RESUMO
Ambulatory surgery centers are the preferred setting for many procedures formerly performed in a hospital setting. This study sought to determine whether outpatient total elbow arthroplasty (TEA) is as safe as inpatient TEA. A retrospective analysis was performed of inpatient (IP) versus outpatient (OP) TEA by a single surgeon over a period of 18 years. Demographic, social, and comorbidity measures as well as complication rates were analyzed and stratified by IP or OP status. Bivariate comparison showed increased prevalence of coronary artery disease in the OP group (32% vs. 7%) and increased age in the IP group (68 years vs. 58 years). All other demographic, social, and comorbidity factors were comparable between the IP and OP groups, although more infections were seen in the IP group. The surgeons' initial learning curve occurred mostly within the IP group. Most important, no difference in complication rate was observed between the IP and OP groups.
Assuntos
Procedimentos Cirúrgicos Ambulatórios/métodos , Artroplastia de Substituição do Cotovelo/métodos , Síndrome do Túnel Ulnar/epidemiologia , Hospitalização , Artropatias/cirurgia , Complicações Pós-Operatórias/epidemiologia , Falha de Prótese , Infecções Relacionadas à Prótese/epidemiologia , Adulto , Idoso , Estudos de Casos e Controles , Comorbidade , Doença da Artéria Coronariana/epidemiologia , Feminino , Seguimentos , Humanos , Artropatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Estudos RetrospectivosRESUMO
Surgical site infections (SSI) are a costly problem. The purpose of this study was to determine the rate of infection and identify patient and technical risk factors for SSI in an orthopaedic ambulatory surgical center. Over 11,000 consecutive orthopaedic surgeries over 5 years were reviewed for SSI as well as demographic, medical, and surgical risk factors. Nearly 400 noninfected patients served as statistical controls. The overall infection rate was 0.33%, which compares favorably to previous studies of outpatient surgery and appears to be substantially lower than SSI rates previously reported for inpatient orthopaedic surgery. Male sex, smoking, and diabetes demonstrated significantly higher risk for infection. Surgery time and duration of anesthesia administration were also associated statistically with SSI. A history of cancer, hypertension, or thyroid problems were all associated with higher but statistically insignificant risk of SSI. Patient age and number of past surgeries were equal in the SSI and control groups.
Assuntos
Infecção da Ferida Cirúrgica/epidemiologia , Procedimentos Cirúrgicos Ambulatórios , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Fumar/epidemiologiaRESUMO
Traditional radiographic imaging of the scapholunate interval is complicated by the lack of a view that combines the dynamism of the clenched-fist stress view with the ability to reliably duplicate the precise angle of pronation that shows optimally the scapholunate interval. We describe a simple radiographic technique that combines these 2 criteria that we have found helpful in the office diagnosis of scapholunate dissociation.