José María Miguelena Bobadilla

Hospital Universitario Miguel Servet, Caesaraugusta, Aragon, Spain

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Publications (25)15.07 Total impact

  • Cirugía Española 12/2013; · 0.87 Impact Factor
  • Cirugía Española 01/2013; · 0.87 Impact Factor
  • E.M. Urbano Mañero, J.M. Miguelena Bobadilla
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    ABSTRACT: Objective To determine whether the removal of the ischaemia tourniquet to perform haemostasis during knee replacement surgery, reduces bleeding, the need for transfusions, the incidence of complications, the incidence of further surgery, and the hospital stay.Patients and methodA non-randomised, prospective, descriptive and observational study was conducted on patients subjected to primary knee replacement with only one anaesthetist and 2 surgical teams. The same surgical technique and prosthesis model was used, with 2 schemes for ischaemia removal and drainage management. The patients were divided into 2 groups. In group i, the ischaemia tourniquet was released during the operation, before wound closure, and leaving the drainages without a vacuum. In group ii the tourniquet was released when the limb was bandaged and the drainages were connected to a vacuum. The parameters recorded were; bleeding during surgery, bleeding due to the drainages, monitoring the haemoglobin and haematocrit, incidence of complications and further surgery, transfusion needs, and hospital stay.ResultsThe study included 100 patients. The mean bleeding during surgery was 230,0 mL in group i and 2,0 mL in group ii (P < .05). The bleeding due to the drainages in group i was 531,2 mL and 601,6 mL in Group ii (P > .05). The total bleeding was 754,3 mL in group i and 621,6 mL in group ii. There were statistically significant differences in both cases (P < .05). The transfusion incidence in both groups was 16,7%. There were no significant differences between either group as regards medical complications or further surgery. A longer hospital stay was observed in group ii.Conclusion In this study, the need for transfusions in knee replacement surgery is not influenced by the time of releasing the ischaemia tourniquet. There is also no relationship between the incidence in postoperative complications and further surgery and the time of removing the tourniquet. The preoperative haemoglobin was the only predictive factor of transfusion in our study.
    Revista espanola de anestesiologia y reanimacion 12/2012; 59(10):556–561.
  • E M Urbano Mañero, J M Miguelena Bobadilla
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    ABSTRACT: OBJECTIVE: To determine whether the removal of the ischaemia tourniquet to perform haemostasis during knee replacement surgery, reduces bleeding, the need for transfusions, the incidence of complications, the incidence of further surgery, and the hospital stay. PATIENTS AND METHOD: A non-randomised, prospective, descriptive and observational study was conducted on patients subjected to primary knee replacement with only one anaesthetist and 2 surgical teams. The same surgical technique and prosthesis model was used, with 2 schemes for ischaemia removal and drainage management. The patients were divided into 2 groups. In group i, the ischaemia tourniquet was released during the operation, before wound closure, and leaving the drainages without a vacuum. In group ii the tourniquet was released when the limb was bandaged and the drainages were connected to a vacuum. The parameters recorded were; bleeding during surgery, bleeding due to the drainages, monitoring the haemoglobin and haematocrit, incidence of complications and further surgery, transfusion needs, and hospital stay. RESULTS: The study included 100 patients. The mean bleeding during surgery was 230,0mL in group i and 2,0mL in group ii (P<.05). The bleeding due to the drainages in group i was 531,2mL and 601,6mL in Group ii (P>.05). The total bleeding was 754,3mL in group i and 621,6mL in group ii. There were statistically significant differences in both cases (P<.05). The transfusion incidence in both groups was 16,7%. There were no significant differences between either group as regards medical complications or further surgery. A longer hospital stay was observed in group ii. CONCLUSION: In this study, the need for transfusions in knee replacement surgery is not influenced by the time of releasing the ischaemia tourniquet. There is also no relationship between the incidence in postoperative complications and further surgery and the time of removing the tourniquet. The preoperative haemoglobin was the only predictive factor of transfusion in our study.
    Revista espanola de anestesiologia y reanimacion 10/2012;
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    ABSTRACT: The training of residents in abdominal wall surgery is a fundamental aspect of surgical training, representing globally 20% of its activity. In this paper, we analyze the current state of resident training in this kind of surgery in Spain, taking into account the broad spectrum it covers: general services, specific functional units, ambulatory surgery programs. To do this, based on the specifications of the specialty program, specific data were used from several different sources of direct information and a review of the results obtained by residents in hernia surgery. In general, our residents agree with their training and the recorded results are in line with objectives outlined in the program. However, it would be important to structure their teaching schedules, a rotation period in any specific unit and their involvement in outpatient surgery programs.
    Cirugía Española 11/2011; · 0.87 Impact Factor
  • José María Miguelena Bobadilla
    Cirugia Espanola - CIR ESPAN. 01/2011; 89(2):130-130.
  • José María Miguelena Bobadilla
    Cirugía Española 12/2010; 88(6):432. · 0.87 Impact Factor
  • José María Miguelena Bobadilla
    Cirugía Española 10/2010; 88(4):209-10. · 0.87 Impact Factor
  • José María Miguelena Bobadilla
    Cirugía Española 09/2010; 88(6):432; author reply 433-4. · 0.87 Impact Factor
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    ABSTRACT: The aim of the study is to try and find out the state of surgical training in Spain and to determine whether it meets the objectives of the Program. The results of two surveys carried out on Residents and General Surgery Tutors by the Spanish Surgeons Association, based on the conclusions of the XXVII Congreso Nacional de Cirugía. The questions formulated referred to general aspects of the Service and specific ones related to access, teaching activity, surgery, research and personal perspectives. The responses were defined, adjusted and categorised as quantitative and qualitative variables. The statistics program G Stat 2.0 was used for processing and the descriptive presentation of the results. The surveys were sent to 626 Residents and 142 Tutors, with a response rate of 19% and 29%, respectively. First year residents predominated (32%) compared to later years, with an R-5 response index of 7.2%. A total of 91% knew the speciality Program well, and 76% were satisfied with the training received. The results obtained as regards surgical activity agree with those established in the Program, both in the number of procedures and in their progression throughout the Residency, although it is not possible to ensure its uniformity. The functions and accreditation of the Tutors which are one of the main foundations of the training process are pending specific regulations.
    Cirugía Española 08/2010; 88(2):110-7. · 0.87 Impact Factor
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    ABSTRACT: IntroductionThe aim of the study is to try and find out the state of surgical training in Spain and to determine whether it meets the objectives of the Program.
    Cirugia Espanola - CIR ESPAN. 01/2010; 88(2):110-117.
  • Cirugia Espanola - CIR ESPAN. 01/2010; 87(5):319-321.
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    Cirugia Espanola - CIR ESPAN. 01/2010; 88(5):353-353.
  • Cirugía Española 08/2009; 87(5):319-21. · 0.87 Impact Factor
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    ABSTRACT: Training in major trauma management is increasingly important in our country and throughout the world in general, but there is great uncertainty about who treats these patients in our country and how do surgical residents obtain experience in evaluation, diagnosis and treatment of these patients. To find out, from surgery residents, the current state of their training and knowledge of major trauma patient care in our country, and their opinions on how to improve it. At the same time, to analyse whether major trauma patient care in our hospitals has changed in recent years, along with the factors that may influence teaching in how to manage these patients. A survey was sent with a pre-paid envelope to 78 university hospitals accredited for resident training, during the period from March to October 2005. When comparing traditional care of major trauma patients with that of the last 5 years there were no statistically significant differences (p = 0.77). The fact that the hospital is a referral centre for trauma care of trauma does not significantly affect whether the resident feels well-trained (p = 0.7), or well-informed (p = 0.33). General surgery residents do not feel well-trained or well-informed on the management of major trauma patients despite working in hospitals that treat these patients and an increasing number of surgeons are involved in the trauma. There are few lines of research into multiple trauma, despite the linkage with university centres.
    Cirugía Española 12/2008; 84(5):267-72. · 0.87 Impact Factor
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    ABSTRACT: On 8 may 2007, the Official Bulletin (BOE) published the new Specialist Training Program. The Post-Graduate Training Section of the Spanish Surgeons Association (AEC), conscious of the importance of this situation, has carried out a reflective analysis of this Program and proposes a series of objectives. The new plan coordinates a training program that sets out three general objectives as regards, knowledge, skills and attitudes that the resident must assimilate and develop, it strictly defines the final product, without substantially changing the previous program and emphasises two fundamental aspects: training in minimally invasive surgery and research training, although the inclusion of previously unpublished new rotations and the continuation of the current assessment model. The logic in the definition of general surgery as "a major discipline paradigm" should lead to important structural changes. Aspects such as regulating work and training times, European Directives, lack of professional motivation and changes in the vocational spectrum of new residents, will make the optimisation of the results difficult a priori. The year 2017 will be the time to judge the results after five groups of surgeon graduates have been trained by this program.
    Cirugía Española 09/2008; 84(2):67-70. · 0.87 Impact Factor
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    ABSTRACT: Introduction Training in major trauma management is increasingly important in our country and throughout the world in general, but there is great uncertainty about who treats these patients in our countryand how do surgical residents obtain experience in evaluation, diagnosis and treatment of these patients. Objective To find out, from surgery residents, the current state of their training and knowledge of major trauma patient care in our country, and their opinions on how to improve it. At the same time, to analyse whether major trauma patient care in our hospitals has changed in recent years, along with the factors that may influence teaching in how to manage these patients. Material and method A survey was sent with a prepaid envelope to 78 university hospitals accredited for resident training, during the period from March to October 2005. Results When comparing traditional care of major trauma patients with that of the last 5 years there were no statistically significant differences (p = 0.77). The fact that the hospital is a referral centre for trauma care of trauma does not significantly affect whether the resident feels well-trained (p = 0.7), or well-informed (p = 0.33). Conclusions General surgery residents do not feel well-trained or well-informed on the management of major trauma patients despite working in hospitals that treat these patients and an increasing number of surgeons are involved in the trauma. There are few lines of research into multiple trauma, despite the linkage with university centres.
    Cirugia Espanola - CIR ESPAN. 01/2008; 84(5):267-272.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: On 8 may 2007, the Official Bulletin (BOE) published the new Specialist Training Program. The Post-Graduate Training Section of the Spanish Surgeons Association (AEC), conscious of the importance of this situation, has carried out a reflective analysis of this Program and proposes a series of objectives. The new plan coordinates a training program that sets out three general objectives as regards, knowledge, skills and attitudes that the resident must assimilate and develop, it strictly defines the final product, without substantially changing the previous program and emphasises two fundamental aspects: training in minimally invasive surgery and research training, although the inclusion of previously unpublished new rotations and the continuation of the current assessment model. The logic in the definition of general surgery as “a major discipline paradigm” should lead to important structural changes. Aspects such as regulating work and training times, European Directives, lack of professional motivation and changes in the vocational spectrum of new residents, will make the optimisation of the results difficult a priori. The year 2017 will be the time to judge the results after five groups of surgeon graduates have been trained by this program.
    Cirugia Espanola - CIR ESPAN. 01/2008; 84(2):67-70.
  • Cirugía Española 08/2007; 82(1):51-2. · 0.87 Impact Factor
  • Cirugía Española 07/2007; 82(1):51–52. · 0.87 Impact Factor