Enhanced Recovery After Surgery (ERAS) Protocols In General Surgery: A Review Of Implementation And Outcomes

ERAS is a group of protocols that aim at affecting positively patients & surrounding lives. surgeons, nurses, physiotherapists, anesthetists, and even healthcare centers hospitals, labs, and pharmacies. Reducing the cost for both hospitals &patients, decreasing the duration of residency in hospitals, and improving patient compliance, developing performance & increasing teamwork between medical staff and patients all fall under the advantages of ERAS. Since it affects the 3 stages of any operation (preoperative-intraoperative-perioperative) it was necessary to implement a suitable protocol for each patient to achieve the best results mostly quitting smoking, fasting for a period before surgery, maintaining body temperature, pressure, and glucose level and the postoperative instructions , care & nutrition to guarantee success and avoidance to recurrence or complications

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population