Kennedy Katie C, Tamburello Kathereen R, Hardie Robert J
Aspen Meadow Veterinary Specialists, Longmont, CO, USA.
J Vet Med Educ. 2011 Winter;38(4):408-13. doi: 10.3138/jvme.38.4.408.
The present study describes the morbidity associated with ovariohysterectomy (OVH) when performed by third-year veterinary students as part of a surgical-training program. Data recorded from medical records included signalment, concurrent illness(es), surgical procedure(s), anesthesia and surgery time, anesthetic and surgical complications, and semester performed. The students' surgical training before the OVH included 39 lecture and 26 laboratory hours. In the present study, 513 animals (206 dogs and 307 cats) were included, of which 120 (23.4%) animals had concurrent illnesses. Median anesthesia time was 145 minutes (ranging from 65 to 240) for cats and 180 minutes (ranging from 90 to 360) for dogs. Median surgery time was 105 minutes (ranging from 50 to 210) for cats and 140 minutes (ranging from 65 to 265) for dogs. There were two (0.4%) major anesthetic complications, one resulting in death. There were 206 (41.7%) minor anesthetic complications, the most common being hypothermia. There were 17 (3.3%) major surgical complications, the most common being body wall dehiscence (n=15), and 49 (9.5%) minor surgical complications, the most common being seroma formation (n=35). Complications were comparable to previous reports. Specific aspects of the program identified for improvement included placing greater emphasis on securely tying the terminal knot of a simple continuous suture pattern to prevent body wall dehiscence, improved measures to reduce post-operative hypothermia, and implementing stricter health screening of animals before enrollment into the program. Faculty program coordinators are encouraged to conduct similar studies so that best practices can be shared and outcomes can be compared as we work toward determining the ideal methods of training students to instill core surgical competencies.
本研究描述了三年级兽医学生在外科培训项目中进行卵巢子宫切除术(OVH)时的发病情况。从病历中记录的数据包括动物特征、并发疾病、手术过程、麻醉和手术时间、麻醉和手术并发症以及实施手术的学期。学生在进行OVH手术前的外科培训包括39小时的讲座和26小时的实验室操作。在本研究中,共纳入513只动物(206只狗和307只猫),其中120只(23.4%)动物患有并发疾病。猫的中位麻醉时间为145分钟(范围65至240分钟),狗的中位麻醉时间为180分钟(范围90至360分钟)。猫的中位手术时间为105分钟(范围50至210分钟),狗的中位手术时间为140分钟(范围65至265分钟)。有两例(0.4%)严重麻醉并发症,其中一例导致死亡。有206例(41.7%)轻微麻醉并发症,最常见的是体温过低。有17例(3.3%)严重手术并发症,最常见的是腹壁裂开(n = 15),49例(9.5%)轻微手术并发症,最常见的是血清肿形成(n = 35)。并发症情况与以往报告相当。确定需要改进的项目具体方面包括更加强调牢固系紧简单连续缝合模式的末端结以防止腹壁裂开、改进措施以减少术后体温过低,以及在动物纳入该项目前实施更严格的健康筛查。鼓励教师项目协调员进行类似研究,以便在我们努力确定培养学生核心手术能力的理想培训方法时,能够分享最佳实践并比较结果。