Reaccreditation or recertification of general surgeons in Spain: That's the question. Results of a national survey.

INTRODUCTION: The Law for the Regulation of Health Professions (LOPS) indicates that health professionals will carry out continuous training throughout their professional life, and will regularly prove their professional competence. The objective of the study was to carry out a national survey to find out the opinion of Spanish surgeons and thus be able to prepare a recertification project by the Spanish Association of Surgeons. METHODS: Cross-sectional observational study carried out in June-July 2020, through a survey sent to the members of the Spanish Association of Surgeons. RESULTS: The survey had a total of 1230 visits and an overall completion rate of 784 responses (67.3%). 69.6% were unaware of the LOPS forecasts and 83.4% were unaware of similar initiatives in other specialties and 95.5% agreed to demand adequate information. 71.4% believed it necessary but only 57% believed that it should be mandatory. 82.9% would agree that it should be regulated through an objective and predictable official procedure. CONCLUSIONS: The concept of re-accreditation is not well known in our specialty and in view of the results obtained, adequate and reliable information seems necessary. Therefore, it would be pertinent to propose by the A.E.C. a specific project to assess activities and skills.

Utilidad de la urocinasa en el tratamiento de los abscesos intraabdominales mediante drenaje percutáneo / Utility of urokinase in percutaneous drainage treatment of intra-abdominal abscesses

Fundamento y objetivo: Analizar el resultado de la utilización de urocinasa en el drenaje percutáneo de abscesos intraabdominales. Pacientes y método: Estudio prospectivo y observacional de 50 pacientes con diagnóstico de absceso intraabdominal tratados en la Unidad de Radiología Intervencionista del Hospital Clínico Universitario de Zaragoza. Todos los procedimientos se realizaron con anestesia local y control ecográfico mediante la utilización de catéteres tipo Pigtail (12 a 14 Fr). Se realizó estudio bioquímico con determinación de pH y dímero D y estudio microbiológico del aspirado inicial. Ulteriormente, se administró una inyección de 10 cm3 de urocinasa (100.000 U) 3 veces al día durante al menos 3 días. Las variables de estudio incluyeron la tasa de resolución como variable principal así como otras variables, como epidemiológicas generales, índices de gravedad de Mannheim y Altona, características del absceso (localización, origen , pH, dímero D y estudio microbiológico), éxito técnico, estancia, días de tratamiento y mortalidad. Se realizó un estudio estadístico descriptivo general de todas las variables mediante el paquete estadístico G-Stat 2.0 para Windows. Resultados: La tasa de resolución fue del 86% y la tasa de éxito técnico del 100%; se realizó cirugía ulterior en 3 casos. La mortalidad fue del 8% (índice de peritonitis de Mannheim superior o igual a 13 e índice de peritonitis de Altona inferior o igual a –3,76). La media de tratamiento fue de 7 días y la media de estancia, de 12 días. Conclusiones: El tratamiento de los abscesos intraabdominales mediante drenaje percutáneo y lavados con urocinasa es un procedimiento seguro y reproducible, y obtiene resultados similares a los presentados en otros estudios (AU)

Background and objective: The aim of the study was to analyze the usefulness of the treatment with Urokinase (UK) in percutaneous drainage of intra-abdominal abscesses (IAA). Patients and Methods (AU) Prospective, observational study of 50 patients treated in the Interventional Radiology Unit from University Hospital Lozano Blesa .Zaragoza. Spain. All procedures were performed under local anesthesia and ultrasound control, using Pigtail catheters (12–14 F). PH , D-dimer determination and microbiological studies were done from the initial aspirated sample. Subsequently, we injected 10 cc of UK (100,000 IU) 3 times a day for 3 days at least. Variables study: Resolution (Principal variable). Other variables included epidemiological, specific prognostic indexes (Mannheim, Altona); types of abscesses (location/origin), pH, D-Dímer and microbiology. Technical success, days of treatment, stay and mortality were also analyzed. Results:Resolution: 86%; technical success: 100%; subsequent surgery: 3 cases. Mean treatment days: 7. Mean stay: 12 days. Death rate: 8% (PMI=/>13 and PIA II=/<−3,76). Conclusions: The treatment of IAA through percutaneous drainage and washed with urokinase, is a safe, feasible and reproducible technique. The outcomes are similar to those reported previously (AU)