Resuscitative endovascular balloon occlusion of the aorta in Canada: a context-specific position paper from the Canadian Collaborative for Urgent Care Surgery (CANUCS).

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a well-described intervention for noncompressible torso hemorrhage. Several Canadian centres have included REBOA in their hemorrhagic shock protocols. However, REBOA has known complications and equipoise regarding its use persists.

Impact of interhospital transfer on patient outcomes in emergency general surgery.

Background: Emergency general surgery patients are at an increased risk for morbidity and mortality compared to their elective surgery counterparts. The complex nature of emergency general surgery conditions can challenge community hospitals, which may lack appropriate systems and personnel. Outcomes related to transfer have not been well-established.

Prospective study of single-stage repair of contaminated hernias with the novel use of calcium sulphate antibiotic beads in conjunction with biologic porcine submucosa tissue graft.

In single-stage hernia repair in the setting of contaminated fields there is a high rate of infection following mesh repair. New strategies to decrease infection in this challenging patient population are needed. Stimulan calcium sulfate antibiotic beads (CSAB) are a biodegradable material that deliver high concentrations of antibiotics locally to a site of insertion.

Patterns of complex emergency general surgery in Canada.

Background: Most of the literature on emergency general surgery (EGS) has investigated appendiceal and biliary disease; however, EGS surgeons manage many other complex conditions. This study aimed to describe the operative burden of these conditions throughout Canada.

Methods: This multicentre retrospective cohort study evaluated EGS patients at 7 centres across Canada in 2014.

Correction to: Ethical considerations in conducting surgical research in severe complicated intra-abdominal sepsis.

[This corrects the article DOI: 10.1186/s13017-019-0259-9.].

Ethical considerations in conducting surgical research in severe complicated intra-abdominal sepsis.

Background: Severe complicated intra-abdominal sepsis (SCIAS) has high mortality, thought due in part to progressive bio-mediator generation, systemic inflammation, and multiple organ failure. Treatment includes early antibiotics and operative source control. At surgery, open abdomen management with negative-peritoneal-pressure therapy (NPPT) has been hypothesized to mitigate MOF and death, although clinical equipoise for this operative approach exists.

Structured operative reporting: a randomized trial using dictation templates to improve operative reporting.

Background: Few studies have addressed the quality of dictated operative reports (ORs). This study documents changes in resident dictation after the introduction of a standardized OR template.

Methods: Twenty residents dictated an OR based on a surgical procedure video.

General surgery 2.0: the emergence of acute care surgery in Canada.

Over the past 5 years, there has been a groundswell of support in Canada for the development of organized, focused and multidisciplinary approaches to caring for acutely ill general surgical patients. Newly forged acute care surgery (ACS) services are beginning to provide prompt, evidence-based and goal-directed care to acutely ill general surgical patients who often present with a diverse range of complex pathologies and little or no pre- or postoperative planning. Through a team-based structure with attention to processes of care and information sharing, ACS services are well positioned to improve outcomes, while finding and developing efficiencies and reducing costs of surgical and emergency health care delivery.

Using the intensive care unit to teach end-of-life skills to rotating junior residents.

Background: This study tested the effectiveness and perceived value of a palliative/end-of-life (P/EOL) curriculum for junior residents implemented during an intensive care unit (ICU) rotation.

Methods: Residents rotating through the ICU over a 6-month period completed pre- and post-curriculum surveys evaluating their self-assessed efficacy in providing P/EOL care and attitudes towards P/EOL care. Scores were analyzed using a paired Student t test.

Why are women deterred from general surgery training?

Background: This study explored the factors contributing to the low application rates to general surgery (GS) residency by female students and compared perceptions of GS between students and female surgeons.

Methods: We distributed surveys to final-year students at 4 medical schools and nationwide to every female general surgeon in Canada.

Results: Of students who were deterred from GS, women were less likely than men to meet a same-sex GS role model and more likely to experience gender-based discrimination during their GS rotation (P < .

A study of career choice patterns among Canadian medical students.

Background: The number of students pursuing general surgery (GS) has declined in Canada. The reasons for this, and program directors' (PDs) perception of it, are unclear.

Methods: A survey was distributed to medical students at Queen's University and the University of Manitoba, and to all Canadian GS program directors to explore causes for the trend and identify potential solutions.

The in-house education of clinical clerks in surgery and the role of housestaff.

Background: While on surgical rotations, clinical clerks spend more time on the ward and in the emergency department than in any other location. Consequently, their in-house experience is of great importance to their education-yet the teaching processes in these settings have never been fully explored. Unlike the structured pre-clerkship years, the exact breakdown of a clerk's hospital-based education is difficult to elucidate.