Programme to introduce and develop minor out-patient surgery in primary care
Arroyo Sebastián, A.; Tomás Gómez, A.J.; Andreu Gálvez, J.; García Peche, P.; Arroyo Sebastián, M.A.; Costa Navarro, D.; Lacueva Gómez, J.; Schwartz Chavarri, H.; Leyn van der Swalm, F.; Calpena Rico, R.
Atencion Primaria 32(6): 371-375
2003
ISSN/ISBN: 0212-6567 PMID: 14572402 Document Number: 560500
Despite the priority placed on it, minor surgery is not performed enough in primary care (PC). To create and evaluate a programme to introduce and develop minor out-patient surgery in primary care in a way that matches our health areas needs. Prospective, longitudinal and descriptive study. Health Area 19 (Valencian Health Service): Surgery Department of Elche Hospital and 3 health centres (HC) (Altabix, Crevillente and Santa Pola). PC doctors and specialist surgeons. STAGES: a) Selection of HC. Working out protocol of kind of patient, pathology, paper-work and establishment of work circuits; b) surgical sessions at the HC, performed by two surgeons assisted by PC doctors (surgical leaders) and with surgical instruments from the hospital; c) surgery performed by PC doctors supervised by a surgeon, with instruments and the sterilisation circuit in the HC. The programme ends up with the PC doctors surgical autonomy and with use of the HCs own resources. 41 surgical sessions took place (14 in Altabix, 14 in Crevillente and 13 in Santa Pola). 335 patients were operated on in 398 surgical procedures (55.5% excisions, 34.9% electrocoagulation, 9.6% others). There were no immediate complications. The monthly evolution in the number of patients was constant, with a mean of 10.22 interventions per session. 36 doctors referred patients and 24 of them performed a surgical procedure. A practical and safe programme to introduce and develop minor surgery in PC, to the satisfaction of doctors and patients.