These WHO guidelines which were updated in 2018, are valid for any country and suitable to local adaptations, and take account of the strength of available scientific evidence, the cost and resource implications, and patient values and preferences.
The 2018 edition of the guidelines includes the re
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vision of the recommendation regarding the use of 80% fraction of inspired oxygen (high FiO2) in surgical patients under general anaesthesia with tracheal intubation and the update of the section on implementation. Between 2017 and 2018, WHO re-assessed the evidence on the use of high FiO2 by updating the systematic review related to the effectiveness of this intervention to reduce SSI and commissioning an independent systematic review on adverse events potentially associated with it. Based on the updated evidence, the GDG decided to revise the strength of the recommendation from strong to conditional.
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During the 17 years since Surgical approaches to the urogenital manifestations of lymphatic filariasis was first published, there has been heightened awareness of the physical, economic and emotional burden of the genitourinary manifestations of fil
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ariasis. With the impetus to provide better guidance for care of those suffering from LF, this update was both warranted and timely.
At the outset, the Committee noted that barriers continue to exist in care of patients affected by LF-associated morbidity. These barriers include lack of information for patients as well as for many healthcare providers, including general surgeons and others within health systems
This update offers a new consensus of the Committee regarding the staging of hydroceles caused by LF, also known as “filariceles”. It recommends integrating LF surgery with other efforts to strengthen surgical care by assessing health facilities for their surgical readiness using the WHO surgical assessment tool or “SAT”. It also recommends integratinghernia surgery with hydrocele surgery and integrating standards for prevention of surgical site infection (SSI).
The update revises recommendations for standard procedures and processes, offers an algorithm for diagnosis (including the use of ultrasound) and discusses postoperative care. It recommends collecting data using the staging and grading system described by Capuano and Capuano along with other metrics for public health management of LF.
A multifaceted approach has therefore been recommended to coordinate public health outreach with national surgical planning and local health systems to include supporting partners such as nongovernmental organizations. Surgical camps with mobile teams, as well as training of personnel at DCP3 “first level” or WHO Level II hospitals (depending on region and resources), have important roles for reducing LF morbidity.
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ecancer has just published a comprehensive set of guidelines for paediatric cancer surgery, applicable to low and high resource settings across the world. You can read the guidelines online
The guidelines have been developed by the International Society of Paediatric
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Surgical Oncology (IPSO) with authors from both High Income Countries and Lower and Middle Income Countries, and have been further validated by experts in the respective fields with the aim of providing evidence-based information for surgeons who care for children with cancer.
These guidelines include information on the care and treatment of children with malignancies, including making a diagnosis, obtaining adequate venous access, performing a surgical resection for solid tumours (with staging and reconstruction), performing procedures for cancer prevention and its late effects, and managing complications of treatment; all with the goal of improving survival and quality of life.
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Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using tric
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losan-coated sutures, but called for assessment of both interventions in low-resource settings. This study aimed to test both interventions in low-income and middle-income countries.
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Saving Lives Through Safe Surgery (SaLTS)
Saving Lives Through Safe Surgery (SaLTS)
The report and an accompanying series of studies show the global uptake of the World Health Organization (WHO) Surgical Safety Checklist in its first ten years since its launch and recommend ways the Checklist can be more effectively used to improve
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surgical safety for millions at risk.
The report found that uptake has been remarkably positive: the Checklist has been adopted in almost 90% of operating rooms in countries with a high Human Development Index (HDI), a country-level measure of health, education, and standard of living. It was referenced by at least 139 (70%) of the world's countries and is included as a national standard by the health ministries of at least 20 countries. The Checklist has also had beneficial qualitative impact, introducing a culture of safety and improved communication within surgical teams, increasing patient trust, and improving job satisfaction.
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Promotion of the quality of clinical care through the identification, promotion and standardization of appropriate procedures, equipment and materials, particularly at district hospital level.
Surgical site infections (SSI) are a serious problem globally; they are the most frequent type of health care-associated infection (HAI) observed on admission in low- and middle-income countries (LM
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ICs). Approximately one in 10 people who have surgery in LMICs acquire an SSI, and SSI is reported as the second most common HAI in Europe and the United States of America. Therefore, it is crucial to include SSI prevention activities in your overall IPC programme.
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The manual provides suggestions for implementing the checklist, understanding that different practice settings will adapt it to their own circumstances.
The implementation manual is designed to help ensure that surgical teams are able to implement
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the checklist consistently. By following a few critical steps, health care professionals can minimize the most common and avoidable risks endangering the lives and well-being of surgical patients
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These guidelines have been extracted from the WHO manual Surgical Care at the District
Hospital (SCDH), which is a part of the WHO Integrated Management Package on Emergency
and Essential Surgical
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Care (IMPEESC).
Refer for details on anaesthesia, head, gunshot and landmine injuries in chapters
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The Lancet Vol.400 (2022) p.17-67-1776. Published:October 31, 2022DOI:https://doi.org/10.1016/S0140-6736(22)01884-0.
Surgical site infection (SSI) is the most common complication of surgery around
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the world: ChEETAh trial finds routinely changing gloves and instruments for wound closure could prevent as many as one in eight SSIs in abdominal surgery
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