The aim of this work is to identify the underlying factors of infections in surgical wounds, as well as injury to the femoral nerve and spleen. Medical literature dating between the years 2000 and 2013 was reviewed using PubMed's electronic service. The structure and shape of semi-automatic retractors used for abdominal surgical procedures were studied. The results we obtained showed that the etiology of infection in surgical wounds and injury to the femoral nerve and spleen are due to semi-automatic retractors. We conclude that prophylactic antibiotic therapy is not sufficient in eradicating these surgical wound infections or injury to the femoral nerve and spleen. This reorganization was based on the Institute of Medicine's (IOM) 2010 analysis of NCI clinical research. This report was highly critical of the inefficiency of the process by which the cooperative groups carry out their trials. Historically, relatively few U.S. oncologists have even participated in clinical research, mostly from academic institutions. Community oncologists, who see the great majority of American cancer patients, have generally been reluctant to participate in federal clinical research due to the bureaucratic burden and low reimbursement. As a result, more than half of the trials initiated by the NCI's cooperative groups do not meet their accrual goals and are closed, generating no data. Further, the attendant bureaucracy ensures that each new Phase III trial startup costs well over a million dollars, which becomes a total loss when a trial closes early. The IOM made a number of recommendations for improving and streamlining that process, including the consolidation of the groups.
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