The Southampton Dupuytren's Clinic: audit of an effective multidisciplinary model.

Introduction. The Southampton Dupuytren's Clinic (SDC) was preceded by a four-month period when the therapist accompanied the surgeon in Clinic to learn about Dupuytren's Disease (DD) and to develop a specific proforma to collect details of the patient, the condition and the planned treatment. Metho...

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Publicado en:Hand Therapy Vol. 15; no. 4; pp. 100 - 105
Autores principales: Warwick, David, Belward, Pete, Vadher, Jane, Setty, Kemp
Formato: forms research tables/charts Journal Article
Publicado: Sage Publications, Ltd. Dec2010
Acceso en línea:Ver este registro en EBSCOhost
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        atl: The Southampton Dupuytren's Clinic: audit of an effective multidisciplinary model.
      aug:
        au:
          Warwick, David
          Belward, Pete
          Vadher, Jane
          Setty, Kemp
        affil: Hand, Wrist and Elbow Unit, Southampton University Hospitals, Southampton SO16 6UY
      sug:
        subj:
          Dupuytren's Contracture
          Ambulatory Care Facilities
          Triage
          Audit
          Human
          Referral and Consultation
          Physical Examination
          Patient History Taking
          Dupuytren's Contracture Surgery
          Multidisciplinary Care Team
          Health Resource Utilization
      ab: Introduction. The Southampton Dupuytren's Clinic (SDC) was preceded by a four-month period when the therapist accompanied the surgeon in Clinic to learn about Dupuytren's Disease (DD) and to develop a specific proforma to collect details of the patient, the condition and the planned treatment. Methods. A special clinic was set up for general practitioner referrals for patients with DD. Each patient was seen by the therapist. A detailed history and examination were recorded on the proforma. Treatment options to include the outcome, risks and benefits of surgery were clearly explained, supported by a handout. The patient was then seen by the surgeon to arrange management. Results. One hundred and ninety-four patients were allocated to the SDC. In all, 5% failed to attend; 8% had an alternative diagnosis made; and 16% with DD were discharged as the disease was not advanced enough for intervention or the patient decided not to have surgery. The therapist then allocated 71% for surgical assessment. The surgeon, to efficiently allocate personnel and theatre resources, listed 22% for skin graft, 8% for fasciotomy, 70% for fasciectomy, 35% for consultant to perform, 35% for fellow/registrar to perform, and 30% for the consultant to train the registrar. Conclusions. We consider that triage and assessment of patients with DD is improved by a multidisciplinary approach: a hand therapist, to quantify deformity and functional deficit, and explain the purpose, risks and outcome of surgery; and a hand surgeon, to decide the type and duration of surgery and the appropriate grade of surgeon.
      pubtype: Academic Journal
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    language: English
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