engleski

Effect of surgical training course on performance of minor surgical procedures in family medicine physicians offices: an observation study

To examine the influence of a practical surgical course on the number of minor surgical procedures performed by family physicians. We compared the number of minor surgical procedures performed by family physicians in 59 offices in city of Osijek and surrounding rural area during 12 months before and after the 40-hour practical surgical course held in September 2006 by surgeons and family medicine specialists. Minor surgical procedures taught in the course included management of ingrown toenails, abscesses/comedones and minor wounds, anesthesia application, disinfection, use and sterilization of surgical instruments and antibiotic treatment. The number of minor surgical procedures performed in family medicine offices almost doubled (503 vs 906 after the course, P<0.001, Wilcoxin test). The median number of abscesses/comedones treatmens per physician increased from 1 to 6 (P<0.001, Wilcoxin test), the number of managed wounds increased from 111 to 217 (P<0.001, Wilcoxin test), while the number of ingrown toenail resections increased from 120 to 186 (P= 0.004, Wilcoxin test). Fifty percent of physicians did not treat patients sugically, irrespective of the training. We found no association between the number of performed procedures and age, lenght of employment, or location of the physician´office (urban vs rural). However, we found that male pfysicians performed more surgical treatments both before and after the course (abscesses/comedones: P<0.001 and P= 0.108 respectively ; ingrown toenail resections: P= 0.008 and P=0.008 respectively ; minor wounds: P=0.030 and P<0.001 ; respectively ). Practical courses can encourage practitioners to treat the patients surgically in their offices and, thus, increase the number of services offered in primary care. Female physicians should be more encouraged to perform minor surgical procedures in their offices.

minor surgical procedures; family physicians; surgical training course

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