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Myths and Legends in Orthopaedic Practice: Are We All Guilty?

机译:骨科实践中的神话传说:我们都有罪吗?

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摘要

Over years of practice, many beliefs and practices become entrenched as tried and tested, and we subconsciously believe they are based on scientific evidence. We identified nine such beliefs by interviewing orthopaedic surgeons in which studies (or lack thereof) apparently do not support such practices. These are: changing the scalpel blade after the skin incision to limit contamination; bending the patient’s knee when applying a thigh tourniquet; bed rest for treatment of deep vein thrombosis; antibiotics in irrigation solution; routine use of hip precautions; routine use of antibiotics for the duration of wound drains; routine removal of hardware in children; correlation between operative time and infection; and not changing dressings on the floor before scrubbing. A survey of 186 practicing orthopaedic surgeons in academic and community settings was performed to assess their routine practice patterns. We present the results of the survey along with an in-depth literature review of these topics. Most surgeon practices are based on a combination of knowledge gained during training, reading the literature, and personal experience. The results of this survey hopefully will raise the awareness of the selected literature for common practices.
机译:经过多年的实践,许多信念和实践都经过尝试和考验而根深蒂固,我们下意识地认为它们是基于科学证据的。我们通过采访整形外科医生发现了九种这样的信念,这些研究中(或缺乏)研究显然不支持这种做法。它们是:在皮肤切口后更换手术刀刀片以限制污染;施加大腿止血带时弯曲患者的膝盖;卧床休息以治疗深静脉血栓;冲洗液中的抗生素;常规使用臀部预防措施;在伤口引流期间常规使用抗生素;常规拆除儿童硬件;手术时间与感染之间的相关性;并且在擦洗之前不要在地板上更换敷料。在学术和社区环境中对186名执业的骨科医生进行了一项调查,以评估他们的常规执业方式。我们介绍了调查结果以及对这些主题的深入文献综述。大多数外科医生的做法是基于在培训,阅读文献和个人经验中获得的知识的结合。这项调查的结果有望提高所选文献对常规做法的认识。

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