Circumventing Acute Compartment Syndrome: Outcomes from a Cadaver-based Course in Fasciotomy Procedural Skills.

Christopher H Renninger, Christopher S Smith, Jennifer A Sanville, Mark W Bowyer, Pamela B Andreatta
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Abstract

Acute compartment syndrome (ACS) represents a surgical emergency requiring effective, complete fasciotomy. The purpose of this study is to evaluate cadaver-based training on the ability of practicing general surgeons to effectively perform upper extremity, thigh, and leg fasciotomies. One hundred seventeen general surgeons underwent a 2-day, cadaver-based course with formative and summative assessments based on validated scoring tools. Overall performance and critical item scores were recorded and compared utilizing analysis of variance with repeated measures and eta-squared values to evaluate effect size. For all three procedures, post-training scores were significantly improved when compared with pre-training scores (p < 0.001). Mean pre-training score for lower leg fasciotomy met the standard for competent performance of the procedure (total score > 80), whereas neither thigh nor upper extremity performance scores met this standard before training. This 2-day, cadaver-based course improves the ability of practicing general surgeons to effectively and independently perform upper extremity, thigh, and lower leg fasciotomies. (Journal of Surgical Orthopaedic Advances 32(4):238-241, 2023).

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避免急性室间隔综合症:以尸体为基础的筋膜切开术手术技巧课程的成果。
急性筋膜室综合征(ACS)是一种外科急症,需要进行有效、彻底的筋膜切开术。本研究的目的是评估以尸体为基础的培训对执业普外科医生有效实施上肢、大腿和小腿筋膜切开术能力的影响。177 名普外科医生参加了为期两天的基于尸体的课程,并根据经过验证的评分工具进行了形成性和总结性评估。课程记录了学员的总体表现和关键项目得分,并利用重复测量方差分析和等方值评估效应大小。与训练前的得分相比,所有三个程序的训练后得分都有明显提高(P < 0.001)。小腿筋膜切开术培训前的平均分达到了胜任手术的标准(总分大于 80 分),而大腿和上肢的表现得分在培训前均未达到这一标准。这个为期两天、以尸体为基础的课程提高了普通外科医生有效、独立地实施上肢、大腿和小腿筋膜切开术的能力。(外科骨科进展杂志》32(4):238-241,2023 年)。
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