LUKMAN OLAJIDE ABDUR-RAHMAN

Professor Lukman Olajide Abdur-Rahman is a Professor of Surgery and Honorary Consultant Paediatric Surgeon. Department of Surgery, Faculty of Clinical Sciences, University of Ilorin and University of Ilorin Teaching Hospital of Unilorin Medical Screening Centre from November 2020. Head of Department of Surgery (Unilorin and UITH), and Chairman UITH Theatre Users’ Committee from 2018 to 2021. Pioneer Coordinator of the Clinical Skills and Simulation Laboratory, College of Health Sciences (2014-2018). Coordinator of the Medical Education and Resource Unit (MERU) of the College of Health Sciences, University of Ilorin (2012-2014). Pioneer Chief Medical Director of Crescent Gold Crown Hospital Limited (2007-2015). Pioneer Director of the Centre for Injury Research and Safety Promotion (CIRASP) of the University of Ilorin Teaching hospital (2007-2011) Coordinator, Basic Surgical Skills Course, Ilorin Centre for West Africa College of Surgeons from 2015 to date.

EDUCATION

MB;BS, MPH, MD, FWACS, FMCS, FACS, FMAS (Amrita, India), IIWCC cert, Global Health Simulation fellow (McGill University, Montreal, Ca),

RESEARCH, TEACHING, or OTHER INTERESTS

Surgery

Scopus Publications

Patterns of Trauma Presentation in Ilorin, Nigeria: A 15-Year Review
G. Ibraheem, Abdur-Rasheed Adegoke Nasir, O. M. Babalola, L. Abdur-rahman and B. Solagberu

Background Injuries make up a significant portion of the emergency surgical patient load in most hospitals, representing a major public health threat The burden of injury as a public health issue is especially pronounced in low- and middle-income countries, where injuries are responsible for up to 90% of mortality. Identifying common mechanisms of trauma and patterns of presentation can aid in identifying at-risk populations and in the development of targeted preventive protocols. Methods From February 2000 to January 2015, a prospective observational study was conducted to examine the patterns of presentation and epidemiology of patients presenting to the surgical emergency department of a University Teaching Hospital. All patients who presented during these 15 years were enrolled in the study. Results A total of 27,588 patients were admitted through the surgical emergency department during the study period. Of these, 18,374 patients (66.6%) presented with trauma, while the remaining 33.4% sought care for other surgical emergencies. Trauma patients were generally younger, with an average age of 30.27 years, compared to an average age of 41.33 years for those presenting with other surgical emergencies. Road traffic crashes accounted for the majority of injuries (65.3%), followed by falls (8.9%) and assaults (6.9%). The majority of patients (69.2%) were transported to the hospital by friends and relatives. Conclusion Injuries represent a substantial portion of the emergency surgical care demands in this setting. Road traffic injuries continue to be the predominant cause of trauma, with young adult males being the most frequent victims.


Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey
Mostafa Shalaby, Ahmed M. ElSheikh, Hosam Hamed, Ahmed Elsheik, Ahmad Sakr, Amgad Fouad, Amr Kassem, Hossam Elfeki, Khaled Madbouly, Khalid H. Alzahrani,et al.
Springer Science and Business Media LLC
Abstract Background SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration The study was registered on clicaltrials.gov “NCT04433286” on 16/06/2020.


Microbiology testing capacity and antimicrobial drug resistance in surgical-site infections: a post-hoc, prospective, secondary analysis of the FALCON randomised trial in seven low-income and middle-income countries
Aaron Oladipo Aboderin, Solomon Amfoabegyi, Abimbola Temitayo Awopeju, Michael Bahrami-Hessari, Emmanuel Isaac Acquah Garchie, Martin Gill, Akosua Karikari, Andrew Kirby, Olufunmilola Makanjuola, Bamidele Mutiu,et al.
Elsevier BV



Global access to technologies to support safe and effective inguinal hernia surgery: prospective, international cohort study
, M Picciochi, A O Ademuyiwa, A Adisa, A E Agbeko, J A Calvache, D Chaudhry, R Crawford, A C Dawson, M Elhadi,et al.
Oxford University Press (OUP)



Access to and quality of elective care: a prospective cohort study using hernia surgery as a tracer condition in 83 countries
A Eylül Dönmez, Aakansha Giri Goswami, Aashna Raheja, Aayush Bhadani, Abd Elrahman Safwat El Kady, Abdalaziz Alniemi, Abdalkarim Awad, Abdalla Aladl, Abdalla Younis, Abdallah Alwali,et al.
Elsevier BV



Characteristics and Clinical Outcomes of Children With Wilms’ Tumour: A 15-year Experience in a Single Centre in Nigeria
Abdulrasheed A. Nasir, Nurudeen T. Abdur-Raheem, Lukman O. Abdur-Rahman, Taibat T. Ibiyeye, Tolulope O. Sayomi, Olanrewaju T. Adedoyin, and James O. Adeniran
Elsevier BV



Routine sterile glove and instrument change at the time of abdominal wound closure to prevent surgical site infection (ChEETAh): a model-based cost-effectiveness analysis of a pragmatic, cluster-randomised trial in seven low-income and middle-income countries
Edward Bywater, Laura Martinez, Sosthene Habumuremyi, Faustin Ntirenganya, Emmanuel Williams, Stephen Tabiri, Maria Fourtounas, Adesoji O. Ademuyiwa, Bokossa K. Covalic Melic, Dhruv N. Ghosh,et al.
Elsevier BV



Strategies to minimise and monitor biases and imbalances by arm in surgical cluster randomised trials: evidence from ChEETAh, a trial in seven low- and middle-income countries
, Didier Ahogni, Aristide Ahounou, K. Alassan Boukari, Oswald Gbehade, Thierry K. Hessou, Sinama Nindopa, M. J. Bienvenue Nontonwanou, Nafissatou Orou Guessou, Arouna Sambo,et al.
Springer Science and Business Media LLC
Abstract Background Cluster randomised controlled trials (cRCT) present challenges regarding risks of bias and chance imbalances by arm. This paper reports strategies to minimise and monitor biases and imbalances in the ChEETAh cRCT. Methods ChEETAh was an international cRCT (hospitals as clusters) evaluating whether changing sterile gloves and instruments prior to abdominal wound closure reduces surgical site infection at 30 days postoperative. ChEETAh planned to recruit 12,800 consecutive patients from 64 hospitals in seven low-middle income countries. Eight strategies to minimise and monitor bias were pre-specified: (1) minimum of 4 hospitals per country; (2) pre-randomisation identification of units of exposure (operating theatres, lists, teams or sessions) within clusters; (3) minimisation of randomisation by country and hospital type; (4) site training delivered after randomisation; (5) dedicated ‘warm-up week’ to train teams; (6) trial specific sticker and patient register to monitor consecutive patient identification; (7) monitoring characteristics of patients and units of exposure; and (8) low-burden outcome-assessment. Results This analysis includes 10,686 patients from 70 clusters. The results aligned to the eight strategies were (1) 6 out of 7 countries included ≥ 4 hospitals; (2) 87.1% (61/70) of hospitals maintained their planned operating theatres (82% [27/33] and 92% [34/37] in the intervention and control arms); (3) minimisation maintained balance of key factors in both arms; (4) post-randomisation training was conducted for all hospitals; (5) the ‘warm-up week’ was conducted at all sites, and feedback used to refine processes; (6) the sticker and trial register were maintained, with an overall inclusion of 98.1% (10,686/10,894) of eligible patients; (7) monitoring allowed swift identification of problems in patient inclusion and key patient characteristics were reported: malignancy (20.3% intervention vs 12.6% control), midline incisions (68.4% vs 58.9%) and elective surgery (52.4% vs 42.6%); and (8) 0.4% (41/9187) of patients refused consent for outcome assessment. Conclusion cRCTs in surgery have several potential sources of bias that include varying units of exposure and the need for consecutive inclusion of all eligible patients across complex settings. We report a system that monitored and minimised the risks of bias and imbalances by arm, with important lessons for future cRCTs within hospitals.


The importance of post-discharge surgical site infection surveillance: an exploration of surrogate outcome validity in a global randomised controlled trial (FALCON)
James C Glasbey, Bryar Kadir, Adesoji O Ademuyiwa, Adewale O Adisa, Aneel Bhangu, Peter Brocklehurst, Sohini Chakrabortee, Pollyanna Hardy, Ewen Harrison, JC Allen Ingabire,et al.
Elsevier BV



Towards Appropriate and Effective Use of the Trauma Scoring Systems in Children
O Abdur-Rahman Lukman
Medknow
Injury remains a major public health problem globally, causing significant death and disability across all the age and sex spectrum.[1] Trauma scoring systems were developed so that care providers would be on the same page in injury classification, assessment, intervention and evaluation of outcomes. Trauma outcome prediction models allow risk adjustment required to determine appropriate level of care, trauma research and the evaluation of outcomes. Paediatric trauma care is faced with the challenge of transmuting adult trauma care system and parameters to serve the children age group, though, modifications were made in the trauma scores and classification over time.[2-4] This has not completely served the optimal care of the injured children who suffer injury nor is it useful for research purposes. In Low and Middle Income Countries, only a few centres utilise the trauma scores in the management of trauma victims including the children.[5] Ideal scoring system must be simple to use, cost effective, sensitive and specific for purpose. The trauma scoring systems were grouped into triage scoring systems (pre-hospital assessment), injury scoring systems and trauma outcome analysis systems (OASs).[4] The calculation of these scores is based on physiologic and anatomic parameters, however, mechanism of injury and certain peculiarities in children cofound the results. Hence, many other scores which include laboratory parameters were developed to address the deficiency in the trauma scores.[6,7]


Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
, Adewale Adisa, Michael Bahrami-Hessari, Aneel Bhangu, Christina George, Dhruv Ghosh, James Glasbey, Parvez Haque, J C Allen Ingabire, Sivesh Kathir Kamarajah,et al.
Oxford University Press (OUP)
Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries.


Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): Mixed-methods study and Rasch analysis
, James Glasbey, Adesoji Ademuyiwa, Alisha Bhatt, Bruce Biccard, Jane Blazeby, Peter Brocklehurst, Sohini Chakrabortee, JC Allen Ingabire, Francis Moïse Dossou,et al.
Oxford University Press (OUP)
Abstract Background The Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation. Methods This was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model. Results In the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach’s α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever). Conclusion This study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways.


The costs of surgical site infection after abdominal surgery in middle-income countries: Key resource use In Wound Infection (KIWI) study
M. Monahan, J. Glasbey, T.E. Roberts, S. Jowett, T. Pinkney, A. Bhangu, D.G. Morton, A.R. de la Medina, D. Ghosh, A.O. Ademuyiwa,et al.
Elsevier BV



Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries
James C Glasbey, Tom EF Abbott, Adesoji Ademuyiwa, Adewale Adisa, Ehab AlAmeer, Sattar Alshryda, Alexis P Arnaud, Brittany Bankhead-Kendall, M K Abou Chaar, Daoud Chaudhry,et al.
Elsevier BV



Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic
BMJ
IntroductionChildhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality.MethodsProspective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months.ResultsAll-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3–11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality.ConclusionsChildren with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer.


The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study
, Michel Adamina, Adesoji Ademuyiwa, Adewale Adisa, Aneel A Bhangu, Ana Minaya Bravo, Miguel F Cunha, Sameh Emile, Dhruva Ghosh, James C Glasbey,et al.
Wiley
The SARS‐CoV‐2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non‐delayed surgery.


Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study
Prasanna Gomes, Jacqueline Montoya Vasquez, Daniel H Rhee, S. Cooper and Y. Kara
BMJ
ObjectivesPaediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs.DesignA multicentre, international, collaborative cohort study.Setting91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020.ParticipantsPatients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin’s lymphoma, Hodgkin lymphoma, Wilms’ tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer.Main outcome measureAll-cause mortality at 30 days and 90 days.Results1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001).ConclusionsThe COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally.


Global guidelines for emergency general surgery: systematic review and Delphi prioritization process
, J. C. Glasbey, R. Moore, A. Ademuyiwa, A. Adisa, B. Biccard, S. Chakrabortee, D. Ghosh, E. Harrison, C. Jones,et al.
Oxford University Press (OUP)
Abstract Background Existing emergency general surgery (EGS) guidelines rarely include evidence from low- and middle-income countries (LMICs) and may lack relevance to low-resource settings. The aim of this study was to develop global guidelines for EGS that are applicable across all hospitals and health systems. Methods A systematic review and thematic analysis were performed to identify recommendations relating to undifferentiated EGS. Those deemed relevant across all resource settings by an international guideline development panel were included in a four-round Delphi prioritization process and are reported according to International Standards for Clinical Practice Guidelines. The final recommendations were included as essential (baseline measures that should be implemented as a priority) or desirable (some hospitals may lack relevant resources at present but should plan for future implementation). Results After thematic analysis of 38 guidelines with 1396 unique recommendations, 68 recommendations were included in round 1 voting (410 respondents (219 from LMICs)). The final guidelines included eight essential, one desirable, and three critically unwell patient-specific recommendations. Preoperative recommendations included guidance on timely transfers, CT scan pathways, handovers, and discussion with senior surgeons. Perioperative recommendations included surgical safety checklists and recovery room monitoring. Postoperative recommendations included early-warning scores, discharge plans, and morbidity meetings. Recommendations for critically unwell patients included prioritization for theatre, senior team supervision, and high-level postoperative care. Conclusion This pragmatic and representative process created evidence-based global guidelines for EGS that are suitable for resource limited environments around the world.


Neonatal abdominal cocoon arising from atypical sequelae of intestinal malrotation: A case report
LO Abdur-Rahman, OA Ojajuni, and TK Raji
Journal of Neonatal Surgery
Background: Abdominal cocoon (AC) is the partial or complete encasement of the intestines and sometimes other abdominal organs by a fibro-collagenous sac causing varied presentations of intestinal obstruction. It has been found in all age groups from neonates to the elderly although neonatal AC is quite rare and only very few cases have been reported. In neonates, the presentation could mimic other causes of partial or complete intestinal obstruction and preoperative diagnosis is usually difficult. Case Presentation: We report an atypical sequela of intestinal malrotation causing neonatal intestinal obstruction due to omental encasement of the small and large bowel. The diagnosis was made intraoperatively though contrast gastrointestinal series suggested the partial obstruction at the duodenal-jejunal level. The patient made a good postoperative recovery after extraction of the bowel from the cocoon (omental sac), partial omentectomy, and Ladd’s procedure. Conclusion: A neonatal abdominal cocoon caused by an omental encasement in a malrotated intestine is a unique presentation and a rare cause of neonatal intestinal obstruction.


Burden and outcome of neonatal surgical conditions in Nigeria: A countrywide multicenter cohort study
Hyginus Okechukwu Ekwunife, Emmanuel Ameh, Lukman Abdur-Rahman, Adesoji Ademuyiwa, Emem Akpanudo, and Felix Alakaloko
Journal of Neonatal Surgery
Background:  Despite a decreasing global neonatal mortality, the rate in sub-Saharan Africa is still high. The contribution and the burden of surgical illness to this high mortality rate have not been fully ascertained. This study is performed to determine the overall and disease-specific mortality and morbidity rates following neonatal surgeries; and the pre, intra, and post-operative factors affecting these outcomes.  Methods: This was a prospective observational cohort study; a country-wide, multi-center observational study of neonatal surgeries in 17 tertiary hospitals in Nigeria. The participants were 304 neonates that had surgery within 28 days of life. The primary outcome measure was 30-day postoperative mortality and the secondary outcome measure was 30-day postoperative complication rates. Results: There were 200 (65.8%) boys and 104 (34.2%) girls, aged 1-28 days (mean of 12.1 ± 10.1 days) and 99(31.6%) were preterm. Sepsis was the most frequent major postoperative complication occurring in 97(32%) neonates. Others were surgical site infection (88, 29.2%) and malnutrition (76, 25.2%). Mortality occurred in 81 (26.6%) neonates. Case-specific mortalities were: gastroschisis (14, 58.3%), esophageal atresia (13, 56.5%) and intestinal atresia (25, 37.2%). Complications significantly correlated with 30-day mortality (p <0.05). The major risk predictors of mortality were apnea (OR=10.8), severe malnutrition (OR =6.9), sepsis (OR =7. I), deep surgical site infection (OR=3.5), and re-operation (OR=2.9).  Conclusion: Neonatal surgical mortality is high at 26.2%. Significant mortality risk factors include prematurity, apnea, malnutrition, and sepsis.


Impact of COVID-19 on vascular patients worldwide: Analysis of the COVIDSurg data
Louise HITCHMAN, Matthew MACHIN, and
Edizioni Minerva Medica
BACKGROUND The COVIDSurg collaborative was an international multicenter prospective analysis of perioperative data from 235 hospitals in 24 countries. It found that perioperative COVID-19 infection was associated with a mortality rate of 24%. At the same time, the COVER study demonstrated similarly high perioperative mortality rates in vascular surgical patients undergoing vascular interventions even without COVID-19, likely associated with the high burden of comorbidity associated with vascular patients. This is a vascular subgroup analysis of the COVIDSurg cohort. METHODS All patients with a suspected or confirmed diagnosis of COVID-19 in the 7 days prior to, or in the 30 days following a vascular procedure were included. The primary outcome was 30-day mortality. Secondary outcomes were pulmonary complications (adult respiratory distress syndrome, pulmonary embolism, pneumonia and respiratory failure). Logistic regression was undertaken for dichotomous outcomes. RESULTS Overall, 602 patients were included in this subgroup analysis, of which 88.4% were emergencies. The most common operations performed were for vascular-related dialysis access procedures (20.1%, N.=121). The combined 30-day mortality rate was 27.2%. Composite secondary pulmonary outcomes occurred in half of the vascular patients (N.=275, 45.7%). CONCLUSIONS Mortality following vascular surgery in COVID positive patients was significantly higher than levels reported pre-pandemic, and similar to that seen in other specialties in the COVIDSurg cohort. Initiatives and surgical pathways that ensure vascular patients are protected from exposure to COVID-19 in the peri-operative period are vital to protect against excess mortality.


Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic
, James C Glasbey, Omar Omar, Dmitri Nepogodiev, Ana Minaya-Bravo, Brittany Kay Bankhead-Kendall, Marco Fiore, Kaori Futaba, Alodia Gabre-Kidan, Rohan R Gujjuri,et al.
Oxford University Press (OUP)
Abstract Background Surgical services are preparing to scale up in areas affected by COVID-19. This study aimed to evaluate the association between preoperative SARS-CoV-2 testing and postoperative pulmonary complications in patients undergoing elective cancer surgery. Methods This international cohort study included adult patients undergoing elective surgery for cancer in areas affected by SARS-CoV-2 up to 19 April 2020. Patients suspected of SARS-CoV-2 infection before operation were excluded. The primary outcome measure was postoperative pulmonary complications at 30 days after surgery. Preoperative testing strategies were adjusted for confounding using mixed-effects models. Results Of 8784 patients (432 hospitals, 53 countries), 2303 patients (26.2 per cent) underwent preoperative testing: 1458 (16.6 per cent) had a swab test, 521 (5.9 per cent) CT only, and 324 (3.7 per cent) swab and CT. Pulmonary complications occurred in 3.9 per cent, whereas SARS-CoV-2 infection was confirmed in 2.6 per cent. After risk adjustment, having at least one negative preoperative nasopharyngeal swab test (adjusted odds ratio 0.68, 95 per cent confidence interval 0.68 to 0.98; P = 0.040) was associated with a lower rate of pulmonary complications. Swab testing was beneficial before major surgery and in areas with a high 14-day SARS-CoV-2 case notification rate, but not before minor surgery or in low-risk areas. To prevent one pulmonary complication, the number needed to swab test before major or minor surgery was 18 and 48 respectively in high-risk areas, and 73 and 387 in low-risk areas. Conclusion Preoperative nasopharyngeal swab testing was beneficial before major surgery and in high SARS-CoV-2 risk areas. There was no proven benefit of swab testing before minor surgery in low-risk areas.


Reducing surgical site infections in low-income and middle-income countries (FALCON): a pragmatic, multicentre, stratified, randomised controlled trial
Adesoji O Ademuyiwa, Pollyanna Hardy, Emmy Runigamugabo, Pierre Sodonougbo, Hulrich Behanzin, Sosthène Kangni, Gérard Agboton, Luke Aniakwo Adagrah, Esther Adjei-Acquah, Ato Oppong Acquah,et al.
Elsevier BV



Impact of Bacillus Calmette-Gue´rin (BCG) vaccination on postoperative mortality in patients with perioperative SARS-CoV-2 infection
Covid Surg Collaborative
Oxford University Press (OUP)
There is little evidence around the potentially protective role of previous Bacillus Calmette-Guerin (BCG) vaccination on postoperative mortality in patients with perioperative SARS-CoV-2 vaccination. Prior BCG vaccination did not protect SARS-CoV-2 infected patients against postoperative pulmonary complications and 30-day mortality.


Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study
James Glasbey, Adesoji Ademuyiwa, Adewale Adisa, Ehab AlAmeer, Alexis P Arnaud, Faris Ayasra, José Azevedo, Ana Minaya-Bravo, Ainhoa Costas-Chavarri, John Edwards,et al.
Elsevier BV
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index <20), moderate lockdowns (20–60), and full lockdowns (>60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.

RECENT SCHOLAR PUBLICATIONS

Patterns of Trauma Presentation in Ilorin, Nigeria: A 15-year Review
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Ethiopian Journal of Health Sciences 35 (1) 2025



Microbiology testing capacity and antimicrobial drug resistance in surgical-site infections: a post-hoc, prospective, secondary analysis of the FALCON randomised trial in seven
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Global access to technologies to support safe and effective inguinal hernia surgery: prospective, international cohort study

British Journal of Surgery 111 (7), znae164 2024



A prognostic model for use before elective surgery to estimate the risk of postoperative pulmonary complications (GSU-Pulmonary Score): a development and validation study in
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Access to and quality of elective care: a prospective cohort study using hernia surgery as a tracer condition in 83 countries
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The Lancet Global Health 12 (7), e1094-e1103 2024



An evaluation of the effectiveness of critical components of the chain of survival in out-of-hospital cardiopulmonary resuscitation in Nigeria
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medRxiv, 2024.05. 31.24308305 2024



Characteristics and clinical outcomes of children with Wilms’ tumour: A 15-year experience in a single centre in Nigeria
AA Nasir, NT Abdur-Raheem, LO Abdur-Rahman, TT Ibiyeye, TO Sayomi, ...
Journal of Pediatric Surgery 59 (5), 1009-1014 2024



Analysis of outcomes of critically ill children mechanically ventilated in a Nigerian Intensive Care Unit (ICU)
OO Oyedepo, EI Oparanozie, AA Nasir, LO Abdur-Rahman
Research Journal of Health Sciences 12 (2), 116-123 2024



Routine sterile glove and instrument change at the time of abdominal wound closure to prevent surgical site infection (ChEETAh): a model-based cost-effectiveness analysis of a
M Kachapila, R Oppong, AO Ademuyiwa, A Bhangu, R Dauda, DN Ghosh, ...
The Lancet Global Health 12 (2), e235-e242 2024



Determinants of Risk-Taking Behaviours among Road Users in Ilorin, Nigeria
GH Ibraheem, AA Nasir, CKP Ofoegbu, LO Abdur-Rahman, OM Babalola, ...
International Journal of Health Sciences 11 (2), 32-38 2023



First successfully separated set of thoraco-omphalopagus twins in Ilorin, Nigeria: A case report
LO Abdur-Rahman, TK Raji, AO Lawal, AA Nasir, OA Adesiyun, ...
Journal of Clinical Sciences 20 (4), 135-140 2023



Arise Tube-A Novel Double-Lumen Suction Tube for Oesophageal Atresia
LO Abdur-Rahman, UA Kalu, OT Sayomi, AA Nasir, JO Taiwo
African Journal of Paediatric Surgery 20 (4), 333-336 2023



The importance of post-discharge surgical site infection surveillance: an exploration of surrogate outcome validity in a global randomised controlled trial (FALCON)
JC Glasbey, B Kadir, AO Ademuyiwa, AO Adisa, A Bhangu, ...
The Lancet Global Health 11 (8), e1178-e1179 2023



Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

British Journal of Surgery 110 (7), 804-817 2023



Variation in postoperative outcomes of patients with intracranial tumors: insights from a prospective international cohort study during the COVID-19 pandemic
MTC Poon, RJ Piper, N Thango, DM Fountain, HJ Marcus, L Lippa, ...
Neuro-oncology 25 (7), 1299-1309 2023



The costs of surgical site infection after abdominal surgery in middle-income countries: Key resource use In Wound Infection (KIWI) study
M Monahan, J Glasbey, TE Roberts, S Jowett, T Pinkney, A Bhangu, ...
Journal of Hospital Infection 136, 38-44 2023



Outcomes of Gynecologic Cancer Surgery During the COVID-19 Pandemic: An International, Multicenter, Prospective CovidSurg–Gynecologic Oncology Cancer Study
C Fotopoulou, T Khan, J Bracinik, J Glasbey, N Abu-Rustum, L Chiva, ...
Obstetrical & Gynecological Survey 78 (5), 277-278 2023



Strategies to minimise and monitor biases and imbalances by arm in surgical cluster randomised trials: evidence from ChEETAh, a trial in seven low-and middle-income countries
NIHR Global Research Health Unit on Global Surgery o. omar@ bham. ac. uk
Trials 24 (1), 259 2023



Genomic analyses in African populations identify novel risk loci for cleft palate (vol 28, pg 1038, 2019)
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HUMAN MOLECULAR GENETICS 2023



Routine sterile glove and instrument change at the time of abdominal wound closure to prevent surgical site infection (ChEETAh): a pragmatic, cluster-randomised trial in seven
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MOST CITED SCHOLAR PUBLICATIONS

Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans

Journal of British Surgery 107 (11), 1440-1449 2020
Citations: 1576



Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle-and high-income countries

BJA: British Journal of Anaesthesia 117 (5), 601-609 2016
Citations: 595



Timing of surgery following SARS‐CoV‐2 infection: an international prospective cohort study
D Lobo, JM Devys
Anaesthesia 77 (1), 110 2021
Citations: 590



Motorcycle injuries in a developing country and the vulnerability of riders, passengers, and pedestrians
BA Solagberu, CKP Ofoegbu, AA Nasir, OK Ogundipe, AO Adekanye, ...
Injury prevention 12 (4), 266-268 2006
Citations: 357



Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study
J Glasbey, A Ademuyiwa, A Adisa, E AlAmeer, AP Arnaud, F Ayasra, ...
The Lancet Oncology 22 (11), 1507-1517 2021
Citations: 287



Elective cancer surgery in COVID-19–free surgical pathways during the SARS-CoV-2 pandemic: an international, multicenter, comparative cohort study
JC Glasbey, D Nepogodiev, JFF Simoes, O Omar, E Li, ML Venn, PGDME, ...
Journal of Clinical Oncology 39 (1), 66-78 2021
Citations: 275



The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis
TEF Abbott, T Ahmad, MK Phull, AJ Fowler, R Hewson, BM Biccard, ...
British journal of anaesthesia 120 (1), 146-155 2018
Citations: 179



Posterior urethral valve
AA Nasir, EA Ameh, LO Abdur-Rahman, JO Adeniran, MK Abraham
World journal of pediatrics 7, 205-216 2011
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Delaying surgery for patients with a previous SARS-CoV-2 infection

Journal of British Surgery 107 (12), e601-e602 2020
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Medical students’ perception of objective structured clinical examination: a feedback for process improvement
AA Nasir, AS Yusuf, LO Abdur-Rahman, OM Babalola, AA Adeyeye, ...
Journal of Surgical Education 71 (5), 701-706 2014
Citations: 112



SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study.
C COVIDSurg, C GlobalSurg
Anaesthesia 77 (1), 28-39 2022
Citations: 108



Pre-hospital care in Nigeria: a country without emergency medical services
BA Solagberu, CKP Ofoegbu, LO Abdur-Rahman, AO Adekanye, ...
Nigerian journal of clinical practice 12 (1) 2009
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Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic

British Journal of Surgery 108 (1), 88-96 2021
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One-stage correction of intermediate imperforate anus in males
JO Adeniran, L Abdur-Rahman
Pediatric surgery international 21, 88-90 2005
Citations: 83



Genomic analyses in African populations identify novel risk loci for cleft palate
A Butali, PA Mossey, WL Adeyemo, MA Eshete, LJJ Gowans, TD Busch, ...
Human molecular genetics 28 (6), 1038-1051 2019
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International study of the epidemiology of paediatric trauma: PAPSA research study
CJ Bradshaw, AS Bandi, Z Muktar, MA Hasan, TK Chowdhury, T Banu, ...
World journal of surgery 42, 1885-1894 2018
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Clinical spectrum of trauma at a university hospital in Nigeria
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European Journal of Trauma 28, 365-369 2002
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Association studies and direct DNA sequencing implicate genetic susceptibility loci in the etiology of nonsyndromic orofacial clefts in sub-Saharan African populations
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Journal of dental research 95 (11), 1245-1256 2016
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Reducing surgical site infections in low-income and middle-income countries (FALCON): a pragmatic, multicentre, stratified, randomised controlled trial
AO Ademuyiwa, P Hardy, E Runigamugabo, P Sodonougbo, H Behanzin, ...
The Lancet 398 (10312), 1687-1699 2021
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Outcomes from elective colorectal cancer surgery during the SARS‐CoV‐2 pandemic
COVIDSurg Collaborative, JC Glasbey, D Nepogodiev, JFF Simoes, ...
Colorectal Disease 23 (3), 732-749 2021
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