Use of WHO Surgical Safety Checklist for Gynaecological Surgeries in a Tertiary Care Hospital, Karachi, Sindh, Pakistan

Abstract

Background: Surgical errors and adverse events contribute significantly to morbidity and mortality worldwide, with complication rates reaching up to 18% in Pakistan. The World Health Organization (WHO) Surgical Safety Checklist (SSC) has been shown internationally to reduce perioperative complications, but its routine use in gynaecological surgeries in Pakistan remains inconsistent. Objective: To report a six-month experience of applying the WHO SSC in elective gynaecological surgeries at a tertiary care hospital in Karachi and describe its impact on patient outcomes. Methods: This observational descriptive study was conducted from December 2024 to May 2025 in the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre, Karachi. A total of 140 women aged 15–60 years undergoing elective gynaecological surgeries, including hysterectomy, laparoscopy, laparotomy, staging laparotomy, and debulking procedures, were enrolled. The WHO SSC was applied in all cases. Data on demographic characteristics, surgical procedures, checklist compliance, complications (graded by Clavien–Dindo), hospital stay, and patient satisfaction were collected prospectively and summarized with descriptive statistics and 95% confidence intervals. Results: Checklist compliance was high, with full three-phase completion in 95.0% of surgeries. Minor complications occurred in 12 patients (8.6%), including Grade I (5.7%) and Grade II (2.9%) events. No Grade III–V complications, reoperations, disability, or mortality were reported. The mean hospital stay was 3.4 ± 1.2 days, and readmissions occurred in 2 patients (1.4%). Patient satisfaction was high, with a mean score of 8.8 ± 0.9 on a 10-point scale. Conclusion: Implementation of the WHO Surgical Safety Checklist in elective gynaecological surgeries was feasible, achieved high compliance, and was associated with low complication rates, short hospital stays, and favorable patient satisfaction. Routine use of the SSC may help reduce preventable adverse events and align surgical safety in Pakistan with international standards.