World Journal of Surgery最新文献

{"title":"Impact of Mode of Arrival to Hospital on Early Mortality in Adults With Penetrating Trauma: A Systematic Review, Meta-Analysis, and Narrative Synthesis.","authors":"Maud M R McCutcheon, John D Allison, Stella R G Smith","doi":"10.1002/wjs.70087","DOIUrl":"10.1002/wjs.70087","url":null,"abstract":"<p><strong>Background: </strong>Penetrating injury is a time-critical disease where early definitive treatment is lifesaving. Although most patients with penetrating trauma reach the emergency department (ED) via emergency medical services (EMS), self-presentation or transport with police are also common. This review synthesizes the available evidence in adult penetrating trauma to evaluate if the mode of transport to hospital impacts early mortality.</p><p><strong>Methods: </strong>Two groups were defined as follows: transport to hospital with emergency medical services (EMS) and 'other' transport (private or police). Medline, Embase, and CENTRAL databases were searched as well as gray literature. Results were screened by two authors. Eligible studies were assessed for quality and risk of bias and included in both a meta-analysis using a random effects calculation of odds ratio and narrative analysis.</p><p><strong>Results: </strong>19 studies were included overall. Meta-analysis using data from nine studies showed EMS transport did not significantly impact early mortality (OR 1.32 [95% CI 0.70-2.48] (p = 0.39)). Overall injury-severity adjusted mortality was assessed using data from 14 studies and was also not significantly affected by EMS transport (OR 1.21 [95% CI 0.93-1.59] (p = 0.16)). Data comparing injury-to-hospital arrival times for medical and nonmedical transport were limited but suggested nonmedical transport was faster amongst an urban cohort of patients.</p><p><strong>Conclusions: </strong>There was no survival benefit associated with EMS transport among this largely USA-based urban cohort of patients with penetrating trauma. Shorter injury-to-hospital arrival times associated with nonmedical transport may, in some cases, outweigh the benefits of prehospital care. These findings support an emphasis on shortening the prehospital phase for severely injured penetrating trauma patients, which may include use of nonmedical transport where transport times are short.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2959-2967"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Axillary Lymph Node Yield and Nodal Burden in Breast Cancer: Experience From a Large Cancer Center in Sub-Saharan Africa.","authors":"Nashivai Kivuyo, Mungeni Misidai, Abdulrahaman Amin, Daniel Kitua, Zephania Gega, Ally Mwanga, Larry Akoko","doi":"10.1002/wjs.70060","DOIUrl":"10.1002/wjs.70060","url":null,"abstract":"<p><strong>Background: </strong>Axillary lymph node yield (LNY) is a critical component of breast cancer staging and treatment planning. International guidelines recommend retrieving ≥ 10 lymph nodes during axillary lymph node dissection (ALND) to ensure adequate staging. This study assessed LNY and its association with pathological nodal burden among patients with breast cancer undergoing ALND at Muhimbili National Hospital (MNH), Tanzania.</p><p><strong>Materials and methods: </strong>We conducted a retrospective analysis of female patients with breast cancer who underwent ALND between January 2018 and December 2024. Clinical and pathological data were abstracted from institutional records. LNY was categorized as < 5, five to nine, or ≥ 10 nodes. Ordinal logistic regression was used to identify factors associated with the pathological nodal stage (pN0-pN3).</p><p><strong>Results: </strong>Among 871 patients, only 27% had ≥ 10 lymph nodes retrieved. Median LNY was 7 (IQR: 4-10). Higher LNY was strongly associated with higher pN category (aOR for five to nine nodes: 2.33; 95% CI: 1.67-3.26; aOR for ≥ 10 nodes: 8.93; 95% CI: 5.89-13.53; and p < 0.001). Additional independent predictors of higher nodal burden included tumor size (T2: aOR 2.34; 95% CI: 1.26-4.34; T3: aOR 2.54; 95% CI: 1.40-4.60; T4: aOR 3.34; and 95% CI: 1.84-6.09), histological grade 2 (aOR 1.63 and 95% CI: 1.09-2.45), and lobular histology (aOR 4.96 and 95% CI: 1.41-17.38). Neoadjuvant chemotherapy was associated with lower nodal burden category in univariate analysis but not after adjusting for LNY.</p><p><strong>Conclusion: </strong>Low LNY is prevalent and strongly associated with understaging of pathological nodal burden. Targeted quality improvement interventions are needed to optimize nodal evaluation and accurate staging to ensure appropriate treatment strategies in resource-limited settings.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2610-2619"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Civilian Penetrating Rectal Injuries Associated With Genitourinary and Bony Injuries.","authors":"Terron Govender, Zahra Abrahams, Deidre McPherson, Sorin Edu, Andrew Nicol, Pradeep Navsaria","doi":"10.1002/wjs.70041","DOIUrl":"10.1002/wjs.70041","url":null,"abstract":"<p><strong>Background: </strong>Combined rectal, bladder, and bone injuries are rare but associated with significant morbidity. This study aims to evaluate the outcomes of such injuries.</p><p><strong>Methods: </strong>A retrospective review of patient records was conducted for all individuals with full thickness penetrating rectal injuries admitted to the Trauma Centre at Groote Schuur Hospital between January 2010 and December 2019. Intraperitoneal rectal injuries were repaired, whereas extraperitoneal rectal injuries were left untreated, with a diverting loop colostomy performed. Intraperitoneal bladder injuries were repaired, whereas extraperitoneal bladder injuries were repaired through cystostomy. Pelvic and spinal fractures were irrigated, but presacral drainage and distal rectal washouts were not performed. Infectious complications and mortality were documented.</p><p><strong>Results: </strong>A total of 104 patients with 134 rectal injuries were identified (10 intraperitoneal, 64 extraperitoneal, and 30 combined injuries). Genitourinary tract injuries were identified in 42 (40.38%) patients, and 50 patients (48.08%) had associated bone injuries, including sacral (22), iliac (9), pubic rami (5), coccygeal (1), acetabular (3), femoral (6), and pelvic joint (5) fractures. A total of 91 diverting loop colostomies and three Hartmann's procedures were performed. Nine fistulae (6.7%) were observed, including three rectocutaneous, three rectovesical, one small bowel cutaneous, one vesicocutaneous, and one enteroenteric. There were 27 infectious complications, including 13 surgical site infections, 2 cases of pelvic osteitis, and 12 soft tissue infections.</p><p><strong>Conclusion: </strong>Extraperitoneal rectal injuries with associated bladder and/or bone injuries can be safely managed with fecal diversion, extraperitoneal bladder repair through cystostomy, and irrigation of bone and joint injuries, with minimal morbidity.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2933-2939"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intestinal Intussusception in Adults: A Systematic Review.","authors":"Sidney Heersche, Jeanne Hirt, Fabio Butti, Martin Hübner, Dieter Hahnloser, Gaëtan-Romain Joliat, Fabian Grass","doi":"10.1002/wjs.70055","DOIUrl":"10.1002/wjs.70055","url":null,"abstract":"<p><strong>Background: </strong>Management of intestinal intussusception remains controversial with regards to conservative versus operative management, as well as choice of surgical procedure.</p><p><strong>Methods: </strong>A systematic review on PubMed/MEDLINE, Web of Science, Google Scholar, SCOPUS/EMBASE, and the Cochrane Library was performed. Articles published between 2004 and 2024 were collected. Case reports and case series < 20 patients were not considered.</p><p><strong>Results: </strong>After screening of 2286 articles, 37 studies totaling 2330 patients were included. All studies were retrospective case series except for one prospective case series and one prospective and retrospective case series. There were 20% of colocolic intussusceptions, 21% of ileocolic intussusceptions, and 65% of enteric (small bowel) intussusceptions. A radiological lead point of the intussusception was described in 31% of patients. Intussusceptions were idiopathic in 39%, and caused by a pathological lead point in 58% of cases. Underlying malignancy was present 25% of cases and was more frequent in case of colocolic intussusceptions (68%), versus 9% in small bowel intussusceptions, and 46% of ileocolic intussusceptions. Operative management was performed in 49% of intussusceptions, mainly through open access (72%). Based on these findings, a comprehensive algorithm is provided to guide treatment decisions in adult patients with intussusception.</p><p><strong>Conclusion: </strong>Data regarding surgical management of the intussusception were heterogenous and poorly reported. In case of colic intussusception, a high degree of suspicion for an underlying malignancy is warranted, and in that regard, an oncological surgical resection without reduction is recommended. Enteric intussusception should be managed according to length, clinical presentation, and interoperative findings of lead points.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2706-2716"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Related Quality of Life and Social Reintegration Indicators Following Reconstructive Surgery: A Prospective Observational Study.","authors":"Shireen Dumont, Silas Msangi, Simon Ponthus, Leslie Elahi, Roba Khundkar, Edward Wayi, Lionel Dumont","doi":"10.1002/wjs.12696","DOIUrl":"10.1002/wjs.12696","url":null,"abstract":"<p><strong>Background: </strong>Studies focusing on disease severity and reconstructive surgical treatment's impact on health-related quality of life (HRQOL) are lacking, particularly in low- and middle-income countries (LMICs). This study aims to assess the impact of reconstructive surgery-related conditions on basic indicators of quality of life and social integration within the context of limited resources and short-term surgical missions.</p><p><strong>Methods: </strong>We conducted a pre-post cohort study at Tumbi Regional Referral Hospital in Tanzania from July 2023 to July 2024. Patients undergoing reconstructive surgery for postburn contractures (PBC), congenital malformations, and trauma-related conditions were included. Surgical outcomes and HRQOL were assessed using patient-reported outcome measures (PROMs) preoperatively and at 12 months postoperatively.</p><p><strong>Results: </strong>Of 120 scheduled patients, 82 were included, with a 12-month follow-up rate of 77.7% and a median age of 3.5 years old. PBC accounted for 73.2% of cases. The patients' primary expectation after surgery was functional recovery (64%). Patient-reported disabilities improved significantly, decreasing from 72% to 9% postoperatively (p < 0.001). The impact on family life improved from 58.8% to 6% (p < 0.001), and reductions in social exclusion and discrimination were observed. Notably, perceptions of witchcraft association declined from 23% to 7.8% (p < 0.014).</p><p><strong>Conclusions: </strong>Assessing the impact of disabilities and surgical outcomes on HRQOL using PROMs is feasible and seems essential during short-term surgical missions. The findings suggest that reconstructive surgery restores functionality and improves quality of life 1 year after the procedure, highlighting its positive impact on patients' social lives and overall well-being.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2794-2800"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Versus Open Approach for Emergency Repair of Groin Hernias: A Systematic Review and Meta-Analysis.","authors":"Simon D Lai, Nicolas J Smith, Brittany Park, Alain Vandal, Andrew D MacCormick","doi":"10.1002/wjs.70076","DOIUrl":"10.1002/wjs.70076","url":null,"abstract":"<p><strong>Background: </strong>Although open repair has historically been the preferred approach over laparoscopic repair for acutely strangulated and incarcerated groin hernias, the laparoscopic approach is gaining popularity. This systematic review and meta-analysis aims to investigate the safety and clinical outcomes of laparoscopic and open groin hernia repair in the emergency setting.</p><p><strong>Methods: </strong>PubMed, Embase, Scopus, Cochrane Library, and Web of Science were systematically searched for articles comparing clinical outcomes between laparoscopic and open emergency groin hernia repair in adult patients. The primary outcome was the length of hospital stay. Secondary outcomes included operative time, postoperative complications, recurrence, reoperation, postoperative mortality, and the rate of conversion from laparoscopic to open repair. Risk of bias was assessed.</p><p><strong>Results: </strong>Thirteen articles (4 prospective and 9 retrospective cohort studies) were included, with a total of 38,659 patients enrolled. Laparoscopic repair resulted in shorter length of hospital stay (MD -2.96 days [95% CI -4.91, -1.01] and p = 0.0074) and lower risk of wound infection (RR 0.29 [95% CI 0.20, 0.43] and p < 0.0001]. No statistically significant differences were observed between the two groups regarding operative time (p = 0.1006), risk of seroma formation (p = 0.3142), and risk of respiratory complication (p = 0.9880). Rate of conversion from laparoscopic to open repair as recorded in five studies was 2.78% ([95% CI 0.60, 11.92]).</p><p><strong>Conclusion: </strong>Emergency laparoscopic repair of groin hernias results in shorter length of hospital stay and lower risks of postoperative morbidity and mortality, with no difference in operative time when compared to open repair. Although further large-scale prospective cohort studies and randomized controlled trials may be required to draw definitive conclusionsregarding the optimal surgical approach, laparoscopic repair of groin hernias appears to be a safe and feasible alternative to conventional open repair in the acute setting.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2733-2741"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical Pitfalls in AI-Based Predictive Models in Surgery.","authors":"Sara Ben Hmido, Houssam Abder Rahim, Boris Keller, Freek Daams, Matthijs Schakel, J Carel Goslings, E J M Nieveen van Dijkum, Stephen Rainey, Geert Kazemier, Marieke Bak, Corrette Ploem","doi":"10.1002/wjs.70080","DOIUrl":"10.1002/wjs.70080","url":null,"abstract":"<p><strong>Background: </strong>Predictive models in surgery promise to improve clinical care by anticipating complications, guiding decision-making, and supporting personalized treatment strategies. Although their potential to enhance outcomes and efficiency is substantial, their integration into clinical practice also raises profound ethical challenges.</p><p><strong>Ethical framework: </strong>These challenges span the entire lifecycle of predictive models from data collection and development to validation and clinical use. They touch upon patient privacy, algorithmic bias, transparency, and the shifting responsibilities of clinicians. Importantly, the ethical concerns are not isolated to one group but shared across patients, developers, and clinicians within a dynamic stakeholder relationship.</p><p><strong>Analysis: </strong>Key risks include biased or unrepresentative datasets, privacy breaches, opaque decision-making processes, and the danger of deskilling surgeons if reliance on algorithms becomes excessive. To mitigate these risks, strategies, such as out-of-distribution detection, standardized data collection, parallel model development, and continuous auditing, are essential. Beyond technical safeguards, embedding predictive models within a framework of accountability and patient-centered care is necessary to sustain trust and equity.</p><p><strong>Conclusion: </strong>The integration of predictive models into surgery requires more than technical excellence, and it demands ethical vigilance. Preparing future clinicians through education that emphasizes both clinical reasoning and ethical awareness is critical. By aligning predictive model development with human-centered values, healthcare systems can ensure that these innovations enhance surgical practice while safeguarding equity, transparency, and patient trust.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2837-2845"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the \"JPCC Barriers to Pediatric Colostomy Care Scoring System\": A Modified Delphi Study.","authors":"Giulia Brisighelli, Catterina Bebington, Marion Arnold, Lindiwe Dyamara, Yentl Gamiet, Leila Hartford, Jane Hoole, Laura Obbes, Juan Scribante","doi":"10.1002/wjs.70101","DOIUrl":"10.1002/wjs.70101","url":null,"abstract":"<p><strong>Background: </strong>In low- and middle-income countries (LMICs), pediatric colostomy care is associated with significant clinical, social, and economic challenges that negatively impact patient outcomes. This study aimed to identify key barriers to pediatric colostomy care and to develop a scoring system for barriers to colostomy care.</p><p><strong>Methods: </strong>A modified Delphi study was conducted, involving caregivers of pediatric patients with colostomies and health care professionals managing such patients in Southern Africa. Forty individuals were invited to participate (20 caregivers and 20 health care professionals). In Round 1, participants were asked to list barriers to colostomy care via an online REDCap survey. Three authors (GB, CB, JS) thematically grouped identified barriers. In Round 2, participants rated the relevance of each statement: ≥ 75% agreement defined consensus. A virtual Round 3 refinement meeting was held with an expert panel to finalize the scoring system.</p><p><strong>Results: </strong>Of the 40 invited individuals, 23 (57.5%) participated in Round 1: 12 health care professionals (9 doctors, 2 nurses, and 1 with an unknown profession) and 11 caregivers. Sixteen participants completed Round 2, with consensus reached on all barrier statements. In Round 3, 4 nurses and 4 doctors reviewed and refined the statements, resulting in a final 36-item JPCC barriers to colostomy care scoring system.</p><p><strong>Conclusion: </strong>This study presents the first scoring system specifically designed to measure barriers to pediatric colostomy care in Southern Africa. The scoring system offers a practical framework for research, clinical assessment, and advocacy. Further multicenter validation is recommended to assess its applicability across diverse settings.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2819-2827"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Extubation Failure and Prolonged Intubation in Patients With Acute Brain Injury Following Surgery: A Retrospective Study.","authors":"Ue-Cheung Ho, Hsueh-Yi Lu, Lu-Ting Kuo","doi":"10.1002/wjs.70057","DOIUrl":"10.1002/wjs.70057","url":null,"abstract":"<p><strong>Background: </strong>Acute brain injury (ABI) is a severe, life-threatening condition with high mortality and morbidity rates. Surgical intervention is often necessary for patients with intracranial hematomas or refractory increased intracranial pressure, necessitating intubation and mechanical ventilation. These patients may experience both extubation failure and prolonged intubation during treatment. This study analyzed the risk factors associated with extubation failure and prolonged intubation in patients with ABIs who underwent surgery.</p><p><strong>Methods: </strong>In this retrospective cohort study, 641 adult patients with ABIs, including spontaneous intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage, and traumatic brain injury, who required mechanical ventilation for > 48 h and survived for > 14 days after surgery, were included. Clinical data, including demographics, clinical characteristics, Glasgow coma scale (GCS) scores, and laboratory test results, were analyzed at admission and before extubation.</p><p><strong>Results: </strong>The mean age of recruited patients was 61.12 ± 16.60 years. In total, 496 (92.9%) patients were successfully extubated after meeting the criteria for weaning and passing the spontaneous breathing test, and 38 (7.1%) were reintubated. Prolonged intubation (> 14 days) was observed in 217 patients (33.9%). Multivariable regression analysis was conducted to identify independent predictors. GCS at the time of extubation was an independent predictor of reintubation, whereas age and initial GCS were identified as independent predictors of prolonged intubation.</p><p><strong>Conclusion: </strong>This study comprehensively characterizes indicators of both extubation failure and prolonged intubation in patients with ABI following surgery. Identifying these risk factors will enable timely intervention and precise prognostic assessment during the early management of patients with ABI.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":"2689-2698"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Trauma Care and Prevention in the COSECSA Region: A Review of Trauma Data Utilization.","authors":"Paul Serrato, Claudia Kabanyana, Fabrizio Darby, Louise Atadja, Bennadettee Biton, Grace Kansayisa, Penelope Kantu Machona, Melanie Sion, Chifundo Kajombo","doi":"10.1002/wjs.70107","DOIUrl":"https://doi.org/10.1002/wjs.70107","url":null,"abstract":"<p><strong>Background: </strong>Trauma research is important for the member countries of the College of Surgeons of East, Central, and Southern Africa (COSECSA) to define the state of trauma systems. We aim to assess the literature describing the translation of trauma data to implementation programs for trauma care improvement or injury prevention in the COSECSA region.</p><p><strong>Methods: </strong>A contemporary narrative review was conducted using PubMed, Embase, Scopus, Web of Science, Global Index Medicus, Global Health, Africa-Wide, and HINARI (searched January 2025). Published studies on injury prevention programs, trauma care improvement, and policy changes in COSECSA were included. Studies focused on measuring trauma prevalence were excluded. Qualitative analysis of interventional design and impact was conducted.</p><p><strong>Results: </strong>Over 1250 abstracts were screened. Nearly all publications using trauma data focused on measuring injury patterns and associated risk factors. Of the 57 translational articles meeting inclusion criteria, 30 (53%) pertained to trauma care capacity building and education, 10 (18%) evaluated quality improvement programs in trauma care, 7 (12%) described injury prevention programs, 5 (9%) assessed injury-related policy changes, and 5 (9%) described secondary benefits of registries such as improved patient assessments. Geographically, 19 (33%) articles originated from Uganda, 10 (18%) from Rwanda, 7 (12%) from Tanzania, 6 (11%) from Kenya, 5 (9%) from Malawi, 4 (7%) from Ethiopia and Botswana each, and 1 (2%) from South Sudan, Mozambique, and Zambia each. The findings reveal significant progress in the COSECSA region in using trauma data to enhance care and prevention efforts. However, transforming data into actionable programs remains a complex and challenging process with ample opportunities for further work.</p><p><strong>Conclusions: </strong>Publications pertaining to implementation programs for trauma care improvement and injury prevention are sparse in the existing literature. We highlight trauma research in the COSECSA region with tangible, direct local benefits. Shifting the focus of trauma research from disease burden to targeted implementation programs may be a more impactful use of scarce resources and research energies.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}