Emergency medicine magnifying loupes

Magnification effect on fine motor skills of dental students

OBJECTIVES

This study observed the effect of different magnification systems on dental students' real and perceived fine motor skills.

METHODS

This was a laboratory-based experimental study. Students in the fifth year of an undergraduate dentistry program (N = 92) participated in this study. The dependent variables were real motor skills, perceived motor skills and time required to complete the fine motor skills test. The independent variable was the use of a magnification system under four conditions. For each condition, the Dental Manual Dexterity Assessment was performed, which consisted of inserting the #3195FF bur into targets positioned on a Styrofoam plate. The accuracy of each penetration of the targets was scored, using a point system with a maximum possible score of 246 points. Students' perceived fine motor skills were assessed using a visual analog scale (VAS) that ranged from zero for no skills to ten for maximum skills. A descriptive statistical analysis and the repeated measures ANOVA were performed (α = 0.05).

RESULTS

The Galilean and Keplerian loupes were found to positively affect students' real fine motor skills (p<0.01); however, perceived fine motor skills and time were significantly better (p<0.01) under the naked eye.

CONCLUSIONS

Dental students' real fine motor skills were better when Galilean and Keplerian loupes were used, but the perceived fine motor skills were not.

Implementing magnification during pre-clinical training: Effects on procedure quality and working posture

OBJECTIVE

The objective of this study was to evaluate the effects of magnification on the quality of two pre-clinical procedures, class I cavity preparations and composite resin restorations, and to evaluate the working posture.

METHODS

This was an experimental laboratory study. The response variables were the quality of cavity preparations and Class I restorations as well as the working posture adopted during the execution of these procedures. The independent variables were the magnification system under four levels (unaided visualisation, the use of a simple loupe, the use of a Galilean loupe and the use of a Keplerian loupe) and the artificial teeth treated. Class I cavity preparations and restorations (N = 320) were performed using standardised procedures, and the quality achieved was evaluated using pre-established criteria. Working posture was recorded using digital video cameras and was evaluated using the Compliance Assessment of Dental Ergonomic Posture Requirements (CADEP). A two-factor analysis of variance (ANOVA) and multiple comparison test were performed (α = 0.05).

RESULTS

The quality of cavity preparation did not differ significantly amongst the different magnification systems (P = 0.082). Galilean and Keplerian systems had a positive impact on restoration quality only for the left mandibular first molar (P = 0.04). Higher posture scores were observed when Galilean and Keplerian loupes (P = 0.01) were used, regardless of the tooth being treated.

CONCLUSION

The use of Galilean and Keplerian magnification lenses did not affect the quality of the pre-clinical procedures performed whilst improved the scores of ergonomic posture.

The value of loupe magnification: an underused tool in emergency medicine

STUDY OBJECTIVES

Loupe magnification is widely used in medicine. Hand surgeons, in particular, use magnification for virtually all cases. The physical examination is more effective with magnification including improved tissue and foreign body identification. It is valuable for meticulous debridement of foreign material. Skin closure is much improved with more clearly identified wound edges. The detail and precision is vastly better allowing more ideal surgical repairs. These principles could improve wound care quality for emergency physicians as well. This article will compare wound visualization with the naked eye and 2.5 magnification loupes to determine the relative value for an emergency physician.

MATERIALS AND METHODS

Using a cadaver model, this article will compare relative visualization using no magnification and 2.5 loupe magnification. Comparative photographs will be used for identification of wound edges and anatomical structures.

RESULTS

The photographs presented demonstrate relative visualization with the naked eye and the 2.5 loupes. These photographs demonstrate the advantage of magnification in wound care and closure. The only significant costs are the loupes which should not be a deterrent for emergency physicians.

DISCUSSION

Loupe magnification is the standard for quality wound care and closure in hand surgery. They are also used in many other fields of medicine, including facial and plastic surgery. Magnification is now common and has proven effective. Emergency physicians, in general, have not readily embraced the use of magnification. Hand wounds and facial laceration repairs in the emergency department (ED) are 2 areas magnification could be particularly helpful. This study clearly demonstrates the relative advantage of magnification for tissue identification, debridement, and skin closure. Magnification is a potentially valuable tool in laceration repair in the ED. It greatly enhances results at minimal costs.

5th Annual David R. Boyd, MD Lecture: Revolutionary advances in wound repair in emergency medicine during the last three decades. A view toward the new millennium

This lecture provides an overview of advances in wound repair devised by our multidisciplinary team of physicians, scientists, and students. Our collective efforts have devised products, drugs, and concepts that are facilitating wound repair without infection and with the least possible scar. Some of the beneficial products and drugs developed or identified by our laboratory include nitrile examination and surgical gloves, magnification loupes, high pressure syringe irrigation, Shur Clens, as well as a wide variety of different wound closure techniques. In addition, our studies of the mechanism of wound injury, soil infection-potentiating fractions, dynamic and static skin tensions, and microflora of the skin have become important predictors of the outcomes of wound repair. During the new millennium, the computerized clinical information system as well as studies of tissue regeneration should dramatically change our approaches to wound repair.

A disposable emergency wound treatment kit

Biomechanical studies in our laboratory have provided a scientific basis for selecting surgical gloves and instruments, drugs, and dressings for traumatic wound treatment. This armamentarium has been incorporated into a disposable emergency wound treatment kit for use in the emergency department. Its upper tray is for wound cleansing, while its lower tray is used for wound closure. A clinical evaluation of the kit by emergency physicians was very favorable because it saved time, eliminating the need to search for and assemble the gloves, instruments, drugs, and dressings for wound treatment.