Tertiary Survey in the Days of Modern Imaging: Assessing the Detection Rate of Clinically Significant Injuries on Tertiary Survey in a Level 2 Trauma Centre.

Aim: To determine the utility of tertiary survey (TS) in patients subjected to whole-body CT (WBCT) or selective CT (SCT) following trauma.

Methods: A retrospective analysis was performed on trauma patients admitted to a level 2 trauma centre following the introduction of a standardised TS form in 2017. The initial imaging protocol (WBCT versus selective CT versus x-ray), subsequently requested imaging, standardised injury data, and length of stay (LOS) were recorded.

How to isolate and manage a colo-atmospheric fistula in a wound requiring negative pressure dressing: a novel technique using a plastic syringe.

We describe the management of a colo-atmospheric fistula following extensive debridement for abdominal wall necrotising fasciitis. This was a novel technique performed with VAC dressing and a plastic syringe to isolate the fistula from the surround tissue.

How is surgery included in the Strategic Health Plans of the Pacific, Papua New Guinea and Timor-Leste?

Background: Papua New Guinea, Pacific Island nations, and Timor-Leste represent a range of island nations with populations ranging from a few thousand to 8 million. They perform on average about 25% of the Lancet Commission of Global Surgery's target 5000 per 100 000 population and their health workforce have significant deficits of trained surgeons and anaesthetists. This study was conducted to determine how the current national health plans of these nations have included surgery and anaesthesia.

Safety and outcomes after oesophagectomy in southern New Zealand: a 25-year audit of a low volume centre.

Background: Over the last 2 decades, outcomes for oesophageal cancer have improved due to advances in surgical and oncological practice. Optimizing outcomes by centralization of oesophagectomy to high-volume centres has been observed. The aim of this study was to establish if technical and oncological outcomes after oesophagectomy in southern New Zealand are comparable to recent benchmarks.

Clinical activity and outcomes during Geelong's general surgery response to the coronavirus disease 2019 pandemic.

Background: The response to the coronavirus disease 2019 pandemic has required conserving capacity and resources to avoid the health sector being overwhelmed. This paper describes Geelong's general surgical response, surgical activity, outcomes and the effect on surgical training.

Methods: Data collected from surgical audits; hospital databases and patient's medical records were used to compare the first 7 weeks of our new service delivery (30 March to 17 May 2020) to the corresponding 7 weeks in 2019 (1 April 2019 to 19 May 2019).

How will increasing surgical volume affect mortality in the Pacific, Papua New Guinea and Timor Leste?

Background: Nine South Pacific nations, Papua New Guinea and Timor Leste, have collaborated to report and publish their surgical metrics as recommended by the Lancet Commission on Global Surgery (LCoGS). Currently, these countries experience about 750 postoperative deaths per year, representing 1% of crude mortality in the region. Given that more than 400 000 annual procedures are needed in the nine nations to reach the LCoGS target of 5000/100 000, we aimed to calculate the potential contribution of perioperative mortality to national mortality where these procedures are performed.

Hernioplasty using low-cost mesh compared to surgical mesh in low- and middle-income countries: a systematic review protocol.

Objective: This review aims to assess the differences in surgical outcomes between hernioplasty using low-cost mesh and surgical mesh in adults undergoing elective hernioplasty in low- and middle-income countries.

Introduction: The use of untreated mosquito netting in inguinal hernioplasty in low- and middle-income countries has been well described in the literature, with two recent limited systematic reviews finding equivalent postoperative surgical outcomes. This comprehensive review, across a wider set of databases and gray literature, will assess a broader set of outcomes including patient and surgeon preference and sterility, report more granular complication outcomes, and include other low-cost mesh alternatives such as resterilized surgical mesh and indigenous products, alongside mosquito net mesh.

Acute colonic pseudo-obstruction (Ogilvie's syndrome) with caecal perforation after caesarean section.

Ogilvie syndrome or acute colonic pseudo-obstruction is characterized by acute dilatation of the colon usually involving caecum and right hemi-colon in the absence of any mechanical obstruction. It is usually associated with an underlying severe illness/infection or surgery, mostly caesarean section and rarely occurs spontaneously. Identification of this condition is important due to the increased risk of bowel ischaemia and perforation particularly with caecal diameter >9 cm.

Missed diagnosis: blunt abdominal injury-case report.

Acute pancreatitis is an uncommon finding in children and therefore one must have a high index of suspicion when evaluating children with blunt abdominal trauma. It can cause severe morbidity and mortality and requires one to be vigilant to make the diagnosis and to ensure appropriate management. We report on a case of acute pancreatitis that had diagnostic and management dilemmas at Colonial War Memorial Hospital (CWMH) in Fiji.