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Alcohol & Drug Related Admissions Into Trauma & Orthopaedics 与酒精和药物有关的创伤和骨科入院情况
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2025-10-01 Epub Date: 2025-09-12 DOI: 10.1016/j.surge.2025.04.018
Dr Vincent Dundas-Smith
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引用次数: 0
Impact of Adjuvant Chemotherapy on 5-Year Overall Survival in Non-Metastatic Colon Cancer: A Population-Based Study in Bulgaria 辅助化疗对非转移性结肠癌5年总生存率的影响:保加利亚一项基于人群的研究
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2025-10-01 Epub Date: 2025-09-12 DOI: 10.1016/j.surge.2025.04.021
Miss Ashpia Rahman
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引用次数: 0
Pitfalls of crude pooling in assessing diagnostic accuracy: A cautionary note 在评估诊断准确性的粗池的陷阱:一个警告。
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2025-10-01 Epub Date: 2025-06-16 DOI: 10.1016/j.surge.2025.05.005
Javier Arredondo Montero MD, PhD
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引用次数: 0
Enhancing medical student learning in the operating theatre: the need for integrated preparation 加强医学生在手术室的学习:综合准备的必要性。
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2025-10-01 Epub Date: 2025-06-30 DOI: 10.1016/j.surge.2025.06.003
Lachlan Dick, Sannah Ali, Katie Hughes
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引用次数: 0
‘Does the use of methylprednisolone improve the post-operative outcome of neonatal and paediatric cardiac surgery?’ 甲基强的松龙的使用是否能改善新生儿和儿童心脏手术的术后预后?’
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2025-10-01 Epub Date: 2025-09-12 DOI: 10.1016/j.surge.2025.04.016
Ms Martina Schatz
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引用次数: 0
Environmental impact of single-use items and their contamination levels in elective orthopaedic surgery 选择性骨科手术中一次性用品对环境的影响及其污染水平。
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2025-10-01 Epub Date: 2025-08-12 DOI: 10.1016/j.surge.2025.07.007
Jessica Rotaru , Peggy Miller , Luke McGarry , John M. O'Byrne

Background

Single-use items have dominated operating theatres since the 1980s, initially perceived to carry a lower risk of surgical site infection and occupational blood exposure while maintaining hospital expenditure. The topic of reusable surgical gowns and drapes has naturally emerged due to discussions regarding climate change. Considering reusable alternatives is the next step in reducing the carbon footprint of operating theatres.

Methods

Clinical waste attributable to single-use items was collected from 93 cases in an elective orthopaedic hospital over four weeks, comprising knee arthroplasty and arthroscopy, hip arthroplasty, foot and ankle and upper limb. Tourniquet use, operation time and blood loss were other parameters collected in each operation. Disposable gowns were visually examined and graded by contamination level. Clinical waste was weighed using a handheld electronic scale.

Results

The mean waste from knee, hip and minor (upper limb, foot and ankle) operating theatres was 3533g, 3966g and 2349g respectively. The average number of gowns used per case was four, as was the number of drapes. Minor operating theatres had the lowest levels of contamination, with 84.34 % of gowns not contaminated at all. Tourniquet use was associated with less waste, carbon emissions, and gown contamination.

Conclusion

A large proportion of operating theatre waste is attributable to disposable items such as gowns and drapes. In the elective orthopaedic setting, these are not heavily contaminated, especially in procedures where tourniquets are utilised. Given the environmental impact of clinical waste, we advocate for the use of reusable alternatives in these procedures.
背景:自20世纪80年代以来,一次性用品在手术室占主导地位,最初被认为在维持医院支出的同时具有较低的手术部位感染和职业性血液暴露风险。由于有关气候变化的讨论,可重复使用的手术服和窗帘的话题自然出现了。考虑可重复使用的替代品是减少手术室碳足迹的下一步。方法:收集某骨科择期医院4周内93例一次性用品废弃物,包括膝关节置换术及关节镜、髋关节置换术、足踝关节及上肢。止血带的使用、手术时间和出血量是每次手术的其他参数。对一次性长袍进行目视检查,并按污染程度分级。使用手持式电子秤称医疗废物的重量。结果:膝关节、髋关节和下肢(上肢、足部和踝关节)手术室的平均废物量分别为3533g、3966g和2349g。每个病例使用的长袍的平均数量是四件,窗帘的数量也是如此。小手术室的污染程度最低,84.34%的手术服完全没有污染。止血带的使用与更少的废物、碳排放和长袍污染有关。结论:手术室废弃物的很大一部分是一次性用品,如手术衣和窗帘。在选择性矫形设置中,这些没有严重污染,特别是在使用止血带的程序中。鉴于医疗废物对环境的影响,我们提倡在这些程序中使用可重复使用的替代品。
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引用次数: 0
SHIELD Project (Study of Hernia Interventions and Evaluation of Length of Stay and Complications) SHIELD项目(疝干预研究及住院时间及并发症评估)
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2025-10-01 Epub Date: 2025-09-12 DOI: 10.1016/j.surge.2025.04.025
Mr. Georgios Karagiannidis , Mohamed Abdallah , Dardan Uka , Yousef Salem , Tejashree Mane , Martin Sinclair
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引用次数: 0
Smarter Trauma Surgery: Exploring the Role of Partial REBOA in Reducing Ischemic Risks 智能创伤手术:探索部分REBOA在降低缺血性风险中的作用
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2025-10-01 Epub Date: 2025-09-12 DOI: 10.1016/j.surge.2025.04.019
Jerome Abishek , M. Abilash
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引用次数: 0
Evaluating the use of absorbable sutures versus sTaples versus tIssue glue in laparoscopic port skin closure (STILS) trial: A prospective, multi-centre randomised clinical trial (RCT) 评估可吸收缝线、订书钉和组织胶在腹腔镜气道皮肤闭合(STILS)试验中的使用:一项前瞻性、多中心随机临床试验(RCT)。
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2025-10-01 Epub Date: 2025-03-17 DOI: 10.1016/j.surge.2025.02.015
Sinead E. Ramjit , Matthew G. Davey , Stephen Keelan , Emer Herlihy , Marie Dromey , Chris Garvey , Timothy S. Nugent , Aisling Fawaz , Lauren O'Connell , Melanie Cunningham , Matthew Fahy , Eanna J. Ryan , Brendan Moran , Lylas Aljohmani , Jeyanthi Narayanasamy , Michael E. Kelly , Clara Healy , Claire Donohoe , Narayansamy Ravi , Paul Neary , Noel E. Donlon

Methods

This prospective, multi-centre RCT was conducted in accordance with the CONSORT guidelines for prospective, parallel group randomised studies. Adult patients undergoing elective laparoscopic surgery at two teaching hospitals in Dublin, Ireland were recruited and assigned to one of three closure methods (sutures (SU), staples (ST) or tissue glue (TG)) with primary outcome being cosmesis and secondary outcomes being closure speed, wound complications, cost effectiveness and sustainability outcomes being assessed by a blinded outcomes assessor.

Results

A total of 147 patients were recruited and randomised with a total of 138 being examined in the final analysis (SU = 48, ST = 63, TG = 27). Patient demographics were similar across all groups for gender, mean age, body mass index and American Society of Anaesthesiologists grade (all p > 0.050). For cosmesis, SU had the lowest overall mean observer (p < 0.001) and patient (p = 0.005) scar scores. Furthermore, when evaluating the breakdown for Observer Scar Score (OSS), SU had the lowest vascularity (p = 0.001), pigmentation (p = 0.006), thickness (p < 0.001), relief (p = 0.003) and pliability (p < 0.001). For patient scar score (PSS), SU had the lowest irregularity (p = 0.035). SU was the most cost-effective (p < 0.001) and had the lowest total produced non-recyclable waste (p < 0.001). ST had the shortest closure time (p < 0.001). Overall, there was a no difference in wound complication rates (SU = 6.3 %, ST = 6.4 %, TG = 18.5 %; p = 0.130).

Conclusion

In conclusion, SU was the most effective method for laparoscopic port site closure with regards to cosmesis, cost-efficiency and surgical sustainability. ST was the marginally quicker method of closure and demonstrated equipoise in terms of complication rate. We advocate for SU as the current ‘gold standard’ with reduced non-recyclable waste generated and a valuable training opportunity for junior trainees.

Trial registration

ClinicalTrials.gov Identifier: NCT03843866.
方法:这项前瞻性、多中心随机对照试验按照CONSORT前瞻性、平行组随机研究指南进行。在爱尔兰都柏林的两家教学医院接受选择性腹腔镜手术的成年患者被招募,并被分配到三种缝合方法(缝合线(SU),订书针(ST)或组织胶(TG))中的一种,主要结果是美容,次要结果是缝合速度,伤口并发症,成本效益和可持续性结果,由盲法结果评估者评估。结果:共招募147例患者并随机分组,最终分析共检查138例(SU = 48, ST = 63, TG = 27)。在性别、平均年龄、体重指数和美国麻醉师协会评分方面,所有组的患者人口统计数据相似(p < 0.05)。结论:总之,在美容、成本效益和手术可持续性方面,SU是腹腔镜下端口闭合最有效的方法。ST是稍快的缝合方法,在并发症发生率方面表现出平衡。我们提倡将可持续发展作为当前的“黄金标准”,减少不可回收废物的产生,并为初级学员提供宝贵的培训机会。试验注册:ClinicalTrials.gov标识符:NCT03843866。
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引用次数: 0
Corrigendum to “The positive effects of preoperative chlorhexidine rinse to reduce postoperative pneumonia after kidney transplantation surgery” [Surgeon. (2025) 23(1) 18–22] “术前氯己定冲洗减少肾移植术后肺炎的积极作用”的勘误表[外科医生。(2025) 23(1) 18-22]。
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2025-10-01 Epub Date: 2025-05-05 DOI: 10.1016/j.surge.2025.04.001
Murat Ferhat Ferhatoglu , Osman Z. Sahin , Taner Kivilcim , Alp Gurkan
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引用次数: 0
期刊
Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
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