Introduktion: Fler och fler opereras inom den dagkirurgiska verksamheten i Sverige. Fo?r att bevara patientsa?kerheten och kvaliteten i va?rden, bo?r den sta?ndigt utva?rderas och vid behov fo?rba?ttras. Alternativ i detta fo?rba?ttringsarbete kan vara anva?ndandet av olika dagkirurgiska fast-track modeller, da?r den perioperativa omva?rdnaden, medicineringen och anestesimetoden anpassas efter individen och det kirurgiska ingreppet.

Background: Postoperative infections are a serious patient safety problem and affects about 3 % of all patients undergoing surgery. The consequences are prolonged hospital stays, high social costs, increased use of antibiotics and impaired quality of life for the patient. It has been shown that postoperative infections may be caused by contamination already in the operating room. Today we know that there is growth of microorganisms on the instrument table´s top, but there is a research gap about the instrument table's edges.Aim: To examine if the sterile drape on the instrument table´s edges are sterile after finished surgery.Method: Contact plates are printed on strategically selected areas on the sterile drapes top and edges. In the pilot study, a total of 51 cultures were taken at the end of three operations which lasted over three hours.Results: Growth on the top surface and the edges of the sterile drape were detected.

SUMMARYPrevious research has shown that there is a connection between the doorways and postoperative wound infections. Despite recommendations from Socialstyrelsen and the individual hospitals' PM there is still high traffic in the operating theatres. In a hybrid theatre environment combined X-ray techniques of surgery, resulting in it being further two categories inside the operating theatre. This may generate an increase in traffic flow. The study is a prospective, non-participant observation study conducted in the spring of 2013 at a university hospital in western Sweden.

Dampness in the indoor environment have been a major issue of discussion the last decades since more and more people complain about their indoor environment. In the present situation there are difficulties to find what causes people?s discomfort in a damp environment even though there is a strong connection between dampness and human health.The aim of the thesis was to contribute to the work done today to achieve a better indoor environment in damp buildings. The purpose of the work was to evaluate whether the measures issued for dampness in the indoor environment contributes to the improvement of health and environment for those who are living or working in that space. Through a literature review, interview and survey the following three questions were answered to achieve the aim and purpose:How are people affected by the indoor environment in damp buildings?Which are the measures issued to prevent dampness in the indoor environment?Do these interventions contribute to a better indoor environment?How people are affected by the indoor environment in damp buildings and how these problems are prevented were the foundation for the continued work with the survey.

Vid operation av primär total höftplastik finns det olika metoder för postoperativ smärtlindring. En tidigare genomförd studie på ett mellansvenskt sjukhus (nedan kallad ?höftprojektet?) visade att ?Local infiltration analgesia? (LIA) initialt minskade postoperativ smärta, underlättade mobilisering samt förkortade vårdtiden, jämfört med spinalt morfin. I denna studie genomfördes en långtidsuppföljning av höftprojektet med mätningar efter 6 respektive 12 veckor. Studiegruppen hade fått LIA vid operationsslutet och kontrollgruppen spinalt morfin.

Bakgrund: Pankreatikoduodenektomi är den enda kurativa behandlingen av pankreascancer och pankreasanastomosläckage (PAL) är en mycket allvarlig postoperativ komplikation. Metoder för att identifiera detta i ett tidigt skede behöver förbättras. Den postoperativa övervakningen består till stor del av vitalparametrar men sjuksköterskan observerar även andra tecken på försämring. Metod: 32 patienter som genomgått pankreatikoduodenektomi inkluderades i studie. Ett bedömningsformulär innehållande 14 parametrar togs fram och användes för att identifiera vad i sjuksköterskans observationer som kan identifiera tidiga tecken på PAL.

Sammanfattning                        Postoperativ smärtbehandling är otillräcklig trots ökad kunskap i smärtfysiologi och utvecklandet av nya farmakologiska riktlinjer. Obehandlad postoperativ smärta kan leda till komplikationer som fördröjd mobilisering, djup ventrombos, lungemboli, hjärtinfarkt, stroke och lunginflammation, vilka leder till ett ökat lidande för patienten både fysiskt och psykiskt samt ökade kostnader för samhället. Anestesisjuksköterskan lägger grunden för den postoperativa smärtbehandlingen före och under anestesin och ska arbeta preventivt för att patientens smärtbehandling ska vara tillräcklig. Syftet med studien var att belysa anestesisjuksköterskans strategier för att förebygga patientens postoperativa smärta efter generell anestesi. Semistrukturerade intervjuer genomfördes med fyra anestesisjuksköterskor på ett västsvenskt sjukhus och analyserades med kvalitativ innehållsanalys.

Background: The purpose of this study was to explore the reasons that motivate women to seek cosmetic breast augmentation surgery, to examine their self-concept and how they relate to their breasts.Methods: Ten female postoperative participants who have undergone an aesthetic breast augmentation surgery on private clinics were interviewed using an unstructured interview format. Self-report questionnaire was used as a complement to the interview. The purpose of this was to examine women's self-concept. Six female postoperative participants who have undergone a breast augmentation surgery on public clinic and had medically confirmed defect also completed the measures.Results: The results of the interview analysis showed that some participants experienced positive physical and psychological outcomes of surgery and some did not. Several main themes were identified relating to the initial reasons for performing surgery.

ABSTRACTAim. To describe intensive care nurses´ experiences of caring for patients with postoperative delirium after heart surgery.Background. Delirium is a common condition after heart surgery. Previous research has focused more on pathophysiology, incidence, etiology, prevention, detection and management, and less on how nurses caring for patients with delirium experience it.Design. A qualitative interview study.Method.

Introduction: Urinary retention is a common postoperative complication associated with bladder distension. Permanent damage to the bladder affects the patient?s quality of life and may lead to a lifelong inability to empty the bladder and needs of self-catheterization with the risk of urinary tract infection. Bladder distension was classified as the fourth largest health care related injury in Sweden in 2013. Bladder distension may occur before the operation starts and is more common among orthopedic patients.

ABSTRACTIntroduction: An increasing number of patients in Sweden receive epidural anaesthesia (EDA) in connection to surgery. Caring for patients with acute pain is a responsibility that is strongly established within the profession of the nurse anaesthetist. If the care provided by the nurse anaesthetist for patients who receive epidural anaesthesia is to evolve then further insight and knowledge is required regarding the individual´s experience.Aim: To describe patients' experiences in receiving epidural anaesthesia based on an earlier perioperative start-up of the EDA.Method: Based on a qualitative approach, the aim is to conduct semi-structured interviews with patients who receive EDA in connection to abdominal or gynaecological surgery. Research subjects' statements in the context of the interviews will be transcribed and then analysed using qualitative content analysis. In order to evaluate the chosen method regarding data collection and analysis model an exploratory pilot study was conducted.

In Sweden over 10.000 patients annually, mostly children, undergo tonsillar surgery. The most common surgical method is total removal of the tonsil, tonsillectomy (TE). During the last decade partial tonsil resection, tonsillotomy (TT), has been reintroduced and is associated with lower primary morbidity and less postoperative pain. The aim of the present study was to evaluate if and to what extent 4-5 year old children?s voice function are affected by tonsillar hypertrophy compared to controls and to study the effects of the two surgical techniques on vocal function.

SammanfattningI arbetet beskrivs olika beteenden och fysiologiska förändringar som kan indikera smärta hos hund. Det finns också en kort beskrivning av tre smärtbedömningskalor: Visuell analog skala (VAS) Glasgow Composite Pain Scale Short Form (GCPS) och University of Melbourne Pain Scale (MPS). Dessa skalor har utvecklats som verktyg för att gradera smärta. VAS har tagits fram för humanvården och de andra är utvecklade för bedömning av postoperativ smärta hos hund. Arbetet innehåller också en mindre studie, där skalorna jämförs mot varandra.

Septic tenosynovitis involving the digital sheath is a relatively common problem in the horse and the prognosis has been considered as poor. However, there are only few studies confirming this. The purpose of this study is to increase the knowledge about the prognosis for septic tenosynovitis in the digital sheath. The literature indicates that half or a bit more than half of the treated horses will return to previous use. The recommended treatment is debridement of the wound, lavage and sometimes application of drains and broadspectrum antibiotics. The prognosis is considered as worse when the infection is established.

Superior Canal Dehiscence Syndrome (SCDS) is a newly described syndrome with symptoms including sound- and pressure induced vertigo, conductive hyperacusis and autophony. SCDS is caused by absence of bone overlying the superior semicircular canal and can be surgically treated. As the syndrome and surgical technique is new, it is of importance to study possible postoperative outcomes..