Saturday, December 27, 2008

Surgical Training

Tetraplegia Hand Surgery Training Unit

This proposal aims at setting up a baseline level for surgical reconstruction in tetraplegia in terms of requirements of education, infrastructure, the number of surgeries per year, access to rehabilitation facilities, outcome measurements and development.

Surgical training
Hand surgeons need specialized training in assessment of tetraplegic patients as well as surgical strategies for reconstruction. Specialized training in reconstructive surgery is undertaken in an established/certified unit.

Infrastructure
The hand surgery service needs to be closely cooperating with a spinal unit or neuro-rehabilitation unit with regular interaction between physiatrists and hand surgeons. Optimally, these two units are located in the same hospital.

Number of surgeries
At least 10 reconstructive operations per year are considered necessary for maintaining surgical training and acceptable level of skill among personnel.

Rehabilitation facilities
Minimum of one therapist needs specific training in not only preoperative assessment, but also to provide instructions for the detailed content of the rehabilitation protocol following surgery. Therapist training is undertaken in a certified unit and with specific training in the full range of rehabilitation efforts from preoperatively until one year postoperatively.

Outcome measurement
It is mandatory to conform to the international standard for outcome measurements including strength, joint mobility and measurement of performance and satisfaction in relation to prioritized preoperatively stated goals (COPM).

Development
It is expected that the unit participates in multi-center studies.

Certification
The organization’s quality management system will be assessed and registered by FESSH (Federation of European Societies for Surgery of the Hand) representatives. The pre-certification qualifications are assessed by the FESSH Council.

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