GSU - Surgeons

CHEETAH Discussed on the BBC

Lead NIHR Clinician Scientist for the Global Health Research Unit on Global Surgery discusses new evidence from recently completed CHEETAH trial

As part of the ongoing promotion for the recently completed CHEETAH trial, Co-Author Aneel Bhangu joined the BBC recently to discuss various aspects of the trial such as why the seemingly simple procedure of using surgical gloves during operations has been proven to dramatically reduce mortality rates through infection across Low- and Middle-Income Countries (LMICs).

The recording below gives further insight into the reasoning behind the GSU's undertaking of this global trial and the next steps for the dissemination of the trial results, including how the team plan to use the results to help change surgical policy on a global scale.

Aneel Bhangu joins the BBC live on the 23rd November 2022.

COVIDSurg Surgical Preparedness Index (SPI) webinar

Discussion on how the new SPI tool can help reduce elective surgery cancellations this winter

Thank you to every who contributed to the Surgical Preparedness Index (SPI) study, which assessed hospitals and surgical volume for over 1600 centres in 119 countries. Congratulations to the network on the recent publication of this work in The Lancet.

We are delighted to announce our network CovidSurg webinar in our IRCAD/Medtronic series, where we will discuss how the SPI tool can now be applied to your hospital.

Join us as we dig deeper to explore:

  • Why every surgeon and anaesthetist should care about surgical preparedness?
  • How and when should I measure the SPI in my hospital?
  • How can the SPI be implemented to reduce cancellations of planned surgery?
  • Who else needs to be involved to maximise impact?
  • Which hospitals and settings could benefit the most?

This will be a unique, first global discussion of the SPI data and its impact on practice from a multidisciplinary panel - don't miss it!

The webinar will be on Monday 28th November 2022

Time: 1900 BST (UK) | 1100 Los Angeles | 1400 New York | 1500 Brasilia | 2000 CET | 2100 Riyadh

You can register for the webinar here.


GSU India Prioritisation Event - an overview of CEI training in Ludhiana

GSU Community Engagement and Involvement (CEI) training and consultation session at CMC Ludhiana, India

The NIHR Global Health Research Unit on Global Surgery (GSU) recently held its first international prioritisation event since the beginning of the pandemic in India, with various meetings taking place in New Delhi, Ludhiana and Kolkata.

Our first overview of the activities that took place focuses on the CEI training session and public consultation at Christian Medical College Ludhiana, India on 29th September 2022.

The training was attended by surgeons, medical students and community health workers with the aim of teaching the fundamentals of CEI and its implementation in research. CEI is a way of collaboratively working with communities who are most likely affected by research outcomes. This includes getting the perspectives of patient, carers and community leaders about the acceptability of a study and strategies to implementing and disseminating findings of completed research.

Following the training, patients and carers joined the group for a consultation on the acceptability of TIGER- a proposed trial that aims to increase access to inguinal hernia surgeries among patients in low and middle-income countries. GSU had done initial work with patients in Ghana but wanted to find out TIGER’s acceptability in the Punjab region.

CEI is an important priority of the Unit and is integrated in all stages of the research it leads. On the 27th of September, leads from GSU Hubs attended a meeting in New Delhi to discuss, among other things, future directions for CEI including a community co-developed patient survey on surgical site infections.

Two new GSU papers in The Lancet will help guide future surgical procedures globally

The Lancet recently published two papers from the completed ChEETAh trial that will help provide safer surgery for elective waiting lists on a global scale

The NIHR Global Health Research Unit on Global Surgery (GSU) team responsible for the completion of the recent ground-breaking ChEETAh trial have unveiled their findings through two recent publications in The Lancet that will benefit elective patients across the globe, particularly surgical patients in Low - and Middle - income Countries (LMIC).

The research team behind the trial found that the routine changing of gloves and instruments just before closing wounds could significantly reduce Surgical Site Infection (SSI) - a leading cause of postoperative complications that arise during surgery. In addition, a new System Preparedness Index (SPI) toolkit was tested that can make hospitals better prepared for various scenarios that could negatively impact on surgical procedures such as pandemics and natural disasters.

You can view the official press release here.

You can also view the trial page here.


GSU at HSR 2022- Global Symposium in Bogota, Colombia

Health Systems Global - GSU feature in the line-up for the Seventh Global Symposium in Bogota, Colombia

The Seventh Global Symposium on Health Systems Research (HSR2022) will take place in Bogota, Colombia from October 31 – November 4, 2022, bringing together approximately 2,000 health systems researchers, policymakers and practitioners from around the world.  HSR 2022. will be a hybrid event.

Date: Monday October 31st - Friday 4th November 2022

The NIHR Global Health Research Unit on Global Surgery will be orchestrating the following workshop during the event:

'Addressing the challenges of delivering effective surgery care throughout health policy and systems research'

Date: Tuesday 1st November

Time: 12:30 - 16:00 (COT) 17:30 - 21:00 (GMT)

You can view the agenda here.

Online registration for the Symposium can be done here. Deadline for registration is Sunday 30th October.

COVIDSurg-3 results webinar

Results from the latest dataset to be discussed this Thursday 20th October

Thank you to everyone who contributed to the CovidSurg-3 study. Outcomes data for almost 20,000 patients with perioperative SARS-CoV-2 infection has now been collected, across 937 hospitals in 89 countries.

The results have been analysed and the team responsible for the pioneering study would like to invite you to their webinar where CovidSurg-3 results will be released for the first time where they will explore:

  • Is surgery safe in the Omicron-era?
  • Does SARS-CoV-2 vaccination reduce patient risk?
  • Do patients who test positive for SARS-CoV-2 need to be delayed before surgery?
  • Can we relax COVID restrictions and increase surgical volume?

The webinar will be on Thursday 20 October 2022.
Time: 1100 Los Angeles | 1400 New York | 1500 Brasilia | 1900 BST (UK) | 2000 CET | 2100 Riyadh

You can register for the webinar here.

GSU Birmingham Team visits Rwanda Hub for SIV, Monitoring and CEI

University of Birmingham colleagues visit Rwanda for the launch of ProtectSurg and Community Engagement activities


Members of the Global Surgery Unit (GSU) of the University of Birmingham visited the GSU Rwanda Hub (hosted at the University of Rwanda) from 19-22 July 2022 for the ProtectSurg site initiation visit and monitoring training and Community Engagement and Involvement (CEI) training and activities. The team also spoke during the 1st University Research Open Day where they spoke about GSU’s recently-concluded trials FALCON and CHEETAH


ProtectSurg is a platform trial that aims to test an inhaled drug that aims to test an inhaled drug that may prevent pulmonary complications such as pneumonia and flu following surgery. FALCON, on the other hand, tested the effectiveness of alcoholic chlorhexidine versus povidone-iodine for skin preparation and the use of antibiotic-coated sutures for surgery to prevent surgical site infections (SSIs). Finally, CHEETAH aimed to look at the impact of changing gloves and instruments before wound closure in preventing SSIs.


The Birmingham team also visited Kibogora Hospital- one of the research spoke sites of the Rwanda Hub where training on ProtectSurg was also done. In addition, selected Community Health Workers (CHWs) in the district were invited to a CEI activity where their awareness and views on research were obtained. The CHWs were also asked about their knowledge of post-surgical care and what sort of training they would need to better support the villages they serve.


The visiting Birmingham team comprised Rachel Lillywhite- Trials Management Team Leader, Donna Smith- Senior Trial Manager and Michael Bahrami-Hessari- Community Engagement and Involvement Manager.

Recent GSU event hosted through Nigeria Hub discusses GlobalSurg 1 ouctome

Surgical experts call for improved efficiencies through increased cross-functional collaboration and partnership in Nigeria

A recent dissemination and engagement event that took place in Nigeria through the GSU's national hub, based in Lagos, looked at various outcomes associated with the GlobalSurg Unit 1 Studies.

The event was held in Ikoyi, Lagos state and was attended by a multitude of academics, clinicians, government bodies and policy makers who all listened to a variety of presentations from colleagues across the GSU network.

You can read the in-depth report from our Nigeria Hub here.

You can also find out more about the Nigeria Team by clicking here.

Further information on GlobalSurg 1 can be found here.

GlobalSurg 3 publication in The Lancet looks at role of hospital facilities in determining patient outcomes

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Early death following cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries. Despite this, little research exists on the relationship between hospital facilities and early postoperative outcomes.

A recent study co-ordinated within the NIHR Global Surgery Unit and resulting publication in The Lancet looks at this relationship and argues that for every 100 cancer operations, one to three early surgical deaths could be saved with improvements to hospital resources worldwide.

The manuscript containing further information can be accessed here.

More information on GlobalSurg 3 can be accessed here.


New GSU publication in The Lancet looks into surgical site infection (SSI) reductions

Alcoholic chlorhexidine skin preparation or triclosan-coated sutures to reduce surgical site infection: a systematic review and meta-analysis of high-quality randomised controlled trials

Surgical site infection (SSI) is the most common complication after surgery worldwide, affecting up to one in five patients across all surgical specialties.

A new meta-analysis, orchestrated by the NIHR Global Surgery Unit has shown that contrary to previous meta-analyses conducted on this subject, no benefit was shown from using alcoholic chlorhexidine skin preparation or triclosan-coated sutures, both of which are more expensive than other readily available alternatives.

The meta-analysis argues for the reconsideration and potential removal of recommendations (both national and global guidance) of routine use of such procedures for the purpose of reducing SSIs.

The manuscript containing further information can be accessed here.