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Prehospital Transportation and Trauma Mortality
Prehospital trauma care policies affect patient outcomes. This study evaluates whether private vehicle transport confers a survival advantage over ground emergency medical services transport for penetrating trauma in urban US trauma systems. Wandling et al retrospectively assessed 103 029 individuals with penetrating injuries who were treated at 298 urban trauma centers and identified a substantial mortality benefit associated with private vehicle transport.
Combining Oral Antibiotics and Bowel Preparation for Surgery
Surgical site infection is a common postoperative complication after colorectal surgery, affecting patient morbidity and mortality. In this cohort study of 89 patients, Vo et al examined the association of combined oral antibiotic and mechanical bowel preparation with surgical site infections in left colon and rectal cancer resections and the effect of this regimen on timely administration of adjuvant therapy. They found that oral antibiotics and mechanical bowel preparation were associated with a significant decrease in surgical site infections overall.
Solving the Emergency General Surgery Crisis
Acute care surgery was proposed as a solution to a national crisis in access to emergency general surgery. Khubchandani and coauthors surveyed 1690 US hospitals, linking responses to geocoded hospital and census data, and found that acute care surgery is diffusing unevenly, with rural and less-educated communities not enjoying the increased access through acute care surgery implementation that urban locations might experience.
Postoperative and Postdischarge Opioid Use
The association between a patient’s postoperative opioid use 24 hours predischarge and the quantity prescribed at discharge is not well understood. Chen et al performed a retrospective, cross-sectional study of 18 343 patients to examine this association. They found that opioids are not prescribed in a patient-specific manner and that potential overprescription may occur regularly after surgery.
Work-Related Injuries in Surgeons
A growing body of literature describes a high rate of work-related musculoskeletal disorders among surgeons and interventionalists; however, estimates vary widely. This systematic review and meta-analysis by Epstein et al synthesizes 21 studies of 5828 physicians to estimate true prevalence. They find that work-related injuries are common and identify opportunities for improvement.
CME Author Audio Interview
Highlights. JAMA Surg. 2018;153(2):101. doi:10.1001/jamasurg.2017.3651
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