Table 1 Surgical questions
From: Hand surgery and hand therapy clinical practice guideline for epidermolysis bullosa
Population | Intervention | Outcome |
|---|---|---|
1. Does surgery improve hand function? | ||
RDEB Age? Stage of deformity | Thumb release Whole hand release Finger contracture release Finger web space release Wrist release Bilateral vs unilateral amputation | Validated patient rated outcome Measures Subjective function Satisfaction Recurrence/timing Pain Independence |
2. Does patient selection/preparation influence outcomes of hand surgery? | ||
RDEB | Assessment of: age, previous surgery/results Ability to participate in decision-making Microbiology Expectations/education Psychological preparedness MDT assessment for associated procedures Medical status (e.g. hemoglobin) Classification/X-rays Family resource assessment Functional assessment/photographs Geography/suspected adherence | Validated patient rated outcome Measures Subjective function Satisfaction Recurrence/timing Pain Independence Sensibility |
3. Do specific surgical techniques/resources influence safety/outcomes of hand surgery? | ||
RDEB | Surgeon experience/surgical equipment Specialist center Intra-op EB nurse support Specialist anesthesia/type of anesthesia Tourniquet Skin graft (type?)/skin substitutes Dressing products/type Splints (plaster/other) pins Antibiotics Bone/joint management Cellular therapy | Validated patient rated outcome Measures Subjective function Satisfaction Recurrence/timing Pain Independence Skin injury Anaesthetic complications |