Introducing the Mesh Integration (MINT) Index: a standardised ratio scale for assessing in vivo hernia mesh performance.

Background: One in 15 people throughout their lifetime will develop an incisional hernia. Poor mesh tissue integration is thought to be responsible for hernia repair failure years after surgery. The aim was to develop a mesh integration index for standardised assessment of in vivo hernia mesh behaviour in the abdominal wall.

Commonly recommended moisturising products: effect on transepidermal water loss and hydration in a scar model.

Background: Moisturizing is a widely recommended and accessible approach to scar management, yet objective evidence supporting the efficacy of commonly used products remains limited. Research suggests that moisturizers may reduce hypertrophic scar activity by normalising transepidermal water loss (TEWL) and enhancing skin hydration.

Aim: This study aimed to provide insights into the effect of generic moisturizers on TEWL and hydration in a scar model, helping clinicians make informed recommendations for scar treatment.

What Makes a Surgical Expert Witness?

Background: Surgical expert witnesses play a crucial role in providing informed and objective opinions on surgical procedures, standards of care and patient outcomes. However, clear criteria outlining the qualifications and level of expertise required to be considered an expert witness are lacking.

Objective: To provide a guideline for the essential and desired qualifications required of a surgeon to serve as an expert witness.

Painfully Obvious? Non-Operative Drivers of Post-Operative Pain and Opioid Exposure in a Predominantly Emergency Surgical Cohort: A Multicentre Observational Study Identifying Non-Operative, Perioperative Pain Correlates.

Introduction: There are many non-operative factors (patient specific and management strategies) that are ubiquitous across all surgeries, which may influence perioperative pain. Recognition of these factors and their association with pain and analgesia requirements could provide avenues for improved perioperative care.

Methods: All consecutive surgical patients admitted to six Australian tertiary hospitals (2017-2024) were included.

Finding common ground: collaboration to solve 'wicked' problems.

Collaboration is both a process and an outcome. Collaboration is based on the idea that interactions between participants with a common goal, working together as partnerships and sharing resources, can solve complex or "wicked" problems that are not possible to solve in isolation. Collaboration may be simple, occurring between individuals, or more complex interorganizational arrangements across sectors, with the life cycle and size of the collaboration determined by the issue at hand.

For CPR or Not-For-CPR? Demographic Factors Predict Resuscitation Order Documentation and CPR Status in General Surgery Patients.

Background: To improve healthcare equity, this study aimed to determine which demographic factors are associated with resuscitation order documentation and not-for-cardiopulmonary resuscitation (CPR) status in general surgery patients.

Methods: A retrospective cohort study was conducted including patients admitted under general surgical services of two hospitals in South Australia over 2 years. Logistic regression evaluated associations between demographic factors, and resuscitation order documentation and not-for-CPR status.

Interventions to Improve Nontechnical Skills in Surgery: A Systematic Review And Meta-Analysis.

Objective: Many surgical adverse events are due to failures in nontechnical skills. Improving nontechnical skills has become a priority for surgical training organizations, yet there is little evidence to guide improvement activities. aim of this review was to investigate the effectiveness of interventions to improve surgeon nontechnical skills overall and by individual domains.

Characterizing Perioperative Sleep in Acute Renal Transplants.

Posttransplant sleep disturbances may influence recovery, immunosuppressive adherence, and graft outcomes. This study examined sleep disruption in acute renal transplant recipients and its relationship with medication comprehension and hospital stressors. A mixed-methods, pilot prospective cohort study was conducted at a metropolitan hospital in Australia.

Use of the Australian and New Zealand Audit of Surgical Mortality (ANZASM) to determine potentially preventable deaths after emergency general surgery.

Background: Patients undergoing emergency general surgery procedures have significantly greater mortality rates than those undergoing the same procedures electively. However, the exact number of potentially preventable deaths after these procedures is unclear. This study aims to examine potentially preventable and nonpreventable deaths after 7 common emergency general surgery procedures and the clinical management issues associated with potentially preventable deaths.

Implementation of a Checklist for Surgical Inpatient Rounds: An Observational Cohort Study.

Background: The surgical ward round is the linchpin of inpatient care. Despite this, it is often pressured by external forces such as theatre times, on-call demands, or outpatient clinics. Checklists have been successful in saving lives, particularly in the operating room.

2024 Update to SAGES guidelines for the use of peroral endoscopic myotomy (POEM) in the treatment of achalasia.

Background: Peroral Endoscopic Myotomy (POEM) is a safe treatment for esophageal achalasia with comparable safety to Heller myotomy plus fundoplication and pneumatic dilatation (PD). More data comparing POEM to Heller Myotomy plus fundoplication and pneumatic dilation are available since the previous Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) guideline published on this topic in 2021.

Objective: This guideline provides an update to the evidence-based guideline from SAGES published in 2021.

The dissemination of surgical clinical practice guidelines-evaluating SAGES' strategies for distribution.

Background: The Society of Gastrointestinal and Endoscopic Surgeons (SAGES) has been a leader in the development of surgical clinical practice guidelines; however, the dissemination and implementation of these remains a challenge. We aim to analyze the user interaction with the SAGES website (sages.org) guidelines' page and guideline downloads from their associated journal Surgical Endoscopy to help inform the organization about its distribution and dissemination methods.

Non-technical error leading to patient fatalities in the Australian surgical population.

Introduction: Many surgical adverse events are due to errors in non-technical skills (NTS); consequently, improving NTS is a priority. However, evidence to guide NTS improvement activities is lacking. This study aimed to investigate the incidence and characteristics of non-technical errors linked to fatalities in a large, representative surgical-patient population to guide future NTS improvement.

Discovery of WEE1 Kinase Inhibitors with Potent Activity against Patient-Derived, Metastatic Colorectal Cancer Organoids.

A library of potent WEE1 kinase inhibitors was synthesized based on the discontinued frontrunner clinical candidate AZD1775 (), many of which were more selective for WEE1 over an undesirable off-target of , the kinase PLK1. When tested against patient-derived organoids (PDOs) grown from -mutated colorectal cancer (CRC) peritoneal metastases, (IC value of 62 nM) exhibited stronger efficacy than (IC value of 120 nM) and the best-in-class clinical candidate ZN-c3 (IC value of 127 nM). Against primary CRC PDOs with -WT, significantly enhanced DNA damage, replication stress and apoptosis compared to , as well as demonstrated high selectivity over patient-matched normal healthy colon PDOs, highlighting a potential therapeutic window for cancer treatment.

Lost in transcription - how accurately are we documenting the surgical ward round?

Background: Ward rounds are crucial to providing high-quality patient care in hospitals. Ward round quality is strongly linked to patient outcomes, yet ward round best practice is severely underrepresented in the literature. Accurate and thorough ward round documentation is essential to improving communication and patient outcomes.

Optimizing ward rounds: systematic review and meta-analysis of interventions to enhance patient safety.

Background: Poor quality ward rounds contribute to a large proportion of patient complications, delayed discharge, and increased hospital cost. This systematic review investigated all interventions aiming to improve patient and process-based outcomes in ward rounds.

Methods: This systematic review was prospectively registered in PROSPERO, the international prospective register of systematic reviews (CRD42023394325).

Postoperative inflammatory responses and association with in-hospital mortality after general surgery.

Background: The relationship between postoperative in-hospital mortality and inflammatory markers has not been well described. This study aimed to characterize the association between specific clinical markers of inflammation and in-hospital mortality in the early postoperative period in general surgical patients.

Methods: This study included consecutive general surgery admissions at two tertiary hospitals in South Australia over a 2-year period.

A phase 1 study to assess the safety, tolerability and effectiveness of PV-10 (Rose Bengal Sodium) in neuroendocrine tumours metastatic to the liver.

Background: Metastatic neuroendocrine neoplasms (mNEN) require new treatment options. Intralesional (IL) PV-10 is an autolytic chemotherapy that may elicit an adaptive immune response.

Methods: This phase 1 study evaluated IL PV-10 administered percutaneously to hepatic lesions in patients with progressive mNEN.

Utilisation of mobile X-ray services by residents of long-term care facilities.

Background: Access to mobile X-ray imaging (MXR) by long-term care facility (LTCF) residents could potentially reduce emergency department transfers. To encourage MXR use, the Australian Government Medicare Benefits Schedule introduced an MXR service subsidy in November 2019.

Aims: To examine the (i) MXR utilisation rate in LTCFs between 1 November 2019 and 30 June 2020; and (ii) individual and LTCF characteristics associated with accessing MXR compared to community-based X-rays.

Machine Learning vs Traditional Approaches to Predict All-Cause Mortality for Acute Coronary Syndrome: A Systematic Review and Meta-analysis.

Background: Acute coronary syndrome (ACS) remains one of the leading causes of death globally. Accurate and reliable mortality risk prediction of ACS patients is essential for developing targeted treatment strategies and improve prognostication. Traditional models for risk stratification such as the GRACE and TIMI risk scores offer moderate discriminative value, and do not incorporate contemporary predictors of ACS prognosis.

SAGES guidelines update to laparoscopy in the era of COVID-19.

Background: Patients requiring cholecystectomy or appendectomy may present with concomitant COVID infection in both the inpatient and outpatient scenarios. It is unclear whether these patients benefit more from operative or nonoperative management in the setting of active COVID infection. These guidelines seek to address urgent and elective clinical scenarios.

Delayed return of bowel function after general surgery in South Australia.

Introduction: Reference ranges for determining pathological versus normal postoperative return of bowel function are not well characterised for general surgery patients. This study aimed to characterise time to first postoperative passage of stool after general surgery; determine associations between clinical factors and delayed time to first postoperative stool; and evaluate the association between delay to first postoperative stool and prolonged length of hospital stay.

Methods: This study included consecutive admissions at two tertiary hospitals across a two-year period whom underwent a range of general surgery operations.