Wilson M S
Department of Surgery, Christie Hospital, Manchester, UK.
Colorectal Dis. 2007 Oct;9 Suppl 2:60-5. doi: 10.1111/j.1463-1318.2007.01360.x.
In spite of postoperative adhesions being common there appears to be a reluctance to use anti-adhesion products routinely. This article compares the incidence of adhesions with other conditions in order to identify the level of risk. The health economics surrounding adhesion-related disease are described. This combined information may be of help to convince health practitioners of the need to take a more active role in adhesion prevention. The SCAR project has identified the risk of adhesion-related disease. This is compared with published risks of other common clinical situations. An economic model first described by the author in 2002 has been revised with 2006 costs [1]. The SCAR data demonstrates a directly related risk of re-admission in certain groups of 9.4% over 5 years [2]. The frequency of including this fact in the consenting process is low (<15%) [3]. Legal precedent has identified a risk of >2% warrants inclusion in the consent process; failure to do so could be considered negligent [4]. Use of an anti-adhesion product with a cost of 130 euros with an efficacy of 25% in 1 year in the UK could save over 40 million euros over a 10-year period. Adhesion risk is frequent enough to include in consent. Failure to do this and avoidance of treatment, which may reduce adhesions will have major financial consequences on healthcare systems.
尽管术后粘连很常见，但人们似乎不愿意常规使用抗粘连产品。本文比较了粘连与其他病症的发生率，以确定风险水平。描述了与粘连相关疾病的卫生经济学情况。这些综合信息可能有助于说服医疗从业者更积极地参与粘连预防工作。SCAR项目已经确定了粘连相关疾病的风险。将其与已公布的其他常见临床情况的风险进行了比较。作者于2002年首次描述的一个经济模型已根据2006年的成本进行了修订[1]。SCAR数据表明，某些群体在5年内再次入院的直接相关风险为9.4%[2]。在知情同意过程中提及这一事实的频率很低（<15%）[3]。法律先例规定，风险>2%就需要在知情同意过程中提及；不这样做可能被视为疏忽[4]。在英国，使用一种成本为130欧元、一年内疗效为25%的抗粘连产品，在10年期间可节省超过4000万欧元。粘连风险频繁到足以在知情同意中提及。不这样做以及避免使用可能减少粘连的治疗方法，将给医疗系统带来重大经济后果。
