RESUMEN
The aim of this study is to present the SurgeForce system, a tissue handling training device for analysis of dynamic force applied to the tissue and objective assessment of basic surgical skills during the suture process. The SurgeForce system consists of a mechanical base formed by two platforms joint with three stainless steel springs and a three axial digital accelerometer attached to the upper platform, which detects the dynamic force caused by a surgeon when performing a suture task over a synthetic tissue pad. Accelerometer data is sent to a control unit where preprocessing to transform the raw data into a force signal is done, and then, the force signal is sent to a computer application, which register the force exerted over the synthetic tissue pad. For validation, 17 participants (6 surgeons and 11 medical students) performed three simple interrupted sutures with knot tying using the SurgeForce system. Ten force-based metrics were proposed to evaluate their performance during the suturing task. Results of the validation showed statistical differences in 8 of 10 force-based parameters for assessment of basic surgical skills during the suture task. The SurgeForce system demonstrated its capacity to differentiate force-based performance of surgeons and medical students. The SurgeForce system has been successfully validated. This system was able to distinguish force performance between experts and novices, showing its potential to distinguish surgeons with basic suture skills from those who are not yet prepared.
Asunto(s)
Laparoscopía , Estudiantes de Medicina , Cirujanos , Competencia Clínica , Humanos , Técnicas de Sutura , SuturasRESUMEN
Objetivo: Proporcionar material didáctico útil al estudiante y al médico general para conocer la técnica de venodisección en un modelo biológico no vivo. Sede: Departamento de Cirugía, Facultad de Medicina, UNAM. Diseño: Modelo de enseñanza. Material y método: Se proporcionan indicaciones, contraindicaciones, características anatómicas y técnica a considerar. Empleamos pata de cerdo como modelo didáctico por ser accesible en costos, disponibilidad y un modelo fácilmente reproducible por los alumnos. Por su semejanza con los eventos clínicos que suceden en los pacientes a nivel hospitalario, consideramos que representa un buen método de enseñanza de habilidades quirúrgicas en el pregrado. Conclusión: El actual modelo biológico es una opción viable y representativa de la venodisección; el alumno aprende a identificar al paciente que requiere de este procedimiento; una vez identificado, podrá realizar el procedimiento de manera adecuada evitando, en la medida de lo posible, cualquier tipo de complicación.
Objective: To provide teaching material useful for the medical student and the general physician to learn the venous cutdown technique in a non-live biological model. Setting: Department of Surgery, School of Medicine, UNAM. Design: Teaching model. Material and method: Indications, contraindication, anatomical characteristics and technique to be considered will be provided. We use a pig foot as didactic model because it is accessible in terms of costs, availability, and can be reproduced easily by students. Due to its similarity with clinical events occurring in patients at the hospital level, we consider that it represents a good teaching method of surgical skills at the undergraduate level. Conclusion: The current biological model is a viable option and representative of venous cutdown. The student learns to identify the patient that requires this procedure, once identified he will be able to perform the procedure adequately avoiding, as much as possible, any type of complication.
RESUMEN
BACKGROUND: "Surgical scrub" of the hands and arms is a fundamental procedure for reducing infection risk. We undertook this study in order to compare different antiseptics and their microbicidal effects, costs and times of the procedures. METHODS: Thirty students followed the surgical scrub procedure using benzalkonium chloride. Seven days later the students used povidone-iodine and, 7 days after that, they used chlorhexidine/alcohol. After the surgical scrub, cultures were obtained from the palms of their hands and from their nail beds. The students wore sterile gloves, which were removed 30 min later to obtain new cultures from the same sites. The cost of the products was calculated in Mexican pesos and the time of each procedure was measured in minutes. RESULTS: There was a statistically significant difference in the number of colony-forming units (CFUs). The number of CFUs was lower in the groups of students who used chlorhexidine/alcohol and povidone-iodine as compared to the benzalkonium chloride group. There was no difference between chlorhexidine/alcohol and povidone-iodine. Costs were higher for povidone-iodine and benzalkonium chloride compared to chlorhexidine/alcohol. Procedure times were similar with povidone-iodine and benzalkonium chloride but the time was reduced approximately five times when using chlorhexidine/alcohol. CONCLUSIONS: It is a proven fact that the lack of surgical scrub favors wound infections, longer hospital stays and increased costs. Therefore, further studies are needed to determine the best antiseptic according to cost/benefit. Chlorhexidine/alcohol proved to be the superior antiseptic in terms of cost/benefit compared to povidone-iodine and benzalkonium chloride.