{"title":"Acute scrotum in children","authors":"Nasib Alchoikani, Michael Stanton","doi":"10.1016/j.mpsur.2025.05.004","DOIUrl":"10.1016/j.mpsur.2025.05.004","url":null,"abstract":"<div><div>Acute scrotum in children is a time-critical surgical emergency, as testicular torsion may be present, and testicular loss may occur without urgent exploration. The differential diagnosis of children presenting with acute scrotum includes torsion of the testicular appendix, epididymo-orchitis, trauma, and idiopathic scrotal oedema. The incidence of testicular torsion in children is approximately 4 per 100,000. A bimodal distribution is seen, with peaks in the first month of life and in early adolescence. This pattern is likely due to a different aetiology of torsion in newborns compared to older children. This review focuses on the surgical approach to acute scrotum in children, from referral to follow-up, with particular attention to considerations for newborns, and a comparison to adult practice.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 8","pages":"Pages 526-529"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The potential use of Reactive Oxygen gel in surgical prophylaxis","authors":"Matthew Dryden","doi":"10.1016/j.mpsur.2025.04.005","DOIUrl":"10.1016/j.mpsur.2025.04.005","url":null,"abstract":"<div><div>The principles of antibiotic use in surgical prophylaxis remain the same. The purpose of this review is to introduce the investigational agent Reactive Oxygen as a possible surgical prophylaxis agent, particularly in the light of the global crisis in antibiotic resistance. There is evidence for its efficacy in the treatment of infected soft tissue and early clinical data for its efficacy in reducing infection in clean surgery (caesarean section), and in complex contaminated surgery (abdominal wall repair and prosthetic joint salvage).</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 7","pages":"Pages 452-457"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Necrotizing pancreatitis","authors":"Andrew Rosser","doi":"10.1016/j.mpsur.2025.04.008","DOIUrl":"10.1016/j.mpsur.2025.04.008","url":null,"abstract":"<div><div>Acute pancreatitis is primarily caused by gallstone disease and exces-sive alcohol use. The clinical course is varied and those with severe disease may develop pancreatic necrosis and localized collections. Up to 30% of patients with pancreatic necrosis develop infection. This is difficult to diagnose but requires prompt treatment with antibiotics and often percutaneous, endoscopic or surgical intervention. The imprudent use of antibiotics risks the overgrowth of antibiotic-resistant organisms and makes the treatment of subsequent infections more challenging. Advances in biomarkers and imaging may improve the detection of infection, but the optimal timing of antibacterial and antifungal initiation and duration remain unresolved. Clinical trials are required to address these questions.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 7","pages":"Pages 445-451"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Microbiology as applied to surgical practice","authors":"James Arwyn-Jones, Surjo K. De","doi":"10.1016/j.mpsur.2025.06.003","DOIUrl":"10.1016/j.mpsur.2025.06.003","url":null,"abstract":"<div><div>Microbiology is integrated throughout surgical practice, and a working knowledge of its basic principles is essential in caring for surgical patients. In particular, it is important to have an understanding of the basic science behind micro-organisms and infection, as well as a knowledge of surgically important micro-organisms and methods of preventing infection in surgical patients. In this article we cover these topics with reference to the MRCS syllabus and include information about relevant micro-organisms and antibiotics.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 7","pages":"Pages 419-429"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Urological infections after endourological procedures","authors":"Robert M Geraghty, Bhaskar K Somani","doi":"10.1016/j.mpsur.2025.04.006","DOIUrl":"10.1016/j.mpsur.2025.04.006","url":null,"abstract":"<div><div>In the past two decades, endourological procedures such as ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL) have become the mainstay of managing kidney stone disease (KSD), with URS also used for investigating upper urinary tract lesions. Post-endourological infections affect between 1% and 6% of cases. Numerous risk factors have been identified, including longer operative times and indwelling ureteric stents, but the literature is largely heterogeneous. Identification of risk factors preoperatively include the use of preoperative urine culture, minimizing stent dwell time and targeted antibiotic use. Intraoperatively, efforts need to be made in minimizing operative times and intra-renal pressures. Although rare, urinary tract infections following endourological procedures remain a risk, with a smaller minority developing potentially deadly urosepsis. Clinical decisions on prevention and treatment of severe sepsis have to be individualized based on the risk factors. Machine learning techniques are currently being utilized to build these tools and might provide an answer in the future.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 7","pages":"Pages 458-463"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sepsis","authors":"James Arwyn-Jones, Andrew J Brent","doi":"10.1016/j.mpsur.2025.06.002","DOIUrl":"10.1016/j.mpsur.2025.06.002","url":null,"abstract":"<div><div>Sepsis is a clinical syndrome that requires prompt recognition and control in order to optimize clinical outcomes in patients. It is very relevant to surgical practice, as it can affect perioperative patients and those recovering on surgical wards. A working knowledge of sepsis is essential to any medical or surgical practitioner, and here we cover the topic with relevance to surgery and the MRCS examination.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 7","pages":"Pages 430-437"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Infection prevention and surgery in the post-pandemic era","authors":"Helen Umpleby, Rebecca Houghton","doi":"10.1016/j.mpsur.2025.04.009","DOIUrl":"10.1016/j.mpsur.2025.04.009","url":null,"abstract":"<div><div>The COVID-19 pandemic has had a significant impact on surgical specialties. Although markedly reduced in the post-vaccination Omicron era, COVID-19 continues to carry risk to the surgical patient, with an increased incidence of pulmonary complications and mortality in patients who test positive perioperatively. Individual risk assessments need to be performed if surgery is being considered within 7 weeks of testing positive for SARS-CoV-2. Rapid testing for SARS-CoV-2 and other respiratory viruses remains essential to enable timely correct patient placement. Infection prevention and control measures are critical to ensure appropriate care is given and to reduce the risk of onward transmission. This article will discuss the measures that were instigated and contributed to infection control in surgery, such as testing, patient isolation, personal protective equipment and ventilation during the pandemic, learnings including keeping basic infection control practices at the heart of any guidance changes and the current state of play in the UK. The collaborative approach seen during the pandemic and the ongoing shared decision making when risk assessing surgical patients is critical to maintaining patient safety and continuing excellent infection prevention and control practices.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 7","pages":"Pages 438-444"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Insight into PCR testing for surgeons","authors":"Adhyana Mahanama, Eleri Wilson-Davies","doi":"10.1016/j.mpsur.2025.04.007","DOIUrl":"10.1016/j.mpsur.2025.04.007","url":null,"abstract":"<div><div>The most commonly used molecular diagnostic technique is the polymerase chain reaction (PCR). PCR detects a short section of genetic code of interest, a cancer gene, human mRNA or a pathogen’s genome. It is used by every specialty in medicine and surgery, with increasing frequency and importance. In this article, the history, steps of the cycle, uses, forms, advantages and disadvantages of PCR are discussed. With the SARS coronavirus-2 pandemic having such an enormous impact on the delivery of elective surgery, decisions to proceed or defer are made by surgeons on a daily basis, based on PCR results. An understanding of these results is provided, what they tell us, what they do not and what other information is required to make these decisions. It is imperative to also look beyond PCR results, seeing the patient within the context of their symptoms, other pathology and imaging results, with the assistance of a medical virologist or microbiologist, in complex cases.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 7","pages":"Pages 474-482"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Test yourself MCQ and single best answer","authors":"Adrian Ben Cresswell","doi":"10.1016/j.mpsur.2025.06.001","DOIUrl":"10.1016/j.mpsur.2025.06.001","url":null,"abstract":"","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 7","pages":"Pages 483-484"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An update on periprosthetic joint infection for UK trainees","authors":"Abay Sundaram, Abtin Alvand","doi":"10.1016/j.mpsur.2025.04.004","DOIUrl":"10.1016/j.mpsur.2025.04.004","url":null,"abstract":"<div><div>An infection of any surgically replaced joint represents a complex medical, social, and economic problem. Infection, and the complications therein, can represent a potential significant threat to a patient's limb, life, and livelihood. We explore the role of the microbiome in normal function and implications of dysbiosis in the development of periprosthetic joint infection; and the essential role of early accurate diagnosis and collaboration between surgeons, infectious diseases specialists/microbiologists and allied health teams. The management of prosthetic joint infections should take place in a multidisciplinary team (MDT). Despite the general principles of management outlined in this review, surgical and antimicrobial management is patient-specific, considering the cultured organism and its sensitivities, and the patient's overall health, comorbidities, their function, goals and expectations.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 7","pages":"Pages 464-473"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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