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Cross-leg flaps remain a vital reconstructive option in the management of complex lower limb injuries, particularly in settings where microsurgical techniques are unavailable or unaffordable. This systematic review evaluates the outcomes, indications, limitations, and success rates of cross-leg flap use in lower limb salvage within resource-limited settings. A comprehensive search of PubMed, Google Scholar, Scopus, ScienceDirect, and the Cochrane Library was conducted to identify studies published up to July 2025, following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Seven studies encompassing a total of 726 patients were included, comprising case reports, case series, retrospective cohorts, and systematic reviews. Trauma was the most common indication for reconstruction, and fasciocutaneous flaps were the predominant type used. External fixators were frequently employed for limb immobilization, with the average time to pedicle division ranging from 20 to 62 days, depending on flap type. Flap survival rates were consistently high across all studies, ranging from 96% to 100%, with minimal reported complications. The review highlights that cross-leg flaps offer a simple, effective, and context-appropriate solution for limb salvage in low-resource environments. Despite limitations in study design and outcome reporting, the consistency of clinical success supports the continued use and teaching of cross-leg flap techniques in global reconstructive surgery. Further prospective studies are needed to standardize outcomes and refine protocols for broader application in underserved surgical systems.

This systematic review aimed to evaluate the comparative effectiveness of alternative wound closure techniques, specifically wound tapes and tissue adhesives, versus traditional suturing in the management of traumatic lacerations in emergency departments. After screening 220 records from databases including PubMed, Cochrane CENTRAL, and Google Scholar, three randomized controlled trials met the inclusion criteria and were analyzed. Across the studies, outcomes assessed included wound closure time, infection and dehiscence rates, and cosmetic or scar-related results. The findings indicate that alternative methods such as wound tape and tissue adhesives offer similar, and in some cases improved, cosmetic outcomes and significantly reduced wound closure times compared to sutures, particularly in low-tension or facial wounds. Infection and dehiscence rates were comparable across interventions. The overall quality of the included studies was satisfactory, with two studies rated as low risk of bias. These findings suggest that in select clinical contexts, particularly where time efficiency and patient comfort are priorities, non-suture methods can be a viable alternative without compromising safety or aesthetic outcomes.

Follow-up checklists are essential tools in ensuring comprehensive patient care, promoting clear communication among healthcare professionals, and enhancing patient safety. This two-cycle clinical audit aimed to evaluate and improve the quality of follow-up checklists in Rabak Teaching Hospital by assessing adherence to standardized documentation practices based on the National Institute for Health and Care Excellence (NICE) guidelines. A retrospective and prospective observational study was conducted over two cycles, with 50 follow-up notes evaluated in each cycle. The first cycle (baseline) was conducted between June 10, 2024, and July 12, 2024, and the second cycle (re-audit) was conducted from August 13, 2024, to August 24, 2024. Data were collected using a premade questionnaire based on NICE guidelines and analyzed using quantitative and qualitative methods. The second cycle revealed significant improvements in the completeness and accuracy of follow-up documentation compared to the first cycle. Key areas such as patient history, vital signs, physical examination, and management plans showed enhanced adherence to guidelines. The findings demonstrate that structured follow-up checklists, combined with staff training and regular audits, can significantly improve documentation quality, thereby optimizing patient care. Continued re-auditing is recommended to sustain these improvements.

Background Surgical site infections (SSIs) are a critical concern in healthcare, particularly in developing countries, where they are among the most prevalent and challenging hospital-acquired infections. Adherence to proper hand hygiene practices is essential to prevent SSIs. However, compliance among surgical teams remains suboptimal due to factors such as time constraints, lack of training, and resource limitations. This study evaluates and enhances adherence to surgical hand scrubbing protocols at Osman Degna Teaching Hospital using World Health Organization (WHO) guidelines. Methods An observational cross-sectional audit was conducted in two cycles between August and October 2024, with 54 observations per cycle. Baseline adherence was assessed in the first cycle. Targeted interventions, including video demonstrations, hands-on training, and feedback, were implemented before the second cycle. Data were collected using a structured checklist and analyzed quantitatively to compare compliance rates and qualitatively to identify barriers to adherence. Results Compliance with hand scrubbing protocols improved significantly from 63.1% in the first cycle to 94.3% in the second. The most notable improvement (51.5%) was observed in rotational rubbing with clasped fingers. Other areas, including scrubbing palms and rinsing hands, showed substantial increases (30.3-42%). These findings highlight the effectiveness of structured training and feedback in enhancing adherence. Conclusion Targeted educational interventions significantly improved compliance with surgical hand scrubbing protocols, contributing to better infection control practices. While these improvements demonstrate the potential of training programs, continued efforts and long-term strategies are necessary to sustain progress and further reduce the risk of SSIs.

Crush syndrome remains a life-threatening complication of traumatic injuries, especially in mass casualty and disaster scenarios. This systematic review evaluates the current clinical and mechanistic understanding of crush-related pathophysiology, anatomical impact, and renal complications, with a focus on therapeutic interventions. Studies were selected using the PICO framework and analyzed under PRISMA guidelines. A total of six studies, including narrative reviews, clinical trials, and a systematic review, were included. Core findings highlighted ischemia-reperfusion injury, rhabdomyolysis, and ferroptosis as key drivers of systemic toxicity, often culminating in acute kidney injury (AKI). Anatomically, prolonged soft tissue compression and necrosis posed serious risks for long-term disability and systemic inflammation. Adjunctive therapies such as hyperbaric oxygen therapy (HBOT) demonstrated potential benefits in wound healing and tissue preservation, though evidence remains limited by study heterogeneity. Overall, this review offers an integrative synthesis of existing knowledge, identifies therapeutic gaps, and emphasizes the need for standardized, evidence-based protocols for managing crush syndrome.