606 Novel application of a surgeon-operated clysis delivery system in burn surgery
Bibliographic record
Abstract
Abstract Introduction Tangential excision of burns is associated with significant bleeding. Sub-eschar insufflation of epinephrine-containing clysis has shown to decrease blood loss and associated complications. Administration of adrenaline-containing infiltrates are also beneficial in the harvest of split thickness skin grafts. Clysis is typically delivered with the assistance of a perfusionist-operated system. This method, however, is associated with significant cost and dependent on personnel availability. This study evaluated the use of a novel surgeon-operated fluid management system in the delivery of clysis in burn surgery. Methods Our initial experience with a novel fluid management system is presented. Prospective collection of infiltration data, including average temperature, pressure, and volume of clysis was performed. Patient and burn factors were evaluated and complications collected. Finally, a cost-effectiveness analysis was conducted. Results Thirty-seven consecutive cases comprising 22 adult patients (15/22, 68% male), with a mean age of 49 years (+/- 19) were reviewed. The mean % total body surface area of all patients was 39 (+/- 21.7). The mean temperature, pressure and volume of administered clysis was 32.2 degrees Celsius (+/- 4.4), 265.04 mmHg (+/-56.17), and 5805.8 mL (+/- 4844.4), respectively. The mean dose of epinephrine administered was 14.5mg (+/- 12.1). The mean temperature variability was 1.1 °C (+/- 1.2). Total mean packed red blood cells (PRBC) transfused was 507.6 mL (+/- 624.4). There were no recorded complications. We identified a cost savings of $20,766 CAD over the cases examined. Conclusions We present the novel application of a fluid management system in burn surgery. This technique provides rapid and safe infiltration of warmed clysis. We are able to maintain intra-operative euthermia despite a large volume of administered clysis and significant intraoperative vulnerability to hypothermia. In addition, this technique may be transfusion-sparing. The introduction of this method of clysis administration was associated with significant cost-savings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".