Surgical care has been an essential component of health care worldwide for over a century. As the incidences of traumatic injuries, cancers and cardiovascular disease continue to rise, the impact of surgical intervention on public health systems will continue to grow.
Surgery is often the only therapy that can alleviate disabilities and reduce the risk of death from common conditions. Every year, many millions of people undergo surgical treatment, and surgical interventions account for an estimated 13% of the world’s total disability-adjusted life years (DALYs).
While surgical procedures are intended to save lives, unsafe surgical care can cause substantial harm. Given the ubiquity of surgery, this has signiﬁcant implications:
- the reported crude mortality rate after major surgery is 0.5-5%;
- complications after inpatient operations occur in up to 25% of patients;
- in industralized countries, nearly half of all adverse events in hospitalized patients are related to surgical care;
- at least half of the cases in which surgery led to harm are considered preventable;
- mortality from general anaesthesia alone is reported to be as high as one in 150 in some parts of sub-Saharan Africa.
WHO and surgical safety
WHO has undertaken a number of global and regional initiatives to address surgical safety. Much of this work has stemmed from the WHO Second Global Patient Safety Challenge “Safe Surgery Saves Lives”. Safe Surgery Saves Lives set about to improve the safety of surgical care around the world by deﬁning a core set of safety standards that could be applied in all WHO Member States.
To this end, working groups of international experts were convened to review the literature and the experiences of clinicians around the world. They reached consensus on four areas in which dramatic improvements could be made in the safety of surgical care: surgical site infection prevention, safe anaesthesia, safe surgical teams and measurement of surgical services.
Member States have continued to be active in addressing these issues. Much of this work has been initiated by the global implementation of the WHO Surgical Safety Checklist, a 19-item tool created by WHO in association with the Harvard School of Public Health.
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