A training method of central venous catheterization using a simulator / 医学教育

1) The central venous catheterization (CVC) training program for 2 trainees involves an instructor, a CVC insertion simulator (Kyoto Kagaku Co., Ltd), and a simulated patient.<br>2) The questionnaire filled out by trainees after the program showed favorable opinions, particularly the method of learning after the practice.<br>3) It is important that effective simulation programs for trainees are designed to develop practical procedures and professional attitudes as a physician using both a simulator and a simulated patient.

Usefulness of Closed Drainage for Prevention of Postoperative Genitourinary Tract Infections : / 日本農村医学会雑誌

We investigated the incidence of surgical site infection and the number of days required for recuperation in patients who used open drains or closed drains after genitourinary tract surgery. As the method of (statistical) examination, Mann-Whitney's U test was used. Enrolled in this study were 14 patients (mean age:66.3 years) using open drains during the period from May to October 2001 (group A) and another 14 patients (mean age:64.9 years) using closed drains during the period from December 2001 to May 2002 (group B). Using gauze and drains, germ culture was made. From cultures it was found that six out of the 14 group A patients (42.8%) had been infected with Staphylococcus epidermidis, enterococcus and/or MRSA (methicillin-resistant Staphylococcus aureus) but that all of the group B patients had been were negative, thus marking a statistically significant difference between the two groups (p<0/01). A check on the duration of the administration of antibiotics showed 7-42 days (mean:24.5 days) for group A as against 4-11 days (mean:6.1 days) for group B. It was also revealed that there was a significant difference (p<0.01) between the two groups in the number of the days when gauze was exchanged:10-31 days (mean:19.1 days) for group A versus 3-10 days (mean:7.9 days) for group B. In many other respects, the closed drainage group was found to be doing well postoperatively compared with the open drainage group.It was also noted that the patients of the open drainage group had run into a lot of difficulties eating, sleeping, excreting and doing daily activities due to bacterial infections.By switching from open drainage to closed drainage in postoperative procedures,our department has succeeded in reducing the incidence of surgical site infections, thus making it possible to obtain a remarkably favorable result in terms of recuperation.