Patient Safety in Surgery最新文献

{"title":"Association between preoperative hypoalbuminemia and surgical site infection in abdominal surgery: a systematic review and meta-analysis.","authors":"Hala Fathi EmamElkhir Omer, Maria Badraldin Ali Saga, Yaser Waheeb Slaiman Naser, Heba Mukhtar Abdalla Mukhtar, Tamney Ahmed Mohammed Hamed, Jawahir Osman Omer Ali, Noon Abdalla Mohamed, Tawasol Mustafa Abdalaty Mohamed, Hadeel Ahmed Ramadan Dawod, Ashraf Hassan Mohamed Hassan, Sagad O O Mohamed","doi":"10.1186/s13037-026-00478-y","DOIUrl":"10.1186/s13037-026-00478-y","url":null,"abstract":"","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13072468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overuse in surgery by deviation from the \"Choosing Wisely\" campaign recommendations: a surrogate of unnecessary surgery and low-value care.","authors":"Ana Garcia-Santa-Vinuela, Jorge Vicente-Guijarro, Diego San Jose-Saras, Paulo Sousa, Cristina Díaz-Agero Pérez, Jesús María Aranaz-Andres","doi":"10.1186/s13037-026-00477-z","DOIUrl":"10.1186/s13037-026-00477-z","url":null,"abstract":"<p><strong>Background: </strong>Inappropriate health care reduces the quality of care and efficiency of the health system. The goal of this study was to analyze the frequency of overuse of five surgical procedures while also determining the epidemiological characteristics of both patients and interventions.</p><p><strong>Methods: </strong>This is a retrospective observational cohort study performed in a tertiary referral center in Spain. Surgical Overuse was analyzed according to five \"Choosing Wisely\" recommendations related to both interventions and perioperative care. The association between overuse and the characteristics of patients and procedures was assessed by bivariate and multivariate predictive analysis. Costs were calculated for each clinical episode using data from the hospital's accounting department; total hospitalization costs from the index procedure to hospital discharge were used for intervention-related overuse, and average unit cost for perioperative practices.</p><p><strong>Results: </strong>A total of 895 clinical episodes were analyzed over one year. Low-value surgery was identified in 9.7% (N: 87; 95% CI: 7.9 to 11.9). Specifically, overuse was identified in 59.6% (53 out of 89; 48.6 to 69.7)) of the echocardiograms performed after valve replacement, 15.7% (26 out of 166; 10.6 to 22.3) of podiatric surgeries, and 2.0% (8 out of 400; 0.9 to 4.1) of cholecystectomies for asymptomatic cholelithiasis. No overuse was found among Mohs surgeries or in the perioperative use of opioids for pediatric patients. The risk of overuse was higher in patients with the following characteristics: increased age (OR [95% CI]: 1.1 [1.1 to 1.2] for each additional year); ≥1 intrinsic risk factor (IRF) (3.5 [1.5 to 8.0] versus absence of IRF); and hospitalized patients (12.8 [4.5 to 37.1] versus ambulatory surgery). Overuse represented an overall cost of €86,858.05.</p><p><strong>Conclusion: </strong>Applying five \"Choosing Wisely\" recommendations, low-value surgical practices were identified, mainly involving echocardiograms after valve replacement, podiatric surgery, and cholecystectomies. Such practices were more frequent among older and hospitalized patients and were associated with direct economic costs.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13015106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of audiovisual recording in the operating room: a nationwide survey of stakeholder perspectives in France.","authors":"Côme Slosse, Arnaud Allemang-Trivalle, Nicolas El Haïk-Wagner, Amandine Luc, Elodie Jeanbert, Eric Vibert, Hervé Bouaziz","doi":"10.1186/s13037-025-00467-7","DOIUrl":"10.1186/s13037-025-00467-7","url":null,"abstract":"","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"20 1","pages":"7"},"PeriodicalIF":2.1,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12870878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond incidence: clarifying the evidence-based predictors of failed spinal anesthesia.","authors":"Tuhin Mistry, Abhijit Sukumaran Nair","doi":"10.1186/s13037-025-00471-x","DOIUrl":"10.1186/s13037-025-00471-x","url":null,"abstract":"","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"20 1","pages":"4"},"PeriodicalIF":2.1,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient safety culture in the operating room of African hospitals: a systematic review.","authors":"Jacques Fadhili Bake, Naicen Ghanmi, Elena Guadagno, Kasereka Masumbuko Claude, Tsongo Kibendelwa Zacharie, Dan Poenaru","doi":"10.1186/s13037-025-00461-z","DOIUrl":"10.1186/s13037-025-00461-z","url":null,"abstract":"<p><strong>Background: </strong>Patient safety in operating rooms has globally improved through interventions such as the World Health Organization (WHO) Surgical Safety Checklist and multidisciplinary team training. However, while evidence from high-income countries is well documented, there remains limited consolidated knowledge on the understanding, application, and effectiveness of safety culture interventions in African surgical settings, which this review seeks to address.</p><p><strong>Methods: </strong>This systematic review examined factors and protocols affecting surgical safety in African operating rooms. We hypothesized that persistent systemic barriers undermine safety culture despite adoption of global measures. Following PRISMA 2020, we searched eight databases (Medline, Embase, Cochrane, Africa-Wide, CINAHL, Global Health, Global Index Medicus, Web of Science) from inception to 5 December 2024, using variations of text words present in the title, abstract, or keyword fields, alongside relevant subject headings, to identify articles addressing surgical safety and culture throughout Africa. Included studies involved operating room professionals in African countries and used quantitative, qualitative, or mixed-methods designs. We excluded non-operating room settings, patient-only studies, inaccessible full texts, reviews, editorials, letters, conference abstracts, and duplicates. Two reviewers independently screened and appraised studies using the Mixed Methods Appraisal Tool. Findings were synthesized narratively with subgroup analysis by study type and theme.</p><p><strong>Results: </strong>Out of 9,875 identified records, 22 studies from 12 African countries (2014-2024) met inclusion criteria, with Ethiopia contributing the highest number (n = 4). Various assessment tools, including the Hospital Survey on Patient Safety Culture, the Safety Attitudes Questionnaire, and the National Surgical, Obstetric, and Anaesthesia Plans interview manual, revealed recurring challenges: inadequate non-punitive responses to errors, communication barriers, hierarchical structures, and resource constraints. Four interventions showed promise: implementation and training on the WHO Surgical Safety Checklist, Safe Surgery 2020 initiatives, Non-Technical Skills for Surgeons training, and multidisciplinary training.</p><p><strong>Conclusion: </strong>The heterogeneity of study designs, sample sizes, and outcome measures limited direct comparisons and precluded meta-analysis. Nonetheless, the review highlights persistent barriers and emerging opportunities to strengthen patient safety culture in African operating rooms. While the WHO Surgical Safety Checklist remains valuable, sustainable progress requires multi-level strategies that address systemic constraints and incorporate context-sensitive adaptations.</p><p><strong>Registration: </strong>PROSPERO, CRD42024627076.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"20 1","pages":"5"},"PeriodicalIF":2.1,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgeons' personal cloth scrub caps: harmless perk or implicit infection prevention risk?","authors":"Jenna Hughes, Emily M Pilc, Clifton Bridges, Hans Robert Tuten","doi":"10.1186/s13037-025-00465-9","DOIUrl":"10.1186/s13037-025-00465-9","url":null,"abstract":"","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"20 1","pages":"2"},"PeriodicalIF":2.1,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Labeled surgical caps improve perioperative patient safety and interprofessional communication in the operating room: a scoping review.","authors":"Loraine P Kouba, Adriano Fabi, Sebastian Bayer, Christian Abshagen, Melanie A Kalweit-Dietsche, Sarah Tschudin-Sutter, Kathrin Bourdeu, Thierry Girard, Elisabeth A Kappos","doi":"10.1186/s13037-025-00473-9","DOIUrl":"10.1186/s13037-025-00473-9","url":null,"abstract":"","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the new \"Brandenburg Acute Bile Duct (BABD) injury classification\" system in 106 patients with accidental bile duct injuries during cholecystectomy.","authors":"R Mantke, J Hafkesbrink, Paasch Ch, R Hunger","doi":"10.1186/s13037-025-00451-1","DOIUrl":"10.1186/s13037-025-00451-1","url":null,"abstract":"<p><strong>Background: </strong>Bile duct injuries following laparoscopic cholecystectomy are rare but serious complications. Timely diagnosis and optimal management remain challenging. Classification systems for bile duct injuries may facilitate diagnosis, guide treatment, and improve outcomes, however their clinical use is limited. This study systematically evaluated existing classification systems and assessed their applicability to all types of injuries. Based on this analysis, a new classification system for acute lesions was developed.</p><p><strong>Methods: </strong>The database of the German Arbitration Board for medical liability issues was queried to identify cases involving bile duct injuries following a cholecystectomy (1990-2021). For each patient, the anatomical location, extent of injury, and therapeutic approach were documented. Injuries were categorized according to 11 published classification systems and a newly developed classification system. The ability to categorize bile duct injuries of all systems was assessed.</p><p><strong>Results: </strong>A total of 106 bile duct injuries were identified. The common bile duct was the most frequently injured structure (31.1%), followed by combined injuries (27.4%), and injuries of the common hepatic duct (17.9%). In 13.2% of cases, an artery was injured in addition to the bile duct lesion. Only 30.2% of bile duct injuries were detected intraoperatively. The most frequently performed techniques were biliodigestive anastomosis (34.4%), direct bile duct anastomosis (31.3%), and leakage closure with stitches (28.1%). None of the 11 existing classifications could categorize all cases; the best-performing systems (Amsterdam, Hannover) classified 82-86%. In contrast, the new Brandenburg Acute Bile Duct Injury (BABD) Classification was able to categorize 99% of the injuries.</p><p><strong>Discussion: </strong>Current classification systems fail to categorize all acute bile duct injuries following cholecystectomies. The BABD Classification, which is based on the anatomical location and extent of injury, allows systematic categorization of all documented acute bile duct lesions and may improve diagnostic clarity, treatment planning, and comparability in future studies.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":"6"},"PeriodicalIF":2.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Root causes of surgical never-events: a systematic review.","authors":"Dilen Parmar, Neil Patel, Catherine Kenneth-Ogah, Sadat Yazdouni, Chaitya Desai, Dimit Raveshia, Ravi Patel","doi":"10.1186/s13037-025-00474-8","DOIUrl":"10.1186/s13037-025-00474-8","url":null,"abstract":"","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":"3"},"PeriodicalIF":2.1,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of complications after intramedullary nailing for lower extremity fractures in low-resource settings: a 10-year experience with the SIGN nail in Nigeria.","authors":"Stephen Adesope Adesina, Isaac Olusayo Amole, Adepeju Olatayo Adegoke, Chiwendu Uchechukwu Isiakpona, Chidiebube Enyeremchi Ukejianya, Sarah Michael-Duja, Imri Goodness Adefokun, Olusola Tunde Ekunnrin, Simeon Ayorinde Ojo, Innocent Chiedu Ikem, Samuel Uwale Eyesan","doi":"10.1186/s13037-025-00463-x","DOIUrl":"10.1186/s13037-025-00463-x","url":null,"abstract":"<p><strong>Background: </strong>In low-resource countries, the incidence of lower extremity long-bone fractures exceeds that in high-resource countries due to higher rates of motor vehicle collisions (MVCs). This situation is worsened by limited resources for adequate care, resulting in significant health and economic impacts. Locked intramedullary nailing (IMN) is a widely accepted treatment for lower extremity fractures, but it carries risks of complications, which have not been well-studied in low-resource settings. Considering the resource differences between high- and low-resource settings, local research is essential for identifying modifiable factors to prevent complications. This study investigated the predictors of complications after IMN with \"Surgical Implant Generation Network\" (SIGN) nails (Richland, WA, USA) for lower extremity fractures in a low-resource setting.</p><p><strong>Methods: </strong>A secondary analysis was performed on prospectively collected data from 666 fractures in 603 patients treated with SIGN nails at a mission teaching hospital in southwestern Nigeria between July 2014 and June 2024. The mean age was 43.2 years, and 65.7% of the patients were male. Fractures meeting the inclusion criteria were classified as with or without complications. Two-thirds (66.8%) were femur fractures, and 33. 2% were tibia fractures. Univariate and binary logistic regression analyses identified significant predictors of complications.</p><p><strong>Results: </strong>The overall complication rate was 11.7%, with infection and non- union being the most common. The mortality rate was 1.1%. Independent predictors of complications included injury mechanism (p = 0.033), fracture age (p = 0.003), fracture type (p < 0.001), prior treatment elsewhere (p = 0.007), and surgery duration (p = 0.004). Fractures resulting from MVCs, older fractures, and open fractures showed higher complication rates. Each additional 30 min of surgery increased the odds of complications by 34% (95% CI, 1.003-1.017).</p><p><strong>Conclusion: </strong>This study shows that IMN with SIGN nails is an effective treatment for fractures in low-resource settings. However, challenges remain, especially with open fractures and delayed treatment. Prioritizing timely surgery, improving infection control, and enhancing surgical efficiency are essential for better outcomes. The findings inform strategies for improvement and highlight the need for further research to develop evidence-based guidelines for IMN in low-resource environments.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"19 1","pages":"39"},"PeriodicalIF":2.1,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}