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[Programme to introduce and develop minor out-patient surgery in primary care]
A Arroyo Sebastián1, A J Tomás Gómez, J Andreu Gálvez
1Servicio de Cirugía General y Aparato Digestivo, Hospital General Universitario, Elche, Alicante, España. arroyocir@hotmail.com
Introduction:
Despite the priority placed on it, minor surgery is not performed enough in primary care (PC).
Objective:
To create and evaluate a programme to introduce and develop minor out-patient surgery in primary care in a way that matches our health areas needs.
Design:
Prospective, longitudinal and descriptive study.
Setting:
Health Area 19 (Valencian Health Service): Surgery Department of Elche Hospital and 3 health centres (HC) (Altabix, Crevillente and Santa Pola).
Participants:
PC doctors and specialist surgeons. STAGES: a) Selection of HC. Working out protocol of kind of patient, pathology, paper-work and establishment of work circuits; b) surgical sessions at the HC, performed by two surgeons assisted by PC doctors (surgical leaders) and with surgical instruments from the hospital; c) surgery performed by PC doctors supervised by a surgeon, with instruments and the sterilisation circuit in the HC. The programme ends up with the PC doctors surgical autonomy and with use of the HCs own resources.
Results:
41 surgical sessions took place (14 in Altabix, 14 in Crevillente and 13 in Santa Pola). 335 patients were operated on in 398 surgical procedures (55.5% excisions, 34.9% electrocoagulation, 9.6% others). There were no immediate complications. The monthly evolution in the number of patients was constant, with a mean of 10.22 interventions per session. 36 doctors referred patients and 24 of them performed a surgical procedure.
Conclusions:
A practical and safe programme to introduce and develop minor surgery in PC, to the satisfaction of doctors and patients.
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