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Reduced Morbidity by Service Standardization

Maximo Deysine, MD; Roger C. Grimson, PhD; Harry S. Soroff, MD

Arch Surg. 1991;126(5):628-630.

Abstract
• To ascertain if service specialization and procedure standardization would improve the complication rate of inguinal herniorrhaphy, the results of all inguinal herniorrhaphies performed during a 3-year period by board-certified general surgeons who also performed a variety of other procedures common to the field of general surgery, assisted by general surgical residents (group B, 390 patients), were compared in the same institution with the results of inguinal herniorrhaphy when performed during 3 years under protocol by a Hernia Service directed by a senior faculty member assisted by junior surgical residents (group C, 442 patients). Group B patients had essentially no follow-up until they reappeared for care at the Hernia Service, whereas patients in group C achieved an 82% 7-year follow-up. The infection and recurrence rates of group C patients (0.45% and 0.9%, respectively) were significantly better than those of group B patients (5.9% and 4.6%, respectively). These results suggest that in our institution, the concentration of patients with hernias in a hernia service, manned by a specialized surgeon, produced better short-and long-term results than those obtained by general surgeons not dedicated to the field of hernia repair. Further studies will be necessary to confirm these findings.

(Arch Surg. 1991;126:628-630)

Author Affiliations
From the Departments of Surgery (Drs Deysine and Soroff) and Community Medicine (Dr Grimson), Northport Veterans Administration Medical Center, Northport, NY, and University Hospital, State University of New York at Stony Brook.

Footnotes
Accepted for publication October 6, 1990.

Reprint requests to State University of New York at Stony Brook, 2000 N Village Ave, Rockville Centre, NY 11570 (Dr Deysine).

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ABSTRACT