Parker Emily B, Smith Jeremy T, Lausé Gregory, Bluman Eric M
Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Department of Orthopaedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany.
Foot Ankle Orthop. 2024 Aug 26;9(3):24730114241270272. doi: 10.1177/24730114241270272. eCollection 2024 Jul.
Extremity surgeons frequently operate on the preoperative stretcher rather than the operating room (OR) table. This study sought to identify differences between stretcher-based (SB) and OR table-based (TB) procedures with regard to time efficiency and OR team member preferences.
We conducted a prospective randomized controlled trial comparing the efficiency of SB vs OR TB foot and ankle procedures. Fifty-two patients undergoing a hardware removal, isolated gastrocnemius recession, soft tissue procedure, or foreign body removal at our day surgery unit were included. Start time and exit time were recorded. "Start time" was the number of minutes between the patient entering the OR and first incision. "Exit time" was the number of minutes between the procedure ending and the patient exiting the OR. Surveys were disseminated to OR staff who participated in the included cases.
The total measured time in the OR was an average 6 minutes shorter in the Stretcher group compared to the OR Table group (10 minutes vs 16 minutes, < .001). SB procedures were associated with a significantly shorter start time (median difference = 4 minutes, = .001), but not exit time (median difference = 1 minute, = .058). No difference was found in actual surgical time. Thirty (96.8%) OR team members perceived SB procedures as enhancing OR efficiency, and 30 (96.8%) respondents considered SB procedures to be equal or superior to OR TB procedures in terms of patient safety. All would recommend or strongly recommend SB procedures.
We found SB foot and ankle procedures to require less room time than OR TB procedures. Particularly for high-volume specialties, an average 6 minutes saved per case may meaningfully improve overall OR efficiency. Most OR team members believed that SB surgery improves OR efficiency and is the safer option for OR team members.
Level II, randomized controlled trial, survey.
肢体外科医生经常在术前担架上而非手术台上进行手术。本研究旨在确定基于担架（SB）和基于手术台（TB）的手术在时间效率和手术室团队成员偏好方面的差异。
我们进行了一项前瞻性随机对照试验，比较SB与TB足部和踝关节手术的效率。纳入了52例在我们日间手术单元接受内固定取出、单纯腓肠肌松解、软组织手术或异物取出的患者。记录开始时间和结束时间。“开始时间”是患者进入手术室至首次切开之间的分钟数。“结束时间”是手术结束至患者离开手术室之间的分钟数。对参与纳入病例的手术室工作人员进行了调查。
与手术台组相比，担架组在手术室的总测量时间平均短6分钟（10分钟对16分钟，P<0.001）。SB手术的开始时间明显更短（中位数差异=4分钟，P=0.001），但结束时间无差异（中位数差异=1分钟，P=0.058）。实际手术时间无差异。30名（96.8%）手术室团队成员认为SB手术提高了手术室效率，30名（96.8%）受访者认为SB手术在患者安全方面与TB手术相当或更优。所有人都推荐或强烈推荐SB手术。
我们发现SB足部和踝关节手术所需的手术室时间比TB手术少。特别是对于高流量专科，每例平均节省6分钟可能会显著提高整体手术室效率。大多数手术室团队成员认为SB手术提高了手术室效率，对手术室团队成员来说是更安全的选择。
二级，随机对照试验，调查。
