Neurosurgical Wrong Surgical Site in Lower-Middle- or Low-Income Countries (LMICs): A Survey Study.

El-Ghandour, N. M. F., A. O. Aguirre, A. Goel, H. Kandeel, T. M. Ali, B. Chaurasia, S. Elmorsy, M. S. Abdelaziz, and M. A. R. Soliman, "Neurosurgical Wrong Surgical Site in Lower-Middle- or Low-Income Countries (LMICs): A Survey Study.", World neurosurgery, vol. 152, pp. e235-e240, 2021.


BACKGROUND: One of the most preventable errors of a surgeon's career is operating on the incorrect surgical site (ICSS). No study in any specialty has ever investigated the incidence of ICSS events in lower-income countries. This study focuses on identifying the occurrence of these events along with an analysis of potential causes leading to these unfortunate events.

METHODS: The authors distributed a survey to neurosurgical colleagues from around the world. These surgeons were first asked to identify details about their practice and incidence and personal experience with ICSS in their own careers. At the end of the survey, they responded to questions about their knowledge of safety checklists.

RESULTS: In this study there was a 63.4% response rate. When combined with those who participated through various social media platforms, there were 178 responses. The incidence rate for every 10,000 cases performed was found to be 22.8 in the cranial group, 88.6 in the cervical group, and 158.8 in the lumbar procedural group. This study identified that 40% of participants had never learned or experienced the ABCD time-out strategy and that 60% of surgeons did not use intraoperative navigation or imaging in their practices. The error has never been disclosed to the patient in 48% of the ICSS cases.

CONCLUSIONS: Due to a lack of application of safety checklist protocol, there is an increased occurrence of ICSS events in lower-income countries. The results of this study demonstrate the necessity of investing time and resources dedicated to avoiding preventable errors.