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August 28, 2021World Journal of SurgeryOpen Access

ERAS Society Recommendations for Improving Perioperative Care in Low‐ and Middle‐Income Countries Through Implementation of Existing Tools and Programs: An Urgent Need for the Surgical Safety Checklist and Enhanced Recovery After Surgery

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Why the study?

Patients with access to surgical care in LMICs face higher risks of complications and mortality than in HICs, with quality deficits being a major concern.

Population

Patients requiring surgical and anesthetic care in low- and middle-income countries (LMICs)

Design

Guideline

Authors

RORavi OoditBBBruce BiccardGNGregg Nelson

Discussion

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Overview

Emphasizes urgent need to address perioperative mortality in LMICs; leaves open which interventions best reduce deaths and economic losses.

Structured PICO

P
Population
Patients requiring surgical and anesthetic care in low- and middle-income countries (LMICs)
I
Intervention
Implementation of existing tools and programs, specifically the Surgical Safety Checklist and Enhanced Recovery After Surgery (ERAS)
O
Outcome
Perioperative complications and mortality

There is an urgent need to implement the Surgical Safety Checklist and ERAS protocols to address the disproportionately high perioperative mortality and complication rates in LMICs.

Limitations

  • Lack of resources and infrastructure for initial and ongoing implementation in LMICs
  • Surgical hierarchies that may not support aspects of the Surgical Safety Checklist
  • Checklist fatigue leading to decreased meaningful use

Cite This Study

Oodit et al. (2021) conducted an editorial in Perioperative care in Low- and Middle-Income Countries. Surgical Safety Checklist (SSC) and Enhanced Recovery After Surgery (ERAS) was evaluated. Implementation of existing evidence-based tools like the Surgical Safety Checklist and Enhanced Recovery After Surgery programs is urgently needed to improve perioperative care and outcomes in LMICs.

synapsesocial.com/papers/6a9ced8d0f77d4edee56085ehttps://doi.org/10.1007/s00268-021-06279-x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Ensuring safe surgical care across resource settings via surgical outcomes data & quality improvement initiatives2019 · 23 citations
  2. 2Enhancing Access for Essential surgical and anesthesia care at Primary Healthcare Settings in Low-Resource Settings: A Scoping Review Protocol2025
  3. 3Tracking perioperative mortality and maternal mortality: challenges and opportunities2016 · 5 citations
  4. 4Closing the data gaps for surgical care delivery in LMICs2016 · 8 citations
  5. 5Evidence on Enhanced Recovery After Surgery Protocols in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis of Postoperative Outcomes2026 · 3 citations