I-Double Gloving Kufakazelwe Ukunciphisa Izingozi Zokulimala Okubukhali

I-double-gloving ifakazelwe ukuthi inciphisa izingozi zokulimala okubukhali kanye nokuchayeka ezifweni eziphuma egazini.

Daniel Cook |Umhleli Omkhulu

Demakhasini ezifundo zemitholampilo afakazele ukusebenza kwe-double-gloving ekuvikeleni amalungu eqembu labahlinzayo ekulimaleni okubukhali, izinti kanye nezifo ezithathelwanayo njenge-HIV, nesifo sokusha kwesibindi kohlobo B kanye no-C, lo mkhuba awukabi umkhuba.Ngokuphindaphindiwe sizwa ukuthi ubufakazi bomtholampilo buyadingeka ukuze kuqhutshwe ushintsho egunjini lokuhlinza.Awu, nakhu.

UKUPHINDA PHANSI

Wonke umuntu ku-OR uyazuza ngokunikela ngamapheya ama-2 wamagilavu.

Izinkomba zokuphepha

Inhlolovo eshicilelwe kujenali ye-Infection Control kanye ne-Hospital Epidemiology (tinyurl.com/pdjoesh) iveza ama-99% odokotela abahlinzayo ababuzwa bake bahlushwa okungenani induku eyodwa yenaliti emisebenzini yabo.Inkinga, phawula abacwaningi, ukuthi ukubhoboza amagilavu ​​okuhlinzwa kuvame ukungabonakali phakathi nezimo, okusho ukuthi odokotela abahlinzayo bangase bachayeke egazini kanye nezingozi zokutheleleka ezihambisana nazo ngaphandle kokwazi.

UKUZWA KOMBHINDE

Kuthatha Amaviki Ama-2 Kuphela Ukuze Uthole Ukuzizwa Kwe-Double-Gloving

Yodokotela bethu abahlinzayo cishe bacabanga ukuthi i-double-gloving inciphisa ukuzwela kwesandla kanye nobuciko.“Naphezu kokwaziswa okuningi okusekela i-double-gloving, inselele enkulu yalokhu kungenelela ukuntuleka kokwamukelwa odokotela abahlinzayo,” kubhala abacwaningi uRamon Berguer, MD, noPaul Heller, MD, kuyi-Journal of the American College of Surgeons ( tinyurl.com/cd85fvl).Izindaba ezinhle, abacwaningi bathi, akuthathi isikhathi eside ukuthi odokotela abahlinzayo baqale ukuzizwa bejwayele ukuncipha kokuzwela kwezandla okuhambisana nokugudluzwa kabili.

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"Imiklamo yamanje ye-underglove yenza i-double-gloving ikhululeke kakhudlwana futhi iholele ekubandlululweni kwamaphuzu angu-2 okuthuthukisiwe - ikhono likadokotela ohlinzayo ukuzwa amaphuzu angu-2 ethinta isikhumba sakhe," kusho uDkt. Berguer, onomuzwa wokuthi odokotela abahlinzayo bangakwazi ukuzivumelanisa ngokugcwele ne-double-gloving ngaphakathi. 2 amaviki okuzama okokuqala.

— UDaniel Cook

IZINDABA5

Abacwaningi bathi amazinga okubhoboza amagilavu ​​ayahluka, yize ubungozi bukhuphuka bufike ku-70% ngesikhathi sezinqubo ezinde kanye nangesikhathi sokuhlinzwa okudinga umzamo omkhulu emigodini ejulile nasezindaweni ezizungezile.
amathambo.Baphinde baphawule ukuthi ucwaningo lubonisa ukuthi ingozi yokuthintana ngegazi yehla isuka ku-70% uma usebenzisa amagilavu ​​awodwa ukuya phansi njengo-2% ngamagilavu ​​aphindwe kabili, mhlawumbe ngenxa yokuthi igilavu ​​yangaphakathi yaboniswa ukuthi ihlale injalo ezimweni ezifika ku-82%.

Ukuze banqume ukuthi lingakanani igazi elidluliselwa ngongqimba olulodwa nakabili lwamagilavu ​​lapho kulimala khona i-percutaneous, abacwaningi banamathisele isikhumba sengulube ngama-lancets azenzakalelayo, alingisa izinti zokuthungatha.Ngokwalokho okutholakele, inani elilinganisiwe lika-0.064 L wegazi lidluliselwa kuma-puncture ekujuleni kuka-2.4mm ukuya kungqimba lwegilavu ​​elingu-1, uma kuqhathaniswa no-0.011 L wegazi kuphela.
izingqimba zamagilavu ​​amabili, okusho ukuthi ivolumu yehliswe ngenani elingu-5.8.

Ngokuphawulekayo, amagilavu ​​amabili asetshenziswe ocwaningweni afaka isistimu yenkomba: igilavu ​​yangaphakathi eluhlaza egqokwa negilavu ​​yangaphandle enombala wotshani.Ngokwabacwaningi, konke ukubhoboza kwezingqimba zangaphandle zamagilavu ​​zazibonakala ngokucacile ngombala oluhlaza wegilavu ​​oboniswa endaweni yokubhoboza.Umehluko wombala unciphisa ingozi yokuchayeka egazini ngokuxwayisa odokotela abahlinzayo nabasebenzi ngokuphulwa okungenzeka ukuthi akunakwanga.

“I-double-gloving kufanele ituswe kuzo zonke izinqubo zokuhlinzwa futhi kufanele idingeke ezinqubweni ezenziwa ezigulini ezinezifo ezaziwayo noma iziguli ezingakahlolelwa izifo,” kusho abacwaningi.Baphinde baveze ukuthi nakuba umphumela wokuvikela we-double-gloving ubonakala, akukabi yinjwayelo ngenxa yezinsolo zokwehliswa kobuciko nomuzwa wokuthinta (ukuthola ubufakazi obuphikisayo, bheka ibha eseceleni ngezansi).

Okukhethekile okuyingozi kakhulu kokuhlinzwa

Umbiko oku-Acta Orthopædica Belgica (tinyurl.com/qammhpz), iphephabhuku elisemthethweni le-Belgian Society of Orthopedics and Traumatology, uthi amazinga okubhobozwa kwamagilavu ​​asukela ku-10% ku-ophthalmology kuya ku-50% ekuhlinzweni okuvamile.Kodwa ukucindezelwa nobunzima bokusebenzisa amasaha anyakazayo, amathuluzi ensimbi kanye nezinto ezifakwa phakathi nezinqubo zamathambo kubeka amagilavu ​​amandla amakhulu okugunda, okubeka ama-orthopod engcupheni enkulu phakathi kochwepheshe bokuhlinzwa, kusho abacwaningi.

Kulolu cwaningo, abacwaningi bahlole amazinga okubhobozwa kwamagilavu ​​ngesikhathi sokushintsha okukhulu kwe-hip namadolo kanye nama-arthroscopies amancane amadolo.Baphinde bahlola ukuthi i-double-gloving inomthelela kangakanani emazingeni okubhoboza nokuthi amanani ayahluka yini phakathi kodokotela abahlinzayo, abasizi babo kanye nabahlengikazi NOMA.

Isilinganiso sokubhobozwa kwamagilavu ​​sisonke sasingu-15.8%, nesilinganiso esingu-3.6% ngesikhathi sokwenziwa kwe-arthroscopies kanye nesilinganiso esingu-21.6% ngesikhathi sokushintsha amalunga.Ngaphezulu kwamaphesenti angama-72 okuphulwa kwemithetho akuzange kubonwe kwaze kwaba yilapho izinqubo seziqediwe
kuphetha.I-3% kuphela yamagilavu ​​angaphakathi ayesengozini - ayikho ngesikhathi se-arthroscopies - uma kuqhathaniswa ne-22.7% yamagilavu ​​angaphandle.

Ngokuphawulekayo, u-4% kuphela wokubhobozwa okurekhodiwe phakathi nezinqubo ezinkulu ezihilela zombili izingqimba zamagilavu.Ingxenye yesine yodokotela abahlinzayo abangama-668 ababehileleke ocwaningweni ihlaselwe amagilavu ​​anembobo, okwakuphezulu kakhulu kunamaphesenti angu-8 wabasizi abangama-348 nabahlengikazi abangama-512 ababhekene nesiphetho esifanayo.

Abacwaningi baphawula ukuthi i-double-gloving in the orthopedic procedures kunciphisa kakhulu isigameko sokubhobozwa kwamagilavu ​​angaphakathi.

Nakuba abasebenzi abahlinzayo abahlinzayo behlisa ngokufanelekile izingozi zokuthola izifo ezitholakala egazini lapho amagilavu ​​ebhoboziwe, bayengeza, ucwaningo lwangaphambilini lubonise amasiko amagciwane athathwe ezindaweni zokubhoboza abe nemiphumela emihle cishe ngo-10% wesikhathi.


Isikhathi sokuthumela: Jan-19-2024