ABSTRACT
Perioperative risk in vascular medicine is particularly high due to the increased prevalence of cardiovascular comorbidity. Therefore, it is of the utmost importance that during periprocedural management the patient remains in good general condition and that the patient is mobilized as soon as possible. Along with implementation of minimally-invasive techniques and endovascular procedures, networking and cooperation between the surgeon, anesthesiologist, physiotherapist and the nursing team can lead to an optimization of perioperative mobilization. The Fast-Track concept represents uncharted territory in the field of vascular surgery and it can provide advantages, particularly in relation to multimorbidity in the field of vascular medicine. The Fast-Track concept was introduced by Danish surgeon Henrik Kehlet and was originally intended to be implemented in general surgery. When compared to conventional management, this method offers better medical results, lower costs and other advantages for the patient: besides a better perioperative condition a reduction of postoperative complications and reduction of overall in-hospital stay was achieved. Therefore, the next logical step was to introduce and adapt this concept to other fields of operative medicine. This paper represents a systematic review on the actual experience of the fast-track concept in vascular surgery.
Subject(s)
Early Ambulation , Endovascular Procedures , Peripheral Arterial Disease/therapy , Vascular Surgical Procedures , Endovascular Procedures/adverse effects , Humans , Interdisciplinary Communication , Intraoperative Care , Length of Stay , Patient Care Team , Peripheral Arterial Disease/surgery , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Time Factors , Treatment Outcome , Vascular Surgical Procedures/adverse effectsABSTRACT
Vascular comorbidities are common in vascular surgery, being associated with perioperative complications. Since it was demonstrated that the postoperative course could be optimized by introduction of the fast track concept in general surgery, application to vascular surgery may also be of benefit. The fast track concept was introduced in our institution on May 1st 2008 with special adjustments for vascular surgery. The authors describe the development and implementation of a clinical pathway, which proved to be of value in vascular surgery.
