ObjectiveTo probe into the risk factors for postoperative surgical site infections in the Department of Cardiothoracic Surgery, and put forward correspondent preventive and treatment measures. MethodA total of 360 patients who underwent operations between February 2011 and March 2013 were the study subjects. The age, sex, basic diseases, surgical time, hospitalization time, surgical implants, and incision category were recorded carefully, and were analyzed for their correlation with surgical site infections. ResultsThere were 27 cases of surgical site infections with an infection rate of 7.50%. Age, hospitalization time, surgical time, basic diseases, surgical implants and incision category were risk factors for surgical site infections (P<0.05). ConclusionsBased on the analysis of risk factors for surgical site infections, we can help patients recover as early as possible by taking preventive measures beforehand.
ObjectiveTo systematically evaluate the effectiveness, safety and ethics of Da Vinci Surigcal System (dVSS)in the field of cardiothoracic surgery, and provide evidence for its clinical application. MethodsWe searched VIP, CNKI, WanFang Database, CBM, official website of National Health and Family Planning Commission of People's Republic of China, PubMed, Cochrane Library, Google Scholar, WHO ICTRP search portal, ClinicalTrials.gov, Chinese Clinical Trial Registration Center, Australian-New Zealand Clinical Trials Registry and ISRCTN to collect clinical trials of dVSS for thoracic and cardiovascular diseases to evaluate its effectiveness, safety and ethics. The search time was from the establishment of each database to January 2014. The quality of included literatures was evaluated by Grades of Recommendations Assessment, Development and Evaluation (GRADE). ResultsA total of 31 studies were identified including 4 case control studies and 27 retrospective studies involving 1 037 patients. The quality of included literatures was all very low. dVSS had been widely used in cardiothoracic surgery including coronary artery bypass grafting, valvuloplasty or valve replacement, thoracic tumor resection, etc. Compared with conventional surgery and thoracoscopy, the safety and effectiveness of dVSS was good, while its economic burden was heavier for the patients. dVSS could benefit patients and improve clinical level of cardiothoracic surgery. The disciplines and qualification of dVSS application was legal, but the maturity of its clinical use needed improvement, and relevant measures were required. The ethics in the research, introduction and application of dVSS had some problems which deserved more attention. ConclusionsClinical use of dVSS in cardiothoracic surgery is relatively safe and effective, but research quality needs to be improved. More studies on the economics and ethics of dVSS are needed in the field of cardiothoracic surgery. Relevant measures of precaution, accountability and patient protection are required to further improve clinical application of dVSS in cardiothoracic surgery, and whole-process ethical supervision should be conducted with the help of existing clinical ethical review platform.
ObjectiveTo explore a standardized model for cardiothoracic surgery resident training program based on a combined clinical and research oriented team approach. Methods We conducted this study in a nationally ranked Class AAA hospital among the eleven residents who were accepted into the program. Throughout their training periods, clinical surgical skills were taught by one-on-one mentoring by individually assigned doctoral degree advisors, other attending surgeons and doctoral degree candidates in the program. To foster their scientific curiosity and research skills, regular didactic lectures in basic science and statistical skills by the doctoral thesis advisors, supplemented by monthly journal clubs during which trainees were required to present and discuss a previously assigned topics based on recent clinical cases within the department, thus combining acquisition of clinical skills and theory/research at the same setting. ResultsEleven physicians were selected for this training path. With respect to clinical surgical skills, 4 residents were judged to be sufficient at the end of the first cycle. The other seven residents at the end of the second cycle. One trainee won the third prize in the Medical Skill Competition in the hospital. As for scientific research skills, the team produced 11 scientific articles, one of which was accepted by the annual national conference in cardiothoracic surgery and the first author was invited to present the article. The team submitted four research projects, one won funding at the provincial competition and three within the medical school. ConclusionOur proposed standardized model of cardiothoracic surgery resident training based on a combined clinical and research oriented approach appears to be practical with moderate success. Adaptation of this model by other cardiothoracic surgery training programs in the nation will further attest to its value and functionality.