脊椎ジャーナル

Coronaviruses can infect a wide range of animals. Two highly contagious and pathogenic coronavirus members have spread in different countries over the last two decades. SARS (severe acute respiratory syndrome coronavirus) first appeared in East Asia in 2002, and Middle East respiratory syndrome coronavirus (MERS) first appeared in the Middle East in 2012. Then, in 2019, a brand-new member of the coronavirus family, acute respiratory syndrome coronavirus 2 (SARS-CoV-2), caused a disease that was later dubbed coronavirus disease 2019 (COVID-19). The COVID-19 virus was discovered in Wuhan, China, and it fueled a global pandemic that infected billions of people. SARS-CoV-2 is a novel -coronavirus that shares 79% and 50% of its genome sequence with SARS-CoV and MERS-CoV24, respectively. SARS-CoV-2 contains six functional open reading frames (ORFs) arranged in 5′-3′ order: Replicase (ORF1a/ORF1b), spike protein (S), envelope protein, membrane protein (M), and nucleocapsid (N). There are also scattered genes encoding accessory proteins among the structural genes, such as ORFs 3, 6, 7a, 7b, 8, and 10. SARS-fulllength CoV-2's 29,903 nucleotides encode 27 viral proteins.

As research defines new treatments to improve patient survival and health, an increasing challenge is determining how to translate these discoveries into routine clinical practise to benefit patients and society. Implementing change and improvement in healthcare is multifaceted, but many healthcare stakeholders must change their behaviour. Healthcare providers, leaders, and administrators, as well as payers, patients, and other professionals, all play important roles and take action when it comes to translating evidence into care. The purpose of this paper is to explain how theories of human behaviour change play an important role in the science of implementation and quality improvement. We begin with a brief review of the intellectual roots of implementation science and quality improvement, followed by a discussion of how behaviour change theories and principles can inform both the goals and challenges of applying behaviour change theories. We use the terms "implementation science" to refer to the underlying science of studying changes in healthcare delivery, and "implementation practise and research" to refer to the work being done more broadly.

Background: In spine surgery postoperative closed suction drainage is used to decrease the potential risks of wound hematoma formation, reduces the risk of infection, cord compression and neurologic deficit. However, the efficacy of drains used for this purpose in adolescent idiopathic scoliosis is controversial. The purpose of this study is to evaluate outcomes of patients after posterior spinal fusion with instrumentation for adolescent idiopathic scoliosis without wound suction drainage.

Methods: A total of 66 patients who underwent posterior spinal fusion and instrumentation for the correction of adolescent idiopathic scoliosis without use of drain from January 2012 to January 2021 were included. Wound dehiscence, wound hematoma, infection, preoperative and postoperative hemoglobin levels and need for transfusion were described as frequency and mean values.

Results: The average age was 15.06 years. Hospital stay was 2.2 days. Patients were followed-up over 50.21 months. There was no deep infection, wound hematoma. The difference between just postoperative and three days after operation hemoglobin levels was not signi icant and no need for transfusion. Only 3 (4.5%) cases with super icial skin infection and 4 (6%) cases with skin and wound dehiscence were treated with dressing and antibiotics with full recovery.

Conclusion: Without using drain for patients with idiopathic scoliosis who underwent posterior spinal fusion and instrumentation, no increase in blood loss, transfusion requirements, wound infection, skin dehiscence, and wound hematoma was observed.