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At least 19 recordsLinked to original sources
PubMed1992

[Prevention of postoperative thromboembolism in Denmark. A questionnaire study on principles of prevention of thrombosis at hospital surgery departments].

In a questionnaire survey among surgical hospital departments in Denmark (1990), we assessed the attitudes and practices of use of postoperative thrombosis prophylaxis (TP). Replies were obtained from 92% of departments. Otological and odontological departments seldom used TP. Among departments performing major surgery a total of 88% used TP routinely (general surgery: 91%, orthopedic surgery: 94%, gynecology: 84%). 68% of these departments used TP according to written instructions. Indications for TP, and methods used, are in accordance with the literature, except for the use of TP in emergency surgery (routine in 36% of departments only), or for the continued use of aspirin for TP in 13% of departments.

Adult↗
PubMed1990

[Organization and practical aspects of autologous blood replacement in a community hospital surgery department].

Replacement of autologous blood by consistent recycling of red blood cells saved perioperatively and autologous FFP collected by plasmapheresis preoperatively is a practicable method with poor risk in order to reduce the use of homologous blood in a community hospital. The reducing effect concerning the use of homologous blood correlates to the extent of the blood loss. Preoperative plasmapheresis and replacement of the autologous plasma has proven to be effective by stabilizing hemostasis as an additional blood-saving effect. The main blood-saving effect was due to the acceptance of lower hemoglobin values in case of autotransfusion maintaining isovolemia by careful control of all parameters of blood circulation and peripheral O2 saturation.

Blood Transfusion, Autologous↗
PubMed1998

[Experience with the use of criteria for evaluating the need for hospitalization in a surgery department].

Acute hospital care is the most expensive form of medical care. Some of patients hospitalized in acute hospitals could be cared for in alternative settings without compromising quality of care. The Appropriateness Evaluation Protocol (AEP) is the most widely used tool for evaluation of appropriateness of hospitalisation in acute care hospitals. We applied AEP to 189 patients admitted within 20 days to department of surgery of a teaching hospital. We have evaluated appropriateness of admission and each following day of stay up till discharge or 15th day of hospitalization. Reasons of inappropriate admissions and delayed discharges were classified and analyzed. Results of the evaluation of selected patients were subject to control by a committee of fully specialized hospital physicians. 16 (8%) of 189 admissions and 306 (27.5%) of 1114 evaluated days of stay failed the AEP criteria. These patients could be well served by lower treatment intensity in outpatient clinics, nursery homes or their own homes. Such a shift in pattern of provided care requires profound organizational changes many of which are out of reach of individual acute hospitals. Despite some limitations we find AEP a useful tool for internal utilization review. External application of AEP in a representative sample of acute care hospitals could provide important data for future development of the Czech health care system.

Health Services Misuse↗
PubMed1997

A new paradigm: the vascular center.

The vascular surgeon, in the absence of effective medical options for the treatment of atherosclerosis, has in the past assumed primary responsibility for the care of patients with peripheral vascular disorders. During the past two decades, management of these patients has become increasingly complex, the direct result of extraordinary proliferation of both our aging population and the expanding technological array of treatment options available. Such patients often require multiple medications with repeated encounters with a variety of specialists resulting in inefficient and not infrequently ineffective care. The concept of a truly integrated multidisciplinary effort to expedite the care of patients with peripheral vascular disease developed in the early 1980s. A vascular center was created at the Brigham and Women's Hospital involving the departments of Surgery, Medicine, and Radiology with their appropriate subspecialty divisions. The combined expertise of dedicated individuals interested in a disease-oriented perspective has resulted in a marked improvement in the efficiency and, it is hopeful, efficacy of management.

Arteriosclerosis↗
PubMed1979

[Activities of the general surgeon in a non-university hospital].

There is little difference between the work of the general surgeon as the head of a provincial hospital (B2) or in a central non-university one (A2). The operative statistics of such a service show that the type of operations is varied and requires broad polyvalence. Surgical services in provincial hospitals should not be subdivided into several specialised department. There is a real need for general surgeons in our country. Their quality depends on a broad and adequate training including the majority of surgical specialities. Such an activity requires constant postgraduate training, analysis of the results and ability to self criticism. Frequent contacts should be encouraged with other colleagues and university hospitals. The head surgeon in a provincial hospital should be able to evaluate the majority of the cases which are submitted to him and to decide whether the patient will be operated by him personnally or by a specialized consultant, or whenever he should be transferred to a specialized unit. This type of work has certain advantages: the possibility of independent decisions, a broad ability in the different surgical fields, allowing an easy adaptation when unexpected situations happen during operation.

General Surgery↗
PubMed1990

[The present states and considerations of orthognathic surgery in Japan. Questionnaire in department of orthodontics of university dental hospital, and department of oral surgery of university medical hospital].

To investigate the present state of orthognathic surgery, questionnaires were sent to 30 departments of orthodontics of university dental hospital and 60 departments of oral surgery of university medical hospital. 1. Orthognathic surgery was carried out in 100% of the departments of orthodontics and 91.8% of the departments of oral surgery examined. 2. There was a difference in the number of patients between individual hospitals. 3. Analyses of cephalogram were used in 96% of the departments of orthodontics and 93% of the departments of oral surgery. 4. Pre- and post-surgical orthodontic treatments were carried out in all of the departments of orthodontics. 5. Orthodontic appliances (83.9%) were used in the departments of orthodontics for intermaxillary fixation, while orthodontic appliances (47.8%) and wire splints (49.2%) were used in the departments of oral surgery. 6. It is pointed out that the criterion of orthognathic surgery, treatment objectives on soft and hard tissue, selection of surgical method, adaptability of soft tissue after surgery, relapse, treatment planning of two jaw surgery, and postoperative stability remain to be solved in future.

Humans↗
PubMed1990

Postoperative hospital retention following ambulatory surgery in a hospital-based program.

In an effort to learn more about resource utilization on ambulatory surgery in hospital departments of surgery and its impact on quality of care, we reviewed the causes of postoperative hospital retention following ambulatory surgery in a hospital-based program. Of 1971 patients operated on in a 6-month period, 188 were retained for a rate of 9.5%. Of these, 71 (3.6%) were retained for observation and 42 (2.1%) for surgery more extensive than planned. The remaining 75 (3.8%) patients represent complications of surgery or anesthesia. The age distribution of patients with complications was the same as the group overall with a single mode at about 30 years, while the distribution of patients retained for observation or who were admitted the day of surgery was bimodal with a second peak at about 70 years. All surgical specialties had comparable rates of postoperative retention, except gynecology which was significantly lower. Many of the patients had multiple procedures or surgery more extensive than planned.

Age Factors↗