos de Cirugía Plástica/educación , Cirugía Plástica/educación , Acceso a la Información , Estudios de Factibilidad , Humanos , Publicación de Acceso Abierto/estadística & datos numéricos , Publicaciones Periódicas como Asunto/economía , Publicaciones Periódicas como Asunto/provisión & distribución , Cirujanos , Encuestas y Cuestionarios , Apoyo a la Formación Profesional/métodos , Reino UnidoAsunto(s)
Enfermedades Óseas/etiología , Trastornos de Traumas Acumulados/etiología , Traumatismos de los Dedos/etiología , Joyas/efectos adversos , Enfermedades Óseas/diagnóstico por imagen , Enfermedad Crónica , Trastornos de Traumas Acumulados/diagnóstico por imagen , Trastornos de Traumas Acumulados/terapia , Traumatismos de los Dedos/diagnóstico por imagen , Traumatismos de los Dedos/terapia , Humanos , Masculino , Persona de Mediana EdadRESUMEN
A woman aged 67 years attended the emergency department with acute abdominal and back pain of 1-day duration with associated vomiting. The patient had multiorgan failure. Resuscitation was started with intravenous fluids and vasopressors. An abdominal CT scan was completed which confirmed the diagnosis of acute gastric volvulus. The patient was successfully resuscitated from a cardiorespiratory arrest during transfer to the operating theatre. The patient subsequently underwent a total gastrectomy with stapling of the oesophageal and duodenal stumps. The abdomen was packed and left open as a laparostomy with a planned relook 48â hours later was to be performed. Unfortunately, the patient continued to deteriorate postoperatively in the intensive care unit despite maximum organ support for multiorgan failure. A decision was made to withdraw treatment and the patient died 10â hours postoperative. This case illustrates the presentation of acute gastric volvulus at a late stage and the high mortality rate associated with it.