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World J Surg. 2017 Dec;41(12):3055-3065. doi: 10.1007/s00268-017-4293-z.

Impact of Surgical Lighting on Intraoperative Safety in Low-Resource Settings: A Cross-Sectional Survey of Surgical Providers.

Author information

1
Department of Surgery, Section of Trauma & Critical Care, Stanford University, 300 Pasteur Drive, S067, Stanford, CA, 94305-5106, USA. jaredf2@stanford.edu.
2
Great Ormond Street Hospital For Children NHS Trust, London, UK.
3
Kings Centre for Global Health, Kings College London, London, UK.
4
Lifebox Foundation, London, UK.
5
Department of Surgery, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia.
6
Department of Surgery, Section of Trauma & Critical Care, Stanford University, 300 Pasteur Drive, S067, Stanford, CA, 94305-5106, USA.
7
Lifebox Foundation, Boston, MA, USA.
8
Department of Clinical Surgery, Royal Infirmary of Edinburgh, University of Edinburgh, Edinburgh, UK.

Abstract

BACKGROUND:

Safe surgery requires high-quality, reliable lighting of the surgical field. Little is reported on the quality or potential safety impact of surgical lighting in low-resource settings, where power failures are common and equipment and resources are limited.

METHODS:

Members of the Lifebox Foundation created a novel, non-mandatory, 18-item survey tool using an iterative process. This was distributed to surgical providers practicing in low-resource settings through surgical societies and mailing lists.

RESULTS:

We received 100 complete responses, representing a range of surgical centres from 39 countries. Poor-quality surgical field lighting was reported by 40% of respondents, with 32% reporting delayed or cancelled operations due to poor lighting and 48% reporting electrical power failures at least once per week. Eighty per cent reported the quality of their surgical lighting presents a patient safety risk with 18% having direct experience of poor-quality lighting leading to negative patient outcomes. When power outages occur, 58% of surgeons rely on a backup generator and 29% operate by mobile phone light. Only 9% of respondents regularly use a surgical headlight, with the most common barriers reported as unaffordability and poor in-country suppliers.

CONCLUSIONS:

In our survey of surgeons working in low-resource settings, a majority report poor surgical lighting as a major risk to patient safety and nearly one-third report delayed or cancelled operations due to poor lighting. Developing and distributing robust, affordable, high-quality surgical headlights could provide an ideal solution to this significant surgical safety issue.

PMID:
29051968
DOI:
10.1007/s00268-017-4293-z
[Indexed for MEDLINE]

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