Cultura

Policy And Ethics In Continuous Surgical Examinations: An Administrative Perspective: Perspectives From Surgery, Sterilization And Infection Control, Anesthesia And Operating Room Practice, Nursing, Clinical Pharmacy, Dentistry, And Clinical Nutrition

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Naif Mohammed Essa Alfarhan, Nawaf Mohammed Essa Alshahrany, Mansour Mohammed Ahmad Alamri, Rshid Atef Abdullah Alrashidi, Ahmed Mohammed Abdulkarim Al-Shammari, Mashael Sehman Mohammad Alanazi
Salem Saleh Al Qirad, Hammam Ali Altamni, Dr. Bandar Al-Qahtani, Hassan Ibrahim Hassan Alomari, Khalid Amer A. Almusayyab, Mana Ali Alsulaiman

Abstract

Background: Continuous surgical examinations are essential to patient safety across the preoperative, intraoperative, and postoperative phases of care. While these examinations are traditionally viewed as clinical processes, they are increasingly shaped by institutional policies, governance frameworks, and ethical accountability. In complex surgical environments, administrative decisions regarding the scope, frequency, and coordination of continuous examinations carry significant ethical implications.

Objective: This article aims to examine continuous surgical examinations from an administrative and ethical perspective, highlighting how policy design, governance structures, and multidisciplinary collaboration influence patient-centered decision-making and ethical responsibility in surgical care.

Methods: A narrative and conceptual analysis was conducted, drawing on established principles of biomedical ethics, healthcare governance literature, and international patient safety and infection control guidelines. The analysis integrates perspectives from surgery, sterilization and infection control, anesthesia and operating room practice, nursing, clinical pharmacy, dentistry, and clinical nutrition to explore shared and discipline-specific ethical responsibilities.

                                       

Results: The analysis demonstrates that continuous surgical examinations function as ethical and administrative instruments rather than purely technical routines. Key challenges include over- and under-monitoring, rigid policy enforcement, resource constraints, fragmented accountability, and moral distress among healthcare professionals. Effective governance frameworks that emphasize proportionality, interdisciplinary coordination, ethical leadership, and continuous evaluation were identified as critical to balancing clinical necessity with ethical responsibility.

Conclusion: Continuous surgical examinations represent a convergence of policy, ethics, and clinical practice. Administrators play a central role in ensuring that monitoring practices promote patient safety without compromising ethical principles or patient dignity. Integrating ethical reasoning into policy development and governance mechanisms is essential for sustaining high-quality, patient-centered surgical care in modern healthcare systems.

Keywords : Continuous surgical examinations; healthcare policy; medical ethics; administrative governance; patient safety; multidisciplinary care..
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty