Ciencia y Educación

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OPTIMIZACIÓN DE LA ATENCIÓN QUIRÚRGICA Y PERIOPERATORIA EN CIRUGÍA

GENERAL, ANESTESIOLOGÍA Y TRAUMA

OPTIMIZING SURGICAL AND PERIOPERATIVE CARE IN GENERAL SURGERY,

ANESTHESIOLOGY, AND TRAUMA

Autores: ¹Dayana Carolina Carrión Prado y

Paul Alexander Orellana Añazco.

¹ORCID ID: https://orcid.org/0009-0009-1329-9797

ORCID ID: https://orcid.org/0009-0000-3438-7272

¹E-mail de contacto: dayanacarrionm@gmail.com

E-mail de contacto: lmartinap2006@gmail.com

Afiliación: ¹Universidad Internacional De La Rioja, (España).

Pontificia Universidad Católica del Ecuador, sede Ibarra, (Ecuador).

Artículo recibido: 1 de Octubre del 2026.

Artículo revisado: 12 de Octubre del 2026.

Artículo aprobado: 12 de Octubre del 2026.

¹Médica general, graduada de la Universidad Técnica de Machala, (Ecuador). Maestrante en Docencia Superior Universitaria en la

Universidad Internacional de La Rioja, (España).

Tecnólogo Superior Universitario en Emergencias Médicas, (Ecuador).

Resumen

El objetivo de esta investigación fue analizar la

evidencia científica sobre la optimización de la

atención quirúrgica y perioperatoria, con

énfasis en cirugía general, anestesiología y

trauma. Se adoptó un enfoque cualitativo y

descriptivo mediante una revisión bibliográfica

de artículos científicos disponibles en Scopus,

PubMed, Springer, ProQuest y SciELO. La

estrategia de búsqueda utilizó los operadores

booleanos AND y OR. Los hallazgos

mostraron una evolución significativa de las

estrategias de optimización, especialmente de

los protocolos de recuperación mejorada

después de la cirugía, que combinan

innovación tecnológica y atención centrada en

el paciente. La profilaxis de infecciones, el

manejo multimodal del dolor y la

prehabilitación contribuyeron a reducir

complicaciones y mejorar la recuperación

funcional. Sin embargo, la heterogeneidad de la

implementación y la disponibilidad limitada de

recursos restringen su aplicación universal. La

integración de herramientas digitales y la

optimización de la gestión hospitalaria

representan componentes relevantes para

mejorar la eficiencia quirúrgica y ofrecer una

atención más segura y personalizada. En

conjunto, los estudios revisados indican que la

optimización perioperatoria puede mejorar los

resultados clínicos, mediante la reducción de la

estancia hospitalaria, las complicaciones y los

reingresos, y favorecer la eficiencia de los

sistemas sanitarios mediante un uso más

adecuado de los recursos. Se concluye que su

implementación requiere protocolos

actualizados y una transformación hacia una

atención quirúrgica integral, personalizada y

colaborativa.

Palabras clave: Optimización, Atención

quirúrgica, Atención perioperatoria,

Cirugía general, Cirugía de trauma,

Anestesiología.

Abstract

The aim of this research was to analyze

scientific evidence on the optimization of

surgical and perioperative care, with a focus on

the fields of general surgery, anesthesiology,

and trauma. A qualitative and descriptive

approach was adopted through a literature

review of scientific articles in databases such as

Scopus, PubMed, Springer, ProQuest, and

SciELO. Boolean operators "AND" and "OR"

were used as the search strategy. The findings

revealed that the optimization of surgical and

perioperative care has evolved significantly

through strategies such as enhanced recovery

after surgery protocols, which enhance

postoperative recovery through a combination

of technological innovation and patient-

centered care. Infection prophylaxis,

multimodal pain management, and

prehabilitation have been shown to reduce

complications and improve functional recovery.

However, heterogeneity in implementation and

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limited resource availability restrict their

universal application. The integration of digital

tools and the optimization of hospital

management are key to improving surgical

efficiency and ensuring safer, more

personalized care. Overall, the studies show that

perioperative optimization not only improves

clinical outcomes—such as reduced hospital

stays, complications, and readmissions—but

also enhances health system efficiency by

lowering costs and optimizing resources. This

requires not only the application of updated

protocols but also a cultural shift towards more

personalized, comprehensive, and collaborative

surgical care.

Keywords: Optimization, Surgical care,

Perioperative care, General surgery,

Trauma surgery, Anesthesiology.

Sumário

O objetivo desta pesquisa foi analisar as

evidências científicas sobre a otimização da

assistência cirúrgica e perioperatória, com

ênfase em cirurgia geral, anestesiologia e

trauma. Adotou-se uma abordagem qualitativa

e descritiva mediante revisão bibliográfica de

artigos científicos disponíveis nas bases

Scopus, PubMed, Springer, ProQuest e

SciELO. A estratégia de busca utilizou os

operadores booleanos AND e OR. Os

resultados mostraram uma evolução

significativa das estratégias de otimização,

especialmente dos protocolos de recuperação

melhorada após a cirurgia, que combinam

inovação tecnológica e cuidado centrado no

paciente. A profilaxia de infecções, o manejo

multimodal da dor e a pré-habilitação

contribuíram para reduzir complicações e

melhorar a recuperação funcional. Entretanto, a

heterogeneidade da implementação e a

disponibilidade limitada de recursos restringem

sua aplicação universal. A integração de

ferramentas digitais e a otimização da gestão

hospitalar constituem componentes relevantes

para melhorar a eficiência cirúrgica e oferecer

cuidados mais seguros e personalizados. Em

conjunto, os estudos revisados indicam que a

otimização perioperatória pode melhorar os

resultados clínicos, mediante a redução do

tempo de internação, das complicações e das

readmissões, e favorecer a eficiência dos

sistemas de saúde por meio do uso mais

adequado dos recursos. Conclui-se que sua

implementação exige protocolos atualizados e

uma transformação em direção a uma

assistência cirúrgica integral, personalizada e

colaborativa.

Palavras-chave: Otimização, Assistência

cirúrgica, Assistência perioperatória,

Cirurgia geral, Cirurgia de trauma,

Anestesiologia.

Introduction

The goal of every medical team has always been

to achieve optimal perioperative recovery, with

fewer complications and benefiting the greatest

number of patients. However, despite advances

in surgical and anesthetic techniques, many

patients still face an exaggerated metabolic and

inflammatory response after major procedures,

which increases the risk of complications,

prolongs hospitalization, and affects functional

recovery (Loughlin et al., 2021). Therefore,

perioperative assessment aims to evaluate the

patient’s health status and their ability to

tolerate the surgical procedure, with the goal of

minimizing risks related both to anesthesia and

the surgical intervention itself (Hübner et al.,

2020).

According to Álvarez et al. (2023),

approximately 234 million major surgeries are

performed worldwide each year. However,

postoperative outcomes do not always meet

expectations. Depending on the country and

institution, up to 4% of patients may die before

hospital discharge, up to 15% may experience

severe postoperative morbidity, and between

5% and 15% could be readmitted within 30

days. These percentages correspond to roughly

1,000 deaths and 4,000 major complications

each hour, highlighting the magnitude of the

problem and estimating that about 50% of these

complications could be preventable,

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emphasizing the urgent need to optimize

surgical and perioperative care.

According to Fehlmann et al. (2022), general

surgeries carry various risks that can affect

patient recovery and prognosis. These include

mortality at different time points—within the

first 30 days, at 90 days, or up to one year after

the procedure. Additionally, major

postoperative complications may compromise

the patient’s progress. The length of hospital

stay is another factor, which can be extended

depending on the severity of the case and

postoperative recovery. These risks underscore

the importance of implementing safety

measures and proper protocols to improve

surgical outcomes.

Pico-Camacho and Vega (2023) discuss

surgical risk and its distorted perception, which

represents a key challenge in optimizing

surgical and perioperative care. A lack of proper

understanding of these risks can adversely

affect decision-making, preoperative

preparation, and adherence to postoperative

recommendations, directly influencing clinical

outcomes. In the context of a comprehensive

review of general surgery, anesthesiology, and

trauma, it is essential to address strategies to

improve risk communication, reduce cognitive

and emotional biases, and strengthen patient

and medical team education.

From another perspective, Guerrero Rodríguez

et al. (2023) affirm that intra- and postoperative

mortality is closely related to the presence of the

lethal triad, consisting of acidosis, hypothermia,

and coagulopathy. The interaction of these three

factors creates a vicious cycle that increases the

risk of uncontrollable bleeding and serious

complications, making their timely

management crucial for optimizing

perioperative and surgical care. For this reason,

collaboration among surgeons,

anesthesiologists, and support staff is essential

to detect potential risks, prevent complications,

and ensure effective transition between the

different phases of the surgical process.

On another note, Luna-Ortiz et al. (2024)

explain in their research that oxidative stress

(OS) and the perioperative complications

arising from it pose a critical challenge in

optimizing surgical and perioperative care. This

phenomenon, triggered by surgical trauma and

inflammatory imbalance, can worsen

postoperative complications, especially in high-

risk patients. Proper management of OS,

through anesthetic strategies and antioxidant

therapies, is vital to improve patient outcomes

throughout the perioperative process.

Thus, at the intersection of general surgery,

anesthesiology, and trauma, a comprehensive

approach and collaboration among these fields

are essential to effectively manage oxidative

stress and other perioperative complications.

Optimization of surgical and anesthetic

procedures should focus not only on surgical

technique but also on prevention and

management of factors that could compromise

patient safety, such as OS. Reviewing current

practices and implementing new strategies to

reduce complications caused by OS will

significantly contribute to improving

perioperative care in general surgery,

anesthesiology, and trauma (Harrison, 2023;

Hübner et al., 2020).

It is important to highlight that surgical and

perioperative care represents a critical aspect of

modern medicine, involving multiple

disciplines and requiring a comprehensive

approach to ensure patient safety and well-

being. In this context, medical teams must work

together to address the various challenges that

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arise before, during, and after a surgical

procedure (García Ríos et al., 2024).

Optimizing care during these critical moments

not only improves clinical outcomes but also

reduces complications, shortens recovery times,

and minimizes costs associated with prolonged

treatments or reinterventions (Köhnenkampf &

Maldonado, 2019).

Based on the above, this study aims to analyze

scientific evidence regarding the optimization

of surgical and perioperative care, focusing on

general surgery, anesthesiology, and trauma. By

reviewing previous studies, it seeks to identify

the most effective approaches and best practices

in surgical and perioperative management.

Providing a detailed review of current practices

and exploring new management strategies, this

work intends to improve the quality of surgical

care, decrease complications before, during,

and after the medical process, and ultimately

enhance clinical outcomes and patients’ quality

of life.

Materials and Methods

This research adopted a qualitative and

descriptive approach, which allowed for an in-

depth exploration of existing studies by

analyzing their characteristics and results

without directly intervening in the phenomena

studied. The qualitative approach facilitated a

thorough interpretation of the various practices

and approaches used in general surgery,

anesthesiology, and trauma, while the

descriptive approach aimed to organize and

present the collected information clearly and

comprehensively, providing an overall and

detailed view of the findings from the reviewed

studies. A bibliographic search was conducted

using scientific articles from databases such as

Scopus, PubMed, Springer, ProQuest, and

SciELO. The search strategy employed Boolean

operators "AND" and "OR" to maximize the

number of relevant articles prior to exclusion.

The search string used was:

((Optimization AND Surgical Assistance OR

Perioperative Care AND General Surgery OR

Trauma Surgery));

((Perioperative Care OR Surgical Care AND

General Surgery OR Trauma Surgery OR

Anesthesiology));

((Surgical Care AND Perioperative Care AND

Anesthesia AND General Surgery)).

The selection process was conducted following

the PRISMA statement. Using PRISMA

provided a clear structure for each stage of the

process, from the identification and screening of

relevant studies to the synthesis and

presentation of results (see Figure 1). Studies

included in this systematic review were

published between 2020 and 2025, available in

both English and Spanish, and focused on the

optimization of surgical and perioperative care,

with a particular emphasis on general surgery,

trauma surgery, and anesthesiology. The

selected studies consisted of primary research,

systematic reviews, meta-analyses,

observational studies, and descriptive research

providing evidence on best practices,

interventions, and outcomes related to

perioperative care, surgical management, and

anesthetic practices. Complete access articles

were prioritized for inclusion. Studies were

excluded if they were published outside the

2020-2025 window, unavailable in English or

Spanish, or focused solely on surgical

procedures not related to general surgery,

trauma, or anesthesiology, or did not address

aspects of surgical and perioperative care.

Publications with inaccessible information or

those not meeting the methodological quality

standards for this review—such as opinion

articles, conference abstracts, or case studies

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lacking a sufficiently representative sample—

were also excluded.

Data analysis employed the narrative synthesis

method due to the diversity and heterogeneity

of available research on optimizing surgical and

perioperative care. The reviewed studies

covered different technical perspectives and

applied contexts within general surgery,

anesthesiology, and trauma surgery. This

method enabled thorough identification,

organization, and contextualization of the main

practices and strategies for optimization,

highlighting common patterns, discrepancies,

and emerging themes in improving safety and

effectiveness in perioperative care.

The study selection process for the review

began with the identification of 50 records in

the databases. Of these, 7 were removed due to

duplication prior to screening. Next, 43 records

were examined, of which 5 were excluded for

not meeting the initial criteria. Subsequently, 38

studies were evaluated for eligibility, resulting

in the exclusion of 23: 5 due to age, 4 because

of language other than Spanish or English, 8 for

lack of relevance to the topic, and 6 due to

restricted access to the full text. Finally, 15

studies were included in the review, focusing on

the optimization of surgical and perioperative

care across key areas such as general surgery,

anesthesiology, and trauma.

Figure 1. PRISMA flow diagram

Source: Authors’ elaboration.

Results and Discussion

The 15 included studies are presented in Table

1, which summarizes their authors, objectives,

methodological approaches, and principal

findings.

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Table 1. Surgical and perioperative care in general surgery, anesthesiology, and trauma

Author(s),

Year

Title

Methods

Results

Velázquez

Gutiérrez &

Vargas Useche

(2021)

Enhanced Recovery After

Surgery: A Paradigm

Shift in Perioperative

Care

Systematic

Review

Velázquez and Vargas discuss ERAS (Enhanced Recovery After Surgery) protocols, which represent a groundbreaking innovation

in contemporary surgical medicine. They are characterized by integrating three essential elements: technological innovation,

advanced physiological understanding, and a humanized, patient-centered approach. The core of these protocols relies on

meticulous nutritional and physiological management, such as early feeding, precise fluid control, and comprehensive metabolic

care. Scientific evidence supports interventions like early oral feeding, which not only ensures safety but also significantly

accelerates recovery (Velázquez Gutiérrez & Vargas Useche, 2021).

Scott et al.

(2023)

Consensus Guidelines for

Perioperative Care for

Emergency Laparotomy:

Recommendations Part

2—Intra- and

Postoperative Care

Systematic

Review

Scott et al. emphasize that perioperative practices such as antibiotic administration, proper cutaneous antisepsis, use of fascial

wound protectors, and glove changes during abdominal closure are recommended to significantly reduce infection risk. Antibiotic

prophylaxis given within 60 minutes before incision has proven effective in decreasing postoperative infections, especially in

emergency abdominal surgeries. Additionally, practices like glove changes and the use of new instruments after abdominal

irrigation, as recommended by the American College of Surgeons, are effective in reducing surgical site infections (SSIs). These

strategies, incorporated into perioperative optimization packages, contribute to enhanced patient safety, reduced complications, and

promote faster, safer recovery (Scott et al., 2023).

Ceresoli,

Braga, et al.

(2023)

Enhanced Perioperative

Care in Emergency

General Surgery: The

WSES Position Paper

Literature

Review

Ceresoli et al. show that perioperative care in general surgery, especially during emergency procedures, focuses on optimizing

patient recovery and minimizing postoperative risks. They recommend a multimodal approach for preventing postoperative nausea

and vomiting (PONV), including using antiemetic medications such as dopamine and serotonin antagonists, and anesthesia that

minimizes opioid and volatile anesthetic use. Monitoring anesthesia depth and neuromuscular blockade is essential to prevent side

effects like postoperative delirium and morbidity associated with residual neuromuscular blockade. Multimodal analgesia,

combining systemic and regional approaches, is key to pain control and reducing opioid dependence, thereby improving recovery

and decreasing complication risks (Ceresoli, Braga, et al., 2023).

Ceresoli,

Biloslavo, et al.

(2023)

Implementing Enhanced

Perioperative Care in

Emergency General

Surgery: A Prospective

Multicenter

Observational Study

Descriptive and

observational

study

This study revealed notable adherence to recovery milestones in the early postoperative days: the first day for nasogastric tube

removal, the second for mobilization and urinary catheter removal, and the third for oral feeding and discontinuation of IV fluids.

These accelerated protocols fostered faster recovery, especially in patients undergoing laparoscopic surgery, who showed earlier

improvements compared to open surgery. However, factors such as preoperative hyperglycemia, fluid overload, abdominal

drainage, surgical duration, and major morbidity were associated with delayed recovery, underscoring the importance of optimizing

perioperative management to minimize these risks and promote efficient recovery (Ceresoli, Biloslavo, et al., 2023).

Mihalj et al.

(2022)

Managing Bottlenecks in

the Perioperative Setting:

Optimizing Patient Care

and Reducing Costs

Literature

Review

Managing bottlenecks in the perioperative environment is crucial to improving efficiency and patient outcomes. It requires a

multidisciplinary approach involving strategic planning, team coordination, and operational adjustments. Factors like infrastructure,

supply chain, and communication can cause disruptions affecting both cost and patient safety. To optimize the system, proactive

planning of procedures and resources, trained staffing, and fostering hospital collaboration—especially during crises—are essential.

This will enable a more efficient and sustainable perioperative workflow (Mihalj et al., 2022).

Schwenk

(2022)

Optimized perioperative

management (fast-track,

ERAS) to enhance

postoperative recovery in

elective colorectal

surgery

Systematic

Review

Schwenk et al. demonstrate that preoperative education, which includes both written and face-to-face information, can reduce

anxiety, improve patient knowledge, and accelerate recovery, especially in procedures like colorectal surgery. Prehabilitation,

involving quitting alcohol and nicotine use along with physical training, is also key to optimizing patient health before surgery.

Quitting smoking and drinking 4-6 weeks prior significantly reduces postoperative complications. Although benefits vary, moderate

aerobic exercise has been shown to improve cardiopulmonary function and reduce hospital stay in high-risk patients. Additionally, a

structured risk assessment approach using checklists or calculators can replace clinical judgment and improve postoperative

outcomes (Schwenk, 2022).

López et al.

(2023)

Recovery begins before

surgery

Systematic

Review

The optimization of perioperative care has evolved to focus not only on improving postoperative mobility and nutrition under the

ERAS (Enhanced Recovery After Surgery) protocol but also on attenuating the surgical stress response to reduce negative effects

like catabolism and maintain homeostasis. While interventions like fast-track protocols offer benefits, a more comprehensive

approach that includes preoperative optimization of modifiable patient factors appears crucial for better outcomes. This involves

enhancing the patient's physical, nutritional, and psychological condition, as these are key to postoperative recovery. The medical

community increasingly recognizes the importance of addressing the entire perioperative process, including evaluating and

managing comorbidities, planning hospital discharge in collaboration with primary care, using surgical checklists, advanced

intraoperative monitoring, and ensuring proper transition to intensive care when needed (López et al., 2023).

Uchino et al.

(2023)

Enhanced recovery

protocols in trauma and

emergency abdominal

surgery: a scoping review

Systematic

Review

This scoping review offers relevant evidence on optimizing surgical and perioperative care, especially for emergency abdominal

surgery (EAS) and trauma, with clear implications for general surgery, anesthesiology, and comprehensive patient management.

The author highlights that despite limited literature, there is a rising interest in implementing ERPs, with studies from both low- and

high-income countries. A positive trend in clinical outcomes, particularly in reducing hospital stays, reinforces the effectiveness of

ERPs as an optimization strategy. Specific preoperative components like early prophylactic antibiotics and patient/family education

are emphasized, as are preanesthetic preparations such as anxiolysis and analgesia. Early recognition of physiological instability and

risk assessment enable timely, safe interventions, especially in vulnerable populations like trauma patients (Uchino et al., 2023).

Ramanujam et

al. (2023)

Thromboelastography in

the perioperative period:

a literature review

Literature

Review

Ramanujam et al. find that thromboelastography (TEG) is a valuable monitoring tool during the perioperative period, particularly in

general surgery patients. It is effective in predicting bleeding, identifying hypercoagulability, and detecting thrombotic events,

which are crucial for individualized patient management. Its application is especially useful when precise assessment of hemostatic

status is needed, such as in patients on clopidogrel, helping guide therapy and avoiding unnecessary treatment suspension. Although

some studies show no significant differences in bleeding prediction or mortality between conventional and TEG-guided protocols,

TEG provides better control over blood product use and improved survival prediction (Ramanujam et al., 2023).

Darnall et al.

(2025)

Upskilling pain relief

after surgery: a scoping

review of perioperative

behavioral intervention

efficacy and practical

considerations for

implementation

Literature

Review & Meta-

Analysis

The authors highlight significant advances in perioperative care through behavioral interventions focused on pain management.

Strategies like cognitive-behavioral therapy (CBT), mindfulness, and psychoeducational skills are effective non-pharmacological

options that complement traditional anesthesia and help reduce postoperative opioid use. From anesthesiology, these approaches

can improve pain control, decrease anxiety, and promote patient self-regulation, leading to faster recovery with fewer

complications. While most studies focus on elective surgeries like knee arthroplasty or spine surgery, principles are highly

applicable to trauma and emergency procedures, where multimodal approaches and emotional stability are crucial (Darnall et al.,

2025).

Rama et al.

(2023)

Perioperative

Management of

Incidental Pulmonary

Embolisms on Trauma

CT Scans: A Narrative

Review

Literature

Review

From an anesthesiology and surgical perspective, the use of anticoagulants such as low molecular weight heparin (LMWH) or

fondaparinux is an effective tool for thromboprophylaxis, although it must be carefully adjusted due to bleeding risk—especially in

patients with brain trauma or requiring urgent intervention. Mechanical prophylaxis is considered the safest initial alternative in

these cases. Managing surgical timing is also crucial; elective procedures are generally postponed until at least three months of

anticoagulation therapy are completed, which directly impacts surgical planning. These findings highlight the importance of a

personalized, interdisciplinary, and dynamic strategy, with continuous monitoring and clinical follow-up between three and six

months to prevent sequelae and adjust treatment. Overall, this evidence reinforces the need for adaptive, risk-based protocols to

optimize outcomes in surgery and trauma without compromising patient safety (Rama et al., 2023).

Agosta et al.

(2024)

Perioperative Mechanical

Circulatory Support for

Cardiac Assistance in

Thoracic Surgery: A

Scoping Review Protocol

Systematic

Review

Findings on the perioperative implantation of temporary mechanical circulatory support (tMCS) demonstrate an emerging approach

to optimizing surgical care, especially in thoracic surgery patients with high cardiovascular risk. The possibility of using these

devices either individually or in combination represents a feasible and safe alternative, particularly in contexts where surgical

complications could lead to acute heart failure—a critical situation that jeopardizes both anesthetic and surgical outcomes. From the

anesthetic perspective, using tMCS allows for more stable hemodynamic management, which is key to preventing intra- and

postoperative adverse events. Additionally, having a planned circulatory support system can expand the surgical eligibility of

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Author(s),

Year

Title

Methods

Results

complex patients without postponing necessary procedures due to cardiac comorbidities. This approach suggests a promising move

toward more personalized, technologically advanced surgical care focused on preventing critical events aligned with continuous

improvement principles in surgery, anesthesiology, and perioperative medicine (Agosta et al., 2024).

Hayat et al.

(2024)

The Role of Mobile

Health Technology on

Perioperative Spinal

Care: A Systematic

Scoping Review and

Narrative Synthesis

Systematic

Review and

Narrative

Synthesis

The evidence underscores the critical importance of physiotherapy as a core component of postoperative recovery, especially in

spinal and orthopedic surgery patients, many of whom have fragility conditions requiring carefully optimized treatment strategies.

In this context, the inclusion of mobile health applications is an innovative tool that enhances patient adherence to rehabilitation

programs, facilitating access to guided exercises via videos, which reduces logistical barriers like travel and improves continuity of

care. From a surgical and anesthesiology standpoint, these digital solutions contribute to more efficient functional recovery,

enabling shorter interventions and reducing risks related to prolonged immobility such as chronic pain or neuromuscular decline.

Additionally, in trauma cases where physiotherapy is vital for restoring function, these apps could be instrumental in maintaining

muscle activity and preventing sequelae in patients with spinal injuries or fragility fractures (Hayat et al., 2024).

Samaniego

Brambilla et al.

(2024)

Comprehensive

Management of the

Surgical Patient:

Preoperative

Optimization and

Postoperative Care in

General Surgery

Systematic

Review

The findings highlight the importance of adopting a comprehensive management approach as a key strategy to optimize clinical

outcomes in general surgery. This holistic approach covers both the preoperative and postoperative phases and involves coordinated

intervention by multidisciplinary teams, which is essential for ensuring safe and efficient care. Preoperative optimization in surgery

allows for risk reduction by identifying and managing comorbidities, strengthening nutritional and physical status, and providing

emotional support, all of which contribute to more controlled surgeries with fewer complications. In anesthesiology, this approach

enables more precise planning of anesthetic management, reducing hemodynamic risks and facilitating better postoperative

recovery. In trauma care, where conditions can change rapidly, this model offers more adaptable, patient-centered care focused on

stability. Additionally, postoperative care emphasizing pain control, complication prevention, rehabilitation, and emotional support

is fundamental for accelerating recovery and improving the patient experience (Samaniego Brambilla et al., 2024).

Cambisaca

López et al.

(2024)

Optimization of Surgical

Care: The Role of

Internal Medicine in

Preoperative Evaluation,

Anesthesiology in

Intraoperative

Management, and

Imaging in Diagnostic

Imaging

Systematic

Review

Cambisaca et al. demonstrate that the coordinated role of internal medicine and anesthesiology in perioperative care is a

fundamental axis for ensuring patient safety and improving clinical outcomes. From internal medicine, preoperative assessment

allows early identification and proactive management of cardiovascular, metabolic, and systemic comorbidities, which are essential

to reduce complications during and after surgery. This evaluation provides a solid basis for risk stratification and supports more

informed surgical decisions, strengthening team collaboration and generating a more patient-centered approach. Anesthesiology

plays a strategic role in intraoperative management, ensuring not only patient comfort but also hemodynamic, respiratory, and

metabolic stability through rigorous monitoring and immediate clinical responses to critical situations. Together, both professionals

serve as pillars in preventing adverse events and establishing a modern, comprehensive, and evidence-based surgical care model

(Cambisaca López et al., 2024).

Source: Authors’ elaboration.

The review of the literature on optimizing

surgical and perioperative care reveals

significant evolution in strategies aimed at

improving outcomes for patients undergoing

general surgery, anesthesiology, and trauma

care. Among the most relevant findings is the

implementation of ERAS (Enhanced Recovery

After Surgery) protocols, which have

revolutionized perioperative recovery by

combining technological innovation, precise

nutritional management, and a patient-centered

approach. Findings reported by Briceño

Torralba (2021) reinforce the effectiveness of

ERAS protocols as key tools for optimizing

surgical and perioperative management,

demonstrating that their implementation is

associated with a significant reduction in

hospital stay duration without increasing

readmission rates, morbidity, or mortality.

In the realm of prophylaxis and prevention of

postoperative infections, the reviewed studies

confirm the efficacy of perioperative antibiotic

administration within 60 minutes before

incision, as well as proper skin antisepsis and

measures such as glove changes during

abdominal closure. These practices have been

shown to significantly lower the risk of surgical

site infections (SSIs), contributing to patient

safety. Aldas Ibujes et al. (2024) mention the

fundamental role of antibiotic prophylaxis in

surgery as a key strategy to prevent infections

and perioperative complications, which is

essential for optimizing clinical results in

general surgery and in highly vulnerable

contexts such as trauma.

Another key aspect identified is the

management of perioperative pain and the

reduction of opioid use through multimodal

strategies. Combined analgesia with regional

techniques and non-pharmacological therapies

such as cognitive-behavioral therapy and

mindfulness have shown promising results in

decreasing opioid dependence and improving

patients’ functional recovery. In contrast,

Bolívar et al. (2024) conducted a study in

general surgery, confirming that early recovery

and early ambulation are critical objectives.

Minimizing opioid use can reduce side effects

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such as nausea, drowsiness, or postoperative

ileus, thereby improving patient experiences

and recovery times.

Preoperative education and prehabilitation

emerge as essential tools to optimize recovery,

especially in colorectal surgery patients. The

suspension of tobacco and alcohol consumption

weeks before surgery, along with physical

training, has demonstrated to reduce

complications and improve cardiopulmonary

function. Ubré (2020) provides solid evidence

on the clinical effectiveness of prehabilitation in

high-risk patients undergoing major abdominal

surgery. The intervention, centered on a

supervised physical resistance and daily activity

promotion program, indicates that preparing the

patient before surgery is not only feasible but

also highly beneficial in reducing postoperative

complications. From the perspective of general

surgery, this approach allows for early

intervention in the patient’s functional status,

enhancing their capacity to cope with surgical

stress.

The use of advanced monitoring tools, such as

thromboelastography (TEG), has proven

valuable for optimizing perioperative

management, allowing for precise assessment

of the patient’s hemostatic status and

facilitating personalized therapeutic decisions.

Hernández-Pérez et al. (2022) highlight the

clinical and operational value of TEG as an

advanced tool in preanesthetic evaluation and

intraoperative hemostatic management,

positioning it as a key resource to optimize

surgical care. For anesthesiology, the real-time

data provided by TEG enable rapid adaptation

of transfusion strategies in cases of

intraoperative bleeding, reducing the need for

empirical transfusions and limiting the risk of

complications related to excessive transfusion,

such as volume overload or

immunosuppression.

Conclusions

The reviewed scientific evidence demonstrates

that optimizing surgical and perioperative care

requires a comprehensive, proactive, and

multidisciplinary approach, especially within

the fields of general surgery, anesthesiology,

and trauma. Strategies such as the

implementation of ERAS protocols,

prehabilitation in high-risk patients, effective

drug management, and the use of advanced

tools like thromboelastography (TEG) represent

substantial advances toward safer, more

efficient, and patient-centered care. From an

anesthesiology perspective, the importance of

multimodal pain management focusing on

reducing opioid use, individualized

hemodynamic monitoring, and anticipatory risk

management is emphasized.

In general surgery, preoperative interventions

that improve functional status and reduce

postoperative complications are beneficial,

while in trauma, applying these principles must

be tailored to the urgency and complexity of

each case, without losing sight of structured,

evidence-based interventions. Collectively, the

analyzed studies show that perioperative

optimization not only improves clinical

outcomes such as shorter hospital stays, reduced

readmissions, and fewer complications—but

also contributes to the sustainability of the

healthcare system by rationalizing resources

and lowering costs. Ultimately, establishing an

optimized perioperative care model involves

not only updating clinical protocols but also

fostering a cultural shift toward more

personalized, multidimensional, and

collaborative surgical care.

 
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Octubre del 2026 
 
Página 125  
 
References 
Agosta, V., D’Andria, J., Bugo, S., Bottussi, A., 
Losiggio,  R.,  &  Monaco,  F.  (2024). 
Perioperative mechanical circulatory support 
for cardiac assistance in thoracic surgery: A 
scoping  review  protocol.  Health  Science 
Reports,  7(11). 
https://pubmed.ncbi.nlm.nih.gov/39980255/  
Aldas,  A.,  Vásquez,  V.,  Granda,  L.,  Plazarte, 
M.,  &  Chuquimarca,  P.  (2024). 
Actualización  de  la  profilaxis  antibiótica 
para  cirugías  abdominales.  Revisión 
bibliográfica.  Ciencia  Latina  Revista 
Científica  Multidisciplinar,  8(1),  1776–
1789. 
https://ciencialatina.org/index.php/cienciala/
article/view/9569  
Álvarez, J., Gutiérrez, D., Chávez, J., & Santos 
Rivas, L. (2023). Manejo de emergencias en 
traumatología. Polo del Conocimiento, 8(4). 
https://www.polodelconocimiento.com/ojs/
index.php/es/article/view/6053 
Bolívar, M., del Valle Bolívar, A., & Bolívar, 
M.  J.  (2024).  Opioid-free  postoperative 
analgesia. In which patients should we use it 
and  which  drugs  to  use?:  A  systematic 
review. Revista Chilena de Anestesia, 53(2), 
143–151. 
https://revistachilenadeanestesia.cl/revchila
nestv53n2-10/  
Briceño, P. (2021). Rehabilitación multimodal 
en  cirugía  pancreática  [Trabajo  de  fin  de 
grado,  Universidad  de  Zaragoza].  Zaguán. 
https://zaguan.unizar.es/record/111205 
Cambisaca  López,  K.,  Hidalgo  Segur,  J., 
Andrade Cabrera, N., & Piedra Cevallos, M. 
(2024).  Optimización  del  cuidado 
quirúrgico: Rol de la medicina interna en la 
evaluación  preoperatoria,  anestesiología  en 
el manejo intraoperatorio e imagenología en 
el  diagnóstico  por  imágenes.  Polo  del 
Conocimiento,  9,  3137–3155.  https://
polodelconocimiento.com/ojs/index.php/es/
article/view/7275 
Ceresoli, M., Biloslavo, A., Bisagni, P., Ciuffa, 
C., Fortuna, L., La Greca, A., Tartaglia, D., 
Zago, M., Ficari, F., Foti, G., Braga, M., & 
ERAS-emergency  surgery  collaborative 
group.  (2023).  Implementing  enhanced 
perioperative  care  in  emergency  general 
surgery:  A  prospective  multicenter 
observational  study.  World  Journal  of 
Surgery,  47(6),  1339–1347.  https://doi.org/
10.1007/s00268-023-06984-9 
Ceresoli, M., Braga, M., Zanini, N., Abu-Zidan, 
F.  M.,  Parini,  D.,  Langer,  T.,  Sartelli,  M., 
Damaskos,  D.,  Biffl,  W.  L.,  Amico,  F., 
Ansaloni,  L.,  Balogh,  Z.  J.,  Bonavina,  L., 
Civil, I., Cicuttin, E., Chirica, M.,  Cui, Y., 
De Simone, B., Di Carlo, I., ... Coccolini, F. 
(2023).  Enhanced  perioperative  care  in 
emergency  general  surgery:  The  WSES 
position paper. World Journal of Emergency 
Surgery,  18,  Article  47.  https://doi.org/10.
1186/s13017-023-00519-2 
Darnall, B. D., Abshire, L., Courtney, R. E., & 
Davin, S. (2025). Upskilling pain relief after 
surgery: A scoping review of perioperative 
behavioral  intervention  efficacy  and 
practical considerations for implementation. 
Regional  Anesthesia  &  Pain  Medicine, 
50(2),  93–101.  https://doi.org/10.1136/
rapm-2024-105601 
Fehlmann,  C.  A.,  Patel,  D.,  McCallum,  J., 
Perry, J. J., & Eagles, D. (2022). Association 
between mortality and frailty in emergency 
general  surgery:  A  systematic  review  and 
meta-analysis. European Journal of Trauma 
and Emergency Surgery, 48(1), 141–151. 
García  Ríos,  C.  A.,  García  Hermida,  M.  I., 
Mosquera Guilcapi, M. de J., & García Ríos, 
V.  E.  (2024).  Cirugía  general  en  atención 
primaria: Un enfoque integral para la salud. 
Editorial  SciELa.  https://doi.org/10.62131/
978-9942-7173-5-1 
Guerrero Rodríguez, M., Proaño Sánchez, M., 
Montufar Benítez, O., & Rojas Carvajal, C. 
(2023). Control de daños en cirugía general. 
RECIAMUC,  7(1),  320–327.  https://
reciamuc.com/index.php/RECIAMUC/
article/view/1018 
Harrison, H.  (2023). Navigating  critical  care: 
Anesthesia  and  surgical  considerations  in 
emergency  situations.  https://doi.org/10.
5281/zenodo.8361832 
Hayat,  J.,  Ramadhan,  M.,  Gonnah,  A.  R., 
Alfadhli,  A.,  &  Al-Naseem,  A.  O.  (2024). 
The  role  of  mobile  health  technology  in 

 
Ciencia y Educación  
    (L-ISSN: 2790-8402 E-ISSN: 2707-3378) 
Vol. 7 No. 10 
Octubre del 2026 
 
Página 126  
 
perioperative  spinal  care:  A  systematic 
scoping  review  and  narrative  synthesis. 
Cureus,  16(2),  e54254.  https://doi.org/10.
7759/cureus.54254 
Hernández-Pérez, A. L., Ramírez-Morales, K., 
Lagarda-Cuevas,  J.,  Revilla-Monsalve,  C., 
Bermúdez-Ochoa, G. M., Juárez-Pichardo, J. 
S.,  &  Gallardo-Hernández,  A.  G.  (2022). 
Thromboelastography  for  general  surgery. 
Revista Mexicana de Anestesiología, 45(1), 
48–59. https://doi.org/10.35366/102903 
Hübner, M., Kusamura, S., Villeneuve, L., Al-
Niaimi, A., Alyami, M., Balonov, K., Bell, 
J., Bristow, R., Cortés Guiral, D., Fagotti, A., 
Falcão,  L.  F.  R.,  Glehen,  O.,  Lambert,  L., 
Mack, L., Muenster, T., Piso, P., Pocard, M., 
Rau, B., Sgarbura, O., ... Nelson, G. (2020). 
Guidelines  for  perioperative  care  in 
cytoreductive surgery (CRS) with or without 
hyperthermic  intraperitoneal  chemotherapy 
(HIPEC): Enhanced Recovery After Surgery 
(ERAS®)  Society  recommendations—Part 
II:  Postoperative  management  and  special 
considerations.  European  Journal  of 
Surgical  Oncology,  46(12),  2311–2323. 
https://doi.org/10.1016/j.ejso.2020.08.006 
Köhnenkampf,  R.,  &  Maldonado,  F.  (2019). 
Protocolos  de  recuperación  acelerada 
después de cirugía ¿tienen espacio en nuestra 
práctica  diaria  actual?  Revista  Chilena  de 
Anestesia,  48(1),  10–27.  https://doi.org/10.
25237/revchilanestv48n01.05 
López, P., Moreira, E., Olano, E., & Silva, L. 
(2023). La recuperación empieza antes de la 
cirugía. Revista Médica del Uruguay, 39(2). 
Loughlin, S., Fraidenraij, U., & Álvarez, A. O. 
(2021).  Programas  de  optimización 
perioperatoria,  enhanced  recovery  y  fast-
track:  ¿Por  qué  están  en  auge?  ¿Qué  son 
realmente  y  cómo  se  implementan  en  la 
práctica? Revista Argentina de Cirugía, 113, 
159–168.  https://aac.org.ar/revista/2021/
113/Abril-Mayo-Junio/4.pdf 
Luna-Ortiz,  P.,  Pilar-Báez,  S.,  Lazcano-
Vázquez, M., & Martínez-Rosas, M. (2024). 
Oxidative stress in the perioperative period: 
Clinical  implications.  Revista  Mexicana  de 
Anestesiología,  47(1),  23–29.  https://www.
scielo.org.mx/pdf/rma/v47n1/0484-7903-
rma-47-01-23.pdf 
Mihalj,  M.,  Corona,  A.,  Andereggen,  L., 
Urman,  R.  D.,  Luedi,  M.  M.,  &  Bello,  C. 
(2022).  Managing  bottlenecks  in  the 
perioperative  setting:  Optimizing  patient 
care  and  reducing  costs.  Best  Practice  & 
Research Clinical Anaesthesiology, 36, 299–
310. 
Pico-Camacho, A., & Vega-Peña, N. (2023). La 
comunicación  del  riesgo  en  cirugía:  Un 
proceso por mejorar. Revista Colombiana de 
Cirugía,  38(4),  600–609.  https://www.
revistacirugia.org/index.php/cirugia/article/
view/2265 
Rama,  E.  I.,  Adeosun,  J.  F.,  Thahir,  A.,  & 
Krkovic,  M.  (2023).  Perioperative 
management  of  incidental  pulmonary 
embolisms on trauma CT scans: A narrative 
review. Cureus. 
Ramanujam,  V.,  DiMaria,  S.,  &  Varma,  V. 
(2023).  Thromboelastography  in  the 
perioperative  period:  A  literature  review. 
Cureus,  15(5),  e39407.  https://doi.org/10.
7759/cureus.39407 
Samaniego  Brambilla,  M.,  Quiroz  González, 
A., González Toledo, J., & Cedeño Álava, A. 
(2024).  Gestión  integral  del  paciente 
quirúrgico:  Optimización  preoperatoria  y 
cuidados postoperatorios en cirugía general. 
Dominio  de  las  Ciencias,  10(1),  940–951. 
https://dominiodelasciencias.com/ojs/index.
php/es/article/view/3754 
Schwenk, W. (2022). Optimized perioperative 
management (fast-track, ERAS) to enhance 
postoperative recovery in elective colorectal 
surgery.  GMS  Hygiene  and  Infection 
Control, 17, Doc10. https://doi.org/10.3205/
dgkh000413 
Scott,  M.  J.,  Aggarwal,  G.,  Aitken,  R.  J., 
Anderson,  I.  D.,  Balfour,  A.,  Foss,  N.  B., 
Cooper,  Z.,  Dhesi,  J.  K.,  French,  W.  B., 
Grant, M. C., Hammarqvist, F., Hare, S. P., 
Havens, J. M.,  Holena, D. N., Hübner, M., 
Johnston,  C.,  Kim,  J.  S.,  Lees,  N.  P., 
Ljungqvist,  O.,  ...  Peden,  C.  J.  (2023). 
Consensus guidelines for perioperative care 
for  emergency  laparotomy  Enhanced 
Recovery  After  Surgery  (ERAS®)  Society 

Ciencia y Educación

(L-ISSN: 2790-8402 E-ISSN: 2707-3378)

Vol. 7 No. 10

Octubre del 2026

Página 127

recommendations Part 2—Emergency

laparotomy: Intra- and postoperative care.

World Journal of Surgery, 47(8), 1850–

1880. https://doi.org/10.1007/s00268-023-

07020-6

Ubré, M. (2020). Prehabilitación como

estrategia de optimización preoperatoria.

https://dialnet.unirioja.es/servlet/tesis?codig

o=302291

Uchino, H., Nguyen-Powanda, P., Tokuno, J.,

Kouyoumdjian, A., Fiore, J. F., & Grushka,

J. (2023). Enhanced recovery protocols in

trauma and emergency abdominal surgery: A

scoping review. European Journal of

Trauma and Emergency Surgery, 49, 2401–

2412.

https://pubmed.ncbi.nlm.nih.gov/37505285/

Velázquez, J., & Vargas, M. (2021).

Recuperación mejorada después de la

cirugía: Un cambio de paradigma en

cuidados perioperatorios. Artículo de

revisión. Revista Venezolana de Cirugía,

74(2).

https://revistavenezolanadecirugia.com/inde

x.php/revista/article/view/427

Esta obra está bajo una licencia de

Creative Commons Reconocimiento-No Comercial

Carrión Prado y Paul Alexander Orellana Añazco.

Declaraciones éticas y editoriales del artículo

Contribución de los autores (Taxonomía CRediT).

Dayana Carolina Carrión Prado: conceptualización de la investigación, diseño metodológico, desarrollo del proceso investigativo, análisis formal de

los datos, redacción del borrador original del manuscrito, revisión crítica del contenido científico y supervisión general del estudio.

Paul Alexander Orellana Añazco: curación y organización de los datos, participación en la recolección de información, validación de los resultados

obtenidos y elaboración de representaciones gráficas y visualización de los datos.

Declaración de conflicto de intereses

Los autores declaran que no existe conflicto de intereses en relación con la investigación presentada, la autoría del manuscrito ni la publicación del

presente artículo.

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La presente investigación no recibió financiamiento específico de agencias públicas, comerciales o de organizaciones sin fines de lucro. En caso de

existir financiamiento institucional o externo, este deberá ser declarado explícitamente por los autores en esta sección.

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El editor responsable certifica que el proceso editorial del presente artículo se desarrolló conforme a los principios de integridad científica, transparencia

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Los autores declaran que la investigación se desarrolló respetando los principios éticos de la investigación científica, garantizando la confidencialidad

de los datos y el respeto a los participantes del estudio. En los casos en que la investigación involucre seres humanos, los procedimientos deben ajustarse

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