Alharbi Rahaf M, Almutairi Ahmed M, Alsharari Kholod K, Almarwani Wejdan K, Hussamuldin Abdulrahman B, Alsaadi Fahad M, Alhazmi Wedyan M
College of Medicine, Almaarefa University, Riyadh, SAU.
College of Medicine, University of Jeddah, Jeddah, SAU.
Cureus. 2024 Apr 9;16(4):e57942. doi: 10.7759/cureus.57942. eCollection 2024 Apr.
Introduction Post-operative adhesions present a number of difficulties, including intestinal obstruction and infertility, and they frequently require readmission due to adhesion-related problems. Notwithstanding these ramifications, there are surprisingly few thorough national surveys that address surgeons' awareness of adhesives. By assessing Saudi surgeons' knowledge of post-operative adhesions and their use of anti-adhesive medications, this study aims to close this knowledge gap. Methods This study is a cross-sectional observational research study aimed at Saudi Arabian surgeons utilizing a self-administered, semi-structured online questionnaire. The questionnaire was distributed to participants via social media and in-person email using basic random selection. It included adhesion morbidity and prevalence, pre-operative informed consent issues, adhesion preventive viewpoints, and anti-adhesive chemical use. Results There were 111 participants in total, of 41% were experienced surgeons with more than five years of experience. According to the survey, the majority of surgeons occasionally employed anti-adhesive compounds, especially during laparotomies (28%), and 38% never used them during laparoscopies. The study found that participants varied in what they informed patients regarding adhesion complications: 25% of participants informed 5%-10% of the patients about the possible adhesion complications in laparotomy procedures, whereas 26% of participants informed 10-25% of the patients in laparoscopic procedures. Compared with their specialist peers, general surgeons agreed more on the clinical significance of adhesions and prevention. Notably, three-quarters of participants were unclear about when to use anti-adhesive compounds. Conclusion While acknowledging the clinical significance of post-operative adhesions and recognizing the potential for prevention, most surveyed surgeons did not include adhesions as a post-operative complication in informed consent. The study underscores a belief in the efficacy of anti-adhesives yet reveals a widespread lack of clarity regarding specific indications for their use. Recommendations include implementing educational sessions during surgical training to heighten awareness of adhesions as a major post-operative complication and to encourage the appropriate utilization of available barriers and pharmacological anti-adhesive products.
引言 术后粘连会带来诸多难题，包括肠梗阻和不孕不育，并且患者常常因粘连相关问题而需要再次入院治疗。尽管有这些影响，但令人惊讶的是，很少有全面的全国性调查涉及外科医生对粘连的认知情况。通过评估沙特外科医生对术后粘连的了解以及他们对抗粘连药物的使用情况，本研究旨在填补这一知识空白。方法 本研究是一项横断面观察性研究，针对沙特阿拉伯外科医生，采用自行填写的半结构化在线问卷。问卷通过社交媒体和个人电子邮件以基本随机抽样的方式分发给参与者。问卷内容包括粘连的发病率和患病率、术前知情同意问题、粘连预防观点以及抗粘连药物的使用情况。结果 共有111名参与者，其中41%是经验丰富的外科医生，有超过五年的工作经验。根据调查，大多数外科医生偶尔使用抗粘连化合物，尤其是在开腹手术期间（28%），而38%的医生在腹腔镜手术中从未使用过。研究发现，参与者在告知患者粘连并发症方面存在差异：25%的参与者在开腹手术中告知5% - 10%的患者可能出现的粘连并发症，而26%的参与者在腹腔镜手术中告知10% - 25%的患者。与专科同行相比，普通外科医生对粘连的临床意义和预防的认同度更高。值得注意的是，四分之三的参与者不清楚何时使用抗粘连化合物。结论 虽然认识到术后粘连的临床意义并认可预防的可能性，但大多数接受调查的外科医生在知情同意中并未将粘连列为术后并发症。该研究强调了对外科医生对抗粘连药物疗效的信任，但也揭示出在其具体使用指征方面普遍缺乏清晰认识。建议包括在外科培训期间开展教育课程，以提高对粘连作为主要术后并发症的认识，并鼓励合理使用现有的屏障和药物性抗粘连产品。
