Journal of the American College of Surgeons
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To date, little is known about the benefits of preoperative bowel preparation in patients undergoing elective ventral hernia repair (VHR). The purpose of this study was to determine the effect of preoperative bowel preparation on 30-day wound events in patients undergoing elective VHR using the Americas Hernia Society Quality Collaborative (AHSQC). ⋯ The use of preoperative bowel preparation in patients undergoing elective VHR does not reduce the risk of 30-day wound events.
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The Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial found no difference in patient outcomes or resident well-being between more restrictive and flexible duty hour policies. Qualitative methods are appropriate for better understanding the experience and perceptions of those affected by duty hour regulations. We conducted a pilot qualitative study on how resident duty hour regulations are perceived by general surgery program directors, surgical residents, and attending surgeons who participated in the FIRST Trial. ⋯ In our pilot study, interviewees valued the flexibility afforded in the Flexible Policy arm, as it allowed them to maximize patient safety and educational attainment. Additional qualitative research will expand on program director, resident, and attending perceptions of resident duty hours as well as perceptions of patient safety. Qualitative methods can contribute to the national debate on resident duty hours.
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Randomized Controlled Trial
Association between Flexible Duty Hour Policies and General Surgery Resident Examination Performance: A Flexibility in Duty hour Requirement for Surgical Trainees (FIRST) Trial Analysis.
Concerns persist about the effect of current duty hour reforms on resident educational outcomes. We investigated whether a flexible, less-restrictive duty hour policy (Flexible Policy) was associated with differential general surgery examination performance compared with current ACGME duty hour policy (Standard Policy). ⋯ Flexible, less-restrictive duty hour policies were not associated with differences in general surgery resident performance on examinations during the FIRST Trial. However, more years under flexible duty hour policies might be needed to observe an effect.