title: In-situ emergency pediatric surgery in the intensive care unit.
abstract: BACKGROUND
  The role of surgery in the intensive care unit (ICU) remains unclear. Although previous studies have not shown any increase in morbidity when operating on patients in the ICU for surgical procedures; there remains a reluctance to operate on sick patients in the ICU.
  
  
  OBJECTIVE
  We did a retrospective study of critically ill children and neonates who underwent in-situ surgery (ISS) to further evaluate its safety and potential. Surgery was aided with the use of operative loupes and high-intensity headlight.
  
  
  METHODS
  The medical records of all patients who had undergone surgical procedures in the pediatric ICU over an 11-year period from January 1998 till December 2008 were retrospectively reviewed. We reviewed our experience looking specifically at wound infection rates along with other morbidities in 543 patients.
  
  
  RESULTS
  Our morbidities were comparable with that of operations performed in the operating theater, with low wound infection rates (1%) for all surgeries undertaken in the pediatric ICU.
  
  
  CONCLUSIONS
  ISS avoids the risks of transfer to the operative theater and the potential delays in theater access. Our results suggest that ISS in a tertiary-level pediatric surgical hospital is safe and does not impact adversely on clinical outcome.
authors.affiliation: Division of Pediatric Surgery, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland. alaaghallab1969@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Ghallab
authors.forename: Y
authors.initials: Y
authors.lastname: El-Gohary
authors.forename: M
authors.initials: M
authors.lastname: Redmond
authors.forename: M
authors.initials: M
authors.lastname: Corbally
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D004630:Emergencies / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D019616:Thoracic Surgical Procedures / Q000706:statistics & numerical data