Surgery and Abdominal Surgeries Dawn

More and more patients are requiring extensive care including total parental nutrition, and long term antibiotic therapy, for what should have been a simple abdominal surgery. An enterocutaneous fistula (ECF) occurs when an abnormal connection occurs between an organ, vessel, or intestine and another structure. Fistulas are usually the result of injury or surgery, but can also result from infection or inflammation. Enterocutaneous fistula (ECF) is an uncommon and poorly studied postoperative complication (Teixeira et al. , 2009).

FISTULA OCCURANCES IN ABDOMINAL SURGERIES 2 The objective of this study was to discover what causes the increase incidence of an ECF after abdominal surgeries. A quantitative approach to obtain information, describe test result data, and cause and effect relationships will be performed. The population would include patients, both male and female, of any age, that have had a recent abdominal surgery. This will include multiple abdominal surgeries such as weight loss procedures, gastric bypass, and gastric sleeve; as well as colon surgeries, and traumas.

The possibility of a fistula would be the dependent variable, since it is the possible effect of an abdominal surgery, and ordinal information such as age of the patient, and the severity of injury score. The cause of the fistula is abdominal surgery therefore it will be considered the independent variable, and nominal information will be used to collect data. The nominal data will include gender, race, performing surgeon, and which operating room was used.

I will use several variations of data including the instances of male versus female patients, and classification of surgery type. Inferential statistics allow the sample to make a generalization about the population, and the study outcome to assist in reaching a conclusion and to test the probability that an observed difference between these two groups is a possibility. The ANOVA test would be the most appropriate for this research topic. Comparing the relationship between multiple surgical procedures, surgeons, and medical history, the ANOVA is a better tool. The ANOVA test allows you to use more than two samples, and allows for testing over a specific period of time.

It would also be the best choice because nominal and ordinal levels of results will be utilized. Data would not only include the types of surgeries and surgeons, but also at what time length before the fistula occurred after the surgical intervention. FISTULA OCCURANCES IN ABDOMINAL SURGERIES 3 Descriptive statistical information will be utilized, since this will help describe, show, and summarize data. Only hard data will be presented in a meaningful way, this is a more simple way to organize the data, and would also be easier for the reader to understand.

I chose the independent variable to include one specific hospital, and specific Doctors, not all hospitals, and Doctors, therefore access to the whole population would not be necessary. Reliability refers to the consistency of a measurement. Validity is how the procedure is measured, and what it intends to measure. Surgeries such as, open versus laparoscopic, will aid in the validity of the results. A more reliable study will be performed using one hospital; there might be too many variables if multiple hospitals were used.

I would also include the surgeons that performed the surgery as informative data. The probability sampling method will be used to decide what patients will be included into the study. Cluster sampling would allow me to include everyone that has had an abdominal surgery. These patients would have an equal chance of being included in the study. Clustering is a form of probability sampling. The assessment technique will be used to evaluate patients for this trial. Everyone who has had an abdominal surgery would have the same chance of being chosen for this study.

Inclusion criterial would be patients that have had an abdominal surgery, since EC fistulas would not occur in other types of surgery. Also included would be the surgeon performing the surgery. Does the fistula rate occur more often with one specific surgeon? Some of the exclusion criteria would be past medical history, mainly patients that have a history of smoking. The study would require a fairly large sample size, because the determination is an unknown relationship between abdominal surgery and EC fistula occurrences.

Two to three FISTULA OCCURANCES IN ABDOMINAL SURGERIES 4 surgeons, with equal amounts of open and laparoscopic surgeries performed would give better data for comparison. Type one errors would be avoided by not rejecting the results of the study if there truly is no correlation between abdominal surgeries and fistula occurrences, also known as the null hypothesis. If the data shows that fistulas occur as much in laparoscopic surgeries at the same rate as open abdominal surgeries, or if all doctors have a very low rate of fistulas, the data will be reported properly.

Type two errors can be avoided by choosing only appropriate candidates for the study. An equal numbers of laparoscopic, and open abdominal surgery patients. I will not let the type of surgery weigh too heavy on either side. If one or two laparoscopic surgeries are chosen and 100 open abdominal surgeries a type two errors is more likely to occur due to sampling bias. FISTULA OCCURANCES IN ABDOMINAL SURGERIES 5 References Teixeira, P. , Indaba, K. , Dubose, J. , Salim, A. , Brown, C. , Rhee, P, … Demetriades, D. (2009, January). Enterocutaneous Fistula Complicating Trauma Laparotomy: A Major Resource Burden. The American Surgeon, 75(1), 30-32. Retrieved from.

More and more patients are requiring extensive care including total parental nutrition, and long term antibiotic therapy, for what should have been a simple abdominal surgery. An enterocutaneous fistula (ECF) occurs when an abnormal connection occurs between an organ, vessel, …

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