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Category: July 2019

We asked our members whether or not there was a place for conservation in healthcare. Owing to efforts around the world to reduce waste–from local initiatives to eliminate plastic straws and bags to much larger undertakings in planet restoration–we wanted to know how hand surgeons took the environment into account in their practice.

Patient Safety Scenario #13: Errors in the Timeout

This essay is the thirteenth installment of the monthly Patient Safety essays, produced by the Patient Safety Subcommittee of the Ethics and Professionalism Committee. The essays are written in the spirit of the aviation industry’s “Black Box Thinking” in order to inform and improve our medical safety record. To read earlier essays and learn how […]

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Hand Surgeons Must Help

By James E. Clune, MD When we think of conservation in the operating room, time is our commodity. We try to limit turnover between cases, we make sure consents and equipment lists are ready at the time of the booking. During the procedure we limit the amount of excess motion in our hands and only […]

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The Environment May Have Recognized You but You Didn’t Recognize It

By Michael G. Galvez, MD We must consider the environment in our field of hand and upper extremity. Why? Believing that the United States has unlimited resources is a contributing factor to why our healthcare system is broken. A broken healthcare system that prioritizes patients with health insurance results in delayed care for many patients. […]

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Hand Surgeons in an Aging Society

By Naoki Kato, MD, PhD Japan’s aging rate (the ratio of the population aged 65 and older to the total population) has reached almost 28%, which is ahead of any other country in the world. The opportunity to provide medical care for these elderly people has increased dramatically in daily clinical consultation. All the elderly […]

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We Can and Should

By Ioannis P. Pappou, MD, PhD The answer to the former question is simple: Yes, there is a place for conservation and the effort needs to be increased significantly. The answer to the latter question is more complicated. We live in a wasteful era and the American society does not prioritize the environment. Unfortunately, we […]

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WALANT and Conservation

By Rey N. Ramirez, MD It is impossible to miss the amount of trash generated in the hospital. Single-use, individually wrapped items are ubiquitous. I find it most noticeable at the end of a carpal tunnel release. Even this simple procedure typically generates a full bag of trash. I believe that one way to practice […]

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Volar Repair of Dorsal Wrist Dislocation

By William Edward Sanders, MD The most recent addition of Green’s Operative Hand Surgery recommends repair of the ulnar aspect of the volar rent that occurs with dorsal wrist dislocation. It states that repair of the space of Poirier is not required because it is an anatomical defect. However, in approximately 6 cases I have […]

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Global Conservation

By Cary Tanner, MD Dr. Lutsky posed the above question for consideration in ASSH Perspectives. Anyone can correct me if I am wrong, but I propose that the best model for conservation is one in which the human spirit is unfettered with regulation, government survey standards, the specter of liability, and where financial support is […]

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Lean and Green Hand Surgery: What Can You Do?

By Robert E. Van Demark, Jr., MD It is estimated that the US healthcare system generates 4 billion tons of waste annually (6600 tons per day). Hospital operating rooms account for approximately 25-35 % of all hospital waste and are responsible for nearly 56% of total hospital costs. Orthopedic surgery is one of the largest […]

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If You Don’t Open It, You Can’t Throw It Away

By Jeffrey C. Wint, MD As surgeons we all too well know how our patient’s individual health history and status affects results. Even a perfect operation, in the most technically skilled hands, is no match for the poor general health of a patient. Similarly, the environment plays a distinct role on our patient’s health. Lack […]

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