Following on from the 2019 thread, here's a look back at #GlobalSurgery research in @BJSurgery & @BjsOpen in 2020.

(articles loosely arranged by theme / not ranked)

@young_bjs @des_winter @robhinchliffe1 @MalinASund @aneelbhangu @DrJamesGlasbey @JoanaffSimoes @AdewaleAdisa1 https://twitter.com/NIHR_GSU/status/1212418625451237376
First up, paediatric trauma epidemiology across two university hospitals in Rwanda.

Rwanda has one of the strongest prehospital systems in Africa.

Striking findings
*27% of all trauma is in children
*trauma in young children common
*mortality rate 4.8%

https://bjssjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/bjs5.50222
A study from neighbouring Uganda focused on traumatic brain injury:

*95% of patients managed non-operatively
*33% mortality
*Outcomes compromised by lack of CT imaging and intracranial pressure monitoring

Investment in diagnostics key for #GlobalSurgery

https://bjssjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/bjs5.50243
A survey of surgeons from 12 countries in the @cosecsa region found <50% had laparoscopic equipment & of these, 41% did not have facilities for lap equipment maintenance

▶️Dissemination of laparoscopy must include logistics for consumables & maintenance

https://bjssjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/bjs5.50255
Importance of infrastructure to delivering surgery was echoed by a national study from Liberia

Overall surgical volume (462 operations per 100,000 population) was low, but there was substantial variation across the country mirroring resource availability

https://bjssjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/bjs5.50349
A simple, affordable intervention intervention to reduce surgical mortality is the Surgical Safety Checklist.

However, a pooled SOS & @GlobalSurg data analysis found lower country HDI to be associated with decreased likelihood of use of the Checklist.

https://bjssjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/bjs.11321
A survey including several countries from Africa, Americas & Asia 🇨🇴🇬🇹🇮🇳🇿🇦🇿🇲 found huge variation in the duration, curricula & assessment of general surgical training programmes.

▶️Perhaps unsurprising given very different health needs around the world?

https://bjssjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/bjs5.50293
There's also a lot of variation globally in SSI prevention practices.

The @NIHR_GSU team tried to condense best available evidence on SSI prevention in to practical, feasible recommendations that can be implemented globally.

#GlobalSurgery

https://bjssjournals.onlinelibrary.wiley.com/doi/10.1002/bjs.11530
The @CovidSurg network was set up to inform surgical care during the COVID-19 pandemic.

@CovidSurg urgently developed a global guideline for surgical care during the pandemic.

Subsequent @CovidSurg papers in @BJSurgery have presented real-world data.

https://bjssjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/bjs.11646
A complementary study in @BJSurgery was a global Delphi study exploring consensus around processes in the operating theatre to ensure safe surgery during the COVID-19 pandemic.

https://bjssjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/bjs.11747
A key knock-on effect of the pandemic on surgery has been the cancellation of elective surgery

@CovidSurg's estimate that the first wave of the pandemic would be associated with up to 28 million cancelled elective surgeries attracted broad media coverage

https://bjssjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/bjs.11746
The global impact of the first weeks of the COVID-19 pandemic on vascular surgery was examined in more depth by @VascResearchNet. In addition to reduced operating volumes, they found surgeons were changing operative & non-operative management strategies.

https://bjssjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/bjs.11961
Of course, many papers in @BJSurgery & @BjsOpen have relevance for all surgery around the world, but I've pulled out those papers I think of particular interest to #GlobalSurgery reader.

Please feel free to flag up any papers that I have missed!
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