The Journal of surgical research
-
Comparative Study
Complications Associated With Placement of Chest Tubes: A Trauma System Perspective.
The insertion of a chest tube is a common procedure in trauma care, and the Advanced Trauma Life Support program teaches the insertion of chest tubes as an essential and life-saving skill. It is also recognized that the insertion of chest tubes is not without risks or complications. The purpose of this study was to evaluate complications of chest tube placement in a level 1 trauma center compared with those placed in surrounding referral hospitals. ⋯ There are opportunities for improving the care of patients who require chest tubes at both referring hospitals and the receiving trauma center. Improving the care of patients who require intercostal drainage requires a systems-based approach, focusing on training and quality improvement.
-
Pilonidal, buttock, and perianal abscesses are common reasons for surgical consultation in the pediatric emergency department. Treatment typically includes a bedside incision and drainage, often followed by an abscess culture, and a course of oral antibiotics. We aimed to study the impact of culture data on changes in management and clinical outcomes. We hypothesized that management is unaffected by culture data, and therefore, fluid culture from pilonidal, buttock, and perianal abscesses in the pediatric population may represent an unnecessary laboratory test and cost. ⋯ We conclude that microbiological culture results are of limited utility in the management of pediatric pilonidal, buttock, and perianal abscesses as they do not appear to alter treatment, and omission of culture is not associated with failure of surgical management.
-
Competency-based medical education surgical curriculums will require frequent, recorded trainee performance evaluations. It is our hypothesis that written feedback after each operation can be used to chart surgical progress, can identify underperforming trainees, and will prove beneficial for resident learning. ⋯ The RRC adds further evidence to the fact that standardized, formative, and timely assessment can capture trainee performance over time and against comparator cohorts in an acceptable format to residents and academic training programs.