Madison, Wis.; Wilkes-Barre, Pa.; and Glenview, Ill. From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin; Plastic and Reconstructive Surgery, Geisinger Wyoming Valley; and private practice.
Plast Reconstr Surg. 2012 Nov;130(5):1038-1047. doi: 10.1097/PRS.0b013e31826945d6.
Beyond the controlled trauma of surgery, the operating room can be a hazardous place for patients and health care workers alike. Modern plastic surgery requires a thorough knowledge of various perioperative risks and methods to minimize these risks. As the importance of teamwork becomes more evident, clear communication skills preoperatively, intraoperatively, and postoperatively become equally critical. To facilitate an improvement in perioperative patient safety, this article will review aspects of communication, including crew resource management, root cause analysis, and surgical-site verification. In addition, the authors will discuss patient positioning, antiseptic hand and patient preparations, and barriers, such as surgical scrubs, gowns, gloves, and drapes.
The authors reviewed the literature regarding operating room safety, both primary research and secondary reviews, via multiple PubMed queries and literature searches. Topics most relevant to inpatient plastic surgery were included in the final analysis and summarized, as a full review of each topic is beyond the scope of this article.
Many possible interventions were identified, with the goal of reducing perioperative complications, such as wrong site surgery, neuropathies, myopathies, compartment syndromes, pressure ulcers, surgical-site infections, and blood-borne disease transmissions among plastic surgeons and their patients.
There are ample opportunities for the reduction of preventable adverse events in plastic surgery. This article aims to provide its reader with the tools to research adverse events and a basic education in avoiding specific preoperative events. A second article addressing intraoperative and postoperative patient safety follows.
除了手术的可控性创伤外，手术室对患者和医护人员来说都是一个危险的地方。现代整形手术需要对各种围手术期风险有透彻的了解，并采取措施将这些风险降到最低。随着团队合作的重要性变得越来越明显，术前、术中和术后清晰的沟通技巧同样至关重要。为了促进围手术期患者安全的改善，本文将回顾沟通方面的内容，包括机组资源管理、根本原因分析和手术部位确认。此外，作者还将讨论患者体位、手部和患者消毒准备以及手术服、手术袍、手套和手术巾等屏障。
作者通过多次 PubMed 查询和文献检索，对手术室安全的文献进行了综述，包括主要研究和次要综述。将与住院整形手术最相关的主题纳入最终分析并进行总结，因为对每个主题进行全面综述超出了本文的范围。
确定了许多可能的干预措施，旨在减少围手术期并发症，如手术部位错误、神经病变、肌肉病变、间隔综合征、压疮、手术部位感染和血源性疾病的传播等。
整形手术中存在大量减少可预防不良事件的机会。本文旨在为读者提供研究不良事件和避免特定术前事件的基本教育工具。随后将有一篇文章介绍术中及术后患者安全问题。
