‘Impact of a Regional Damage Control Surgery Pathway on Time to Surgery for Neonates with Severe Necrotising Enterocolitis. A prospective cohort study.’

jpedsurg.org

In the UK, published time from diagnosis of perforation to surgery for babies with Necrotising Enterocolitis (NEC) was 23·5 hours. We aimed to determine if a standardised regional referral pathway, combined with a damage control surgical approach (DCS) could reduce timings associated with referral to first surgical intervention.

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Article · Sep 2025 · 1 min read

In brief

This prospective cohort study evaluates whether implementing a standardised regional referral pathway combined with damage control surgery can reduce the time from diagnosis to surgical intervention in neonates with perforated necrotising enterocolitis, addressing the baseline 23.5-hour delay documented in UK practice.

UK baseline: median 23.5 hours from NEC perforation diagnosis to surgery—a critical delay for unstable neonates.
Standardized regional referral pathways can streamline transfer logistics and reduce time to surgical intervention.
Damage control surgery (DCS) approach prioritizes rapid initial intervention over definitive repair in unstable NEC patients.
Reducing time to surgery in perforated NEC may improve outcomes by limiting peritoneal contamination and hemodynamic compromise.
Regional coordination between NICUs and pediatric surgery centers is essential for timely NEC management.

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