RESUMO
This guideline covers care for adults (aged 18 and over) having elective or emergency surgery, including dental surgery. It covers all phases of perioperative care, from the time people are booked for surgery until they are discharged afterward. The guideline includes recommendations on preparing for surgery, keeping people safe during surgery and pain relief during recovery.
Assuntos
Humanos , Adulto , Cuidados Pós-Operatórios/reabilitação , Procedimentos Clínicos/organização & administração , Assistência Perioperatória/reabilitação , Manejo da Dor , Cuidados Intraoperatórios/reabilitaçãoRESUMO
Enhanced recovery after surgery (ERAS) is an evidence-based approach to perioperative care of the surgical patient. A mounting body of literature in gynecologic surgery has demonstrated that ERAS improves postoperative outcomes, shortens hospital length of stay, and reduces cost without increasing complications or readmissions. Most of the existing literature has concentrated on open surgery, questioning if patients undergoing minimally invasive surgery also derive benefit. Our aim was to systematically review the literature on ERAS after minimally invasive gynecologic surgery (MIGS) with and without bowel surgery. Given the paucity of studies on ERAS in MIGS with bowel surgery (1 study), we expanded our search to include studies of ERAS in patients undergoing minimally invasive colorectal resections alone. Twelve studies were identified through an electronic database search of PubMed, Medline, and Ovid EMBASE. These studies included patients undergoing MIGS for benign and/or malignant indications and showed that ERAS pathways decreased length of stay and/or increased the proportion of same-day discharge surgeries, improved patient satisfaction, and reduced hospital costs while maintaining low postoperative complication and readmission rates. Although limited, data from a single study suggest that ERAS in MIGS with bowel surgery leads to shortened hospital stay, stable postoperative morbidity, and less readmissions. Although the variation between the published protocols underscores the need for standardization, existing literature supports the adoption of ERAS as safe and effective when planning MIGS.
Assuntos
Procedimentos Cirúrgicos em Ginecologia/reabilitação , Intestinos/cirurgia , Laparoscopia/reabilitação , Procedimentos Cirúrgicos Robóticos/reabilitação , Métodos Epidemiológicos , Feminino , Custos Hospitalares , Humanos , Cuidados Intraoperatórios/métodos , Cuidados Intraoperatórios/reabilitação , Laparoscopia/métodos , Tempo de Internação/estatística & dados numéricos , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Alta do Paciente/estatística & dados numéricos , Satisfação do Paciente , Assistência Perioperatória/métodos , Cuidados Pós-Operatórios/métodos , Cuidados Pós-Operatórios/reabilitação , Complicações Pós-Operatórias/prevenção & controle , Recuperação de Função Fisiológica , Procedimentos Cirúrgicos Robóticos/métodosRESUMO
La fijación externa es una técnica cada vez más utilizada en nuestros hospitales, dado que se puede emplear como técnica definitiva en la estabilización de fracturas cerradas, o provisional en fracturas abiertas o en las que existen una alteración cutánea. Además su indicación en muy versátil pudiéndose utilizar en el caso de fracturas en las vértebras cervicales, de la mandíbula, en la articulación de la muñeca, de las falanges, del codo, en fracturas de pelvis, de fémur, de la tibia, articulación de la rodilla y tobillo, entre otras. Además proporciona comodidad al paciente, disminuye el dolor, facilita los cuidados de enfermería y el transporte y movilización del mismo. Con todo ello se hace necesaria la realización de un plan de cuidados estandarizado en el perioperatorio de estos pacientes, que facilite el trabajo de las enfermeras, y permita la aplicación y registro de los mismos siguiendo una metodología científica (AU)
El object of this article is to establish the standardized nursing plan in the peri-operative care of patients with external fixation, the purpose of which is to facilitate the work of peri-operative nurses (AU)
