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1.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(3): 374-375, 2020 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-32386007

RESUMO

Upper limb injury is a common disease in hand surgery. After surgery, it is necessary to raise the patient's arm to reduce limb swelling and promote recovery. In clinic, clothes or pillows are usually placed under the arm to raise it, but in this way the arm cannot be fixed well and easily slide down, without ideal raising effect. Therefore, the upper limb raising pad for assisting the raising of the affected limb is specially designed. The device is composed of shell, mounting plate, strut, elastic band and spring. The position of the strut is adjusted by squeezing or lifting the spring, so as to change the inclination angle of the mounting plate and to adjust the raising height of the upper limb. After the height is determined, the affected limb is placed comfortably and then fixed with the elastic band. The device can freely adjust the raising height of the affected limb and effectively fix the affected limb to reduce its swelling, thus promoting recovery. This device is worthy to be clinically popularized and applied.


Assuntos
Mãos/cirurgia , Extremidade Superior , Humanos , Equipamentos Cirúrgicos
3.
Rev. SOBECC ; 25(1): 58-64, 31-03-2020.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1096334

RESUMO

Objetivo: Discutir os aspectos que devem ser considerados na validação concorrente da limpeza no Centro de Materiais e Esterilização (CME). Método: Revisão narrativa da literatura científica, legislação e normatização pertinentes. Resultados: A validação da limpeza na rotina deve considerar: o design dos produtos, a definição e a exequibilidade dos procedimentos operacionais padrão, além da estrutura do CME, dimensionamento, seleção e treinamento de pessoal, registro e interpretação dos resultados obtidos pelos testes químicos na rotina. Conclusão: A validação concorrente da limpeza dos produtos para saúde no CME imprime a cultura da valorização dessa etapa do processamento entre todos os colaboradores do setor, de tal forma que a limpeza passa a ser, de fato, o núcleo central do processamento


Objective: To discuss the aspects that should be considered in the concurrent cleaning validation at Sterile Processing Department (SPD). Method: Narrative review of scientific literature, legislation, and pertinent normalizations. Results: The routine cleaning validation should consider the product design, definition, and feasibility of standard operating procedures (SOP); SPD structure; staff sizing; selection and training; and the recording and interpretation of results obtained by routine chemical tests. Conclusion: The concurrent cleaning validation of health products at SPD points out the value of this stage to all employees in the sector such that cleaning becomes a core function of health service product processing.


Objetivo: Discutir los aspectos que deben considerarse en la validación concurrente de limpieza en el Centro de Materiales y Esterilización (CME). Método: revisión narrativa de la literatura científica relevante, legislación y normas. Resultados: La validación de la limpieza en la rutina debe considerar: el diseño de los productos, la definición y la viabilidad de los procedimientos operativos estándar, además de la estructura del CME, dimensionamiento, selección y capacitación del personal, registro e interpretación de los resultados obtenidos por las pruebas químicas en el rutina Conclusión: La validación concurrente de la limpieza de productos de salud en CME impresiona la cultura de valorar esta etapa de procesamiento entre todos los empleados del sector, de tal manera que la limpieza se convierta, de hecho, en el núcleo central del procesamiento


Assuntos
Humanos , Equipamentos Cirúrgicos , Esterilização , Enfermagem , Centros Cirúrgicos , Saúde , Hospitais
4.
J Surg Res ; 251: 137-145, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32143058

RESUMO

BACKGROUND: Fostering medical students' appreciation for team members particularly those from other disciplines with varying levels of experience promotes a promising beginning to a health care career. METHODS: During surgical clerkship orientation, third-year medical students completed 30-item TeamSTEPPS Teamwork Attitudes Questionnaire preintervention and postintervention, spent 7 min identifying errors in a simulated operating room, followed by recorded physician-led 30-min discussions. RESULTS: Postintervention (67) compared with preintervention (141) mean TeamSTEPPS Teamwork Attitudes Questionnaire domain scores were statistically significantly higher for team structure (4.59, 4.70; P = 0.03) and higher but not significant for leadership (4.74, 4.75; P = 0.86), situation monitoring (4.62, 4.68; P = 0.32), communication (4.40, 4.50; P = 0.14), and decreased for mutual support (4.43, 4.36; P = 0.43). Medical students identified 2%-93% of 33 staged errors and 291 additional errors, which were placed into 14 categories. Soiled gloves in the operative field and urinary bag on the floor were the most frequently identified staged errors. Experienced nurses compared with medical students identified significantly more errors (mean, 17.7 versus 11.7, respectively; P < 0.001). Recognizing errors when lacking familiarity with the operative environment and appreciating teammates' perspectives were themes that emerged from discussions. CONCLUSIONS: This well-received teamwork exercise enabled medical students to appreciate team members' contributions and other disciplines' perspectives, in addition to the synergy that occurs with multidisciplinary teams.


Assuntos
Comportamento Cooperativo , Educação Médica/métodos , Relações Interprofissionais , Erros Médicos , Estudantes de Medicina , Procedimentos Cirúrgicos Operatórios/educação , Atitude do Pessoal de Saúde , Comunicação , Humanos , Salas Cirúrgicas , Equipe de Assistência ao Paciente , Treinamento por Simulação , Equipamentos Cirúrgicos , Inquéritos e Questionários
5.
World Neurosurg ; 138: 262-268, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32142945

RESUMO

BACKGROUND: Carotid pseudoaneurysm is a rare complication of pituitary surgery and can present with epistaxis. Nasal packing is considered first-line treatment for the control of carotid bleeding. We describe a case of complete occlusion of the contralateral cavernous carotid artery because of nasal packing placed to control hemorrhage from a cavernous carotid pseudoaneurysm. CASE DESCRIPTION: A 55-year-old man presented with a history of recurrent epistaxis requiring multiple hospital visits and nasal packing over a 9-month period. Nasal endoscopies failed to show a source of bleeding; therefore, the patient underwent bilateral sphenopalatine artery ligations. Postoperative computed tomography angiogram showed no evidence of aneurysm, but did report indistinctness of the lateral sphenoid walls. Symptoms remained controlled for 4 months, but ultimately, he presented to the emergency department with massive epistaxis. A magnetic resonance angiogram noted a 2- to 3-mm left cavernous carotid pseudoaneurysm, and the patient underwent endovascular embolization of bilateral internal maxillary arteries. Significant epistaxis was noted immediately thereafter and he was taken to the operating room to control bleeding. A 4-cm absorbable nasal packing was placed into each sphenoid cavity after profuse bleeding from the left sphenoid sinus was noted. After control of bleeding, cerebral angiogram showed complete occlusion of bilateral internal carotid arteries (ICAs). The right-sided packing was adjusted, and the ICA profusion improved. CONCLUSIONS: To our knowledge, this is the only report that describes complete occlusion of the contralateral cavernous carotid artery because of extrinsic compression of the lateral sphenoid wall, in the setting of a symptomatic pseudoaneurysm.


Assuntos
Lesões das Artérias Carótidas/etiologia , Lesões das Artérias Carótidas/terapia , Artéria Carótida Interna , Hemorragia Cerebral/terapia , Epistaxe/terapia , Complicações Pós-Operatórias/terapia , Lesões das Artérias Carótidas/diagnóstico por imagem , Artéria Carótida Interna/diagnóstico por imagem , Hemorragia Cerebral/diagnóstico por imagem , Epistaxe/diagnóstico por imagem , Epistaxe/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico por imagem , Equipamentos Cirúrgicos
6.
Artigo em Inglês | MEDLINE | ID: mdl-32098053

RESUMO

To assess the prevalence of upper extremity work-related musculoskeletal disorders (WMSDs) among surgical device mechanics compared to a control group, a total of 70 employees were included and assigned to three occupational groups (grinders, packers, and control). Personal factors, work exposure, manual skill, and complaints were assessed by two self-administered questionnaires and an industry test. WMSDs were diagnosed in a standardised clinical examination. The two-one-sided t-tests (TOST) procedure was used to test the clinical equivalence of the respective grinding and packaging groups vs. the control group in terms of the Disabilities of the Arm, Shoulder and Hand (DASH) score. Thirty-nine study participants (56%) experienced at least one WMSD at the elbow, forearm, and/or wrist, mainly with signs of epicondylitis and nerve entrapment at the medial elbow. The risk of grinders developing upper extremity WMSD was about 2.5-times higher and packers had an 8.6-fold higher risk of a clinically relevant DASH > 29 compared to the control group. However, these differences were not statistically significant. The groups were also proven to be clinically equivalent in terms of DASH score. Surgical device mechanics do not seem to have worse DASH values or be at higher risk of upper limb WMSDs compared to a control group. This is the first study to analyse and compare different workplaces in this industry that are also common in other industries.


Assuntos
Doenças Musculoesqueléticas , Doenças Profissionais , Equipamentos Cirúrgicos , Carga de Trabalho , Estudos Transversais , Feminino , Humanos , Masculino , Doenças Musculoesqueléticas/epidemiologia , Fatores de Risco , Inquéritos e Questionários , Extremidade Superior
7.
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 31(1): 37-41, ene.-feb. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-190370

RESUMO

En cirugía de columna, ciertos dispositivos y algunas técnicas quirúrgicas han sido abandonados por completo o se hallan en franco declive. Aunque empleados en miles de pacientes, dichos tratamientos no han demostrado una efectividad sólida y duradera y, ocasionalmente, asocian morbilidades inaceptables. Ejemplos de abandono son la quimionucleólisis, la discectomía percutánea, la discectomía por láser o los geles antifibrosis. Otras técnicas se encuentran en marcado retroceso como los dispositivos interespinosos o las prótesis discales lumbares. Generalmente una técnica se abandona por falta de efectividad, morbilidad excesiva, sustitución por otra técnica más eficaz y menos agresiva, por falta de comercialización o por prohibición de su uso. En las últimas décadas, la enorme presión comercial y una creciente demanda social han conseguido convencer a muchos cirujanos de columna para que empleen tratamientos no suficientemente sustentados por estudios sólidos ni avalados por el paso del tiempo, muchos de los cuales eventualmente se abandonan


In spine surgery, certain surgical techniques and devices are currently in marked decline or have been completely abandoned. Although used in thousands of patients, such treatments failed to demonstrate durable and sound effectiveness, and sometimes associate inacceptable morbidity. Chemopapain injections, percutaneous discectomy, laser discectomy or antiadhesion gels are examples of abandoned therapies. Some other techniques are in frank decline like implantation of interspinous devices or lumbar disc prosthesis. In general, a technique is abandoned due to inefficacy, excessive associated morbidity, substituted by another more efficacious and less aggressive technique, end of commercialization, or usage prohibition. In the last decades, a great commercial pressure plus an increasing social demand have managed to convince many spine surgeons to indicate treatments not sufficiently supported by scientific evidence nor consolidated over time, many of which are eventually abandoned


Assuntos
Humanos , Dor Lombar/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/tendências , Coluna Vertebral/cirurgia , Discotomia/métodos , Procedimentos Neurocirúrgicos/tendências , Quimiólise do Disco Intervertebral , Cordotomia , Equipamentos Cirúrgicos/tendências , Equipamentos e Provisões , Neurocirurgia/tendências
8.
Br J Oral Maxillofac Surg ; 58(2): 139-145, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31937410

RESUMO

The treatment of craniomaxillofacial and cervical wounds in a disaster relief setting is done by clinicians from local medical treatment facilities, non-governmental organisations (NGO), or the military. Although each group and individual surgeon will need specific equipment, this will be restricted by weight, portability and interoperability. We systematically reviewed scientific and commercial publications according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The papers we identified described the portable equipment that is required to treat patients who need damage-control surgery (decompressive craniectomy, temporary stabilisation, and internal and external fixation of the facial bones) for craniomaxillofacial and cervical injuries in austere or military settings. Austere settings are those in which there is an inherent lack of infrastructure, such as facilities, roads, and power. A total of 35 papers or scientific articles recommended the equipment that is needed to manage these injuries, but we could find no module that was specifically designed for use in these environments. Multiple modules are currently required to provide comprehensive surgical care and many of the items in the existing maxillofacial and neurosurgical kits are rarely used, which increases the cost of initial procurement and resupply. Duplications in equipment between modules also increase the size, weight, and financial cost. We suggest the equipment that is required to make up a rationalised, lightweight, and compact module that can be used for all craniomaxillofacial and cervical operations in austere settings.


Assuntos
Traumatismos Craniocerebrais/cirurgia , Militares , Cirurgiões , Equipamentos Cirúrgicos , Ossos Faciais , Humanos , Pescoço
9.
Sci Rep ; 10(1): 325, 2020 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-31941957

RESUMO

In 2015, we experienced the largest in-hospital Middle East respiratory syndrome (MERS) outbreak outside the Arabian Peninsula. We share the infection prevention measures for surgical procedures during the unexpected outbreak at our hospital. We reviewed all forms of related documents and collected information through interviews with healthcare workers of our hospital. After the onset of outbreak, a multidisciplinary team devised institutional MERS-control guidelines. Two standard operating rooms were converted to temporary negative-pressure rooms by physically decreasing the inflow air volume (-4.7 Pa in the main room and -1.2 Pa in the anteroom). Healthcare workers were equipped with standard or enhanced personal protective equipment according to the MERS-related patient's profile and symptoms. Six MERS-related patients underwent emergency surgery, including four MERS-exposed and two MERS-confirmed patients. Negative conversion of MERS-CoV polymerase chain reaction tests was noticed for MERS-confirmed patients before surgery. MERS-exposed patients were also tested twice preoperatively, all of which were negative. All operative procedures in MERS-related patients were performed without specific adverse events or perioperative MERS transmission. Our experience with setting up a temporary negative-pressure operation room and our conservative approach for managing MERS-related patients can be referred in cases of future unexpected MERS outbreaks in non-endemic countries.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Surtos de Doenças/prevenção & controle , Coronavírus da Síndrome Respiratória do Oriente Médio/genética , Procedimentos Cirúrgicos Operatórios , Adolescente , Adulto , Idoso , Criança , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Infecção Hospitalar/virologia , Feminino , Pessoal de Saúde , Humanos , Controle de Infecções/métodos , Masculino , Pessoa de Meia-Idade , Salas Cirúrgicas , Equipamento de Proteção Individual/virologia , República da Coreia/epidemiologia , Equipamentos Cirúrgicos/virologia , Centros de Atenção Terciária
10.
World Neurosurg ; 134: 233-239, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31706970

RESUMO

Ambroise Paré was celebrated surgeon of the 16th century whose practical accomplishments, books, and ideas transformed surgery and was a precursor for the later development of neurosurgery. He developed many surgical innovations related to wound management, arterial ligation for the prevention of hemorrhage during limb amputations, and the treatment of war-related head and spine injuries. He maintained that a surgeon should operate gently to reduce pain and improve outcome, and he dedicated his career to the wounded, sick, and poor. He also served 4 consecutive French monarchs-Henri II and his 3 sons François II, Charles IX, and Henri III. As a Huguenot (a Reformed Protestant) by faith, he lived in an environment dominated by Catholicism. Hence, his practice and life were sometimes hindered by political circumstances and religious prejudice. In this historical vignette, we will discuss the professional accomplishments of Ambroise Paré that influenced the future development of neurosurgery, including his descriptions of phantom-limb pain and peripheral nerve injury, his innovations in neurotraumatology, and the saws he invented for use in skull surgery. We will also highlight Paré's broad neurosurgical contributions to the field. Finally, we will discuss his personal life during the difficult and dangerous political circumstances of 16th century France.


Assuntos
Neurocirurgia/história , Catolicismo/história , Craniotomia/história , Craniotomia/instrumentação , França , História do Século XVI , Traumatismos dos Nervos Periféricos/história , Membro Fantasma/história , Política , Protestantismo/história , Equipamentos Cirúrgicos/história , Traumatologia/história
11.
Zhongguo Yi Liao Qi Xie Za Zhi ; 43(5): 330-333, 2019 Sep 30.
Artigo em Chinês | MEDLINE | ID: mdl-31625328

RESUMO

With the technology development in Internet of Things (IoT) area, it is good to try to use IoT and cloud computing technologies to improve the efficiency of medical equipment management. This article described using CT as sample to do the data capture and data analysis with the IoT technology. The positive result got shows the benefit of the exploring.


Assuntos
Computação em Nuvem , Internet , Equipamentos Cirúrgicos
12.
Facial Plast Surg ; 35(5): 458-466, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31639870

RESUMO

In rhinoplasty, osteotomies are performed to manipulate the bony nasal vault to improve the function and/or the aesthetics of the nose. This article provides an overview of the instruments used for osteotomies, as well as the indications and techniques for osteotomies in nasal profileplasty.


Assuntos
Osteotomia , Rinoplastia , Equipamentos Cirúrgicos , Osso Nasal , Nariz/cirurgia , Osteotomia/instrumentação
13.
World Neurosurg ; 132: 114-117, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31476467

RESUMO

OBJECTIVE: Neurosurgical operating rooms are equipped with microscopes in order to provide a good standard of care. Nevertheless, in developing countries, microscopes are not always available. During a short period in a western Africa hospital, we adapted our smartphones as a valid alternative to the microscope. METHODS: Using a shaped tin can, a smartphone cover, and a rod fixed to the bed, we could make a support for a smartphone creating a simple "homemade" exoscope, which allowed us to have magnification and light in the surgical field. RESULTS: Among others, we performed 5 surgical interventions of both spinal and brain surgery using our smartphone as a magnifier. This allowed us to overcome the absence of a better magnification system. CONCLUSIONS: This simple "smartphone-based exoscope" allows surgeons to get an adequate magnification during surgery when microscopes or magnification goggles are not available. It can be a useful solution in developing countries where often nothing better is available.


Assuntos
Microscopia/instrumentação , Procedimentos Neurocirúrgicos/instrumentação , Smartphone , Equipamentos Cirúrgicos/provisão & distribução , Neoplasias Encefálicas/secundário , Neoplasias Encefálicas/cirurgia , Países em Desenvolvimento , Humanos , Deslocamento do Disco Intervertebral/cirurgia , Vértebras Lombares , Neoplasias Meníngeas/cirurgia , Meningioma/cirurgia , Metastasectomia/métodos
14.
J Vet Cardiol ; 25: 32-40, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31542555

RESUMO

Pulmonary artery banding (PAB) is a viable but underreported palliative option for hemodynamically significant ventricular septal defect in small animals. A significant challenge associated with PAB is judging the degree of band tightening, which can be further complicated when animals are immature and still growing at the time of PAB. If a pulmonary artery band is overtightened or becomes progressively too tight after surgery, the result can be reversal of shunt flow with potentially devastating consequences. Placement of a band that could be percutaneously dilated using a balloon catheter affords a minimally invasive option for partially or completely relieving the band should it become too tight after PAB. This report describes a surgical technique for placement of a dilatable pulmonary artery band, reviews guidelines for tightening the band, and reports the outcome of three cats undergoing the procedure. All three cats showed evidence of reduced hemodynamic load after PAB for a period of up to three years after PAB.


Assuntos
Doenças do Gato/cirurgia , Comunicação Interventricular/veterinária , Artéria Pulmonar/cirurgia , Animais , Gatos , Comunicação Interventricular/cirurgia , Hemodinâmica , Masculino , Equipamentos Cirúrgicos , Toracotomia/veterinária
15.
J Craniofac Surg ; 30(7): e595-e597, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31503120

RESUMO

In the oropharyngeal region examinations, the abeslang (tongue depressor) used to create a wider field of vision and press down the tongue to make the pharynx easier. In order to look under the tongue, the depressor is redesigned so that it can be examined under the tongue and transformed into a retractor by creating an angle in the body of the present invention. This technique is intended to be used in conjunction with new technology surgical procedures. Our invention consists of the stem (1), the body (2), the end (3) and the notch (4), and the angle (5) in the angled model. This model, which is more effective than the routine tongue depressors at the same time it will not make any difference regarding cost. It will also allow the use of new surgical techniques while at the same time ensuring the exclusion of language in operations.


Assuntos
Desenho de Equipamento , Língua , Humanos , Orofaringe , Faringe , Exame Físico , Equipamentos Cirúrgicos
16.
Trans Am Clin Climatol Assoc ; 130: 136-144, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31516177

RESUMO

A global outbreak of invasive Mycobacterium chimaera infections has been associated with exposure to certain heater-cooler devices (HCDs) used during cardiopulmonary bypass. Outbreak investigations have shown that these HCDs harbor M. chimaera in water circuits and generate bio-aerosols in the operating room, leading to airborne transmission to patients during surgery. Whole genome sequencing data support a common-source outbreak originating at an HCD manufacturing facility. Most clinical infections are associated with implanted devices, diagnosis is often delayed, and treatment requires device removal and prolonged antibiotic therapy. Because it is nearly impossible to eradicate M. chimaera from HCDs using existing disinfection approaches, strict separation of HCD exhaust from operating room air is necessary to prevent patient exposure. Lessons learned from this outbreak include: 1) medical device risks are difficult to predict, requiring improved expert review before approval, and 2) advances in genomics provide powerful tools for outbreak investigation and public health surveillance.


Assuntos
Aerossóis , Ponte Cardiopulmonar , Surtos de Doenças , Infecções por Mycobacterium não Tuberculosas/epidemiologia , Mycobacterium , Infecções Relacionadas à Prótese/epidemiologia , Equipamentos Cirúrgicos/microbiologia , Infecção da Ferida Cirúrgica/epidemiologia , Microbiologia da Água , Procedimentos Cirúrgicos Cardiovasculares , Humanos , Infecções por Mycobacterium não Tuberculosas/microbiologia , Infecções por Mycobacterium não Tuberculosas/prevenção & controle , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/microbiologia , Complicações Pós-Operatórias/prevenção & controle , Implantação de Prótese , Infecções Relacionadas à Prótese/microbiologia , Infecções Relacionadas à Prótese/prevenção & controle , Infecção da Ferida Cirúrgica/microbiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Suíça/epidemiologia , Fatores de Tempo , Reino Unido/epidemiologia , Estados Unidos/epidemiologia
19.
Vet Clin North Am Exot Anim Pract ; 22(3): 471-487, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31395326

RESUMO

Surgery can be challenging in exotic pets owing to their small size and blood volume, and their increased anesthetic risk compared with small animals. Various devices are available to facilitate suturing, cutting, and hemostasis in the human and veterinary fields. These surgical equipment improve the simplicity, rapidity, and effectiveness of surgery. Vessel-sealing devices, radiosurgery, lasers, and ultrasound devices are commonly used because of their ease of use and increase in surgical efficiency. Other surgical devices are available (eg, stapling devices) but are not discussed in this article.


Assuntos
Animais Exóticos , Equipamentos Cirúrgicos/veterinária , Animais , Biópsia/instrumentação , Biópsia/veterinária , Castração/instrumentação , Castração/veterinária , Desenho de Equipamento , Hemostasia Cirúrgica/instrumentação , Hemostasia Cirúrgica/veterinária , Humanos , Terapia a Laser/instrumentação , Terapia a Laser/veterinária , Lasers/normas , Fígado/patologia , Fígado/cirurgia , Pancreatectomia/instrumentação , Pancreatectomia/veterinária , Radiocirurgia/instrumentação , Radiocirurgia/veterinária , Esplenectomia/instrumentação , Esplenectomia/veterinária , Equipamentos Cirúrgicos/tendências , Procedimentos Cirúrgicos Ultrassônicos/instrumentação , Procedimentos Cirúrgicos Ultrassônicos/veterinária , Procedimentos Cirúrgicos Vasculares/instrumentação
20.
Am Surg ; 85(7): 717-720, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31405414

RESUMO

Operating rooms (ORs) contribute to at least 40 per cent of hospital costs. There is an existing cost waste in ORs for surgical devices that are opened without being used. There is a paucity of data evaluating the hospital cost of opened but unused OR supplies. The goal of this observational study is to examine the cost of opened but unused OR supplies for general surgery cases. We performed a quality improvement project of OR cost waste by observing 30 cases. Surgical cases of a senior surgeon who had been at the institution for more than five years were evaluated for items opened appropriately and whether the items are used. The cases evaluated ranged from open hernia repairs to robotic-assisted hernia repairs. We found that the cost of instruments opened but not used was $4528.18. Of the cases evaluated, we found that a range of 0 per cent to 27 per cent of total items were wasted, an average of 8.3 per cent. We found that for the open inguinal hernia case, there was minimal waste. The highest waste was among complex cases such as the robotic-assisted inguinal hernia with an average waste and cost of 15.8 per cent and $379. We found that on average for less complex cases such as open inguinal hernia repairs, $1.44 was potentially wasted per case, whereas for more complex cases up to $379 was wasted per case. We identified the outdated preference cards, lack of instrument knowledge, circulating nurse, and surgical technician distractions as reasons for contributing to waste.


Assuntos
Custos Hospitalares , Hospitais Militares/economia , Salas Cirúrgicas/economia , Equipamentos Cirúrgicos/economia , Humanos , Estados Unidos
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