The Critical Portions of Carpal Tunnel Surgery: A Comparison Between Opinions of Surgeons and the General Public.

Autor:	Pidgeon TS; Department of Orthopaedic Surgery, Division of Hand, Upper Extremity, and Microvascular Surgery, Duke University Medical Center, Duke University School of Medicine, Durham, NC. Electronic address: tyler.pidgeon@duke.edu., Lauder AS; Department of Orthopedic Surgery, Division of Hand, Upper Extremity, and Microvascular Surgery, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO., Tong BC; Department of Surgery, Division of Cardiac and Thoracic Surgery, Duke University Medical Center, Duke University School of Medicine, Durham, NC., Green CL; Duke Clinical Research Institute, Duke University Medical Center, Duke University School of Medicine, Durham, NC., Risoli T Jr; Duke CTSI Biostatistics, Epidemiology and Research Design (BERD) Methods Core, Duke University Medical Center, Duke University School of Medicine, Durham, NC., Richard MJ; Department of Orthopaedic Surgery, Division of Hand, Upper Extremity, and Microvascular Surgery, Duke University Medical Center, Duke University School of Medicine, Durham, NC., Mithani SK; Department of Surgery, Department of Orthopaedic Surgery, Division of Plastic, Maxillofacial and Oral Surgery, Duke University Medical Center, Duke University School of Medicine, Durham, NC.
Jazyk:	angličtina
Zdroj:	The Journal of hand surgery [J Hand Surg Am] 2021 Mar; Vol. 46 (3), pp. 242.e1-242.e11. Date of Electronic Publication: 2020 Oct 27.
DOI:	10.1016/j.jhsa.2020.08.016
Abstrakt:	Purpose: Attending surgeons must participate in critical and key portions of procedures and otherwise be immediately available. However, surgeon-defined standards of the critical and key portions of surgery have been questioned, potentially affecting trainee graduated responsibility. This study compares the opinions of surgeons and the general public regarding what constitutes the critical portions of carpal tunnel release (CTR). Methods: A survey was devised inquiring about the appropriateness of surgical trainee execution of each step of CTR. Surgeons who perform CTR were queried (n = 112) and 32 (29%) responded. The survey was modified to compare responses from a sample of 184 nonmedical respondents (NMRs). The NMRs were excluded if they indicated having a career in health care. Results: Of the surgeon respondents, 94% (n = 30) had completed hand fellowship training, 53% (n = 17) declared themselves academic or affiliated with academia, and 53% (n = 17) utilized concurrent operating rooms. The NMR average age was 35.3 ± 10.3 years, 40% were female (n = 73), and they represented various regions of the United States including an assortment of socioeconomic and ethnic groups. Surgeons demonstrated significantly more hesitation with trainees performing surgical steps. Academic surgeons were significantly more comfortable having trainees performing surgical steps than nonacademic surgeons. Critical portions of CTR as agreed upon by surgeons and NMRs included incision, dissection, transverse carpal ligament division, and inspection of the median nerve for injury/complete release. Conclusions: Surgeons are significantly less comfortable with trainee performance of CTR steps than the general public. Surgeons who regularly work with trainees are more accepting of trainee involvement than those who do not. Clinical Relevance: Understanding the opinions of surgeons as well as NMRs with respect to surgical trainee participation in the operating room is important to optimize the informed consent process as well as influence hospital policies that affect graduated surgical trainee autonomy. (Copyright © 2021 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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