Surgery content commonly referenced by physicians includes perioperative management guidelines, procedure-specific recommendations, randomized trials evaluating surgical and perioperative care, therapeutic strategies, and clinical tools for estimating surgical risk. The following 10-item framework reflects widely used and recent sources that inform surgical care.

1. American Heart Association/American College of Cardiology/American College of Surgeons/American Society of Nuclear Cardiology/Heart Rhythm Society/Society of Cardiovascular Anesthesiologists/Society of Cardiovascular Computed Tomography/Society for Cardiovascular Magnetic Resonance/Society for Vascular Medicine Perioperative Cardiovascular Management Guideline — The 2024 American Heart Association/American College of Cardiology perioperative cardiovascular management guideline provides recommendations for cardiovascular evaluation and management of adults undergoing noncardiac surgery. Developed following a literature search conducted through March 2023, the guideline updates and replaces the 2014 recommendations and addresses management strategies including pharmacologic therapy, perioperative monitoring, and devices.

2. Society of American Gastrointestinal and Endoscopic Surgeons Appendicitis Guideline — The Society of American Gastrointestinal and Endoscopic Surgeons guideline addresses diagnosis and management of appendicitis in adult and pediatric patients. Based on a systematic review covering 2010 to 2022, the guideline includes conditional recommendations on operative management of uncomplicated and complicated appendicitis, timing of surgery, surgical techniques, drain placement, postoperative antibiotic duration, and interval appendectomy following nonoperative treatment of complicated appendicitis.

3. Society of American Gastrointestinal and Endoscopic Surgeons Fluorescence Image-Guided Surgery Guideline — The 2025 Society of American Gastrointestinal and Endoscopic Surgeons guideline provides recommendations on intraoperative fluorescence image-guided surgery using indocyanine green in gastrointestinal procedures. The guideline was informed by a systematic review with literature searches generally conducted through October 2022 and an updated search for the colorectal anastomosis question through September 2024. It addresses applications including identification of primary abdominal cancers, nonregional metastases, and lymph nodes during gastrointestinal cancer resection, as well as use during esophageal and left-sided colorectal anastomoses.

4. Society for Healthcare Epidemiology of America/Infectious Diseases Society of America/Association for Professionals in Infection Control and Epidemiology Surgical Site Infection Prevention Practice Recommendation — The 2022 update to the Society for Healthcare Epidemiology of America–sponsored practice recommendation provides practical guidance for acute-care hospitals on implementing and prioritizing surgical site infection prevention measures. Published in 2023, the document updates the 2014 recommendations and distinguishes between essential practices for acute-care hospitals and additional approaches that may be considered when surgical site infections remain uncontrolled after essential practices have been implemented.

5. SUNRRISE Trial — In the randomized phase 3 SUNRRISE trial involving 840 adults undergoing emergency laparotomy, incisional negative pressure wound therapy did not result in a statistically significant reduction in the rate of surgical site infection at 30 days compared with the surgeon’s choice of wound dressing. Surgical site infections occurred in 28% (112 of 394) of patients in the negative pressure wound therapy group and 27% (108 of 394) of those in the comparison group.

6. EPCAT III Trial — In the randomized EPCAT III trial involving 5,429 patients undergoing total hip or knee arthroplasty, aspirin alone was noninferior to rivaroxaban followed by aspirin for preventing symptomatic venous thromboembolism. Venous thromboembolism occurred in less than 1% of patients in each group, while major or clinically relevant nonmajor bleeding occurred in 45 of 2,718 patients receiving aspirin alone and 54 of 2,647 receiving rivaroxaban followed by aspirin.

7. PREVENT CLOT Trial — In the randomized PREVENT CLOT trial involving 12,211 adults with operatively treated extremity fractures or pelvic or acetabular fractures, aspirin was noninferior to low-molecular-weight heparin for preventing mortality at 90 days. Nonfatal pulmonary embolism occurred in 1.49% of patients in each group, while deep vein thrombosis occurred in 2.5% of patients receiving aspirin and 1.7% receiving low-molecular-weight heparin. 

8. POISE-3 Trial — In the randomized POISE-3 trial involving 9,535 patients undergoing noncardiac surgery, tranexamic acid was associated with a lower rate of the composite bleeding outcome at 30 days compared with placebo. The outcome occurred in 9.1% (433 of 4,757) of patients receiving tranexamic acid and 11.7% (561 of 4,778) receiving placebo. The composite cardiovascular outcome occurred in 14.2% (649 of 4,581) of patients receiving tranexamic acid and 13.9% (639 of 4,601) receiving placebo, but noninferiority was not established for the composite cardiovascular outcome.

9. CODA Trial — In the randomized CODA trial involving 1,552 adults with appendicitis, antibiotic treatment was noninferior to appendectomy based on health status at 30 days. Among patients assigned to antibiotics, 29% underwent appendectomy within 90 days, including 41% of those with an appendicolith and 25% of those without an appendicolith.

10. American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator — The American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator estimates patient-specific risks of 19 outcomes within 30 days following surgery. The calculator incorporates patient characteristics, including age, American Society of Anesthesiologists class, body mass index, and hypertension requiring medication, along with the planned procedure, to support surgical decision-making and informed consent.

Sources: American Heart Association, American College of Surgeons, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, Society for Vascular Medicine, American College of Cardiology, Society of American Gastrointestinal and Endoscopic Surgeons, The New England Journal of Medicine, Circulation, JAMA, Infection Control & Hospital Epidemiology, Society for Healthcare Epidemiology of America, Infectious Diseases Society of America, Association for Professionals in Infection Control and Epidemiology