Risk management in pediatric surgery

Girolamo Mattioli, Stefano Avanzini, Alessio Pini-Prato, Piero Buffa, Edoardo Guida, Giovanni Rapuzzi, Michele Torre, Valentina Rossi, Giovanni Montobbio, Ubaldo Rosati, Vincenzo Jasonni

Research output: Contribution to journalArticlepeer-review


Purpose: To present the experience documented over 1 year of analysis and quality control on surgical complications and organizational accidents. Methods: All children admitted during the study period at our Institution were included in the analysis, which consisted of four phases: (1) definition and standardization of perioperative diagnostic and therapeutic tracks; (2) staff education; (3) documentation and data implementation, and (4) "Morbidity and Mortality" audit. Results: Over a 1-year study period, 3,116 children were admitted to our Institution: 2,222 out of 3,116 (71.3%) children underwent a surgical procedure. A total number of 184 complications were recorded in 149 patients. One hundred and seventy-one (92.9%) complications occurred following a surgical procedure. Fifty-six out of 149 complicated patients (37.6%) required a re-operation. Thirty-five out of 184 (19%) complications were classified as organizational. Infection represented the most common complication. All cases of anastomotic dehiscence and perforation, bowel obstruction, and stoma malfunction required reintervention. None of the postoperative bleedings required a second surgical procedure. Conclusion: Although a proper statistical comparison with literature complication rates is not feasible, our experience confirms the importance of quality-control audit in health care systems. Prolonged observation, long-term follow up, and comparison with previous results will represent our future goal.

Original languageEnglish
Pages (from-to)683-690
Number of pages8
JournalPediatric Surgery International
Issue number8
Publication statusPublished - Aug 2009


  • Adverse event
  • Audit
  • Incident reporting
  • Quality of care
  • Risk management

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

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