How Labs Contribute to Safe Surgery in Nigeria

Why surgical safety starts long before the incision

In Nigeria, where surgical capacity is expanding and more patients are accessing procedures, the importance of safe surgery cannot be overstated. Every time a patient enters an operating theatre, multiple layers of risk converge—anesthesia, underlying disease, blood loss, infection, organ stress. A well-equipped laboratory forms the bedrock of these safety layers—not a luxury, but a necessity. The World Health Organization (WHO) lists pre-operative evaluation among the fundamental steps in its Safe Surgery checklist.

When labs are integrated into surgical workflows—pre-op, intra-op, post-op—they help reduce complications, cancellations and adverse outcomes. Here’s how.

Three key ways labs ensure safe surgery

1. Pre-operative screening: reducing risk, setting the stage

Before a surgical cut, the lab helps answer: Is the patient ready?

Haemoglobin/complete blood count (CBC): Determines anaemia, platelet status and basic red/white cell health.
Clotting profile (PT/INR, aPTT): Especially important if patient is on anticoagulants or has liver disease.
Renal and liver function tests (creatinine, AST/ALT, bilirubin): Many underlying conditions may increase peri-operative risk.
Blood grouping and cross-match: Ensures safe transfusion when needed.
Other tests tailored to patient: For example, in known heart disease, ECG + specific biomarkers may be needed.
Guidelines emphasise that lab tests before surgery should not be ordered arbitrarily in low-risk patients—but should be driven by individual risk factors and planned procedure. NCBI+1
In Nigeria, ensuring access to labs in district hospitals and proper referral for test abnormalities is a major safety gain.

2. Intra-operative and blood-bank support: real-time lab safety

During surgery:

Rapid blood-grouping and cross-matching: If major blood loss occurs, the lab must deliver compatible units without delay.
Point-of-care (POC) testing: In longer or complex surgeries, labs may monitor electrolytes, glucose, coagulation and acid-base status. These labs support anaesthetists and surgeons in making real-time decisions.
Microbiology surveillance: For high-risk surgeries (e.g., abdominal, orthopaedic) labs help guide antibiotic coverage and monitor for surgical-site infection risk.

3. Post-operative monitoring: catching complications early

After surgery, labs continue to protect the patient by:

Monitoring haemoglobin/platelets to detect bleeding or delayed haemorrhage.
Tracking kidney/liver panels to spot organ stress from anaesthesia or drugs.
Checking infection markers (WBC, CRP, cultures) if a patient shows signs of infection.
Monitoring glucose and electrolytes, especially in major or critical surgeries where metabolic stress is high.
This lab-driven monitoring allows early intervention before minor issues progress into major complications.

Why this matters for Nigeria’s surgical system

In many Nigerian hospitals, lab infrastructure is unevenly distributed, leading to delays in testing or missing critical pre-op information. Strengthening labs yields direct benefit to surgical safety.
A cancelled or postponed surgery due to missing or abnormal lab tests affects patient trust, resource use and system efficiency. Reliable labs reduce cancellations and improve theatre utilisation.
Lab-based decision-making helps manage scarce resources (blood, ICU beds, specialized post-op care) by ensuring only patients ready for surgery proceed.
Safe surgery is part of national health-system strengthening; labs power that through diagnostics, monitoring and data for quality improvement.

Practical steps for surgeons, lab managers and hospital leaders

Develop pre-operative lab panels based on local capacity and patient risk (e.g., CBC + clotting + renal/liver for moderate-risk surgery).
Ensure lab turnaround time standards, especially for urgent or intra-operative labs.
Link the lab department with the blood-bank service, so cross-matching and compatible units are available on time.
Set up post-operative lab monitoring protocols for surgeries with known risk of bleeding, organ stress or infection.
Participate in audit and quality assurance: track how many surgeries were delayed due to missing labs, lab turnaround times, test abnormality rates, complication rates. Use data to improve.
Invest in training and equipment: POC testing, digital lab-information systems, reliable cold-chain and reagent supply all matter.

Challenges and how to address them

Resource gaps: Many hospitals in Nigeria may lack full lab capabilities or POC testing. Solutions include regional hub labs, mobile diagnostic units and collaborative networks.
Cost and access: Patients may delay surgery because they cannot afford pre-op labs. Hospitals can consider subsidised panels for surgical patients or integrate into funding models.
Coordination breakdowns: Lab results may not reach surgical teams in time. Digital links, clear workflows and accountability help.
Routine vs indicated testing: Some evidence says routine testing in healthy low-risk patients may not change management. SciSpace Therefore, hospitals must define rational testing policies—balancing safety, cost and local epidemiology.

Final thoughts

In the theatre of safe surgery, the lab is both foundation and sentinel. It ensures readiness before the cut, supports survival during the procedure, and monitors recovery afterward. For Nigeria, as surgical volumes rise and complexity grows, the role of diagnostic labs becomes ever more critical—not a background service, but a frontline partner in saving lives.

When surgeons, anesthetists, lab technologists and hospital leaders embrace this reality, the result is fewer cancellations, fewer complications, shorter stays and a stronger health system. The next time a surgical patient walks into the operating room, may it be with diagnostics behind them and safety ahead.

Labs may not wear scrubs, but in the story of surgery in Nigeria, they are the unsung heroes that make every incision safer.