Accelerated postoperative rehabilitation: multidisciplinary issue. Part 2

The modern model of inpatient surgical care of private and optimized state/govermental medical institutions allows us to change the paradigm of nosological attachment of the hospital bed to one profile of specialists for an adaptive model, when the wards can be reassigned depending on the needs of the hospital. In such multidisciplinary medical centers with mixed hospital beds without a nominal distinction in the nosological departments, a new therapeutic service is being developed - hospitalists, which provide a consistent curation of hospitalized patients, compensation of chronic therapeutic illnesses with patient's preparation for surgical interventions. Our work describes the experience of Fast Track recovery program with the active participation of a hospitalist in a surgical team, which is a new experience in the practice of Russian colorectal surgery.

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Fast-tract: Therapist's role

Bashankaev

Loriya

Aliev

et al. 2018

Khir. Z. im. N.I. Pirogova

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Ultrasound method for assessing the severity of local wound complications after surgical interventions on the abdominal organs

Izmailov

Доброквашин²,

Izmailov³

et al. 2022

Kazan Med J

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Background. The ultrasound method of examination is often used to detect liquid formations of a postoperative wound. For this reason, the search for new criteria for assessing the course of the wound process is currently relevant. Aim. To study the possibility of using the ultrasound method of research to determine the severity of postoperative wound complications according to the ClavienDindo classification and further optimal tactics, diagnosis and treatment. Material and methods. 255 patients after surgery for various urgent diseases of the abdominal organs, as well as patients with elective surgeries were examined. All patients underwent complex clinical, laboratory and instrumental studies. Continuous values that do not have a normal distribution were processed using non-parametric methods the values were presented in the format Me [Q1; Q3], the difference in unrelated groups was assessed by the MannWhitney U test, and in related groups, by the Wilcoxon test. Results. The postoperative period in 58 (22.7%) of 255 patients was complicated by postoperative wound complications, which had I, II, III severity according to the ClavienDindo classification. On the 5th day of ultrasound examination of the surgical site with the III degree of severity of postoperative wound complications, there was a statistically significant increase in the echogenicity width of tissues in the area of the wound defect compared with the III severity of complications. Conclusion. The ultrasound method of research allows to evaluate the effectiveness of reparative processes in damaged tissues and the development of complications, as well as to determine the severity of their course in the postoperative period for planning further surgical tactics.

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Peri-Operative Rehabilitation: Eras or Pics Prevention?

Губайдуллин

Гусакова

Cheremisov

et al. 2019

Vestn. anesteziol. reanimatol.

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Rehabilitation technologies and provision of conditions for their implementation in surgery units, as well as in resuscitation and intensive care wards make an integral part of the modern medical practice. Currently, the efficacy of these approaches has been proven and formalized to a certain extent in the form of enhanced recovery after surgery in the intensive care units. Despite the different context and categories of patients on rehabilitation, these approaches have much in common both from a scientific and clinical point of view.

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Accelerated postoperative rehabilitation: multidisciplinary issue. Part 2

Abstract: The program improves the results of surgical treatment, reduces number of complications and cost of treatment, improves the "quality" of hospital stay and satisfaction of meeting with doctors.

Cited by 5 publications

References 27 publications

Fast-tract: Therapist's role

Fast-tract: Therapist's role

Ultrasound method for assessing the severity of local wound complications after surgical interventions on the abdominal organs

Peri-Operative Rehabilitation: Eras or Pics Prevention?

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