ObjectiveTo analyze the current situation of day surgery patients’ withdrawal from hospitalization, and put forward reasonable and effective measures and suggestions.MethodsDescriptive statistical analysis and trend chi-square test were conducted on the hospitalization withdrawal rate of day surgery in the Day Surgery Ward of the Second Affiliated Hospital Zhejiang University School of Medicine from 2012 to 2020. The reasons for hospitalization withdrawal and the operation methods of withdrawn cases from 2019 to 2020 were descriptively analyzed.ResultsFrom 2012 to 2020, the hospitalization withdrawal rate of day surgery decreased from 4.48% to 2.19%, with a significant decrease and a linear downward trend (χ2trend=138.500, P<0.001). From 2019 to 2020, patient factor was the most important reason for hospitalization withdrawal of day surgery, accounting for 79.72%; secondly, long waiting time for surgery, abnormal examination results, inadequate preoperative evaluation, medical insurance reimbursement, epidemic situation in 2020 and other reasons had affected the patients’ hospitalization withdrawal of day surgery to varying degrees. Endoscopic lithotripsy accounted for the largest proportion (210 cases, accounting for 20.87%) in the withdrawn procedures from 2019 to 2020, followed by minimally invasive rotary resection for breast lesions (126 cases, accounting for 12.52%).ConclusionImproving preoperative evaluation, strengthening preoperative communication, implementing efficient medical treatment, and shortening the waiting time for surgery can reduce the rate of hospitalization withdrawal of day surgery.
Pre-rehabilitation is an emerging preoperative management strategy designed to mitigate surgical stress responses and expedite postoperative recovery through optimized interventions, which typically includes exercise training, nutritional support, and psychological counseling. For patients undergoing transcatheter aortic valve replacement (TAVR), the implementation of pre-rehabilitation measures is particularly crucial. This article reviews the necessity and principal components of pre-rehabilitation in TAVR patients, and offers suggestions including constructing the best pre-rehabilitation intervention program for TAVR, enhancing patient compliance and engagement in the recovery process, and paying attention to the management of frailty for TAVR patients. The aim is to provide a reference for healthcare professionals seeking to further refine the pre-rehabilitation management model for TAVR patients.
By learning the nearly ten years’ experience and summaries in day surgery, West China Hospital of Sichuan University drafts a series of standards for day surgery management. This article mainly introduces the pre-administration management standards of West China Hospital of Sichuan University, involving: standards for the management of surgeons, nurses, patients, and the type of operation; standards for pre-administration work procedure; standards for pre-administration health education; standards for appointment, scheduling, and coordination for day surgery; and standards for surgery notification. This paper aims to share experience with peer professionals, and provide theoretical basis and practical guidance for the standardization and development of day surgery, as well as the establishment of a safe day surgery management system.
Patients with severe traumatic brain injury (TBI) have a higher mortality rate, often dying within a few hours after injury. The management of trauma site, transportation, and early hospital stay is closely related to the outcome of TBI patients. The final success rate of TBI patients varies after different prehospital treatments, and the quality of prehospital treatment for TBI needs to be further improved. Therefore, the TBI prehospital management guideline emerged, and the third version of the guideline was released in April 2023. In order to provide better advice and guidance on the treatment of prehospital TBI, this article interprets the key points of updating the third edition of the prehospital TBI management guideline.
Ten cases of soft tissue defect at palm orwrist were repaired by reversed fasciocutaneousflap from the forearm. All were. survived excepttwo cases having necrosis of the distal portion ofthe graft. The blood supply of the skin of the fore-arm was comming from the perforation fasciocuta-neous and musculocutaneous giving rise from theulna , radial and interosseous arteries. Therefore ,when the flap was designed,it was best to have thefascial pedicle over the arterial trunks in order toinclude more perforating arteries in the flap . It was indicated that venous supply might also played an important role in flap nutrition.