Forrester Jared A, Boyd Nicholas J, Fitzgerald J Edward F, Wilson Iain H, Bekele Abebe, Weiser Thomas G
Department of Surgery, Section of Trauma & Critical Care, Stanford University, 300 Pasteur Drive, S067, Stanford, CA, 94305-5106, USA.
Great Ormond Street Hospital For Children NHS Trust, London, UK.
World J Surg. 2017 Dec;41(12):3055-3065. doi: 10.1007/s00268-017-4293-z.
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.
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.
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.
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.
安全的手术需要高质量、可靠的手术视野照明。在资源匮乏地区，停电情况常见且设备和资源有限，关于手术照明质量或潜在安全影响的报道较少。
生命盒基金会成员通过迭代过程创建了一种新颖的、非强制性的、包含18个项目的调查工具。该工具通过外科协会和邮件列表分发给在资源匮乏地区执业的外科医生。
我们收到了100份完整回复，代表了来自39个国家的一系列手术中心。40%的受访者报告手术视野照明质量差，32%的受访者报告因照明不佳导致手术延迟或取消，48%的受访者报告每周至少经历一次停电。80%的受访者报告其手术照明质量存在患者安全风险，18%的受访者有过照明质量差导致患者出现负面结果的直接经历。停电发生时，58%的外科医生依赖备用发电机，29%的外科医生使用手机照明进行手术。只有9%的受访者经常使用手术头灯，最常见的障碍是价格昂贵和国内供应商不佳。
在我们对在资源匮乏地区工作的外科医生的调查中，大多数人报告手术照明差是患者安全的主要风险，近三分之一的人报告因照明不佳导致手术延迟或取消。开发和分发坚固、经济实惠、高质量的手术头灯可以为这一重大手术安全问题提供理想的解决方案。
