This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

A traffic‐light coding system to organize emergency surgery across surgical disciplines. BJS 2014; 101: 134-140.

Published: 22nd November 2013

Authors: A. Leppäniemi, I. Jousela

Background

Emergency surgery is associated with night‐time procedures and disruption of elective surgery. An analysis was undertaken of the effect of classifying emergency operations uniformly with a three‐tier urgency colour code and the use of dedicated daytime operating rooms.

Method

Observed changes from 2001 to 2012 in the number, timing and ability to meet the urgency‐designated colour code deadline were retrieved from the computer‐based operating theatre organization system for all emergency operations.

Results

The number of emergency operations performed annually ranged from 3330 to 4341, with an increasing trend. The proportion of night‐time emergency operations decreased from 27·4 per cent (2563 of 9347) before to 23·5 per cent (7731 of 32 959) after introduction of the colour coding system in 2004 (χ² = 61·94, 1 d.f., P < 0·001). In 2007, owing to long preoperative delays in patients with acute appendicitis and acute cholecystitis, colour codes for these patients were upgraded from ‘orange’ to ‘red’ and from ‘yellow’ to ‘orange’ respectively. The proportion of patients operated on with a red code before and after this change increased from 45·2 per cent (5831 of 12 907 operations) to 62·7 per cent (13 020 of 20 778 operations; χ² = 986·99, 1 d.f., P < 0·001). In 2012, the office‐hours raw utilization time for the principal emergency operation theatre was 85·4 per cent.

Conclusion

The structural separation of elective and emergency surgery, the use of dedicated daytime operating theatres and the implementation of a universal classification of emergency operations reduced night‐time surgery, improved the efficiency of operating theatre utilization during daytime, shortened preoperative delay in patients requiring urgent surgery, and enabled monitoring and corrective actions for providing emergency surgery services.

Full text

You may also be interested in

Leading article

Network meta‐analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia.

Authors: J. H. H. Olsen, S. Öberg, K. Andresen, T. W. Klausen, J. Rosenberg

Original article

Outcomes of surgery for benign and malignant adrenal disease from the British Association of Endocrine and Thyroid Surgeons’ national registry. BJS 2019; 106: 1495-1503.

Authors: N. Patel, R. J. Egan, B. R. Carter, D. M. Scott‐Coombes, M. J. Stechman, A. Afzaal et al.

A traffic‐light coding system to organize emergency surgery across surgical disciplines. BJS 2014; 101: 134-140.

Background

Method

Results

Conclusion

You may also be interested in

A good surgical death. BJS 2019; 106: 1427-1428.

Randomized controlled trial of plain English and visual abstracts for disseminating surgical research via social media.

Systematic review of the current status of cadaveric simulation for surgical training.

Network meta‐analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia.

Effect of donor nephrectomy time during circulatory‐dead donor kidney retrieval on transplant graft failure.

Diagnostic performance of MRI and histology in assessment of deep lipomatous tumours.

Dysregulation of the actin scavenging system and inhibition of DNase activity following severe thermal injury.

Trauma models to identify major trauma and mortality in the prehospital setting.

5G‐assisted telementored surgery.

Validation of the Norwegian survival prediction model in trauma (NORMIT) in Swedish trauma populations.

Human model of burn injury that quantifies the benefit of cooling as a first aid measure. BJS 2019; 106: 1472-1479.

Outcomes of surgery for benign and malignant adrenal disease from the British Association of Endocrine and Thyroid Surgeons’ national registry. BJS 2019; 106: 1495-1503.