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Checklist reduces surgical complications

Last changed: 14 October 2016

The objective of the present study was to examine whether the use of a surgical safety checklist (SSC) could reduce the incidence of complications after small animal surgery.

Study design

Prospective clinical study.


Client-owned dogs and cats (n = 520).


Consecutive cases were enrolled in the study, the first 300 cases without implementation of the surgical checklist (SSC-), followed by 220 cases with implementation of the checklist (SSC+). The checklist was adapted from the WHO surgical checklist and consisted of three different check points: (1) before induction of anaesthesia (sign in), (2) before surgical incision (time out), and (3) before recovery (sign out). In-hospital outcomes were prospectively recorded, and complications within 6 weeks were retrospectively recorded by reviewing medical records and by telephone interviews with owners. The severity of each recorded complication was graded as minor, moderate, or severe. Comparisons were made between SSC- and SSC+ outcomes.


There were significantly more complications in SSC- animals than SSC+ animals (SSC- 52/300 vs. SSC+ 15/220, P = .0003). There was a significantly higher frequency of SSI (P = .045) and wound healing complications (P = .0006) for SSC- animals than SSC+ animals.


The frequency and severity of postoperative complications was significantly decreased after introduction of a surgical checklist. All veterinary hospitals should consider using a surgical checklist. Compliance with implementation of the checklist is important for success.

Link to the article

Reduction of Surgical Complications in Dogs and Cats by the Use of a Surgical Safety Checklist, Annika Bergstrom, Maria Dimopoulou, and Mikaela Eldh, Vet Surg. 2016 Jul;45(5):571-6. doi: 10.1111/vsu.12482.


Annika Bergström
Senior Lecturer at the Department of Clinical Sciences; Small Animal Unit                                                        

Telephone: 018-672680