ABSTRACT
RESUMEN Objetivo: describir las percepciones de los cirujanos en formación durante la fase inicial de la pandemia por COVID-19. Material y métodos: se realizó el análisis transversal de una encuesta de 51 preguntas a médicos en formación de un Servicio de Cirugía General en un hospital de la Argentina. Se abarcaron 5 ámbitos: institucional, asistencial, académico, doméstico y emocional. Resultados: en total 55 médicos completaron la encuesta (91,7%): 35 residentes y 20 becarios de perfeccionamiento; 56,4% eran hombres. El 98,1% consideró suficiente la información brindada por el hospital y el servicio sobre las medidas tomadas con respecto al COVID-19. Si bien el 98,1% consideró satisfactorios los instructivos sobre los equipos de protección personal, el 38% informó inconvenientes en su utilización. El 92,5% de los residentes estuvo de acuerdo con el esquema de guardias implementado. El 94,5% incrementó el tiempo dedicado a actividades académicas. El 75% consideró útil el cronograma de clases virtuales implementado. El 72,7% de los encuestados consideró que contaba con espacios donde manifestar sus preocupaciones. El 60% consideró adecuada la supervisión. El 81,81% manifestó preocupación por perder habilidad manual. El 53% dijo sentirse frustrado y el 54% manifestó temor de contagiar a su familia/pareja. Conclusión: conocer las percepciones de los cirujanos en formación en la fase inicial de la pandemia por COVID-19 permitió detectar oportunidades de mejora e incorporar nuevas estrategias educativas para afrontar las fases siguientes, asegurando el aprendizaje y priorizando su bienestar físico y psicosocial.
ABSTRACT Objective: The aim of this study is to describe the perceptions of surgeons in training during the initial phase of the COVID-19 pandemic. Material and methods: A 51-question survey was conducted among physicians in training from a department of surgery in an Argentine hospital. Five domains were explored: institutional, healthcare, academic, domestic and emotional. Results: The survey was completed by 55 physicians (91.7%): 35 residents and 20 fellows. Among the respondents, 98.1% considered the information provided by the hospital and the department about the measures implemented in the COVID-19 stetting was sufficient. 98.1% considered that the instructions about personal protective equipment were satisfactory, but 38% reported difficulties to use them. 92.5% of the residents agreed with the system implemented for on-call shifts, 94.5% increased the time dedicated to academic activities, 75% considered the virtual class schedule implemented as very useful and 72.72% perceived that they had spaces to express their concerns. The supervision was considered adequate by 60%; 81.81% were worried to lose manual dexterity; 53% felt frustrated and 54% were afraid of infecting their family/partner. Conclusion: Understanding the perceptions of surgeons in training in the initial phase of the COVID-19 pandemic made it possible to detect opportunities for improvement and incorporate modifications to address the following phases, ensuring learning and prioritizing their physical and psychosocial well-being.
ABSTRACT
Abstract Klippel-Trenaunay syndrome (KTS) is a rare vascular malformation characterized by capillary malformation, venous malformations, and soft tissue or bone hypertrophy that affect the extremities in most cases. Knee or hip arthropathy are common associated conditions and cause serious disability. We present the case of a patient with a diagnosis of KTS and severe knee arthropathy. A 34-year-old man with KTS was referred to our hospital with severe knee arthropathy, with the joint fixed in a 90° position. CT Angiography and MRI of the left leg showed important varicose development of the superficial venous system with intraarticular vessels. After discussion of the case by a multidisciplinary committee, the patient was enrolled on a physiotherapy program and had achieved significant improvements in movement and quality of life at 12-month follow-up. Treatment of KTS is primarily conservative and a multidisciplinary approach is necessary.
Resumo A síndrome de Klippel-Trenaunay (SKT) é uma malformação vascular rara caracterizada por malformação capilar, malformações venosas e hipertrofia de tecidos moles ou ósseos que afetam as extremidades na maioria dos casos. A artropatia do joelho ou do quadril é uma condição comumente associada e causa sérias deficiências. Apresentamos o caso de um paciente com diagnóstico de SKT e artropatia grave do joelho. Um homem de 34 anos com SKT foi encaminhado ao nosso hospital com artropatia grave do joelho com articulação fixa na posição de 90 °. A angiotomografia e a ressonância magnética da perna esquerda mostraram importante desenvolvimento varicoso do sistema venoso superficial com vasos intra-articulares. Após o caso ser discutido em um comitê multidisciplinar, o paciente foi incluído em um programa de fisioterapia, obtendo uma melhora significativa nos movimentos e na qualidade de vida após 12 meses de acompanhamento. O tratamento da SKT é principalmente conservador e exige uma abordagem multidisciplinar.