Hand Trauma Committee organisation

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Hand Trauma Committee organisation

• T Dubert

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24 countries are full FESSH membres

• New members
• Slovenia
• Russia
• Tcheque Republic

Finland
Norway
Sweden
Ireland
Denmark
Holland
UK
Poland
Belgium
Germany
France
Switzerland
Austria
Hungary
Romania
Portugal
Spain
Italy
Bulgaria
Turkey
Greece
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Hand Trauma Committee

• Consensus issues on replantation in the upper
  limb A Landi and D Elliot
• First Meeting Göteborg 2005
• Second Meeting Glasgow 2006
• Third Meeting Athens 2007
• Fourth Meeting Lausanne 2008
• Fifth Meeting Poznan 2009

2 representatives / countryNominated by the
National boards
Tufan Kaleli Ilhami Kuru
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• 309 Hand trauma centres

44 in France
1 In Bulgaria
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1 centre per 1 million populationThis
concentration is close to the recommendations
already published for level-I trauma centres
(Haas et al., 1997).
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Average 6 surgeons / centre
13 in Germany
1,6 in the UK
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But all these surgeons dont have a hand
surgery certification
withhand certification
Scandinavian countries
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Public 83Private 17
97 are available 24/24
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Only 697 surgeons (38) have validated a
national or a European Hand surgery degreeOnly
25 have validated a microsurgical degree
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Mother specialities
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Mother specialities in Europe
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20363 cases operated in January
Poland, Denmark, Bulgaria and Belgium are missing
444 replantations
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Benign lesions
Even minor injuries might generate high
costs Rosberg 2005 Frazier et
al. 1978 Rosberg et al.
2005 Wittemann et al. 1994
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Understanding this audit

• Lack of validity of the data
• What is Hand Trauma?
• Criteria for a Hand Trauma Centre?
• Who is a Hand Trauma surgeon?

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HTC guidelinesAccreditation commissionB
Battiston (Italy) Chairman, R Böttcher
(Germany), Yo Baeten (Belgium), Esther Vögelin
(Switzerland), HE Rosberg (Sweden), T Dubert
(France)

• What is Hand Trauma?
• What should be a Hand Trauma Centre?
• Who should be a Hand Trauma surgeon?

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What is Hand Trauma?

• Any closed or open injury to the wrist and/or the
  hand, substantially involving skin, muscle,
  tendon, bone and joint, nerve and/or vessels.

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Criteria for  Hand Trauma surgeon 

• Hand surgeon
• Member of his National Hand Surgery Society
• Microsurgery recognition
• Certificate of training or national diploma
  Including some technical practice
• Clinical activity during a 3 months period
• gt24 trauma cases in the OR (including 5
  microsurgery)as first operator or attested
  under the responsibility of a senior surgeon.

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Criteria for a  Hand Trauma Centre 

• At least 3 Hand Trauma Surgeons on duty
• Availability 24/24
• Clinical activity gt 2 trauma cases in the OR/
  day
• HTC delegate (FESSH diploma validated)

Tolerance 10 years
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Every year we are building a new mapbased
on these approved guidelines
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Centres with completed questionnaire
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Centres with completed questionnaire And
available 2424, 7/7, 365/365
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Centres with completed questionnaire And
available 2424, 7/7, 365/365
And 3 Hand Trauma Surgeons
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Centres with completed questionnaire And
available 2424, 7/7, 365/365
And 3 Hand Trauma Surgeonsand gt 2 OR /day
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Centres with completed questionnaire And
available 2424, 7/7, 365/365
And 3 Hand Trauma Surgeonsand gt 2 OR
/dayand 1 FESSH diploma
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Hand Trauma Committee validation process
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National Boards National Representatives
Hand Trauma Centres
HTC Accreditation commission
List of Hand Trauma Centres
FESSH management office
Validation of the email adresses
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National Boards National Representatives
Hand Trauma Centres
HTC Accreditation commission
e questionnaire to each centre
Filled out e Questionnaire
FESSH management office
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National Boards National Representatives
Hand Trauma Centres
HTC Accreditation commission
Once a year
FESSH management office
Filled out e Questionnaire
Controlled filled out e Questionnaires
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National Boards National Representatives
Hand Trauma Centres
HTC Accreditation commission
Final validation
FESSH management office
Web site Directory Map
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We are building a new mapbased on these
approved guidelines
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HTC validation results2009
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HTC certification sheets