Is there a role for artistic training in surgery? A multi-institutional assessment of general surgeons and plastic surgeons

Author(s):  
Allison C. Hu ◽  
Beatrice J. Sun ◽  
Wendy K.Y. Ng
Author(s):  
James J. Drinane ◽  
Brian Drolet ◽  
Ashit Patel ◽  
Joseph A. Ricci

Abstract Introduction Fellowship-trained hand surgeons may have residency training in either orthopedic, plastic, or general surgery, generating significant variability in education background. To study the effect of different training backgrounds on practice pattern variations, we utilized the NSQIP (National Surgical Quality Improvement Database) database to assess hand surgery volumes and case variety by specialty. Materials and Methods NSQIP years 2008 to 2017 was queried with hand surgery current procedural terminology codes defined by the American Board of Orthopedic Surgery. Procedures were grouped according to type and specialty, and relative rates calculated. Hand society membership data were used to determine if procedural volume for each specialty in each category and overall contribution to the volume of hand surgery performed nationally was distributed in accordance with membership data. Results A total of 145,015 hand surgeries were performed; 13,267 (9.1%) by general surgeons, 28,402 (19.6%) by plastic surgeons, and 103,346 (71.3%) by orthopedic surgeons. Orthopedic surgeons performed significantly more bone, fracture, joint, and tendon cases. General surgeons and plastic surgeons performed higher than expected numbers of soft tissue coverage and cases overall with respective excesses of 183 and 22%. Conclusion Hand surgery is an available fellowship pathway from multiple residencies. Fellowship training does not level the field of real-world practice patterns. Residency training experiences significantly impact practice.


2019 ◽  
Vol 8 (2) ◽  
Author(s):  
David Muchuweti ◽  
Hopewell Mungani ◽  
Hopewell Mungani ◽  
Farai Mahomva ◽  
Edwin Gamba Muguti ◽  
...  

Oftentimes general surgeons working in poorly resourced communities carry out emergency abdominal surgery in patients with acute abdomen with no definitive preoperative diagnosis. The definitive diagnosis is made at laparotomy. Perforated small bowel obstruction secondary to heavy Infestation with Ascaris Lumbricoides brings a number of intraoperative challenges requiring correct intraoperative surgical management decisions. We present a case of a 17 year-old patient who was admitted with a diagnosis of small bowel obstruction who at laparotomy was found to have perforated gangrenous small bowel volvulus with heavy worm load visible through the bowel wall. Because of faecal peritoneal contamination and haemodynamic instability she underwent a two staged procedure with good outcome.


2014 ◽  
Vol 7 (2) ◽  
pp. 31-63
Author(s):  
Sonia Lagerwall

This article deals with Philippe Druillet's three-volume comic adaptation (1980–1985) of Salammbô, Gustave Flaubert's historical novel from 1862, set three centuries BC. Flaubert was famous for not wanting his texts illustrated: he argued that the preciseness of images would undo the poetic vagueness of his written words. The article examines how Druillet tackles the challenge of graphically representing Flaubert's canonical work without reducing the priestess Salammbô into a given type. The analysis shows a dynamic adaptation process in which Druillet gives a kaleidoscopic form to Flaubert's text. His variation on the Salammbô character foregrounds photography, a medium historically relevant to the novel but also to Druillet's own artistic training. Featuring his character Lone Sloane in the role of Mathô, the adaptation proves to be a highly personal appropriation of the novel, where Druillet enhances an autobiographical dimension of his work previously hinted at in La Nuit and Gaïl.


2020 ◽  
Vol 5 (1) ◽  
pp. e000542
Author(s):  
Nabil Issa ◽  
Whitney E Liddy ◽  
Sandeep Samant ◽  
David B Conley ◽  
Robert C Kern ◽  
...  

BackgroundCricothyrotomy is associated with significant aerosolization that increases the potential risk of infection among healthcare providers. It is important to identify simple yet effective methods to suppress aerosolization and improve the safety of healthcare providers.Methods5 ear, nose and throat and general surgeons used a locally developed hybrid cricothyrotomy simulator with a porcine trachea to test three draping methods to suppress aerosolization during the procedure: an X-ray cassette drape, dry operating room (OR) towels and wet OR towels. The three methods were judged based on three categories: effectiveness of suppression, availability in all healthcare systems and ease of handling.ResultsAll five surgeons performed the procedure independently using each of the three suppression methods. The wet OR towel drape was found to be an effective method to suppress aerosolization, and it did not hinder the surgeons from performing the procedure accurately. This finding was confirmed by using an atomized fluorescein dye injection into the porcine trachea, representing aerosolized material while performing the procedure.ConclusionsWe present a novel intervention using wet towels to suppress aerosolization during cricothyrotomy. Wet towels are cheap and readily available within any healthcare setting regardless of the financial resources available.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Suleyman Utku Celik ◽  
Alperen Aslan ◽  
Eylul Coskun ◽  
Beyza Nur Coban ◽  
Zeynep Haner ◽  
...  

Abstract Background Burnout resulting from long-term and unmanaged workplace stress is high among healthcare professionals, especially surgeons, and affects both individuals and the quality of patient care. The objective of this study was to determine the prevalence and associated factors for burnout among attending general surgeons and to identify possible preventive strategies. Methods A national cross-sectional survey using a 35-item questionnaire was conducted among members of the Turkish Surgical Society. The survey evaluated demographics, professional and practice characteristics, social participation, and burnout as well as interventions to deal with burnout. Burnout was defined as a high score on the emotional exhaustion (EE) and/or depersonalization (DP) subscales. Surgeons with high scores on both the EE and DP and a low score on personal accomplishment (PA) were considered to have severe burnout. Results Six hundred fifteen general surgeons completed the survey. The median EE, DP, and PA scores were 34 (IQR, 20–43), 9 (IQR, 4–16), and 36 (IQR, 30–42), respectively. Overall, the prevalence of burnout and severe burnout were 69.1 and 22.0%, respectively. On multivariable analysis, factors independently associated with burnout were working in a training and research hospital (OR = 3.34; P < 0.001) or state hospital (OR = 2.77; P = 0.001), working ≥ 60 h per week (OR = 1.57; P = 0.046), and less frequent participation in social activities (OR = 3.65; P < 0.001). Conclusions Burnout is an important problem among general surgeons with impacts and consequences for professionals, patients, and society. Considering that burnout is a preventable condition, systematic efforts to identify at-risk populations and to develop strategies to address burnout in surgeons are needed.


Author(s):  
Stephen Stopenski ◽  
Areg Grigorian ◽  
Rachel Roditi ◽  
Zeljka Jutric ◽  
Maki Yamamoto ◽  
...  
Keyword(s):  

2021 ◽  
Vol 13 (01) ◽  
pp. 35-41
Author(s):  
Sunyarn Niempoog ◽  
Kiat Witoonchart ◽  
Woraphon Jaroenporn

AbstractModern hand surgery in Thailand started after the end of World War II. It is divided into 4 phases. In the initial phase (1950-1965), the surgery of the hand was mainly performed by general surgeons. In 1965-1975, which was the second phase, many plastic surgeons and orthopaedic surgeons graduated from foreign countries and came back to Thailand. They played a vital role in the treatment of the surgery of the hand and set up hand units in many centers. They also contributed to the establishment of the “Thai Society for Surgery of the Hand,” which still continues to operate. In the third phase (1975-2000), there was a dramatic development of microsurgery because of the rapid economic expansion. There were many replantation, free tissue transfers, and brachial plexus surgeries in traffic and factory-related accidents. The first hand-fellow training program began in 1993. In the fourth phase (since 2000), the number of hand injuries from factory-related accidents began declining. But the injury from traffic accidents had been increasing both in severity and number. Moreover, the diseases of hand that relate to aging and degeneration had been on the rise. Thai hand surgeons have been using several state-of-the-art technologies such as arthroscopic and endoscopic surgery. They are continuing to invent innovations, generating international publications, and frequently being invited as speakers in foreign countries.


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