McQuail P M, McCartney B S, Baker J F, Kenny P
Department of Trauma and Orthopaedics, Connolly Memorial Hospital, Mill Road, Blanchardstown, Dublin 15, Ireland.
Ann Med Surg (Lond). 2016 Nov 9;12:54-59. doi: 10.1016/j.amsu.2016.10.006. eCollection 2016 Dec.
Diathermy is an integral part of many modern surgical procedures. While diathermy is generally accepted as 'safe', electrosurgery-induced injuries are among the more common causes for malpractice litigation. The purpose of this study was to evaluate the awareness among surgeons of the principles, risks, precautions and appropriate use of diathermy.
All surgeons employed from Senior House Officer (SHO) to Consultant grade in two teaching hospitals were surveyed. Sixty-three surgeons were asked to complete an anonymous questionnaire, which recorded level of training and addressed competence in principles, hazards, and precautions to be taken with diathermy.
Eight Consultants, 5 Specialist Registrars, 19 Registrars and 13 SHO's responded (71% response). All but three subspecialties were represented. Eighty-two percent (37/45) had no formal diathermy training. Despite 89% (40/45) of surgeons regarding diathermy as a safe instrument, 56% felt they had inadequate understanding of the principles and failed to demonstrate an appropriate awareness of the potential risks. Fifty seven percent exhibited a dangerous lack of awareness in managing equipment not yielding the desired effect and 22% were unaware of any patient groups requiring special caution. Only 42% wanted formal training.
Our results show a dearth of awareness among surgeons regarding diathermy. Given our findings, we urge a shift in attitude towards diathermy, with surgeons adopting a more cautious and safe approach to diathermy use. We recommend that formal training be introduced as a hospital based initiative.
透热疗法是许多现代外科手术不可或缺的一部分。虽然透热疗法通常被认为是“安全的”，但电外科手术引起的损伤是医疗事故诉讼中较为常见的原因之一。本研究的目的是评估外科医生对透热疗法的原理、风险、预防措施及正确使用的认知情况。
对两家教学医院从高级住院医师（SHO）到顾问级别的所有外科医生进行了调查。63名外科医生被要求填写一份匿名问卷，问卷记录了培训水平，并涉及透热疗法的原理、危害及预防措施方面的能力。
8名顾问医生、5名专科住院医生、19名住院医生和13名高级住院医师做出了回应（回应率71%）。除三个亚专业外，其他所有专业都有代表。82%（37/45）的医生没有接受过正式的透热疗法培训。尽管89%（40/45）的外科医生认为透热疗法是一种安全的器械，但56%的人觉得他们对其原理理解不足，未能表现出对潜在风险的适当认知。57%的人在处理未产生预期效果的设备时表现出危险的认知不足，22%的人不知道任何需要特别谨慎对待的患者群体。只有42%的人希望接受正式培训。
我们的结果表明外科医生对透热疗法缺乏认知。鉴于我们的研究结果，我们敦促对外科医生对待透热疗法的态度做出转变，使其在使用透热疗法时采取更谨慎和安全的方法。我们建议将正式培训作为一项基于医院的举措引入。
