Taking steps to ensure safer surgeries

Why do we care about surgical safety?

Surgical care and its safe delivery affect the lives of millions of people. About 234 million major operations are performed worldwide every year.

The change in disease patterns worldwide is increasing the need for surgical services considerably. Epidemics and infections are giving way as leading causes of death to ischemic heart diseases, cancers, and trauma - which need surgical interventions.

Ensuring better access to surgical care and its safe delivery is crucial for its effectiveness. The available evidence suggests that as many as half of the complications and deaths arising from surgery could be avoided if certain basic standards of care were followed.

WHO is taking steps to address these issues through:
the Global Initiative for Emergency and Essential Surgical Care;
its guidelines for essential trauma care; and
the Second Global Patient Safety Challenge initiative.

Here are some interesting facts, courtesy the World Health Organization:

Globally, about 234 million major surgical operations are conducted a year. This equates to about one operation for every 25 persons. Every year 63 million people undergo surgery to treat traumatic injuries, another 10 million for pregnancy-related complications, and 31 million more for treating cancers.

Studies suggest that complications following surgery result in disability or prolonged stay in 3-25% of hospitalized patients, depending upon complexity of surgery and hospital setting. These rates would mean that at least 7 million patients annually may have post-operative complications.

Rates of death following major surgery are reported to be between 0.4% and 10%, depending on the setting. Estimating the impact of these rates, at least 1 million patients would die every year during or after an operation.

Information regarding surgical care has been standardized or systematically collected only in a few research studies globally. As a result, most surgical interventions worldwide are not recorded. It is essential to measure surgical care on a global basis for promoting surgical safety, preventing disease and improving care.

Surgical care has been shown to be cost effective in developing settings. Ensuring safe delivery of care will only improve its efficacy.

Dramatic improvements have been made in the administration of anaesthesia over the past 30 years, but not in all parts of the world. In some regions, anaesthesia-related mortality is as high as 1 in 150 patients receiving general anaesthesia.

Safety measures are inconsistently applied in surgery, even in sophisticated settings. Simple steps can reduce complication rates. For example, improving the timing and selection of antibiotics prior to skin incision can reduce the rate of surgical site infections by up to 50%.

WHO has developed guidelines for safe surgery and a checklist of surgical safety standards applicable in all countries and health settings. Preliminary results of an evaluation in eight pilot sites worldwide show that the checklist has nearly doubled the likelihood that patients will receive treatment as per standards of surgical care – such as an antibiotic before incision and confirmation that the surgery team has the correct patient for the correct operation.

The Safe Surgery Saves Lives initiative is collaborating with more than 200 ministries of health, national and international medical societies and professional organizations to reduce deaths and complications in surgical care.


I think that the most striking portion of these facts is that safety measures are applied inconsistently, and that over one million people going under die each year...how many of these could be avoided I wonder?