Centralisation of paediatric services: assessing impact in suspected testicular torsion
BAUS ePoster online library. Zimmermann E.
Jun 26, 2018; 211358
Ms. Eleanor Zimmermann
Ms. Eleanor Zimmermann
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Rate & Comment (0)
Introduction: In our Trust, paediatric services were recently centralised to a single unit within our multi-site configuration - 17 miles from the Urology Centre. We analysed the impact of this change on the management of patients with suspected testicular torsion. We examined referral numbers, time to specialist assessment, 'knife-to-skin' time, surgical findings and need for orchidectomy.

Methods: Using a comprehensive electronic database we conducted a closed loop audit on suspected testicular torsion outcomes over two 12-month periods, pre and post paediatric centralisation (2015 and 2017).

Results: We observed that the total number of scrotal explorations reduced from 41 to 21 - of which 28 and 12 respectively were within the paediatric population. Median age of patients was 15 (range 4-51) vs 16 (range 4-46). There was no significant difference in time from presentation to 'knife-to-skin' overall: 195 mins vs 227 mins, p=0.20, or in the paediatric population: 211 vs 210 mins, p=0.95. Overall, five patients exceeded a 6-hour target of 'knife-to-skin' time during 2015 compared to one in 2017. There were in total 6 vs 4 confirmed torsions on exploration - all testes were viable. No orchidectomy was required in either period of analysis.

Conclusion: Since paediatric services have been centralised away from our Urology Centre there has been a reduction in patients breaching the 6-hour target. This may reflect a reduction in patient transfers, with Urological surgeons travelling to the new paediatric site. Total numbers of referrals have fallen which may indicate a shift of some patients to neighbouring units.
    This eLearning portal is powered by:
    This eLearning portal is powered by MULTIEPORTAL
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.

Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.

Save Settings