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Introducción: El 11 de marzo de 2020, la Organización Mundial de la Salud declara la COVID-19, enfermedad producida por un nuevo coronavirus (SARS-CoV-2), como una pandemia. Cuba, a pesar de todas las regulaciones establecidas por las autoridades sanitarias y estatales, desde el inicio de la pandemia, comienza el año 2021 con más de 29 mil enfermos y alrededor de 200 fallecidos. Objetivo: Describir las medidas que conforman el protocolo de actuación de la Unidad Quirúrgica del Instituto Nacional de Nefrología en el enfrentamiento a la COVID-19. Métodos: Se realizó una revisión de la literatura actual. Las fuentes de información utilizadas fueron: Google Académico, Medline, Embase, PubMed, Hinari, Clinical Key, Elsevier, Research-Gate, Web of Science, web de la OMS y el sitio oficial de gobierno del Ministerio de Salud Pública en Cuba. Desarrollo: En el contexto actual, la Unidad Quirúrgica del Instituto Nacional de Nefrología asume cirugías generales y urológicas, urgentes y emergentes, así como cirugías electivas relacionadas con el acceso vascular para hemodiálisis. Se establecen medidas higiénico-epidemiológicas recomendadas internacionalmente para las unidades quirúrgicas durante la pandemia, las cuales quedan descritas en el presente artículo. Conclusiones: La existencia de un protocolo de actuación en la Unidad Quirúrgica para el enfrentamiento a la COVID- 19 constituye una herramienta indispensable con el fin de crear un escenario preventivo de la enfermedad. Todos los trabajadores deben estar capacitados y tener a su disposición los equipos de protección individual(AU)
Introduction: On March 11, 2020, the World Health Organization (WHO) declared COVID-19, a disease produced by a new coronavirus (SARS-CoV-2), as a pandemic. Cuba, despite all the regulations established by health and state authorities since the beginning of the pandemic, begins the year 2021 with more than 29.000 sick people and about 200 deaths. Objective: To describe the measures that make up the performance protocol of the surgical unit of the National Institute of Nephrology in the confrontation of COVID-19. Methods: A review of the current literature was carried out. The sources of information used were Google Scholar, Medline, Embase, PubMed, Hinari, Clinical Key, Elsevier, Research-Gate, Web of Science, the WHO's website and the official government site of the Ministry of Public Health in Cuba. Development: In the current context, the surgical unit of the National Institute of Nephrology performs general and urological, urgent and emergent surgeries, as well as elective surgeries related to vascular access for hemodialysis. Internationally recommended hygienic-epidemiological measures are established for surgical units during the pandemic, which are described in this article. Conclusions: The existence of a performance protocol in the surgical unit for the confrontation of COVID- 19 is an indispensable tool for creating a preventive scenario against the disease. All workers should be trained and have personal protective equipment at their disposal(AU)
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Humans , Male , Female , Clinical Trial ProtocolABSTRACT
Resumen: Mientras el mundo enfrenta una pandemia por el agente vírico 2019-nCoV, las áreas críticas como la unidad quirúrgica se deben preparar para evitar la contaminación del personal de atención médica y el entorno. Los objetivos de este artículo son presentar las recomendaciones actuales para el uso de equipo de protección personal, dar a conocer los dispositivos útiles en la práctica de la anestesia y explicar las modificaciones y adecuaciones que se deben hacer a los recursos humanos y a los materiales dentro del área quirúrgica.
Abstract: While the world is facing a pandemic caused by the virus 2019-nCoV, critical hospital areas like the surgical unit must be ready to prevent contamination of the environment and the healthcare provider. The main purpose of this article is to review the current recommendations for using personal protection equipment, introduce devices that can prove useful for the practice of anesthesia and to explain the modifications and adaptations that must be made to both human and material resources in the surgical unit.
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Background: Proper documentation of the surgery done in the form of operative notes is a very important aspect of surgical practice. The aim of this clinical audit was to identify the existing standard of the operative notes written in a general surgical unit in a quaternary care hospital; and to compare it with the recommendations given by Royal College of Surgeons, England (in Good Surgical Practice, 2014) and if needed, to improve the standard of practice.Methods: In the first loop of this prospective audit, 75 consecutive operative notes which were written were compared with the RCS guidelines and the areas which had missing data were identified. These areas were informed to the residents, who are primarily involved in the documentation of the operative notes. The second loop of the audit was conducted after a gap of 4 months involving 75 consecutive operative notes again.Results: The areas which were initially deficient were better documented when analysed in the second loop.Conclusions: Documentation of operative notes does not always comply with the set guidelines as highlighted in the first loop of our audit. But by employing a clinical audit it is possible to identify the existing deficiencies and thereby improving the standards of practice. Also, operative note writing should be taught as part of surgical training. Definitions should be clearly provided, and specific guidelines should be established to improve the quality of the operative notes and their use to improve patient safety.
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Background: With teleneurosurgery, more patients with head injury are managed in the primary hospital under the care of general surgical unit. Growing concerns regarding the safety and outcome of these patients are valid and need to be addressed.Method: This study is to evaluate the outcome of patients with mild head injury which were managed in non-neurosurgical centres with the help of teleneurosurgery. The study recruits samples from five primary hospitals utilising teleneurosurgery for neurosurgical consultations in managing mild head injury cases in Johor state. Two main outcomes were noted; favourable and unfavourable, with a follow up review of the Glasgow Outcome Scale (GOS) at 3 and 6 months.Results: Total of 359 samples were recruited with a total of 11 (3.06%) patients have an unfavourable. no significant difference in GOS at 3 and 6 months for patient in the unfavourable group (P = 0.368).Conclusion: In this study we have found no significant factors affecting the outcome of mild head injury patients managed in non-neurosurgical centres in Johor state using the help of teleneurosurgery.
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Object To design a mobile class 1000 laminar flow clean field surgery unit to provide a clean space to facilitate the mobile medical rescue team to execute emergency operations in the field tent, private house and etc.Methods The principle of positive pressure isolation and finite element simulation were involved in the design of two-way air intake channel on the top, flexible isolation laminar flow clean module which could be constructed rapidly, three-stage composite clean air supply module and integrated surgery module with box instrumentation.Results The field surgery unit had all its performances meet the desired requirements, of which, the ventilation rate was 24 times per hour, the relative positive atmospheric pressure value was higher than 5 Pa in the surgical unit, and the cleanness reached level 6 at the operating and surrounding areas.Conclusion The field surgical unit can be deployed rapidly, and has the key indexes accord with the desired requirements for cleanness, ventilation rate and positive pressure difference, and thus can be used for the surgery support of the mobile medical rescue team during wartime operations and emergency medical rescue.
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Aim: The aim of this study was to evaluate the utility and safety of a mobile eye surgical unit (MESU) in providing quality cataract surgery for the indigent rural population with poor access to quality eye care. Materials and Methods: Two buses connected by a vestibule were built to meet the requirements for a self‑sufficient operation theater (OT). In every camp, safe transportation of units, good alignment of buses, safe water, and maintenance of sterile environment were achieved with optimal utilization of OT. Results: Two thousand and twenty‑one patients in 21 remote locations underwent cataract surgery in MESU between 2012 and 2015. Visual outcome was 6/9 or better in 79.3%, posterior capsular rupture in 0.91%, zonulardialysis in 0.3%, aphakia in 0.2%, iridodialysis in 0.2%, and there was no incidence of endophthalmitis. Conclusion: MESU is a safe alternative in combating preventable blindness due to cataract in far‑off villages and tribal areas by providing quality eye care at the patient’s doorstep. This model has a great potential for duplication in other parts of India.
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To introducethe high frequency electro-surgical unit safety operation, reduce the pain of the patients, to maximize the effect of high frequency electro-surgical unit.
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PURPOSE: To introduce and assess the results of punctoplasty using a radiofrequency surgical unit for punctal stenosis. METHODS: Patients who complained of epiphora, had an intact lacrimal pathway below puncti, and underwent punctoplasty with the Ellman Surgitron F.F.P.F were evaluated in the present study. RESULTS: A total of 19 patients (31 eyes) were included in the study. The average age was 55 years (+/-15.7 years). At the last follow-up visit, 27 eyes (87%) had patent puncti, 1 eye became stenotic again, and 3 eyes were completely obstructed. Twenty-two eyes (71%) showed almost complete disappearance of dye on the fluorescein dye-disappearance test (FDDT). Twenty-five eyes (81%) had symptomatic improvement. No significant complication was reported postoperatively. CONCLUSIONS: Punctoplasty with a radiofrequency surgical unit is a simple and effective method for punctal stenosis.
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Humans , Constriction, Pathologic , Eye , Fluorescein , Follow-Up Studies , Lacrimal Apparatus DiseasesABSTRACT
PURPOSE: To evaluate the efficacy of the radiofrequency surgical unit for the removal of benign tumors at the eyelid margin. METHODS: Twenty-five benign tumors at the eyelid margin were removed with the Ellman Surgitron F.F.P.F(R). Histologic examination of the excised tumors was performed in 18 of the 25 cases. RESULTS: There were 15 eyes of 15 females and 10 eyes of 10 males with age ranging from 20.9 to 73.5 years (mean, 41.8 years). Over a mean follow-up of 21.1 months, there was no instance of recurrence in any of the patients. In addition, there were no serious complications except temporary foreign body sensation and eye discharges. CONCLUSIONS: Using the radiofrequency surgical unit for benign tumors at the eyelid margin may simplify the surgery, avoid recurrence, and produce a satisfactory cosmetic effect.