surgery

AAP Adds 5 Surgical Recommendations to Choosing Wisely Campaign

The American Academy of Pediatrics has released 5 surgical practices that physicians and patients should question as part of the Choosing Wisely campaign.

The list was created by members of the group’s Section on Surgery Subcommittee on Education and Delivery of Surgical Care. The list was based upon a literature review and on expert opinion, and was approved by more than a dozen committees, councils, and sections.

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This list includes:

  • Whole-body computed tomography (CT) scanning (pan-scanning) should be avoided in pediatric trauma patients.
  • CT scan should not be used as a first-line imaging modality in the evaluation of suspected appendicitis. Rather, ultrasound should be conducted first.
  • Fundoplications should not be performed during gastrostomy insertion in most children who are otherwise thriving with gastric feedings.
  • Most children with umbilical hernias should not be referred to a pediatric surgeon until around aged 4 to 5 years.
  • Acetaminophen and/or non-steroidal anti-inflammatory medications should be used to reduce post-operative opioid requirements in pediatric patients.

—Michael Potts

Reference:

American Academy of Pediatrics – section on surgery. Choosing Wisely. http://www.choosingwisely.org/societies/american-academy-of-pediatrics-section-on-surgery/. Published November 4, 2019. Accessed November 7, 2019.