Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland最新文献

{"title":"Assessing the impact of surgical timing on complication rates and functional outcomes in distal radius fractures: A systematic review and meta-analysis.","authors":"Nicolaas Leon Kotze, Alexander Price, Charles Timon, Andrew Simpkin, Patrick Groarke","doi":"10.1016/j.surge.2026.08.002","DOIUrl":"https://doi.org/10.1016/j.surge.2026.08.002","url":null,"abstract":"<p><strong>Aims: </strong>Distal radius fractures (DRFs) are prevalent injuries, particularly among the elderly and young active individuals. Recent studies have emphasized the timing of surgical intervention, which may influence complication rates and functional outcomes. While some reviews have found no significant differences in outcomes between early and late surgery, others have suggested benefits from early intervention. Current guidelines from the British Orthopaedic Association Audit Standards for Trauma (BOAST) recommend surgical fixation within specific timeframes, yet optimal timing remains a topic of ongoing debate. This systematic review and meta-analysis aimed to assess the impact of surgical timing on complication rates and functional outcomes in closed DRFs.</p><p><strong>Methods: </strong>A comprehensive search was conducted across multiple electronic databases, including PubMed, EMBASE, and the Cochrane Library, to identify relevant studies. Eligible studies included randomized control trials and observational studies which compared early versus late surgical treatment. Meta-analyses were conducted on pooled data from compatible studies.</p><p><strong>Results: </strong>Fourteen studies involving 2104 patients were included in this analysis. Meta-analysis revealed late surgical intervention was associated with an 8% increase in complication rates (95% CI 4% to 13%). Functional outcomes demonstrated that early surgery led to improved range of motion in flexion, pronation, and supination; however, no statistically significant differences were observed in extension. Further, Patient-Reported Outcome Measures did not exhibit significant differences between early and late surgical interventions.</p><p><strong>Conclusion: </strong>Early surgical intervention for DRFs is associated with lower complication rates and improved range of motion, however it does not improve patient reported outcomes.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a national clinical guideline for cauda equina syndrome improves referral quality and reduces delays to MRI.","authors":"Orla Hennessy, Oisin M O'Connor, Niall P McGoldrick, Aiden Devitt, John F Quinlan","doi":"10.1016/j.surge.2026.07.003","DOIUrl":"https://doi.org/10.1016/j.surge.2026.07.003","url":null,"abstract":"<p><strong>Background: </strong>Cauda equina syndrome (CES) is a neurological emergency with significant potential for permanent morbidity and medicolegal consequences. Timely MRI is essential, yet delays remain common. The Irish Health Service Executive (HSE) published a National Clinical Guideline for CES in June 2024. This study evaluates the impact of its introduction on referral quality and time to MRI in a tertiary, non-spinal centre.</p><p><strong>Methods: </strong>A retrospective review of all suspected CES referrals from the emergency department to the orthopaedic department was performed over a 40-month period spanning guideline introduction (October 2022 to January 2026). Primary outcomes included triage-to-MRI and referral-to-MRI times. Secondary outcomes encompassed documentation of post-void residual volume (PVR), ASIA score, and red flag symptoms.</p><p><strong>Results: </strong>124 pre-guideline and 71 post-guideline referrals were included. Mean triage-to-MRI time decreased from 20.5 to 13.0 h (36.5% reduction; p = 0.017), with standard deviation falling from 16.2 to 7.7 h, indicating greater consistency. The proportion scanned within 24 h rose from 73.9% to 89.1% (p = 0.046). Referral-to-MRI time was substantially longer for out-of-hours/weekend referrals than in-hours referrals in both periods (pre-guideline: 20.3 vs 7.2 h; post-guideline: 12.1 vs 4.3 h). ED-initiated MRI prior to orthopaedic referral increased from 1.5% to 26.1. Documentation improved across all metrics, with ASIA score recording showing the greatest improvement.</p><p><strong>Conclusion: </strong>Implementation of a national CES guideline significantly improved referral quality and reduced time to MRI. However, a persistent and clinically significant out-of-hours access gap highlights the need for dedicated overnight and weekend MRI pathways as a priority for future service development.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148690171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk and predictors of postoperative mortality in patients with liver cirrhosis undergoing trauma laparotomy: A systematic review and meta-analysis with meta-regression.","authors":"Omkaar Divekar, Aya Kambal, Jordan Stewart, Libor Hurt, Michalis Iosifidis, Shahin Hajibandeh, Shahab Hajibandeh","doi":"10.1016/j.surge.2026.07.002","DOIUrl":"https://doi.org/10.1016/j.surge.2026.07.002","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the effect of liver cirrhosis on postoperative mortality after trauma laparotomies.</p><p><strong>Methods: </strong>A PRISMA-compliant meta-analysis with meta-regression using random-effects modelling was conducted (last search: 25 August 2025). All studies comparing the risk of postoperative mortality in adult patients with and without liver cirrhosis undergoing trauma laparotomies were included. The certainty of evidence was evaluated using GRADE system.</p><p><strong>Results: </strong>Eight studies comprising 3,285 patients were included (cirrhosis group: 733; no cirrhosis group: 2,552). Both groups were comparable in terms of age (MD: 1.27 years, 95% CI -0.25, 2.79, p = 0.100), male sex (RD: 0.02, 95% CI -0.02, 0.06, p = 0.380), injury severity score (MD: 3.52, 95% CI -3.69, 10.73, p = 0.340), penetrating mechanism of injury (RD: -0.10, 95% CI -0.29, 0.09, p = 0.320), and blunt mechanism of injury (RD: 0.10, 95%CI -0.09, 0.29, p = 0.320). The risk of postoperative mortality was higher in patients with cirrhosis (OR: 3.68, 95% CI 2.76, 4.91, p < 0.00001). Age (coefficient: 0.015, p = 0.016) and blunt mechanism of injury (coefficient: 0.237, p = 0.047) increased the risk of postoperative mortality; penetrating mechanism of injury (coefficient: - 0.272, p = 0.042) was associated with reduced risk of mortality; male sex (coefficient: -0.424, p = 0.139) and injury severity score (coefficient: 0.004, p = 0.358) did not affect the mortality.</p><p><strong>Conclusions: </strong>Liver cirrhosis may increase the risk of postoperative mortality in patients undergoing trauma laparotomies (moderate certainty). The decision to perform a trauma laparotomy in a patient with cirrhosis should ideally be guided by a multidisciplinary discussion to carefully weigh the potential risks against the expected benefits.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"There is a very limited role for surgery in the management of gunshot wounds to the spine - A South African experience.","authors":"Reuben He, Victor Kong, Cynthia Cheung, Jonathan Ko, Daniel Lee, Joshua Ahn, Shuba Kosna, William Yeung, Hong Lee, Howard Wain, Damian Clarke","doi":"10.1016/j.surge.2026.06.001","DOIUrl":"https://doi.org/10.1016/j.surge.2026.06.001","url":null,"abstract":"<p><strong>Purpose: </strong>Spinal gunshot wounds (GSW) are relatively uncommon but can be both devastating and life-changing. The exact role of surgery remains unclear. This study reviews our institutional experience with spinal GSW management and examines the clinical outcome of these patients in a developing world setting.</p><p><strong>Methods: </strong>A retrospective study was conducted over a 10-year period from December 2012 to December 2022 at a major trauma centre in South Africa. All patients who sustained spinal GSW were included.</p><p><strong>Results: </strong>201 patients with a spinal GSW were included (male: 89%, mean age: 31 years, median Injury Severity Score (ISS): 16). AIS classifications: E (60%), A (20%), B (8%), D (7%), and C (3%). All patients underwent a CT scan, and 65% had an MRI. In 95% there was a bony spine injury, and in 37% a spinal cord injury. 3% of all patients underwent surgical intervention. A management algorithm for spinal GSW patients is detailed in Fig. 2. Overall, 18% of patients required admission to the intensive care unit (ICU), and 23% had one or more complications. Common complications included hospital-acquired pneumonia and acute kidney injury. The overall in-hospital mortality rate was 11% (23/201). Of the 178 patients who survived to hospital discharge, 73% were discharged for ongoing spinal rehabilitation, and the remainder were discharged home.</p><p><strong>Conclusion: </strong>Although spinal GSWs are morbid with devastating consequences, there is a very limited role for spinal surgery, as neurological recovery is unlikely to improve. Non-operative management may be of benefit in resource-constrained public healthcare facilities. Future research should focus on refining the indications for surgical intervention in this patient cohort.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant tyrosine kinase inhibitor therapy for locally advanced, well-differentiated thyroid cancer.","authors":"Rosa Bock, Sam Arman, Gracia Lana Ardila Pardo, Anna Loroch, Ashley Hay, Brendan Conn, Alan Christie, David Noble, Reena Dwivedi, Mark Strachan, Lucy Wall, Iain J Nixon","doi":"10.1016/j.surge.2026.05.001","DOIUrl":"https://doi.org/10.1016/j.surge.2026.05.001","url":null,"abstract":"<p><strong>Introduction: </strong>Locally advanced, well-differentiated thyroid cancer presents a surgical challenge, particularly when tumours involve the airway or other critical structures. Neoadjuvant tyrosine kinase inhibitors (TKIs) may downsize disease and improve operability, but evidence remains limited. This study reports oncological and surgical outcomes following neoadjuvant TKI therapy in a single-centre cohort.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted of patients with locally advanced, well-differentiated thyroid cancer treated with pre-operative TKI therapy between 2016 and 2025. Clinical outcomes, surgical aims and procedures, complications, recurrence, and survival were recorded. Tumour volume reduction was assessed radiologically.</p><p><strong>Results: </strong>Nine patients were included (median age 60 years; 78% female). All had T4a disease, and 3 had pulmonary metastases. Median TKI duration was 7 months. Most patients experienced grade 1-2 adverse effects; 3 developed grade 3-4 toxicity. Tumour volume reduction occurred predominantly within the first 3-6 months, with continued regression up to 18 months. Primary surgical aims were achieved in 89%, including successful conversion of unresectable disease to resectable and avoidance of laryngectomy in all 4 patients for whom it was initially indicated. After a median 44-month follow-up, 5-year recurrence-free and disease-specific survival were both 89%; one patient with metastatic disease died during follow-up and no patient developed uncontrolled central neck disease.</p><p><strong>Conclusion: </strong>Neoadjuvant TKI therapy facilitated surgical management and reduced the need for morbid airway surgery in selected patients with locally advanced, well-differentiated thyroid cancer. These findings support its use within multidisciplinary pathways, although prospective studies are needed to refine patient selection and treatment duration.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Endovascular Aneurysm Repair surveillance in the United Kingdom: A survey of current clinical practice.","authors":"Ahamed Thawwab Mohideen, Ahmad Alhalawani, Shiva Dindyal, Devender Mittapalli","doi":"10.1016/j.surge.2026.05.003","DOIUrl":"https://doi.org/10.1016/j.surge.2026.05.003","url":null,"abstract":"<p><strong>Objective: </strong>This survey aims to establish current post-EVAR surveillance practice across vascular centres in the United Kingdom (UK) and report variations in practice, including adherence to the latest European Society of Vascular Surgery (ESVS) clinical practice guidelines.</p><p><strong>Methods: </strong>Cross-sectional web-based survey disseminated to 64 aortic centres in the UK, and data collected on use of imaging modalities (with the option to select one or multiple) at set time points after standard infrarenal and complex EVAR. Modalities included computed tomographic angiography (CTA), duplex ultrasound (DUS), contrast enhanced ultrasound (CEUS), magnetic resonance angiography (MRA) and abdominal x-ray (AXR).</p><p><strong>Results: </strong>Response rate was 84.4% (54/64 centres). Early imaging was CTA at 44(81.5%), DUS at 22(40.7%) and AXR at 8 (14.8%) centres for standard EVAR and CTA at 37 (94.9%), DUS at 11 (28.2%) and AXR at 6 (15.4%) centres for complex EVAR, with variability in timing. One year imaging for standard EVAR was CTA at 21 (44.7%), DUS at 30 (63.8%) and AXR at 9 (19.1%) centres, and CTA at 26 (81.3%), DUS at 11 (34.4%) and AXR at 7 (21.9%) centres for complex EVAR. The predominant choice for annual surveillance after standard EVAR was DUS at 45 (83.3%) centres followed by CTA at 10 (18.5%) centres, with the dominant choice CTA at 22 (56.4%) centres and DUS at 21 (53.8%) centres after complex EVAR. Only one centre employed an extended interval after initial imaging until 5 years after EVAR.</p><p><strong>Conclusions: </strong>This survey reveals the variation in surveillance practices after EVAR between vascular centres in the United Kingdom, with limited adherence to the ESVS clinical practice guidelines. There continues to be reliance on CTA for early post-EVAR surveillance, with ultrasound mostly used for long-term follow-up. Creation of nationally agreed consensus protocols under the stewardship of a recognized body would foster more homogeneous practice.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to operative exposure in foundation training.","authors":"L Mills, H Davis, M Okocha","doi":"10.1016/j.surge.2026.04.010","DOIUrl":"https://doi.org/10.1016/j.surge.2026.04.010","url":null,"abstract":"<p><strong>Background: </strong>Early exposure to the operating theatre is a key determinant of surgical career interest and technical skills development. Despite this, contemporary data describing barriers to theatre access for UK foundation doctors are limited. This study characterises perceived barriers to operative exposure within a large regional cohort.</p><p><strong>Methods: </strong>Foundation doctors (FY1, FY2 or equivalent) across the South West of England completed a 41-item online survey following a surgical rotation (22nd July-16th August 2025). The survey included multiple-choice and Likert-scale questions assessing career intentions, operative exposure, and perceived barriers, alongside free-text questions exploring contextual factors. Quantitative data were analysed using Microsoft Excel and IBM SPSS® Statistics. Qualitative data were analysed using the constant comparative method within NVivo 15.</p><p><strong>Results: </strong>A total of 296 doctors responded (20.5%). Of these, 69.3% were FY1 and 28.7% FY2; 27.4% intended to apply for core surgical training (CST). Ward workload was the most frequently cited barrier to theatre attendance (57.6%), followed by rota inflexibility or absence of protected time (25.5%) and surgical culture (7.4%). Qualitative analysis identified four overarching themes: heavy ward dependency, inflexible rota structures, competition for limited operative opportunities, and cultural pressures, including peer resentment and reluctance from theatre teams to extend operating lists. Most respondents obtained their primary theatre exposure through rostered clinical hours (68.0%), with 11.7% relying predominantly on unpaid time. Only 50% of CST-intending trainees felt on track to achieve the required 40 logged cases.</p><p><strong>Conclusion: </strong>Foundation doctors face substantial structural and cultural barriers to accessing the operating theatre. Mandated protected theatre time, improved ward staffing, and structured early surgical skills teaching may mitigate these constraints and support equitable preparation for CST.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mesenteric preservation vs extended mesenteric excision in Crohn's disease: A systematic review and meta-analysis.","authors":"A O'Mahony, C Cullinane, J Ariaratnam, E Condon, C A Fleming, C Peirce, Yi Li, J C Coffey","doi":"10.1016/j.surge.2026.04.008","DOIUrl":"https://doi.org/10.1016/j.surge.2026.04.008","url":null,"abstract":"<p><strong>Background: </strong>There remains ongoing debate and lack of consensus regarding the benefit of extended mesenteric excision (EME) compared to limited mesenteric excision (LME) in the surgical management of Crohn's disease (CD). This study aimed to synthesise the most recent evidence through an up-to-date meta-analysis comparing clinical outcomes following EME versus LME.</p><p><strong>Methods: </strong>This study was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, with prospective registration on PROSPERO (CRD420251020438). PubMed, Cochrane and Scopus were searched for studies published to April 2025. The primary outcome was surgical recurrence, defined as need for repeat surgery for CD. Secondary outcomes included endoscopic recurrence, postoperative complications, length of stay and operative duration. Meta-analysis was performed using RevMan 5.4. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Risk of bias was assessed using ROBINS-I and RoB2 criteria.</p><p><strong>Results: </strong>Six studies (four non-randomized and two randomized), comprising 4469 patients, met inclusion criteria. EME was significantly associated with reduced surgical recurrence compared to LME (OR = 0.31; 95% CI [0.11-0.87]; p = 0.03). There was no difference in endoscopic recurrence between groups (OR 0.77; 95% CI 0.46-1.27; p = 0.30). There were no significant differences in rates of superficial surgical site infection, intra-abdominal collections, anastomotic leaks, operative duration or length of stay.</p><p><strong>Conclusion: </strong>Our findings demonstrate that EME is associated with a significant reduction in surgical recurrence in CD compared to LME, without any increase in post-operative complications, operative time, or length of hospital stay.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of chest injuries in a trauma centre without local cardiothoracic surgery.","authors":"K Lin Shu'An, P Patil, A Brown, S Henderson, C Donald, J Scollay","doi":"10.1016/j.surge.2026.04.009","DOIUrl":"https://doi.org/10.1016/j.surge.2026.04.009","url":null,"abstract":"<p><strong>Background and aims: </strong>The vast majority of UK Major Trauma Centres either have on site cardiothoracic surgery or are located in proximity to a cardiothoracic centre. One exception is Ninewells Hospital, Dundee, which is located 70 miles from the nearest cardiothoracic department. The nature of this atypical arrangement and its implications are reviewed.</p><p><strong>Methods and results: </strong>The Scottish Trauma Audit group (STAG) was searched for details of patients sustaining a thoracic injury and presenting to NHS Tayside over a 17 month period. Data were analyzed for demographic information, mechanisms of injury, associated injuries, management and outcome. 250 trauma patients were identified. One hundred and twelve patients (44.8%) were aged seventy years or older. Two hundred and thirteen patients (85.2%) underwent a thoracic CT scan. Fifty three patients (21%) required regional anaesthesia and 29 (12%) needed a chest drain. One patient underwent a resuscitative thoracotomy and 2 needed subclavian artery embolisation. Only 1 patient required an emergency transfer to a cardiothoracic centre.</p><p><strong>Conclusion: </strong>A trauma centre without local cardio-thoracic surgery can deal with the majority of chest injuries. The contemporary management of chest injuries includes the liberal usage of CT scanning and regional anaesthetic techniques. The need for surgical intervention or transfer to a cardio-thoracic facility is rare.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of paediatric dog bite injuries presenting to plastic surgery services.","authors":"S Carr, R Leon, S Keelan, C M Hurley, C de Blacam","doi":"10.1016/j.surge.2026.04.011","DOIUrl":"https://doi.org/10.1016/j.surge.2026.04.011","url":null,"abstract":"<p><strong>Background: </strong>Dog bites represent a significant number of presentations to plastic surgery services in Ireland. Recent changes to legislation around ownership of restricted breeds of dog has highlighted safety in the public domain. The aim of this study was to provide a descriptive analysis of paediatric dog bite injuries.</p><p><strong>Methods: </strong>This was a retrospective case series of all dog bite injuries referred to the plastic surgery service in Children's Hospital Ireland at Crumlin over a 3-year period (2020-2023). Patient demographics, group or breed of dog, details of injuries and interventions required, length of hospital stay, follow-up appointments and complications were recorded.</p><p><strong>Findings: </strong>Eighty-nine patients were identified, 48 (53.9%) male and 41 (46.06%) female. The mean age at presentation was 6.8 years (range 1-15 years). Fifty-three (59.6%) of dog bites were from a family pet. Where documented, 32 (70%) of the dogs involved were non-legislated breeds and 14 (30%) were legislated breeds. Facial and head & neck injuries were most common. There was one pediatric intensive care admission and one mortality as result of dog bite injuries.</p><p><strong>Conclusion: </strong>Dog bite injuries in children are highly morbid and preventable. In addition to legislation, mitigation of risk requires a multimodal, community-based approach that encompasses education of children, parents and dog owners.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}