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Avoiding wrong site surgery: a systematic review.

John Devine1, Norman Chutkan, Daniel C Norvell

  • 1Orthopedic Service, Department of Surgery, Eisenhower Army Medical Center, Ft. Gordon, GA 30809, USA. john-devine@comcast.net

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This summary is machine-generated.

Wrong site surgery is a serious patient safety event. Current checklists are insufficient, and intraoperative imaging is recommended to prevent these errors in spine surgery.

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Area of Science:

  • Patient Safety
  • Surgical Complications
  • Medical Error Prevention

Background:

  • Wrong site surgery is a significant concern, ranking high in sentinel event statistics.
  • The Joint Commission (JC) reported 455 cases (12.8%) between 1995-2005.
  • Quantifying the incidence and implications of wrong site surgery remains challenging.

Purpose of the Study:

  • To determine the incidence and causes of wrong site surgery.
  • To evaluate the effectiveness of preoperative measures in preventing wrong site surgery.

Main Methods:

  • Systematic review of English language literature from 1990-2008.
  • Searched electronic databases and reference lists for relevant articles.
  • Two independent reviewers assessed evidence quality using GRADE criteria.

Main Results:

  • Estimated incidence of wrong site surgery ranges from 0.09 to 4.5 per 10,000 surgeries.
  • No current literature supports the effectiveness of the JC Universal Protocol in reducing wrong site surgery rates.

Conclusions:

  • Wrong site surgery is potentially preventable.
  • Existing checklists from the North American Spine Society and JC are insufficient alone.
  • Recommend intraoperative imaging and comparison with preoperative studies to confirm the correct surgical site.