Effectiveness of Telementoring in Surgery Compared With On-site Mentoring: A Systematic Review

2017 ◽  
Vol 24 (4) ◽  
pp. 379-385 ◽  
Author(s):  
Elif Bilgic ◽  
Sena Turkdogan ◽  
Yusuke Watanabe ◽  
Amin Madani ◽  
Tara Landry ◽  
...  
Keyword(s):  
Systematic Review ◽  
Distance Learning ◽  
Educational Intervention ◽  
Clinical Encounter ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Training Tool ◽  
Levels Of Evidence ◽  
Technical Issues

Background. Mentorship is important but may not be feasible for distance learning. To bridge this gap, telementoring has emerged. The purpose of this systematic review was to evaluate the effectiveness of telementoring compared with on-site mentoring. Methods. A search was done up to March 2015. Studies were included if they used telementoring between surgeons during a clinical encounter and if they compared on-site mentoring and telementoring. Results. A total of 11 studies were included. All reported no difference in complication rates, and 9 (82%) reported similar operative times; 4 (36%) reported technical issues, which was 3% of the total number of cases in the 11 studies. No study reported on higher levels of evidence for effectiveness of telementoring as an educational intervention. Conclusion. Studies reported that telementoring is associated with similar complication rates and operative times compared with on-site mentoring. However, the level of evidence to support the effectiveness of telementoring as a training tool is limited. There is a need for studies that provide evidence for the equivalence of the effectiveness of telementoring as an educational intervention in comparison with on-site mentoring.

scholarly journals Distance learning and its impact on educational intervention on palliative care to nursing professionals–A pilot study

2021 ◽  
Vol 11 (11) ◽  
pp. 7
Author(s):  
Eric Benchimol Ferreira ◽  
Layz Alves Ferreira Souza ◽  
Maria Alves Barbosa ◽  
Claudia Paula Guimarães ◽  
Michelle Augusta Santos ◽  
...  
Keyword(s):  
Palliative Care ◽  
Distance Education ◽  
Distance Learning ◽  
Educational Intervention ◽  
Professional Training ◽  
Interdisciplinary Teams ◽  
Second Phase ◽  
Training Tool ◽  
Quasi Experimental ◽  
Nursing Professionals

Background and objective: Distance education (DE) is a professional training tool that was utilized to work with nursing professionals in this investigation on palliative care. This innovative form of care is used by interdisciplinary teams in a holistic way, with biological, psychological and spiritual aspects. Besides it is uniquely significant during pandemic lockdowns such as the current restrictions in nowadays. The aim of the study was to evaluate the knowledge of nursing professionals about palliative care, before and after an educational intervention through distance education.Methods: This is a quasi-experimental study carried out in a medium-sized state teaching hospital located in the Midwest region of Brazil. Participants: 31 nursing professionals who worked in the internal medicine ward. First phase, the prior knowledge about palliative care was evaluated through a questionnaire containing 24 semi-structured questions. In the second phase seven 20-minute video lessons were prepared, recorded and sent to the participating group. Third phase the same questionnaire was used to evaluate participants and they were inquired how they perceived they knowledge after distance learning.Results: A total of 31 professionals were enrolled in the first phase of the study and 29 answered the evaluation questionnaire after DE intervention. Most nursing professionals (61.2%) had between 31 and 50 years, 30 (96.7%) professionals had studied between 10 and 20 years. After DE there was an increase of 33% correct answers. Distance learning improved professional practice and increased confidence at work.Conclusions: Distance education is well accepted and promotes an increase of knowledge by up to a third on palliative care issues and also increased self-confidence among professionals.

scholarly journals Clinical Application of Antimicrobial Bone Graft Substitute in Osteomyelitis Treatment: A Systematic Review of Different Bone Graft Substitutes Available in Clinical Treatment of Osteomyelitis

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
T. A. G. van Vugt ◽  
J. Geurts ◽  
J. J. Arts
Keyword(s):  
Bone Graft ◽  
Clinical Studies ◽  
Local Treatment ◽  
Complication Rates ◽  
Success Rates ◽  
Level Of Evidence ◽  
Levels Of Evidence ◽  
Systemic Antibiotic Therapy ◽  
Eradication Of Infection ◽  
Bone Graft Substitutes

Osteomyelitis is a common occurrence in orthopaedic surgery, which is caused by different bacteria. Treatment of osteomyelitis patients aims to eradicate infection by debridement surgery and local and systemic antibiotic therapy. Local treatment increases success rates and can be performed with different antimicrobial bone graft substitutes. This review is performed to assess the level of evidence of synthetic bone graft substitutes in osteomyelitis treatment. According to the PRISMA statement for reporting systematic reviews, different types of clinical studies concerning treatment of osteomyelitis with bone graft substitutes are included. These studies are assessed on their methodological quality as level of evidence and bias and their clinical outcomes as eradication of infection. In the fifteen included studies, the levels of evidence were weak and in ten out of the fifteen studies there was a moderate to high risk of bias. However, first results of the eradication of infection in these studies showed promising results with their relatively high success rates and low complication rates. Due to the low levels of evidence and high risks of bias of the included studies, these results are inconclusive and no conclusions regarding the performed clinical studies of osteomyelitis treatment with antimicrobial bone graft substitutes can be drawn.

scholarly journals Interventions to Mitigate Fatigue Induced by Physical Work: A Systematic Review of Research Quality and Levels of Evidence for Intervention Efficacy

2019 ◽  
pp. 001872081987614 ◽  
Author(s):  
Lin Lu ◽  
Fadel M. Megahed ◽  
Lora A. Cavuoto
Keyword(s):  
Systematic Review ◽  
Methodological Quality ◽  
Workplace Safety ◽  
Research Quality ◽  
Physical Work ◽  
Controlled Trials ◽  
Physical Fatigue ◽  
Level Of Evidence ◽  
Levels Of Evidence ◽  
Moderate Evidence

Objective:We present a literature review on workplace physical fatigue interventions, focusing on evaluating the methodological quality and strength of evidence.Background:Physical fatigue is a recognized workplace problem, with negative effects on performance and health-related complaints. Although many studies have focused on the mechanisms and consequences of fatigue, few have considered the effectiveness of interventions to mitigate fatigue.Method:A systematic review of the workplace safety literature for controlled trials of physical fatigue interventions was conducted. Data on intervention type, subject characteristics, targeted tasks and body locations, outcome measures, and study design were extracted. The methodological quality for each study was evaluated using the PEDro scale, and the level of evidence was based on quality, amount, and consistency.Results:Forty-five controlled trials were reviewed, examining 18 interventions. We categorized those interventions into individual-focused ( N = 28 studies, nine interventions), workplace-focused ( N = 12 studies, five interventions), and multiple interventions ( N = 5 studies, four interventions). We identified moderate evidence for interventions related to assistive devices and task variation. There was moderate evidence supporting no fatigue attenuation for the garment change category of interventions. The interventions in the remaining categories had limited to minimal evidence of efficacy. The heterogeneity of the included trials precludes the determination of effect size.Conclusion:This review showed a lack of high levels of evidence for the effectiveness of most physical fatigue interventions.Application:Due to a lack of high levels of evidence for any category of reviewed physical fatigue interventions, further high-quality studies are needed to establish the efficacy of others.

Fat Grafting to Improve Results of Facelift: Systematic Review of Safety and Effectiveness of Current Treatment Paradigms

2020 ◽  
Vol 41 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Felipe Molina-Burbano ◽  
J Michael Smith ◽  
Michael J Ingargiola ◽  
Saba Motakef ◽  
Paymon Sanati ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fat Grafting ◽  
Treatment Modalities ◽  
Fat Graft ◽  
Cochrane Library ◽  
Complication Rates ◽  
Volume Loss ◽  
Level Of Evidence ◽  
Superficial Musculoaponeurotic System ◽  
Age Related

Abstract Background Autologous fat grafting is a helpful supplement to facelift surgery that helps to combat age-related volume loss of facial structures. Despite the widespread prevalence of combined facelift and fat-grafting, significant procedural variation exists between providers. Objectives The primary purpose of this systematic review was to study the efficacy and complication rates of facelift with lipofilling compared with facelift alone. Methods A systematic review of the Cochrane Library and MEDLINE databases as completed was undertaken to identify all clinical reports of fat grafting combined with facelift surgery based on the following key terms: (“fat grafting” OR “lipotransfer” OR “lipofilling” OR “fat transfer”) AND (“facelift” OR “rhytidectomy” OR “SMASectomy” OR “facial rejuvenation”). Data on techniques, outcomes, complications, and patient satisfaction were collected. Results The systematic review was performed in April 2017. In total, 248 articles were identified for review. After application of exclusion criteria, 15 primary studies were included in this review. Various facelift techniques were reported, including deep-plane or sub–superficial musculoaponeurotic system (SMAS) facelift, SMAS facelift, modified minimal access cranial suspension lift, component facelift, midface lift, SMAS plication, SMAS-stacking/SMASectomy, and SMASectomy. The most common locations of fat graft injection included the nasolabial folds, tear troughs, temporal regions, midface/cheek/malar eminence, marionette groove, lips, and ear lobes. The addition of fat grafting to facelift surgery resulted in significant improvements in facial volume and aesthetic assessments. Conclusions Combined facelift and fat grafting is a safe and efficacious means to simultaneously address age-related ptosis and volume loss. Further research is required to validate and improve existing treatment modalities. Level of Evidence: 3

Emergent urinary decompression in acute stone-related urinary obstruction: A systematic review and meta-analysis

2021 ◽  
pp. 205141582110170
Author(s):  
David Eugenio Hinojosa-Gonzalez ◽  
Mauricio Torres-Martinez ◽  
Sergio Uriel Villegas-De Leon ◽  
Cecilia Galindo-Garza ◽  
Andres Roblesgil-Medrano ◽  
...  
Keyword(s):  
Systematic Review ◽  
Length Of Stay ◽  
Operative Time ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Percutaneous Nephrostomy ◽  
Complication Rates ◽  
Success Rates ◽  
Level Of Evidence ◽  
Cell Counts

Introduction: Emergent urinary decompression through percutaneous nephrostomy (PCN) or ureteric stent (URS) remains a mainstay in the management of urethral calculi-related obstruction with associated signs of infection or renal injury. Available evidence has shown similar performance, and current guidelines endorse both treatment strategies. Methods: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria up until August 2020. Studies included data on stone size and location, operative time, complications, length of stay, analgesic consumption, quality of life (QoL), and clinical outcomes between URS and PCN. Results: Ten studies with a total population of 772, of which 420 were treated with URS and 352 with PCN, were included. No statistical difference in operative time between both techniques was found. Nevertheless, length of stay in PCN was longer than in USR, with a mean difference of −1.87 days ((95% CI −2.69 to −1.06), Z=4.50, p=0.00001). No differences were found in the time to normalization of temperature or white blood cell counts. There were no significant differences in success rates, with an overall odds ratio (OR) of 0.60 ((95% CI 0.26 to −1.40), Z=1.17, p=0.24), or spontaneous passage after emergent drainage between groups. Complication rates ranged from 5% to 25% in URS and from 0% to 38% in PCN. In the studied population, out of the 157 patients from four studies describing complications, only 5% of URS procedures presented complications compared to 2% in PCN, showing a relatively low complication rate for either group (OR=2.07 (95% CI 0.89–4.84), Z=1.68, p=0.09). Differences in QoL were not significant. Conclusion: Both methods are equally effective, with no clear advantage for PCN over URS. Level of evidence: IV

scholarly journals Return to Play After Revision Anterior Shoulder Stabilization: A Systematic Review

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712098205
Author(s):  
Brian C. Lau ◽  
Lorena Bejarano Pineda ◽  
Tyler R. Johnston ◽  
Bonnie P. Gregory ◽  
Mark Wu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Return To Play ◽  
Rate Of Return ◽  
Bone Block ◽  
Complication Rates ◽  
Weighted Mean ◽  
Shoulder Stabilization ◽  
Level Of Evidence ◽  
Patient Goals ◽  
Open Stabilization

Background: Revision shoulder stabilizations are becoming increasingly common. Returning to play after revision shoulder stabilizations is important to patients. Purpose: To evaluate the return-to-play rate after revision anterior shoulder stabilization using arthroscopic, open, coracoid transfer, or free bone block procedures. Study Design: Systematic review; Level of evidence, 4. Methods: All English-language studies published between 2000 and 2020 that reported on return to play after revision anterior shoulder stabilization were reviewed. Clinical outcomes that were evaluated included rate of overall return to play, level of return to play, and time to return to play. Study quality was evaluated using the Downs and Black quality assessment score. Results: Eighteen studies (1 level 2; 17 level 4; mean Downs and Black score, 10.1/31) on revision anterior shoulder stabilization reported on return to play and met inclusion criteria (7 arthroscopic, 5 open, 3 Latarjet, and 3 bony augmentation), with a total of 564 revision cases (mean age, 27.9 years; 84.1% male). The weighted mean length of follow-up was 52.5 months. The overall weighted rate of return to play was 80.1%. The weighted mean rate of return to play was 84.0% (n = 153) after arthroscopic revision, 91.5% (n = 153) after open revision, 88.1% (n = 149) after Latarjet, and 73.8% (n = 65) after bone augmentation. The weighted mean rate of return to same level of play was 69.7% for arthroscopic revision, 70.0% for open revision, 67.1% for Latarjet revision, and 61.8% after bone block revision. There were 5 studies that reported on time to return to play, with a weighted mean of 7.75 months (4 arthroscopic) and 5.2 months (1 Latarjet). The weighted mean rates of complication (for studies that provided it) were 3.3% after arthroscopic revision (n = 174), 3.5% after open revision (n = 110), 9.3% after Latarjet revision (n = 108), and 45.8% after bone block revision (n = 72). Conclusion: Revision using open stabilization demonstrated the highest return-to-play rate. Revision using Latarjet had the quickest time to return to play but had higher complication rates. When evaluated for return to same level of play, arthroscopic, open, and Latarjet had similar rates, and bone block had lower rates. The choice of an optimal revision shoulder stabilization technique, however, depends on patient goals. Higher-quality studies are needed to compare treatments regarding return to play after revision shoulder stabilization.

A Systematic Review and Meta-Analysis of Complications Associated With Autogenous Diced Cartilage Wrapped in Fascia Used in Nasal Dorsum Augmentation

2021 ◽  
Author(s):  
Seied Omid Keyhan ◽  
Shaqayeq Ramezanzade ◽  
Behnam Bohluli ◽  
Hamid Reza Fallahi ◽  
Madjid Shakiba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Donor Site ◽  
Reference List ◽  
Complication Rates ◽  
Nasal Dorsum ◽  
Level Of Evidence ◽  
Recipient Site ◽  
Diced Cartilage

Abstract Background Nasal dorsum augmentation is a highly challenging rhinoplastic procedure. Problems encountered in this surgery, such as residual humps, irregularities, and asymmetry, account for a significant number of revision rhinoplasties. Objectives The aim of this meta-analysis was to assess complication rates and graft harvesting site morbidity and revision rates. Methods We carried out a systematic review of the literature for pertinent materials in PubMed/Medline and Google Scholar up to and including August 2020. In addition, the reference list of included studies was searched manually. The criteria used were those described in the PRISMA Declaration for performing systematic reviews. Results The initial search yielded 236 results. After 3 stages of screening, 16 papers (18 groups) were included in the systematic review and meta-analysis. Our results indicated that the total rates for the complications studied were as follows: graft resorption, 2.52%; insufficient augmentation, 3.93%; deviation (graft displacement), 1.77%; infection, 2.30%; irregularity, 1.36%; supra-tip depression, 1.13%; overcorrection, 3.06%; hematoma at recipient site, 1.36%; and visible bulging of the graft, 2.64%. The total rates for donor site hypertrophic scar and donor site hematoma were 2.64% and 3.58%, respectively. The rate of the revision surgery was 3.03%. Conclusions Current findings suggest the overall complications and revision rates with the use of diced cartilage wrapped in fascia for dorsum augmentation were relatively low and this technique is a reliable treatment choice for patients with primary/secondary dorsum deficiencies. Further studies with larger sample sizes and long-term follow-ups, clearer definitions of complications, and objective measurements are warranted to draw reliable practical conclusions. Level of Evidence: 4

Pre-operative counselling for laryngectomy patients: a systematic review

2015 ◽  
Vol 130 (1) ◽  
pp. 15-20 ◽  
Author(s):  
E Fitzgerald ◽  
A Perry
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Methodological Quality ◽  
Search Strategy ◽  
Concept Map ◽  
Review Of The Literature ◽  
Level Of Evidence ◽  
Levels Of Evidence

AbstractObjectives:This study aimed to undertake a systematic review of the literature about pre-operative counselling for laryngectomy patients, identify its practice and patient and (where possible) carer perceptions.Methods:A search strategy was formulated using a concept map and a Population, Intervention, Comparative Interaction and Outcomes (‘PICO’) schema. All publications from 1975 to 2015 reporting pre-operative counselling of laryngectomy patients were included. Papers were retrieved and critiqued, and those included were assigned a level of evidence (according to the Joanna Briggs Institute schema).Results:Of the 56 papers retrieved, 21 were included in the review. The literature is limited: studies demonstrate bias and are of poor methodological quality. There are clear, persistent reports by patients and carers of shortfalls in clinical practice.Conclusion:Studies on pre-operative counselling for laryngectomees are flawed in design and represent weak levels of evidence. Pre-operative counselling has not been operationalised, resulting in differing paradigms being examined. Aggregation of data and/or results is not possible and the veracity of many studies is questioned.

scholarly journals The Use of High Strength Sutures and Anchors in Olecranon Fractures: A Systematic Review

2021 ◽  
Vol 12 ◽  
pp. 215145932199662
Author(s):  
Omid Nazifi ◽  
Rajitha Gunaratne ◽  
Harry D’Souza ◽  
Aaron Tay
Keyword(s):  
Systematic Review ◽  
High Strength ◽  
The Elderly ◽  
Tension Band ◽  
Current Evidence ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Suture Tension ◽  
Reoperation Rates ◽  
Olecranon Fractures

Purpose/Background: Olecranon fractures are common, particularly in the elderly osteoporotic population. Although various techniques of fixation are available, the gold standard—tension band wiring (TBW)—has high complication and reoperation rates. We sought to identify current evidence for the use of high-strength suture tension banding methods to determine whether they reduce complications and reoperation rates while maintaining fixation. Methods: A systematic review of several databases was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases included Cochrane, PubMed, MEDLINE and Embase. We searched for evidence of at least Level I to IV (according to NHMRC) of the use of tension band suturing or anchors in the surgical treatment of displaced olecranon fractures. We also analyzed the cost of fixation in our institute. Results: Four hundred and forty articles were identified. Of these, 9 met the inclusion criteria. One hundred thirty-one subjects had an average age of 66 years. All the studies showed that high-strength suture tension banding/anchoring maintained fixation with displaced olecranon fractures, reducing the complication rates and showed minimal reoperation rates. There was also a significant cost advantage of the suture tape construct mainly due to avoiding subsequent removal of metal. Conclusion: Tension band suturing or anchoring displaced olecranon fractures may be an alternative cost effective method to TBW in maintaining fixation, reducing metalware complications and reducing re-operation rates. Level of Evidence: IV.

scholarly journals Do Patient Positioning and Portal Placement for Arthroscopic Subtalar Arthrodesis Matter?

2020 ◽  
Vol 8 (7) ◽  
pp. 232596712092645
Author(s):  
Alan G. Shamrock ◽  
Annunziato Amendola ◽  
Natalie A. Glass ◽  
Keith H. Shamrock ◽  
Christopher C. Cychosz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prone Position ◽  
Fixed Effects ◽  
Patient Positioning ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Repeat Surgery ◽  
Subtalar Arthrodesis ◽  
Lateral Group ◽  
Portal Placement

Background: Arthroscopic subtalar arthrodesis was first described over 2 decades ago and originally performed in the lateral decubitus or supine position using anterolateral and posterolateral portals situated about the fibula. More recently, several authors have advocated for prone positioning utilizing posteromedial and posterolateral portals with an optional accessory lateral portal. To date, a comparison of these techniques has been limited. Purpose: To determine the effect of patient positioning and portal placement on complication rates after arthroscopic subtalar arthrodesis. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Patients were placed into 1 of 3 groups: the lateral group if they were positioned lateral or supine with lateral-based portals; the 2-portal prone group if they were positioned prone with posteromedial and posterolateral portals; or the 3-portal prone group if posteromedial, posterolateral, and accessory lateral portals were utilized in the prone position. Inverse variance–weighted fixed-effects models were used to evaluate pooled estimates. Results: A total of 20 studies examining 484 feet in 468 patients with a mean follow-up of 36.1 months were included for analysis. Overall, 8 studies examined patients in the prone position with 2 posterior portals (n = 111; 22.9%), 7 articles evaluated lateral portals (n = 182; 37.6%), and 5 studies examined patients in the prone position with 3 portals (n = 191; 39.5%). The total complication rate was similar ( P = .620) between the 2-portal prone (18.9%), 3-portal prone (17.8%), and lateral (17.6%) groups. There was no difference observed in the rate of complications secondary to portal placement ( P ≥ .334), rate of painful hardware ( P ≥ .497), and rate of repeat surgery ( P ≥ .304). The 2-portal prone group had a significantly higher rate of nonunion than the lateral group (8.1% vs 1.1%, respectively; P = .020) but not the 3-portal prone group (5.8%; P = .198). Conclusion: The current study demonstrated a higher rate of nonunion following arthroscopic subtalar arthrodesis with prone patient positioning using posteromedial and posterolateral portals without an accessory lateral portal.

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