Pulvertaft Hand Trauma Audit
Aims: To compare workload with previous years and compare time to treat with national standards. Methods: A prospective audit conducted in June 2018. A proforma was completed for each patient attending hand trauma clinic and hand trauma theatre. Findings were analysed using Excel and compared with data from previous years. Results: A total of 408 patients were seen in June. The number of operations has increased since 2011 and 2014 when previous audits were done. The majority of patients were operated on by a consultant on a planned hand theatre list. The regional block was the favoured mode of anaesthesia in the unit. Overall, our mean time from injury to surgery had increased to 5.6 days compared to 2.5 days in 2014. With regards to the national guideline of a tendon or nerve injury being referred to a hand trauma unit within 72 hours, we were meeting this target 89% of the time. Our mean time from injury to operative repair of a tendon or nerve was 4 days with a median of 5 days; the national guideline recommends operative repair of the tendon of nerve with 5-7 days. Conclusion: Most patients were managed conservatively but when they did undergo surgery, most cases were performed on a planned list under a regional block. We were meeting the national guidelines for the treatment of tendon and nerve injuries much of the time. However, the system may be at risk in the future because of the high volume of patients being seen and the inherent challenges of providing a service to a wide geographic area.
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