ABSTRACT
BACKGROUND: The dress code for surgeons has evolved over time from formal suit-and-tie to crisp white coat, and currently to various forms of smart-casual attire; however, there is no stipulated or rigid uniform guideline. It is important to explore and discuss the various forms of attire in relation to patients' ideals and perceptions of a surgeon. METHODS: An observational study in the form of a paper-based questionnaire was carried out at the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), Chris Hani Baragwanath Academic Hospital (CHBAH) and Wits Donald Gordon Medical Centre (WDGMC). Seven questions (Q1-Q7) were posed with various dress categories to select from in each question, namely: formal, smart, smart-casual and scrubs. Descriptive analysis of the survey responses, and the determination of the association between survey responses and a) hospital, b) gender, c) age group was performed. Fisher's exact test was used where the requirements for the chi-square test could not be met. Attire groups with n < 15 were not analysed. The strength of the associations was measured by Cramer's V and the phi coefficient respectively. Data analysis was carried out using SAS v9.4 for Windows. A 5% significance level was used. RESULTS: A total of 387 questionnaires were filled out with a total of 376 fully completed and eligible samples in consenting participants of 18 years and older. In all seven questions, scrubs were the preferred attire. Overall, for Q1-Q5 and Q7, after scrubs, smart was the next most popular attire. For Q6, after scrubs, smart, smart-casual and formal were all popular, indicating some leeway on weekends and public holidays. There was a significant association between each of the responses to the question and hospital (p < 0.0001). At CHBAH, patients preferred scrubs more and smart attire less, compared to CMJAH and WDGMC. At CMJAH, preference for formal attire was greater when compared to the other two hospitals. CONCLUSION: Overall, patients preferred their surgeons to be dressed in scrubs as this attire easily identified surgeons and instilled confidence in the wearer.
Subject(s)
Surgeons , Humans , South AfricaABSTRACT
BACKGROUND: Laparoscopic donor nephrectomy has become the procedure of choice for living donor kidney transplantation in many centres. We report on our experience with hand-assisted laparoscopic donor nephrectomy (HALDN). We concentrated on graft function and postoperative surgical complications in the recipient population, and compared outcomes to a similar recipient group who had received kidneys procured by open living-donor nephrectomy (OLDN). METHOD: Following the receipt of institutional approval, the files of all patients who received a kidney transplant between September 2008 and June 2011 were reviewed. One hundred patients with end-stage renal disease received kidney transplantations from living donors. OLDN was performed in 65 donors, and 35 underwent HALDN. Delayed graft function (DGF) and postoperative complications were recorded. RESULTS: Six adverse events were reported, during which five patients presented with DGF. One DGF was reported in the HALDN group, and four in the OLDN group. The morbidity in the HALDN group (1/35, 3%) was a graft rupture secondary to acute rejection which required exploration and transplant nephrectomy. Reoperation was required in five patients in the OLDN group (5/65, 8%). This amounted to overall morbidity of 6%, with no recipient mortalities. CONCLUSION: As previously documented, HALDN is safe for the donor, and not inferior to OLDN. In this study, it was associated with neither an increased incidence of DGF, nor a higher complication rate in the transplant recipient, when compared to the cohort that received a kidney harvested using the OLDN technique.