[Programme to introduce and develop minor out-patient surgery in primary care].
BACKGROUND
Despite the priority placed on it, minor surgery is not performed enough in primary care (PC).


OBJECTIVE
To create and evaluate a programme to introduce and develop minor out-patient surgery in primary care in a way that matches our health areas needs.


METHODS
Prospective, longitudinal and descriptive study.


METHODS
Health Area 19 (Valencian Health Service): Surgery Department of Elche Hospital and 3 health centres (HC) (Altabix, Crevillente and Santa Pola).


METHODS
PC doctors and specialist surgeons. STAGES: a) Selection of HC. Working out protocol of kind of patient, pathology, paper-work and establishment of work circuits; b) surgical sessions at the HC, performed by two surgeons assisted by PC doctors (surgical leaders) and with surgical instruments from the hospital; c) surgery performed by PC doctors supervised by a surgeon, with instruments and the sterilisation circuit in the HC. The programme ends up with the PC doctors surgical autonomy and with use of the HCs own resources.


RESULTS
41 surgical sessions took place (14 in Altabix, 14 in Crevillente and 13 in Santa Pola). 335 patients were operated on in 398 surgical procedures (55.5% excisions, 34.9% electrocoagulation, 9.6% others). There were no immediate complications. The monthly evolution in the number of patients was constant, with a mean of 10.22 interventions per session. 36 doctors referred patients and 24 of them performed a surgical procedure.


CONCLUSIONS
A practical and safe programme to introduce and develop minor surgery in PC, to the satisfaction of doctors and patients.
Arroyo Sebastián
A
A
Servicio de Cirugía General y Aparato Digestivo, Hospital General Universitario, Elche, Alicante, España. arroyocir@hotmail.com
Tomás Gómez
A J
AJ
Andreu Gálvez
J
J
García Peche
P
P
Arroyo Sebastián
M A
MA
Costa Navarro
D
D
Lacueva Gómez
J
J
Schwartz Chavarri
H
H
Leyn van der Swalm
F
F
Calpena Rico
R
R
D000556:Ambulatory Surgical Procedures; D006801:Humans; D013511:Minor Surgical Procedures; D011320:Primary Health Care; D016730:Program Development; D011446:Prospective Studies; D013030:Spain