Background: The complete lockdown in Nigeria earlier this year as a result of the COVID-19 pandemic severely disrupted surgical care and training in all ramifications as mostly, only emergency cases were seen besides COVID-19 patients. After the lockdown, and gradual introduction of out-patient and elective surgical care and other medical services, measures to prevent transmission of the virus in our daily surgical practice as well as the introduction of virtual meetings and training are some of the new normal that will remain even after the pandemic. Aim: The aim of this paper is to assess the impact of the COVID-19 pandemic on residency training in surgical specialties in Northcentral Nigeria. Methodology: The objective was achieved using an online questionnaire distributed to residency training tertiary centres in Northcentral Nigeria. Results: We found that various aspects of training were affected differently by the pandemic, with novel strategies adopted to minimize the impact. Conclusion: We conclude that although there was a reduction in core activities of surgical training, there were strategies in place to mitigate the negative impact of the pandemic by streamlining care to protect the surgical community, whilst adopting new methods to sustain learning. There is need to incorporate these new methods into mainstream surgical training in the sub-region even after this pandemic.

Aims: The COVID-19 pandemic disrupted healthcare globally and several authors have observed a change in the presentation of acute appendicitis within the period. We have observed an upsurge in the presentation of complicated appendicitis within the first 4 weeks of 2021. We aim to compare our findings with a similar period prior to the COVID-19 pandemic. Study design: Observational cohort study. Place and duration of the study: Benue State University Teaching Hospital(BSUTH), Makurdi, Nigeria. Methodology: We identified all patients that presented with appendicitis in our facility within the first four weeks of 2021 and retrieved their folders to ascertain our observation. We then retrieved the folders of patients who presented with appendicitis a year earlier when the pandemic was inexistent in our country. We compared the data between the two periods. Results: In the period of the pandemic, we found an increased presentation of acute appendicitis, with most patients presenting as complicated appendicitis. There was an increased length of time between symptom onset and presentation, increase in operating time, postoperative complications, and length of hospital stay in the index period. Conclusion: We conclude that there is an apparent increase in the presentation of complicated appendicitis with a resultant increase in post-operative complications and morbidity. However, these changes are likely a result of our response to the COVID-19 pandemic rather than the pathology of the SARS CoV-2 virus. We suggest that with the relaxation of movement restrictions and lockdowns in most places, and availability of COVID-19 vaccines, public enlightenment is necessary to encourage an early presentation of acute abdominal conditions with a view to decreasing morbidity.

Introduction Non-technical skills (NTS) like situational awareness, decision making, leadership, communication, and teamwork, are critical elements for enhancing surgical safety. In low-income contexts, NTS are often considered soft skills and therefore not included in formal medical education curriculums or continuing medical education. A survey was designed to explore exposure to NTS for interprofessional teams in North-Central Nigeria and identify perceived barriers and facilitates to surgical safety to inform the design of a contextualized curriculum. Methods Six institutions with high surgical volumes, including private not-for-profit and government-owned teaching hospitals, were purposively identified. Using snowball sampling through surgical team leads, a 19-item, web-based cross-sectional survey was distributed to 71 surgical providers, anaesthetists and perioperative nurses between August and November 2021. Data was analysed using proportions and Fisher's exact test. Results The survey had a 95.7% completion rate. Respondents included 17 anaesthetists, 21 perioperative nurses, and 29 surgeons. Over half were unaware of the concept of NTS, and 96% had never heard of a NTS framework for variable resource contexts. Only 8% had received NTS training. Communication and teamwork were considered the most deficient personal skills (38, 57%), and the most needed for team improvement (45, 67%). There was a high demand for training by all team members (64, 96%), motivated by expectations of improved patient safety and better team dynamics. Respondents preferred week-long, hybrid training courses with in-person and online components. Perceived barriers to attendance were time conflicts and costs. Perceived facilitators included a desire for self-improvement and patient safety. Conclusions Interprofessional surgical teams in the Nigerian context have a high degree of interest in NTS training, believing it can improve patient safety, team dynamics and personal performance. Implementation of NTS training programs should emphasize interprofessional communication and teamwork.

Background: Preoperative hair removal from hair bearing areas is widely practised. Razors are widely used in poor resource settings despite concerns that they may be associated with surgical wound infection. In contrast, clippers are not commonly used in this setting because they are expensive. Objective was to compare effectiveness of depilation, cost and wound infection rates following the use of razors and clippers in preoperative hair removal in clean surgical operations in a resource-poor setting.Methods: A randomized controlled study was carried out over 1 year. Surgeries were randomized into two groups who had preoperative hair removal using razors and clippers respectively. The participants were then monitored postoperatively for wound infection.Results: Seventy-nine operative sites were assigned to each group. Seventy-six (96%) and 65 (82%) operative sites in the razor-shaved and hair-clipped group respectively had complete hair removal (p=0.005). Twenty-three (29%) and 4 (5%) operative sites in the razor-shaved and hair-clipped group respectively had some degree of skin injury (p=0.000). The total rate of wound infection was 5.7%, however, 7 (8.9%) and 2 (2.5%) operative sites in the razor-shaved and hair-clipped groups respectively were infected (p=0.167). The mean cost incurred in the razor-shaved and hair-clipped group was approximately N587±1,644.60 and N 1,272±883.46 respectively (p=0.001). Conclusions: Though razors provided more effective depilation, they caused more surface abrasions and were associated with more wound infections, though not statistically significant. Clippers are however associated with greater cost and this could be a major constraint where resources are limited.