Patient Safety in Surgery最新文献

{"title":"A novel evaluation tool for combat trauma simulation: Delphi expert panel consensus report.","authors":"Samuel Weber, Henrik Teuber, Basil Andreas Hatz, Michael Kuny, Bastian Grande, Michaela Kolbe, Hans-Christoph Pape, Sascha Jan Baettig","doi":"10.1186/s13037-026-00493-z","DOIUrl":"10.1186/s13037-026-00493-z","url":null,"abstract":"<p><strong>Background: </strong>Modern armed conflicts reveal increasingly complex injury patterns that challenge both civilian and military healthcare systems. In Switzerland, exposure to such injuries is limited. For a planned multicenter, high-fidelity, in-situ simulation-based study assessing trauma care performance across both military and civilian prehospital and clinical teams, a standardized and validated evaluation tool is required. The current study was designed to develop a consensus-based performance assessment tool/framework for evaluating the management of complex combat trauma, integrating civilian and military standards of care.</p><p><strong>Methods: </strong>A structured consensus process was conducted, combining an initial nominal group technique with a multi-round Delphi process. Fourteen experts from military medicine, emergency medicine, anesthesiology, and trauma surgery participated. Assessment items were iteratively refined until predefined consensus criteria were achieved.</p><p><strong>Results: </strong>Consensus was reached after five Delphi rounds. The evaluation tool includes 35 items covering key domains such as prioritization of interventions, procedural quality, adherence to trauma principles, and time to critical actions. Initial differences between civilian and military perspectives-particularly regarding cervical spine immobilization, neurological assessment, coagulation management, and fluid resuscitation-were identified and resolved through the consensus process.</p><p><strong>Conclusion: </strong>The results of this Delphi-based evaluation framework highlight both areas of consensus and ongoing controversy in modern combat trauma care. Differences between civilian and military perspectives are largely driven by divergent injury patterns, resources, and operational constraints. By explicitly incorporating these differences into a standardized evaluation tool, this study provides a robust framework for comparing performance across different levels of trauma care.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340535","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":"Algorithmic bias in surgical risk prediction models and its impact on patient safety: a review.","authors":"Mohamed Mustaf Ahmed","doi":"10.1186/s13037-026-00495-x","DOIUrl":"10.1186/s13037-026-00495-x","url":null,"abstract":"<p><p>The increasing adoption of machine learning and artificial intelligence in surgical risk prediction has introduced new challenges related to the fairness and equity of these algorithms. These models range from regression-based risk calculators to machine learning systems, and differential performance may reflect poor calibration within a group, which is mainly a safety concern, or unequal performance between groups, which is mainly an equity concern. Predictive models trained on surgical registry data have shown differential performance across racial and ethnic groups in some studies, raising concerns about the potential for these tools to perpetuate or amplify existing disparities in surgical care. This review examines the sources and mechanisms of algorithmic bias in surgical risk prediction models, evaluates the evidence for differential model performance across patient subgroups, and discusses emerging debiasing strategies and regulatory frameworks. Training datasets from major surgical registries frequently contain incomplete or poorly granular race and ethnicity data, and the inclusion of race as a predictive variable remains controversial. Individual studies have reported lower sensitivity or higher false-negative rates for specific subgroups, potentially leading to an underestimation of surgical risk in those groups, although such discrimination-based measures do not by themselves establish miscalibration or demonstrated harm. Debiasing techniques, including reweighting, adversarial training, and fairness-aware multitask learning, have shown promise but remain largely untested in surgical contexts and are constrained by inherent trade-offs between within-group calibration and error rate parity across groups. Although regulatory bodies have begun to address algorithmic fairness, standardized auditing frameworks for surgical prediction models are still lacking. This review highlights the need for multicenter, demographically diverse validation studies, transparent model reporting, and equity-focused governance to ensure that artificial intelligence in surgery serves all patients safely and equitably.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309961","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":"Increased injury severity and age-related mortality in trauma victims after e-bike versus conventional bicycle accidents: a concerning call to action!","authors":"Deniz D Özman, Sabine M I Roth, Maria Gabriella Fois, Luca Diehr, Michel P J Teuben, Huanglin Zhang, Max Praster, Till Berk, Frank Hildebrand, Rald V M Groven","doi":"10.1186/s13037-026-00494-y","DOIUrl":"10.1186/s13037-026-00494-y","url":null,"abstract":"<p><strong>Background: </strong>Although e-bike accidents are of growing clinical relevance, there is limited large-scale research comparing injury patterns and outcomes between e-bike (EB) and conventional bicycle (CB) accidents in large patient cohorts. This study performed comparative analyses of both groups to identify patients at risk and guide future prevention and clinical management strategies.</p><p><strong>Methods: </strong>A retrospective analysis of the TraumaRegister DGU^® was conducted. Patients aged 16 years or older who sustained severe injuries (AIS ≥ 3 in minimally one body region) in accidents involving conventional bicycles or e-bikes between January 2020 and December 2023 were included. Patient demographics, injury patterns, trauma severity, treatment characteristics, and clinical outcomes were analyzed.</p><p><strong>Results: </strong>A total of 9,170 bicycle accident cases were included (EB n = 1,160; CB n = 8,010). EB riders were significantly older than CB riders (median age 63 years; IQR 53-73 vs. 57 years IQR 44-69; p < 0.001) and more frequently sustained polytrauma (16.7% vs. 12.3%; p < 0.001). Compared with CB riders, EB riders more often suffered injuries to the head (67.2% vs. 56.2%; p < 0.01), face (22.7% vs. 17.8%; p < 0.001), and chest (55.2% vs. 51.8%; p = 0.030), and were more likely to sustain injuries affecting multiple body regions (p < 0.001). Primary ICU treatment was required more frequently after EB accidents (70.3% vs. 63.5%; p < 0.001). Age-stratified analyses showed that younger EB riders were more frequently involved in nighttime and alcohol-related accidents, whereas mortality increased significantly with age, from 2.7% in patients aged 16-59 years to 18.6% in those aged ≥ 80 years.</p><p><strong>Conclusions: </strong>E-bike accidents are associated with a higher prevalence of head, face, and chest injuries, increased rates of polytrauma and multi-region injuries, and a greater need for ICU treatment compared with conventional bicycle accidents. These differences are particularly relevant in older riders, who represent the majority of severely injured e-bike users and experience substantially higher mortality rates. Targeted prevention strategies, improved protective measures, and age-specific risk communication may help reduce the burden of e-bike-related injuries.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13288559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296902","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":"Unrecognized intraoperative thermal injury to the foot following arthroscopic anterior cruciate ligament reconstruction: a case report.","authors":"Chun-Chieh Yeh, Han-Ying Wang, Chung-Hsun Chang, Wen-Tung Hsieh","doi":"10.1186/s13037-026-00491-1","DOIUrl":"10.1186/s13037-026-00491-1","url":null,"abstract":"<p><strong>Background: </strong>Perioperative burn or pressure-thermal skin injury is a rare but preventable complication of surgery. Although burns related to warming devices or electrosurgical instruments have been reported, such injuries following arthroscopic anterior cruciate ligament (ACL) reconstruction are exceedingly uncommon.</p><p><strong>Case presentation: </strong>We report an unrecognized perioperative deep partial-thickness skin injury involving the dorsum of the foot, most consistent with a thermal or combined pressure-thermal injury, following revision arthroscopic ACL reconstruction under general anesthesia. A pneumatic tourniquet was applied for 120 min. A forced-air warming system was used for upper-body warming without direct contact with the operative limb, which was loosely covered with a stockinette without additional padding. Shortly after transfer from the post-anesthesia care unit to the ward, a 8 × 4 cm deep partial-thickness skin injury was identified on the ipsilateral dorsum of the foot. Conservative wound care was initiated, and the lesion gradually epithelialized over approximately three months. The injury resulted in transient soft-tissue contracture with plantar flexion restricted to approximately 30°, interfering with early postoperative rehabilitation. At 9 months after surgery, the wound had fully healed, ankle range of motion had recovered to 15° of dorsiflexion and 40° of plantar flexion, and the patient reported no resting pain, shoe-wear difficulty, or limitation in daily activities.</p><p><strong>Conclusion: </strong>Clinically significant perioperative deep partial-thickness skin injury can occur during routine knee arthroscopy even in the absence of an obvious direct thermal source. This case suggests that local pressure, drape-related insulation, impaired distal heat dissipation due to tourniquet use, and retained ambient heat may interact to produce occult injury. This case highlights system-level prevention opportunities, including distal extremity padding, avoidance of heat trapping under drapes, and routine whole-limb skin inspection in the post-anesthesia care unit and after ward transfer to facilitate early recognition of occult injuries.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266525","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":"Challenges for implementation of \"Enhanced Recovery After Surgery\" (ERAS) protocols and artificial intelligence support tools in resource-limited countries.","authors":"Abdullahi Hassan Elmi","doi":"10.1186/s13037-026-00492-0","DOIUrl":"10.1186/s13037-026-00492-0","url":null,"abstract":"<p><p>Surgical patient safety remains a major challenge in resource-limited settings, where preventable harm may be increased by delayed assessment, limited monitoring, workforce shortages, weak documentation, and inconsistent use of standardized perioperative protocols. Enhanced Recovery After Surgery offers an evidence-based pathway for improving perioperative care, while artificial intelligence may support risk prediction, complication surveillance, audit feedback, and clinical decision-making. This correspondence argues that artificial intelligence and Enhanced Recovery After Surgery should be considered complementary patient safety strategies rather than separate innovations. In low-resource surgical systems, their combined use may strengthen perioperative reliability, improve early recognition of risk, and support continuous quality improvement. However, implementation must be gradual, locally adapted, ethically governed, and built on essential safety practices such as checklist adherence, multidisciplinary teamwork, staff training, and audit.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"20 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259971","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":"The role of early venous duplex screening in improving patient safety indicator-12 (PSI-12) classification accuracy: a retrospective cohort study.","authors":"Adam S Surti, Robert T Matthews, Oana Popescu, Malak Bentaleb, Rodrigo F Alban","doi":"10.1186/s13037-026-00489-9","DOIUrl":"10.1186/s13037-026-00489-9","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) is a major cause of morbidity among surgical patients. Patient Safety Indicator 12 (PSI-12) identifies perioperative VTE events. This study evaluates whether early admission duplex ultrasound identifies VTEs associated with PSI-12 coding and assesses PSI-12 classification accuracy.</p><p><strong>Methods: </strong>A single-center retrospective analysis was conducted on surgical patients with a venous duplex ultrasound within 48 h of admission at a large academic medical center (2013-2024). Two cohorts were analyzed: (1) all surgical patients with early duplex imaging, (2) PSI-12 positive elective surgical patients with early duplex imaging. The primary outcome was the prevalence of pre-existing DVT identified within 48 h among PSI-12 positive patients. Diagnostic accuracy of early abnormal duplex findings for predicting PSI-12 classification was assessed using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).</p><p><strong>Results: </strong>Among all 10,498 surgical patients, 10.6% had positive duplex findings for DVT. PSI-12 positive patients had double the prevalence compared to PSI-12 negatives (20.9% vs. 10.4%, p < 0.001). In PSI-12 positive elective cases, 10.7% of preoperative duplex studies identified a DVT. Misclassification, defined as PSI-12 positive admissions without imaging-confirmed DVT or pulmonary embolism, occurred in 8.7% of elective cases. Overall, 36.7% of PSI-12 positive patients had abnormal early duplex findings. Early duplex demonstrated limited sensitivity but high specificity (sensitivity 36.7%, specificity 81.7%, PPV 3.7%, NPV 98.5%).</p><p><strong>Conclusions: </strong>Our findings suggest possible pre-existing disease rather than hospital-acquired VTE in PSI-12 positive patients. Incorporating admission duplex studies could improve PSI-12 classification accuracy, reduce costs, and enhance patient safety.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206644","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":"Nurse-led enhanced recovery care in spine surgery: a new frontier in patient-centric perioperative recovery.","authors":"Fatemeh Arjmandnia, Ehsan Alimohammadi","doi":"10.1186/s13037-026-00490-2","DOIUrl":"10.1186/s13037-026-00490-2","url":null,"abstract":"","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"20 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145005","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":"Safe surgical management of two concomitant giant hepatic hydatid cysts: a case report.","authors":"Hamdah Hanifa, Wiaam Al-Refaai, Raghad Maksoud, Lana Bakir, Malak Al-Refaai, Myral Talab Agha, Malak Alenawi, Bessan Al-Refaai, Rasha Al-Halbouni, Nirmin Bachlah, Fadiah Albaroudi, Samya Zino, Mohi Alddin Mahouk, Kawther Kalaa, Mohammad Shafa'a, Samer Sara","doi":"10.1186/s13037-026-00488-w","DOIUrl":"10.1186/s13037-026-00488-w","url":null,"abstract":"<p><strong>Background: </strong>Hydatid disease (HD) is a parasitic infection caused by the larval stage of the tapeworm Echinococcus granulosus. The liver is primary affected, accounting for up to 70% of cases, but it can also affect other organs such as the spleen, pelvic cavity, and bones. Patients can remain asymptomatic for 10 to 15 years. This report, accompanied by an extensive literature review, aims to contribute to the understanding of the diagnostic and surgical management of giant hepatic hydatid cysts, given their rarity and the variety of locations in the body where they occur.</p><p><strong>Case presentation: </strong>A 32-year-old male presented with a 3-day history of diffuse abdominal pain. Examination revealed a tense abdomen, and laboratory tests showed mild leukocytosis. Ultrasound and CT scan demonstrated two giant hepatic hydatid cysts. The patient underwent elective open surgery with aspiration of both cysts, instillation of a scolicidal solution, removal of the germinative membranes, and partial pericystectomy with preservation of hepatic tissue. A drain was placed, and the postoperative course was uneventful. He was discharged after 3 days of hospitalization. Albendazole therapy was initiated 2 weeks postoperatively and continued for 6 months. At 6-month follow-up, the patient was asymptomatic with normal liver function tests and no evidence of recurrence on imaging.</p><p><strong>Conclusion: </strong>Our case highlights that despite the limited medical resources in conflict-affected Syria, hepatic hydatid cysts can be successfully managed effectively through a combination of radiological evaluation, open surgical intervention, and antiparasitic drug therapy, resulting in a significant improvement in patient outcomes.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"20 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057566","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":"Incidental discovery of abdominal splenosis mimicking metastatic disease during elective incisional hernia repair: a case report.","authors":"Soniya Shankar Kalpana, Balaji Durairaj","doi":"10.1186/s13037-026-00487-x","DOIUrl":"10.1186/s13037-026-00487-x","url":null,"abstract":"<p><strong>Background: </strong>Abdominal splenosis is a benign condition that occurs when splenic tissue is implanted within the abdominal cavity after splenic trauma or splenectomy. Most patients remain asymptomatic, and the condition is often detected incidentally. However, when multiple nodules are present, they can closely resemble peritoneal metastases and create uncertainty, particularly when they are encountered unexpectedly during surgery. A lack of awareness may lead to overly aggressive surgical decisions or delays in definitive management.</p><p><strong>Case presentation: </strong>We describe a patient in whom abdominal splenosis was incidentally identified during the repair of an incisional hernia associated with a chronic discharging sinus. During exploration, numerous reddish-brown nodules were noted over the omentum and peritoneal surfaces, raising concern for peritoneal carcinomatosis, especially given the patient's family history of colorectal cancer. A few representative nodules were excised and sent for histopathological examination. Intraoperative frozen section analysis was not performed, and therefore, the decision to proceed was based on gross intraoperative findings. In the absence of frozen-section confirmation, the decision to proceed with mesh repair was made based on the benign intraoperative appearance of the nodules (well-circumscribed, non-infiltrative, no ascites), and a clean operative field without evidence of infection. Considering these findings, the surgical team proceeded with definitive mesh repair of the hernia during the same operation. Histopathology later confirmed the presence of splenic tissue consistent with splenosis. The patient had an uneventful postoperative recovery.</p><p><strong>Conclusion: </strong>This case demonstrates that intraoperative recognition of splenosis, supported by careful assessment and limited biopsy, allows safe continuation of planned surgery without unnecessary delay or overtreatment. Awareness of this entity is essential to guide appropriate intraoperative decision-making and avoid misinterpretation as metastatic disease.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989533","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":"Balancing patient safety and sustainable healthcare for orthopaedic device utilization in resource-limited countries: insights from the REBOOT Study.","authors":"","doi":"10.1186/s13037-026-00475-1","DOIUrl":"10.1186/s13037-026-00475-1","url":null,"abstract":"<p><p>BACKGROUND: Access to orthopaedic care in low- and middle-income countries is limited by device scarcity and high costs, despite the significantly greater burden of trauma. The reuse of reprocessed implants and equipment has emerged as a pragmatic solution, but safety assurance and governance remain inconsistent. We described current reuse practices in low- and middle-income countries, evaluated safety risks and mitigation strategies to balance equity and sustainability with patient protection, and highlighted opportunities to reduce healthcare costs. METHODS: We conducted a multinational, cross-sectional survey of orthopaedic clinicians in hospitals in low- or middle-income countries between June 2024 and February 2025. Primary outcomes were device-specific reuse prevalence and safety governance; secondary outcomes were reuse drivers and risks. RESULTS: A total of 113 respondents from 36 hospitals in seven low- and middle-income countries participated. The majority (84%) worked in university-based hospitals or postgraduate training centres, and most (78%) were orthopaedic and spine consultants or residents. External fixator components were most frequently reused (80%), with implantable pins or wires reused by 67%; 51% reported using reprocessed implantable devices at least weekly. Only 35% knew the exact source of reused implants; devices mostly originated from explants or de-sterilised but unimplanted stock. 55% used reprocessed implants without any quality testing or recertification, and 34% were unsure; just 8% reported formal re-evaluation. Ninety-eight per cent were unaware of any applicable guidelines. The reuse of reprocessed devices did not differ significantly by hospital affiliation, hospital resourcing, level of care, or respondent’s years of orthopaedic experience. Perceived benefits were affordability and access, while reported concerns included device failure, ethical/litigation issues, and patient disapproval—all amplified by variable reprocessing standards and poor traceability. CONCLUSIONS: The use of reprocessed orthopaedic biomaterials is common in low- and middle-income countries. External fixator components are the most reprocessed implants, with cost and availability as the primary drivers. Unclear sourcing, weak quality assurance, and absent guidance create avoidable safety risks. Safer practice requires context-specific standards for sourcing/reprocessing, validated decontamination and sterilisation with full traceability, risk-stratified reuse, mandatory quality testing/recertification of reprocessed implants, informed consent that addresses reuse, and regular audit of practice compliance. </p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"20 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700296","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}