ABSTRACT
Introduction: hospitals are the centers consuming most of the resources in the health sector. Determining the efficiency of hospitals is very beneficial when resources are limited. To determine efficiency of an organization, several indicators are used for comparison. Pabon Lasso Graph is one of the techniques that simultaneously compares these indicators. The main purpose of this study was to determine the efficiency of social security hospitals of Tehran based on Pabon Lasso Model in 2011
Methods: this descriptive cross-sectional study was carried out in seven hospitals under the direct supervision of social security in Tehran in 2011
Results: in this study, the average bed occupancy rate, average length of stay and bed turnover rate in hospitals were 77/75%, 4/03 days, and 82/29 per year, respectively. The results showed two hospitals were in zone I, a hospital in zone II, a hospital in zone III and three hospitals were located in zone IV. And only one hospital was efficient
Conclusion: the findings showed that only one hospital [14/2%] from seven hospitals appeared to be efficient. Hospital manager should take into consideration the hospitals that were inefficient
ABSTRACT
Necrosis of skin flaps is considered as an important complication in reconstructive surgery. We conducted an experimental study to investigate the efficacy of low-molecular weight heparin, clopidogrel and their combination to improve the flap survival. Forty male, adult Sprague-Dawlay rats were divided randomly into 4 groups. Standard rectangular, distally based dorsal random pattern skin flap was elevated. To prevent the graft effect, a sterile sheet was put under the flap. No pharmacological agent was administered for the control group. In group 2, single subcutaneous dose of enoxaparin [3.2 mg/kg] was immediately administrated after surgery. In group 3, clopidogrel [25 mg/kg] was given orally for 7 days. In group 4, both enoxaparin and clopidogrel were administrated. The rats were evaluated on post-operative day 7 for viable and necrotic portions of flaps. The mean and SD of necrosis was 17.79 +/- 2.5 cm in the control group, 16.20 +/- 3.1 cm in low-molecular weight heparin, 15.25 +/- 3.8 cm in combined therapy group and 13.69 +/- 2.7 cm in clopidogrel group. Clopidogrel was the only pharmaceutical agent that produced a significant increase in the flap survival area. Clopidogrel may be an effective pharmaceutical agent that significantly increases viability of random skin flaps in rats, but low-molecular weight heparin and their combination did not have any significant beneficial effects
ABSTRACT
We have found prefabrication of hairless radial forearm free flap to be a useful technique for nasal reconstruction. Prior skin grafting and a suitable period of maturation permits safe, reliable surgery. Its use should be considered in those patients whose forehead tissue is not suitable or in whom appropriate distant flaps are not available, as is often the case with hirsute males