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1. Using a theory-based, customized video game as an educational tool to improve physicians’ trauma triage decisions: study protocol for a randomized cluster trial

Author: Mohan, Deepika, Angus, Derek C., Chang, Chung-Chou H., Elmer, Jonathan, Fischhoff, Baruch, Rak, Kim J., Barnes, Jacqueline L., Peitzman, Andrew B., and White, Douglas B.
Published: 2024
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2. 2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery

Author: de’Angelis, Nicola, Schena, Carlo Alberto, Marchegiani, Francesco, Reitano, Elisa, De Simone, Belinda, Wong, Geoffrey Yuet Mun, Martínez-Pérez, Aleix, Abu-Zidan, Fikri M., Agnoletti, Vanni, Aisoni, Filippo, Ammendola, Michele, Ansaloni, Luca, Bala, Miklosh, Biffl, Walter, Ceccarelli, Graziano, Ceresoli, Marco, Chiara, Osvaldo, Chiarugi, Massimo, Cimbanassi, Stefania, Coccolini, Federico, Coimbra, Raul, Di Saverio, Salomone, Diana, Michele, Dioguardi Burgio, Marco, Fraga, Gustavo, Gavriilidis, Paschalis, Gurrado, Angela, Inchingolo, Riccardo, Ingels, Alexandre, Ivatury, Rao, Kashuk, Jeffry L., Khan, Jim, Kirkpatrick, Andrew W., Kim, Fernando J., Kluger, Yoram, Lakkis, Zaher, Leppäniemi, Ari, Maier, Ronald V., Memeo, Riccardo, Moore, Ernest E., Ordoñez, Carlos A., Peitzman, Andrew B., Pellino, Gianluca, Picetti, Edoardo, Pikoulis, Manos, Pisano, Michele, Podda, Mauro, Romeo, Oreste, Rosa, Fausto, Tan, Edward, Ten Broek, Richard P., Testini, Mario, Tian Wei Cheng, Brian Anthony, Weber, Dieter, Sacco, Emilio, Sartelli, Massimo, Tonsi, Alfredo, Dal Moro, Fabrizio, and Catena, Fausto
Published: 2023
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3. Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the S.P.Ri.M.A.C.C. study

Author: Fugazzola, Paola, Cobianchi, Lorenzo, Di Martino, Marcello, Tomasoni, Matteo, Dal Mas, Francesca, Abu-Zidan, Fikri M., Agnoletti, Vanni, Ceresoli, Marco, Coccolini, Federico, Di Saverio, Salomone, Dominioni, Tommaso, Farè, Camilla Nikita, Frassini, Simone, Gambini, Giulia, Leppäniemi, Ari, Maestri, Marcello, Martín-Pérez, Elena, Moore, Ernest E., Musella, Valeria, Peitzman, Andrew B., de la Hoz Rodríguez, Ángela, Sargenti, Benedetta, Sartelli, Massimo, Viganò, Jacopo, Anderloni, Andrea, Biffl, Walter, Catena, Fausto, and Ansaloni, Luca
Published: 2023
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4. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group

Author: ten Broek, Richard PG, Krielen, Pepijn, Di Saverio, Salomone, Coccolini, Federico, Biffl, Walter L, Ansaloni, Luca, Velmahos, George C, Sartelli, Massimo, Fraga, Gustavo P, Kelly, Michael D, Moore, Frederick A, Peitzman, Andrew B, Leppaniemi, Ari, Moore, Ernest E, Jeekel, Johannes, Kluger, Yoram, Sugrue, Michael, Balogh, Zsolt J, Bendinelli, Cino, Civil, Ian, Coimbra, Raul, De Moya, Mark, Ferrada, Paula, Inaba, Kenji, Ivatury, Rao, Latifi, Rifat, Kashuk, Jeffry L, Kirkpatrick, Andrew W, Maier, Ron, Rizoli, Sandro, Sakakushev, Boris, Scalea, Thomas, Søreide, Kjetil, Weber, Dieter, Wani, Imtiaz, Abu-Zidan, Fikri M, De’Angelis, Nicola, Piscioneri, Frank, Galante, Joseph M, Catena, Fausto, and van Goor, Harry
Subjects: Patient Safety, Prevention, Digestive Diseases, Clinical Research, Evaluation of treatments and therapeutic interventions, 7.3 Management and decision making, 6.4 Surgery, Management of diseases and conditions, Oral and gastrointestinal, Disease Management, General Surgery, Guidelines as Topic, Humans, Intestinal Obstruction, Tissue Adhesions, Treatment Outcome, Small bowel obstruction, Adhesions, Surgery, Laparoscopy, Laparotomy
Abstract: BackgroundAdhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups.MethodsThe guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group. A systematic literature search was performed prior to the update of the guidelines to identify relevant new papers on epidemiology, diagnosis, and treatment of ASBO. Literature was critically appraised according to an evidence-based guideline development method. Final recommendations were approved by the workgroup, taking into account the level of evidence of the conclusion.RecommendationsAdhesion formation might be reduced by minimally invasive surgical techniques and the use of adhesion barriers. Non-operative treatment is effective in most patients with ASBO. Contraindications for non-operative treatment include peritonitis, strangulation, and ischemia. When the adhesive etiology of obstruction is unsure, or when contraindications for non-operative management might be present, CT is the diagnostic technique of choice. The principles of non-operative treatment are nil per os, naso-gastric, or long-tube decompression, and intravenous supplementation with fluids and electrolytes. When operative treatment is required, a laparoscopic approach may be beneficial for selected cases of simple ASBO.Younger patients have a higher lifetime risk for recurrent ASBO and might therefore benefit from application of adhesion barriers as both primary and secondary prevention.DiscussionThis guideline presents recommendations that can be used by surgeons who treat patients with ASBO. Scientific evidence for some aspects of ASBO management is scarce, in particular aspects relating to special patient groups. Results of a randomized trial of laparoscopic versus open surgery for ASBO are awaited.
Published: 2018

5. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery

Author: Bala, Miklosh, Catena, Fausto, Kashuk, Jeffry, De Simone, Belinda, Gomes, Carlos Augusto, Weber, Dieter, Sartelli, Massimo, Coccolini, Federico, Kluger, Yoram, Abu-Zidan, Fikri M., Picetti, Edoardo, Ansaloni, Luca, Augustin, Goran, Biffl, Walter L., Ceresoli, Marco, Chiara, Osvaldo, Chiarugi, Massimo, Coimbra, Raul, Cui, Yunfeng, Damaskos, Dimitris, Di Saverio, Salomone, Galante, Joseph M., Khokha, Vladimir, Kirkpatrick, Andrew W., Inaba, Kenji, Leppäniemi, Ari, Litvin, Andrey, Peitzman, Andrew B., Shelat, Vishal G., Sugrue, Michael, Tolonen, Matti, Rizoli, Sandro, Sall, Ibrahima, Beka, Solomon G., Di Carlo, Isidoro, Ten Broek, Richard, Mircea, Chirika, Tebala, Giovanni, Pisano, Michele, van Goor, Harry, Maier, Ronald V., Jeekel, Hans, Civil, Ian, Hecker, Andreas, Tan, Edward, Soreide, Kjetil, Lee, Matthew J., Wani, Imtiaz, Bonavina, Luigi, Malangoni, Mark A., Koike, Kaoru, Velmahos, George C., Fraga, Gustavo P., Fette, Andreas, de’Angelis, Nicola, Balogh, Zsolt J., Scalea, Thomas M., Sganga, Gabriele, Kelly, Michael D., Khan, Jim, Stahel, Philip F., and Moore, Ernest E.
Published: 2022
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6. WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment

Author: Smyth, Luke, Bendinelli, Cino, Lee, Nicholas, Reeds, Matthew G., Loh, Eu Jhin, Amico, Francesco, Balogh, Zsolt J., Di Saverio, Salomone, Weber, Dieter, ten Broek, Richard Peter, Abu-Zidan, Fikri M., Campanelli, Giampiero, Beka, Solomon Gurmu, Chiarugi, Massimo, Shelat, Vishal G., Tan, Edward, Moore, Ernest, Bonavina, Luigi, Latifi, Rifat, Hecker, Andreas, Khan, Jim, Coimbra, Raul, Tebala, Giovanni D., Søreide, Kjetil, Wani, Imtiaz, Inaba, Kenji, Kirkpatrick, Andrew W., Koike, Kaoru, Sganga, Gabriele, Biffl, Walter L., Chiara, Osvaldo, Scalea, Thomas M., Fraga, Gustavo P., Peitzman, Andrew B., and Catena, Fausto
Published: 2022
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7. The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly

Author: Fugazzola, Paola, Ceresoli, Marco, Coccolini, Federico, Gabrielli, Francesco, Puzziello, Alessandro, Monzani, Fabio, Amato, Bruno, Sganga, Gabriele, Sartelli, Massimo, Menichetti, Francesco, Puglisi, Gabriele Adolfo, Tartaglia, Dario, Carcoforo, Paolo, Avenia, Nicola, Kluger, Yoram, Paolillo, Ciro, Zago, Mauro, Leppäniemi, Ari, Tomasoni, Matteo, Cobianchi, Lorenzo, Dal Mas, Francesca, Improta, Mario, Moore, Ernest E., Peitzman, Andrew B., Sugrue, Michael, Agnoletti, Vanni, Fraga, Gustavo P., Weber, Dieter G., Damaskos, Dimitrios, Abu-Zidan, Fikri M., Wani, Imtiaz, Kirkpatrick, Andrew W., Pikoulis, Manos, Pararas, Nikolaos, Tan, Edward, Broek, Richard Ten, Maier, Ronald V., Davies, R. Justin, Kashuk, Jeffry, Shelat, Vishal G., Mefire, Alain Chicom, Augustin, Goran, Magnone, Stefano, Poiasina, Elia, De Simone, Belinda, Chiarugi, Massimo, Biffl, Walt, Baiocchi, Gian Luca, Catena, Fausto, and Ansaloni, Luca
Published: 2022
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8. WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections

Author: Sartelli, Massimo, Coccolini, Federico, Kluger, Yoram, Agastra, Ervis, Abu-Zidan, Fikri M., Abbas, Ashraf El Sayed, Ansaloni, Luca, Adesunkanmi, Abdulrashid Kayode, Augustin, Goran, Bala, Miklosh, Baraket, Oussama, Biffl, Walter L., Ceresoli, Marco, Cerutti, Elisabetta, Chiara, Osvaldo, Cicuttin, Enrico, Chiarugi, Massimo, Coimbra, Raul, Corsi, Daniela, Cortese, Francesco, Cui, Yunfeng, Damaskos, Dimitris, de’Angelis, Nicola, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, de Jonge, Stijn W., Di Bella, Stefano, Di Saverio, Salomone, Duane, Therese M., Fugazzola, Paola, Galante, Joseph M., Ghnnam, Wagih, Gkiokas, George, Gomes, Carlos Augusto, Griffiths, Ewen A., Hardcastle, Timothy C., Hecker, Andreas, Herzog, Torsten, Karamarkovic, Aleksandar, Khokha, Vladimir, Kim, Peter K., Kim, Jae Il, Kirkpatrick, Andrew W., Kong, Victor, Koshy, Renol M., Inaba, Kenji, Isik, Arda, Ivatury, Rao, Labricciosa, Francesco M., Lee, Yeong Yeh, Leppäniemi, Ari, Litvin, Andrey, Luppi, Davide, Maier, Ronald V., Marinis, Athanasios, Marwah, Sanjay, Mesina, Cristian, Moore, Ernest E., Moore, Frederick A., Negoi, Ionut, Olaoye, Iyiade, Ordoñez, Carlos A., Ouadii, Mouaqit, Peitzman, Andrew B., Perrone, Gennaro, Pintar, Tadeja, Pipitone, Giuseppe, Podda, Mauro, Raşa, Kemal, Ribeiro, Julival, Rodrigues, Gabriel, Rubio-Perez, Ines, Sall, Ibrahima, Sato, Norio, Sawyer, Robert G., Shelat, Vishal G., Sugrue, Michael, Tarasconi, Antonio, Tolonen, Matti, Viaggi, Bruno, Celotti, Andrea, Casella, Claudio, Pagani, Leonardo, Dhingra, Sameer, Baiocchi, Gian Luca, and Catena, Fausto
Published: 2022
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9. Splenic trauma: WSES classification and guidelines for adult and pediatric patients

Author: Coccolini, Federico, Montori, Giulia, Catena, Fausto, Kluger, Yoram, Biffl, Walter, Moore, Ernest E, Reva, Viktor, Bing, Camilla, Bala, Miklosh, Fugazzola, Paola, Bahouth, Hany, Marzi, Ingo, Velmahos, George, Ivatury, Rao, Soreide, Kjetil, Horer, Tal, ten Broek, Richard, Pereira, Bruno M, Fraga, Gustavo P, Inaba, Kenji, Kashuk, Joseph, Parry, Neil, Masiakos, Peter T, Mylonas, Konstantinos S, Kirkpatrick, Andrew, Abu-Zidan, Fikri, Gomes, Carlos Augusto, Benatti, Simone Vasilij, Naidoo, Noel, Salvetti, Francesco, Maccatrozzo, Stefano, Agnoletti, Vanni, Gamberini, Emiliano, Solaini, Leonardo, Costanzo, Antonio, Celotti, Andrea, Tomasoni, Matteo, Khokha, Vladimir, Arvieux, Catherine, Napolitano, Lena, Handolin, Lauri, Pisano, Michele, Magnone, Stefano, Spain, David A, de Moya, Marc, Davis, Kimberly A, De Angelis, Nicola, Leppaniemi, Ari, Ferrada, Paula, Latifi, Rifat, Navarro, David Costa, Otomo, Yashuiro, Coimbra, Raul, Maier, Ronald V, Moore, Frederick, Rizoli, Sandro, Sakakushev, Boris, Galante, Joseph M, Chiara, Osvaldo, Cimbanassi, Stefania, Mefire, Alain Chichom, Weber, Dieter, Ceresoli, Marco, Peitzman, Andrew B, Wehlie, Liban, Sartelli, Massimo, Di Saverio, Salomone, and Ansaloni, Luca
Subjects: Physical Injury - Accidents and Adverse Effects, Childhood Injury, Emergency Care, Patient Safety, Pediatric, Hematology, Injuries and accidents, Abdominal Injuries, Adult, Conservative Treatment, Guidelines as Topic, Hemodynamics, Humans, Spleen, Wounds and Injuries, Trauma, Classification, Guidelines, Embolization, Surgery, Non-operative, Conservative
Abstract: Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions. Lastly, as the management of adults and children must be different, children should always be treated in dedicated pediatric trauma centers. In fact, the vast majority of pediatric patients with blunt splenic trauma can be managed non-operatively. This paper presents the World Society of Emergency Surgery (WSES) classification of splenic trauma and the management guidelines.
Published: 2017

10. Development and Validation of the Air Medical Prehospital Triage Score for Helicopter Transport of Trauma Patients

Author: Brown, Joshua B, Gestring, Mark L, Guyette, Francis X, Rosengart, Matthew R, Stassen, Nicole A, Forsythe, Raquel M, Billiar, Timothy R, Peitzman, Andrew B, and Sperry, Jason L
Subjects: Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Adult, Aged, Air Ambulances, Female, Humans, Injury Severity Score, Male, Middle Aged, Patient Selection, Reproducibility of Results, Retrospective Studies, Survival Rate, Triage, Wounds and Injuries, Young Adult, air medical, emergency medical services, helicopter, injury, prehospital, scene, transport, trauma, triage, Medical and Health Sciences, Surgery, Clinical sciences
Abstract: ObjectiveThe aim of this study was to develop and internally validate a triage score that can identify trauma patients at the scene who would potentially benefit from helicopter emergency medical services (HEMS).Summary background dataAlthough survival benefits have been shown at the population level, identification of patients most likely to benefit from HEMS transport is imperative to justify the risks and cost of this intervention.MethodsRetrospective cohort study of subjects undergoing scene HEMS or ground emergency medical services (GEMS) in the National Trauma Databank (2007-2012). Data were split into training and validation sets. Subjects were grouped by triage criteria in the training set and regression used to determine which criteria had a survival benefit associated with HEMS. Points were assigned to these criteria to develop the Air Medical Prehospital Triage (AMPT) score. The score was applied in the validation set to determine whether subjects triaged to HEMS had a survival benefit when actually transported by helicopter.ResultsThere were 2,086,137 subjects included. Criteria identified for inclusion in the AMPT score included GCS 29, flail chest, hemo/pneumothorax, paralysis, and multisystem trauma. The optimal cutoff for triage to HEMS was ≥2 points. In subjects triaged to HEMS, actual transport by HEMS was associated with an increased odds of survival (AOR 1.28; 95% confidence interval [CI] 1.21-1.36, P
Published: 2016

11. Not all prehospital time is equal

Author: Brown, Joshua B, Rosengart, Matthew R, Forsythe, Raquel M, Reynolds, Benjamin R, Gestring, Mark L, Hallinan, William M, Peitzman, Andrew B, Billiar, Timothy R, and Sperry, Jason L
Subjects: Public Health, Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Physical Injury - Accidents and Adverse Effects, Clinical Research, Good Health and Well Being, Adolescent, Adult, Aged, Ambulances, Emergency Medical Services, Female, Humans, Injury Severity Score, Male, Middle Aged, Pennsylvania, Registries, Time Factors, Transportation of Patients, Trauma Centers, Triage, Wounds and Injuries, Outcome, prehospital time, emergency medical services, intubation, extrication, Clinical sciences, Nursing
Abstract: BackgroundTrauma is time sensitive, and minimizing prehospital (PH) time is appealing. However, most studies have not linked increasing PH time with worse outcomes because raw PH times are highly variable. It is unclear whether specific PH time patterns affect outcomes. Our objective was to evaluate the association of PH time interval distribution with mortality.MethodsPatients transported by emergency medical services in the Pennsylvania trauma registry from 2000 to 2013 with a total PH time (TPT) of 20 minutes or longer were included. TPT was divided into three PH time intervals: response, scene, and transport time. The number of minutes in each PH time interval was divided by TPT to determine the relative proportion each interval contributed to TPT. A prolonged interval was defined as any one PH interval contributing equal to or greater than 50% of TPT. Patients were classified by prolonged PH interval or no prolonged PH interval (all intervals < 50% of TPT). Patients were matched for TPT, and conditional logistic regression determined the association of mortality with PH time pattern, controlling for confounders. PH interventions were explored as potential mediators, and PH triage criteria used identify patients with time-sensitive injuries.ResultsThere were 164,471 patients included. Patients with prolonged scene time had increased odds of mortality (odds ratio, 1.21; 95% confidence interval, 1.02-1.44; p = 0.03). Prolonged response, transport, and no prolonged interval were not associated with mortality. When adjusting for mediators including extrication and PH intubation, prolonged scene time was no longer associated with mortality (odds ratio, 1.06; 95% confidence interval, 0.90-1.25; p = 0.50). Together, these factors mediated 61% of the effect between prolonged scene time and mortality. Mortality remained associated with prolonged scene time in patients with hypotension, penetrating injury, and flail chest.ConclusionProlonged scene time is associated with increased mortality. PH interventions partially mediate this association. Further study should evaluate whether these interventions drive increased mortality because they prolong scene time or by another mechanism, as reducing scene time may be a target for intervention.Level of evidencePrognostic/epidemiologic study, level III.
Published: 2016

12. Helicopters and injured kids

Author: Brown, Joshua B, Leeper, Christine M, Sperry, Jason L, Peitzman, Andrew B, Billiar, Timothy R, Gaines, Barbara A, and Gestring, Mark L
Subjects: Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Clinical Research, Pediatric, Physical Injury - Accidents and Adverse Effects, Good Health and Well Being, Adolescent, Air Ambulances, Child, Child, Preschool, Emergency Medical Services, Female, Follow-Up Studies, Humans, Injury Severity Score, Male, Multiple Trauma, Odds Ratio, Propensity Score, Retrospective Studies, Survival Rate, Time Factors, Time-to-Treatment, Transportation of Patients, Triage, United States, Young Adult, Helicopter, children, outcomes, prehospital, emergency medical services, Clinical sciences, Nursing
Abstract: BackgroundHelicopter emergency medical services (HEMS) are frequently used to transport injured children, despite unclear evidence of benefit. The study objective was to evaluate the association of HEMS compared with ground emergency medical services (GEMS) transport with outcomes in a national sample of pediatric trauma patients.MethodsPatients 15 years or younger undergoing scene transport by HEMS or GEMS in the National Trauma Data Bank from 2007 to 2012 were included. Propensity score matching was used to match HEMS and GEMS patients for likelihood of HEMS transport based on demographics, prehospital physiology and time, injury severity, and geographic region. Absolute standardized differences of less than 0.1 indicated adequate covariate balance between groups after matching. The primary outcome was in-hospital survival, while the secondary outcome was discharge disposition in survivors. Conditional logistic regression determined the association between HEMS versus GEMS transport with outcomes while controlling for demographics, admission physiology, injury severity, nonaccidental trauma, and in-hospital complications not accounted for in the propensity score. Subgroup analysis was performed in patients with a transport time of greater than 15 minutes to capture patients with the potential for HEMS transport.ResultsA total of 25,700 HEMS/GEMS pairs were matched from 166,594 patients. Groups were well matched, with all propensity score variables having absolute standardized differences of less than 0.1. In matched patients, HEMS was associated with a 72% increase in odds of survival compared with GEMS (adjusted odds ratio, 1.72; 95% confidence interval, 1.26-2.36; p < 0.01). Transport mode was not associated with discharge disposition (p = 0.47). Subgroup analysis included 17,657 HEMS/GEMS pairs. HEMS was again associated with a significant increase in odds of survival (adjusted odds ratio, 1.81; 95% confidence interval, 1.24-2.65; p < 0.01), while transport mode was not associated with discharge disposition (p = 0.58).ConclusionScene transport by HEMS was associated with improved odds of survival compared with GEMS in pediatric trauma patients. Further study is warranted to understand the underlying mechanisms and develop specific triage criteria for HEMS transport in this population.Level of evidenceTherapeutic study, level III.
Published: 2016

13. Helicopter transport improves survival following injury in the absence of a time-saving advantage

Author: Brown, Joshua B, Gestring, Mark L, Guyette, Francis X, Rosengart, Matthew R, Stassen, Nicole A, Forsythe, Raquel M, Billiar, Timothy R, Peitzman, Andrew B, and Sperry, Jason L
Subjects: Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Air Ambulances, Ambulances, Cohort Studies, Emergency Medical Services, Female, Humans, Injury Severity Score, Logistic Models, Male, Multiple Trauma, Odds Ratio, Propensity Score, Quality Improvement, Retrospective Studies, Risk Assessment, Survival Analysis, Time Factors, Time-to-Treatment, Transportation of Patients, Surgery, Clinical sciences
Abstract: BackgroundAlthough survival benefits have been shown at the population level, it remains unclear what drives the outcome benefits for helicopter emergency medical services (HEMS) in trauma. Although speed is often cited as the vital factor of HEMS, we hypothesized a survival benefit would exist in the absence of a time savings over ground emergency medical services (GEMS). The objective was to examine the association of survival with HEMS compared with GEMS transport across similar prehospital transport times.MethodsWe used a retrospective cohort of scene HEMS and GEMS transports in the National Trauma Databank (2007-2012). Propensity score matching was used to match HEMS and GEMS subjects on the likelihood of HEMS transport. Subjects were stratified by prehospital transport times in 5-minute increments. Conditional logistic regression determined the association of HEMS with survival across prehospital transport times strata controlling for confounders. Transport distance was estimated from prehospital transport times and average HEMS/GEMS transport speeds.ResultsThere were 155,691 HEMS/GEMS pairs matched. HEMS had a survival benefit over GEMS for prehospital transport times between 6 and 30 minutes. This benefit ranged from a 46% increase in odds of survival between 26 and 30 minutes (adjusted odds ratio [AOR], 1.46; 95% CI, 1.11-1.93; P < .01) to an 80% increase in odds of survival between 16 and 20 minutes (AOR, 1.80; 95% CI, 1.51-2.14; P < .01). This prehospital transport times window corresponds to estimated transport distance between 14.3 and 71.3 miles for HEMS and 3.3 and 16.6 miles for GEMS.ConclusionWhen stratified by prehospital transport times, HEMS had a survival benefit concentrated in a window between 6 and 30 minutes. Because there was no time-savings advantage for HEMS, these findings may reflect care delivered by HEMS providers.
Published: 2016

14. Geographic Variation in Outcome Benefits of Helicopter Transport for Trauma in the United States

Author: Brown, Joshua B, Gestring, Mark L, Stassen, Nicole A, Forsythe, Raquel M, Billiar, Timothy R, Peitzman, Andrew B, and Sperry, Jason L
Subjects: Biomedical and Clinical Sciences, Clinical Sciences, Physical Injury - Accidents and Adverse Effects, Clinical Research, Good Health and Well Being, Adolescent, Adult, Aged, Aged, 80 and over, Air Ambulances, Databases, Factual, Female, Healthcare Disparities, Humans, Logistic Models, Male, Middle Aged, Outcome Assessment, Health Care, Propensity Score, Retrospective Studies, United States, Wounds and Injuries, Young Adult, geographic, helicopter, outcome, trauma, variation, Medical and Health Sciences, Surgery, Clinical sciences
Abstract: ObjectiveEvaluate the effect of US geographic region on outcomes of helicopter transport (HT) for trauma.BackgroundHT is an integral component of trauma systems. Evidence suggests that HT is associated with improved outcomes; however, no studies examine the impact of geographic variation on outcomes for HT.MethodsRetrospective cohort study of patients undergoing scene HT or ground transport in the National Trauma Databank (2009-2012). Subjects were divided by US census region. HT and ground transport subjects were propensity-score matched based on prehospital physiology and injury severity. Conditional logistic regression was used to evaluate the effect of HT on survival and discharge to home in each region. Region-level characteristics were assessed as potential explanatory factors.ResultsA total of 193,629 pairs were matched. HT was associated with increased odds of survival and discharge to home; however, the magnitude of these effects varied significantly across regions (P
Published: 2016

15. Geographic distribution of trauma centers and injury-related mortality in the United States

Author: Brown, Joshua B, Rosengart, Matthew R, Billiar, Timothy R, Peitzman, Andrew B, and Sperry, Jason L
Subjects: Public Health, Health Sciences, Physical Injury - Accidents and Adverse Effects, Clinical Research, Good Health and Well Being, Geography, Hospital Mortality, Humans, Trauma Centers, United States, Wounds and Injuries, Geospatial, spatial, trauma systems, fatality rate, nearest neighbor, Clinical sciences, Nursing
Abstract: BackgroundRegionalized trauma care improves outcomes; however, access to care is not uniform across the United States. The objective was to evaluate whether geographic distribution of trauma centers correlates with injury mortality across state trauma systems.MethodsLevel I or II trauma centers in the contiguous United States were mapped. State-level age-adjusted injury fatality rates per 100,000 people were obtained and evaluated for spatial autocorrelation. Nearest neighbor ratios (NNRs) were generated for each state. A NNR less than 1 indicates clustering, while a NNR greater than 1 indicates dispersion. NNRs were tested for difference from random geographic distribution. Fatality rates and NNRs were examined for correlation. Fatality rates were compared between states with trauma center clustering versus dispersion. Trauma center distribution and population density were evaluated. Spatial-lag regression determined the association between fatality rate and NNR, controlling for state-level demographics, population density, injury severity, trauma system resources, and socioeconomic factors.ResultsFatality rates were spatially autocorrelated (Moran's I = 0.35, p < 0.01). Nine states had a clustered pattern (median NNR, 0.55; interquartile range [IQR], 0.48-0.60), 22 had a dispersed pattern (median NNR, 2.00; IQR, 1.68-3.99), and 10 had a random pattern (median NNR, 0.90; IQR, 0.85-1.00) of trauma center distribution. Fatality rate and NNR were correlated (ρ = 0.34, p = 0.03). Clustered states had a lower median injury fatality rate compared with dispersed states (56.9 [IQR, 46.5-58.9] vs. 64.9 [IQR, 52.5-77.1]; p = 0.04). Dispersed compared with clustered states had more counties without a trauma center that had higher population density than counties with a trauma center (5.7% vs. 1.2%, p < 0.01). Spatial-lag regression demonstrated that fatality rates increased by 0.02 per 100,000 persons for each unit increase in NNR (p < 0.01).ConclusionGeographic distribution of trauma centers correlates with injury mortality, with more clustered state trauma centers associated with lower fatality rates. This may be a result of access relative to population density. These results may have implications for trauma system planning and require further study to investigate underlying mechanisms.Level of evidenceTherapeutic/care management study, level IV.
Published: 2016

16. Textbook outcome in urgent early cholecystectomy for acute calculous cholecystitis: results post hoc of the S.P.Ri.M.A.C.C study

Author: Fugazzola, P, Carbonell-Morote, S, Cobianchi, L, Coccolini, F, Rubio-Garcia, J, Sartelli, M, Biffl, W, Catena, F, Ansaloni, L, Ramia, J, Augustin, G, Moric, T, Awad, S, Alzahrani, A, Elbahnasawy, M, Massalou, D, De Simone, B, Demetrashvili, Z, Kimpizi, A, Schizas, D, Balalis, D, Tasis, N, Papadoliopoulou, M, Georgios, P, Lasithiotakis, K, Ioannidis, O, Bains, L, Magnoli, M, Cianci, P, Conversano, N, Pasculli, A, Andreuccetti, J, Arici, E, Pignata, G, Tiberio, G, Podda, M, Murru, C, Veroux, M, Distefano, C, Centonze, D, Favi, F, Agnoletti, V, Bova, R, Convertini, G, Balla, A, Sasia, D, Giraudo, G, Gabriele, A, Tartaglia, N, Pavone, G, D'Acapito, F, Fabbri, N, Ferrara, F, Cimbanassi, S, Ferrario, L, Ciof, S, Ceresoli, M, Fumagalli, C, Degrate, L, Degiuli, M, Sofa, S, Licari, L, Tomasoni, M, Dominioni, T, Fare, C, Maestri, M, Vigano, J, Sargenti, B, Anderloni, A, Musella, V, Frassini, S, Gambini, G, Improta, M, Patriti, A, Coletta, D, Conti, L, Malerba, M, Andrea, M, Calabro, M, De Zolt, B, Bellio, G, Giordano, A, Luppi, D, Corbellini, C, Sampietro, G, Marafante, C, Rossi, S, Mingoli, A, Lapolla, P, Cicerchia, P, Siragusa, L, Grande, M, Arcudi, C, Antonelli, A, Vinci, D, De Martino, C, Armellino, M, Bisogno, E, Visconti, D, Santarelli, M, Montanari, E, Biloslavo, A, Germani, P, Zaghi, C, Oka, N, Fathi, M, Rios-Cruz, D, Hernandez, E, Garzali, I, Duarte, L, Negoi, I, Litvin, A, Chowdhury, S, Alshahrani, S, Moreira, C, Ponce, I, Mendoza-Moreno, F, Campana, A, Bayo, H, Serra, A, Landaluce, A, Estraviz-Mateos, B, Markinez-Gordobil, I, Serradilla-Martin, M, Cano-Paredero, A, Dobon-Rascon, M, Hamid, H, Baraket, O, Gonullu, E, Leventoglu, S, Turk, Y, Buyukkasap, C, Aday, U, Kara, Y, Kabuli, H, Atici, S, Colak, E, Chooklin, S, Chuklin, S, Ruta, F, Di Martino, M, Dal Mas, F, Abu-Zidan, F, Di Saverio, S, Leppaniemi, A, Martin-Perez, E, de la Hoz Rodriguez, A, Moore, E, Peitzman, A, Fugazzola P., Carbonell-Morote S., Cobianchi L., Coccolini F., Rubio-Garcia J. J., Sartelli M., Biffl W., Catena F., Ansaloni L., Ramia J. M., Augustin G., Moric T., Awad S., Alzahrani A. M., Elbahnasawy M., Massalou D., De Simone B., Demetrashvili Z., Kimpizi A. -D., Schizas D., Balalis D., Tasis N., Papadoliopoulou M., Georgios P., Lasithiotakis K., Ioannidis O., Bains L., Magnoli M., Cianci P., Conversano N. I., Pasculli A., Andreuccetti J., Arici E., Pignata G., Tiberio G. A. M., Podda M., Murru C., Veroux M., Distefano C., Centonze D., Favi F., Agnoletti V., Bova R., Convertini G., Balla A., Sasia D., Giraudo G., Gabriele A., Tartaglia N., Pavone G., D'Acapito F., Fabbri N., Ferrara F., Cimbanassi S., Ferrario L., Ciof S., Ceresoli M., Fumagalli C., Degrate L., Degiuli M., Sofa S., Licari L., Tomasoni M., Dominioni T., Fare C. N., Maestri M., Vigano J., Sargenti B., Anderloni A., Musella V., Frassini S., Gambini G., Improta M., Patriti A., Coletta D., Conti L., Malerba M., Andrea M., Calabro M., De Zolt B., Bellio G., Giordano A., Luppi D., Corbellini C., Sampietro G. M., Marafante C., Rossi S., Mingoli A., Lapolla P., Cicerchia P. M., Siragusa L., Grande M., Arcudi C., Antonelli A., Vinci D., De Martino C., Armellino M. F., Bisogno E., Visconti D., Santarelli M., Montanari E., Biloslavo A., Germani P., Zaghi C., Oka N., Fathi M. A., Rios-Cruz D., Hernandez E. E. L., Garzali I. U., Duarte L., Negoi I., Litvin A., Chowdhury S., Alshahrani S. M., Moreira C. C. L., Ponce I. A., Mendoza-Moreno F., Campana A. M., Bayo H. L., Serra A. C., Landaluce A., Estraviz-Mateos B., Markinez-Gordobil I., Serradilla-Martin M., Cano-Paredero A., Dobon-Rascon M. A., Hamid H., Baraket O., Gonullu E., Leventoglu S., Turk Y., Buyukkasap C., Aday U., Kara Y., Kabuli H. A., Atici S. D., Colak E., Chooklin S., Chuklin S., Ruta F., Di Martino M., Dal Mas F., Abu-Zidan F. M., Di Saverio S., Leppaniemi A., Martin-Perez E., de la Hoz Rodriguez A., Moore E. E., Peitzman A. B., Fugazzola, P, Carbonell-Morote, S, Cobianchi, L, Coccolini, F, Rubio-Garcia, J, Sartelli, M, Biffl, W, Catena, F, Ansaloni, L, Ramia, J, Augustin, G, Moric, T, Awad, S, Alzahrani, A, Elbahnasawy, M, Massalou, D, De Simone, B, Demetrashvili, Z, Kimpizi, A, Schizas, D, Balalis, D, Tasis, N, Papadoliopoulou, M, Georgios, P, Lasithiotakis, K, Ioannidis, O, Bains, L, Magnoli, M, Cianci, P, Conversano, N, Pasculli, A, Andreuccetti, J, Arici, E, Pignata, G, Tiberio, G, Podda, M, Murru, C, Veroux, M, Distefano, C, Centonze, D, Favi, F, Agnoletti, V, Bova, R, Convertini, G, Balla, A, Sasia, D, Giraudo, G, Gabriele, A, Tartaglia, N, Pavone, G, D'Acapito, F, Fabbri, N, Ferrara, F, Cimbanassi, S, Ferrario, L, Ciof, S, Ceresoli, M, Fumagalli, C, Degrate, L, Degiuli, M, Sofa, S, Licari, L, Tomasoni, M, Dominioni, T, Fare, C, Maestri, M, Vigano, J, Sargenti, B, Anderloni, A, Musella, V, Frassini, S, Gambini, G, Improta, M, Patriti, A, Coletta, D, Conti, L, Malerba, M, Andrea, M, Calabro, M, De Zolt, B, Bellio, G, Giordano, A, Luppi, D, Corbellini, C, Sampietro, G, Marafante, C, Rossi, S, Mingoli, A, Lapolla, P, Cicerchia, P, Siragusa, L, Grande, M, Arcudi, C, Antonelli, A, Vinci, D, De Martino, C, Armellino, M, Bisogno, E, Visconti, D, Santarelli, M, Montanari, E, Biloslavo, A, Germani, P, Zaghi, C, Oka, N, Fathi, M, Rios-Cruz, D, Hernandez, E, Garzali, I, Duarte, L, Negoi, I, Litvin, A, Chowdhury, S, Alshahrani, S, Moreira, C, Ponce, I, Mendoza-Moreno, F, Campana, A, Bayo, H, Serra, A, Landaluce, A, Estraviz-Mateos, B, Markinez-Gordobil, I, Serradilla-Martin, M, Cano-Paredero, A, Dobon-Rascon, M, Hamid, H, Baraket, O, Gonullu, E, Leventoglu, S, Turk, Y, Buyukkasap, C, Aday, U, Kara, Y, Kabuli, H, Atici, S, Colak, E, Chooklin, S, Chuklin, S, Ruta, F, Di Martino, M, Dal Mas, F, Abu-Zidan, F, Di Saverio, S, Leppaniemi, A, Martin-Perez, E, de la Hoz Rodriguez, A, Moore, E, Peitzman, A, Fugazzola P., Carbonell-Morote S., Cobianchi L., Coccolini F., Rubio-Garcia J. J., Sartelli M., Biffl W., Catena F., Ansaloni L., Ramia J. M., Augustin G., Moric T., Awad S., Alzahrani A. M., Elbahnasawy M., Massalou D., De Simone B., Demetrashvili Z., Kimpizi A. -D., Schizas D., Balalis D., Tasis N., Papadoliopoulou M., Georgios P., Lasithiotakis K., Ioannidis O., Bains L., Magnoli M., Cianci P., Conversano N. I., Pasculli A., Andreuccetti J., Arici E., Pignata G., Tiberio G. A. M., Podda M., Murru C., Veroux M., Distefano C., Centonze D., Favi F., Agnoletti V., Bova R., Convertini G., Balla A., Sasia D., Giraudo G., Gabriele A., Tartaglia N., Pavone G., D'Acapito F., Fabbri N., Ferrara F., Cimbanassi S., Ferrario L., Ciof S., Ceresoli M., Fumagalli C., Degrate L., Degiuli M., Sofa S., Licari L., Tomasoni M., Dominioni T., Fare C. N., Maestri M., Vigano J., Sargenti B., Anderloni A., Musella V., Frassini S., Gambini G., Improta M., Patriti A., Coletta D., Conti L., Malerba M., Andrea M., Calabro M., De Zolt B., Bellio G., Giordano A., Luppi D., Corbellini C., Sampietro G. M., Marafante C., Rossi S., Mingoli A., Lapolla P., Cicerchia P. M., Siragusa L., Grande M., Arcudi C., Antonelli A., Vinci D., De Martino C., Armellino M. F., Bisogno E., Visconti D., Santarelli M., Montanari E., Biloslavo A., Germani P., Zaghi C., Oka N., Fathi M. A., Rios-Cruz D., Hernandez E. E. L., Garzali I. U., Duarte L., Negoi I., Litvin A., Chowdhury S., Alshahrani S. M., Moreira C. C. L., Ponce I. A., Mendoza-Moreno F., Campana A. M., Bayo H. L., Serra A. C., Landaluce A., Estraviz-Mateos B., Markinez-Gordobil I., Serradilla-Martin M., Cano-Paredero A., Dobon-Rascon M. A., Hamid H., Baraket O., Gonullu E., Leventoglu S., Turk Y., Buyukkasap C., Aday U., Kara Y., Kabuli H. A., Atici S. D., Colak E., Chooklin S., Chuklin S., Ruta F., Di Martino M., Dal Mas F., Abu-Zidan F. M., Di Saverio S., Leppaniemi A., Martin-Perez E., de la Hoz Rodriguez A., Moore E. E., and Peitzman A. B.
Abstract: Introduction: A textbook outcome patient is one in which the operative course passes uneventful, without complications, readmission or mortality. There is a lack of publications in terms of TO on acute cholecystitis. Objetive: The objective of this study is to analyze the achievement of TO in patients with urgent early cholecystectomy (UEC) for Acute Cholecystitis. and to identify which factors are related to achieving TO. Materials and methods: This is a post hoc study of the SPRiMACC study. It ́s a prospective multicenter observational study run by WSES. The criteria to define TO in urgent early cholecystectomy (TOUEC) were no 30-day mortality, no 30-day postoperative complications, no readmission within 30 days, and hospital stay ≤ 7 days (75th percentile), and full laparoscopic surgery. Patients who met all these conditions were taken as presenting a TOUEC. Outcomes: 1246 urgent early cholecystectomies for ACC were included. In all, 789 patients (63.3%) achieved all TOUEC parameters, while 457 (36.6%) failed to achieve one or more parameters and were considered non-TOUEC. The patients who achieved TOUEC were younger had significantly lower scores on all the risk scales analyzed. In the serological tests, TOUEC patients had lower values for in a lot of variables than non-TOUEC patients. The TOUEC group had lower rates of complicated cholecystitis. Considering operative time, a shorter duration was also associated with a higher probability of reaching TOUEC. Conclusion: Knowledge of the factors that influence the TOUEC can allow us to improve our results in terms of textbook outcome.
Published: 2024

17. Pretrauma Center Red Blood Cell Transfusion Is Associated With Reduced Mortality and Coagulopathy in Severely Injured Patients With Blunt Trauma

Author: Brown, Joshua B, Cohen, Mitchell J, Minei, Joseph P, Maier, Ronald V, West, Michaela A, Billiar, Timothy R, Peitzman, Andrew B, Moore, Ernest E, Cuschieri, Joseph, and Sperry, Jason L
Subjects: Biomedical and Clinical Sciences, Clinical Sciences, Physical Injury - Accidents and Adverse Effects, Clinical Research, Good Health and Well Being, Adult, Blood Coagulation Disorders, Emergency Medical Services, Endopeptidase Clp, Erythrocyte Transfusion, Female, Heat-Shock Proteins, Humans, Injury Severity Score, Male, Middle Aged, Propensity Score, Prospective Studies, Protozoan Proteins, Shock, Hemorrhagic, Treatment Outcome, Wounds, Nonpenetrating, blood, prehospital, resuscitation, trauma, transfusion, Inflammation and the Host Response to Injury Investigators, Medical and Health Sciences, Surgery, Clinical sciences
Abstract: ObjectiveTo evaluate the association of pretrauma center (PTC) red blood cell (RBC) transfusion with outcomes in severely injured patients.BackgroundHemorrhage remains a major driver of mortality. Little evidence exists supporting PTC interventions to mitigate this.MethodsBlunt injured patients in shock arriving at a trauma center within 2 hours of injury were included from the Glue Grant database. Subjects were dichotomized by PTC RBC transfusion. Outcomes included 24-hour mortality, 30-day mortality, and trauma-induced coagulopathy [(TIC), admission international normalized ratio >1.5]. Cox regression and logistic regression determined the association of PTC RBC transfusion with outcomes. To address baseline differences, propensity score matching was used.ResultsOf 1415 subjects, 50 received PTC RBC transfusion. Demographics and injury severity score were similar. The PTC RBC group received 1.3 units of RBCs (median), and 52% were scene transports. PTC RBC transfusion was associated with a 95% reduction in odds of 24-hour mortality [odds ratio (OR) = 0.05; 95% confidence interval (CI), 0.01-0.48; P < 0.01], 64% reduction in the risk of 30-day mortality [hazard ratio = 0.36; 95% CI, 0.15-0.83; P = 0.02], and 88% reduction in odds of TIC (OR = 0.12; 95% CI, 0.02-0.79; P = 0.03). The matched cohort included 113 subjects (31% PTC RBC group). Baseline characteristics were similar. PTC RBC transfusion was associated with a 98% reduction in odds of 24-hour mortality (OR = 0.02; 95% CI, 0.01-0.69; P = 0.04), 88% reduction in the risk of 30-day mortality (hazard ratio = 0.12; 95% CI, 0.03-0.61; P = 0.01), and 99% reduction in odds of TIC (OR = 0.01; 95% CI, 0.01-0.95; P = 0.05).ConclusionsPTC RBC administration was associated with a lower risk of 24-hour mortality, 30-day mortality, and TIC in severely injured patients with blunt trauma, warranting further prospective study.
Published: 2015

18. 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

Author: de’Angelis, Nicola, Catena, Fausto, Memeo, Riccardo, Coccolini, Federico, Martínez-Pérez, Aleix, Romeo, Oreste M., De Simone, Belinda, Di Saverio, Salomone, Brustia, Raffaele, Rhaiem, Rami, Piardi, Tullio, Conticchio, Maria, Marchegiani, Francesco, Beghdadi, Nassiba, Abu-Zidan, Fikri M., Alikhanov, Ruslan, Allard, Marc-Antoine, Allievi, Niccolò, Amaddeo, Giuliana, Ansaloni, Luca, Andersson, Roland, Andolfi, Enrico, Azfar, Mohammad, Bala, Miklosh, Benkabbou, Amine, Ben-Ishay, Offir, Bianchi, Giorgio, Biffl, Walter L., Brunetti, Francesco, Carra, Maria Clotilde, Casanova, Daniel, Celentano, Valerio, Ceresoli, Marco, Chiara, Osvaldo, Cimbanassi, Stefania, Bini, Roberto, Coimbra, Raul, Luigi de’Angelis, Gian, Decembrino, Francesco, De Palma, Andrea, de Reuver, Philip R., Domingo, Carlos, Cotsoglou, Christian, Ferrero, Alessandro, Fraga, Gustavo P., Gaiani, Federica, Gheza, Federico, Gurrado, Angela, Harrison, Ewen, Henriquez, Angel, Hofmeyr, Stefan, Iadarola, Roberta, Kashuk, Jeffry L., Kianmanesh, Reza, Kirkpatrick, Andrew W., Kluger, Yoram, Landi, Filippo, Langella, Serena, Lapointe, Real, Le Roy, Bertrand, Luciani, Alain, Machado, Fernando, Maggi, Umberto, Maier, Ronald V., Mefire, Alain Chichom, Hiramatsu, Kazuhiro, Ordoñez, Carlos, Patrizi, Franca, Planells, Manuel, Peitzman, Andrew B., Pekolj, Juan, Perdigao, Fabiano, Pereira, Bruno M., Pessaux, Patrick, Pisano, Michele, Puyana, Juan Carlos, Rizoli, Sandro, Portigliotti, Luca, Romito, Raffaele, Sakakushev, Boris, Sanei, Behnam, Scatton, Olivier, Serradilla-Martin, Mario, Schneck, Anne-Sophie, Sissoko, Mohammed Lamine, Sobhani, Iradj, ten Broek, Richard P., Testini, Mario, Valinas, Roberto, Veloudis, Giorgos, Vitali, Giulio Cesare, Weber, Dieter, Zorcolo, Luigi, Giuliante, Felice, Gavriilidis, Paschalis, Fuks, David, and Sommacale, Daniele
Published: 2021
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19. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections

Author: Sartelli, Massimo, Coccolini, Federico, Kluger, Yoram, Agastra, Ervis, Abu-Zidan, Fikri M., Abbas, Ashraf El Sayed, Ansaloni, Luca, Adesunkanmi, Abdulrashid Kayode, Atanasov, Boyko, Augustin, Goran, Bala, Miklosh, Baraket, Oussama, Baral, Suman, Biffl, Walter L., Boermeester, Marja A., Ceresoli, Marco, Cerutti, Elisabetta, Chiara, Osvaldo, Cicuttin, Enrico, Chiarugi, Massimo, Coimbra, Raul, Colak, Elif, Corsi, Daniela, Cortese, Francesco, Cui, Yunfeng, Damaskos, Dimitris, de’ Angelis, Nicola, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, de Jonge, Stijn W., Dhingra, Sameer, Di Bella, Stefano, Di Marzo, Francesco, Di Saverio, Salomone, Dogjani, Agron, Duane, Therese M., Enani, Mushira Abdulaziz, Fugazzola, Paola, Galante, Joseph M., Gachabayov, Mahir, Ghnnam, Wagih, Gkiokas, George, Gomes, Carlos Augusto, Griffiths, Ewen A., Hardcastle, Timothy C., Hecker, Andreas, Herzog, Torsten, Kabir, Syed Mohammad Umar, Karamarkovic, Aleksandar, Khokha, Vladimir, Kim, Peter K., Kim, Jae Il, Kirkpatrick, Andrew W., Kong, Victor, Koshy, Renol M., Kryvoruchko, Igor A., Inaba, Kenji, Isik, Arda, Iskandar, Katia, Ivatury, Rao, Labricciosa, Francesco M., Lee, Yeong Yeh, Leppäniemi, Ari, Litvin, Andrey, Luppi, Davide, Machain, Gustavo M., Maier, Ronald V., Marinis, Athanasios, Marmorale, Cristina, Marwah, Sanjay, Mesina, Cristian, Moore, Ernest E., Moore, Frederick A., Negoi, Ionut, Olaoye, Iyiade, Ordoñez, Carlos A., Ouadii, Mouaqit, Peitzman, Andrew B., Perrone, Gennaro, Pikoulis, Manos, Pintar, Tadeja, Pipitone, Giuseppe, Podda, Mauro, Raşa, Kemal, Ribeiro, Julival, Rodrigues, Gabriel, Rubio-Perez, Ines, Sall, Ibrahima, Sato, Norio, Sawyer, Robert G., Segovia Lohse, Helmut, Sganga, Gabriele, Shelat, Vishal G., Stephens, Ian, Sugrue, Michael, Tarasconi, Antonio, Tochie, Joel Noutakdie, Tolonen, Matti, Tomadze, Gia, Ulrych, Jan, Vereczkei, Andras, Viaggi, Bruno, Gurioli, Chiara, Casella, Claudio, Pagani, Leonardo, Baiocchi, Gian Luca, and Catena, Fausto
Published: 2021
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20. Diagnosis and management of small bowel obstruction in virgin abdomen: a WSES position paper

Author: Amara, Yousef, Leppaniemi, Ari, Catena, Fausto, Ansaloni, Luca, Sugrue, Michael, Fraga, Gustavo P., Coccolini, Federico, Biffl, Walter L., Peitzman, Andrew B., Kluger, Yoram, Sartelli, Massimo, Moore, Ernest E., Di Saverio, Salomone, Darwish, Esfo, Endo, Chikako, van Goor, Harry, and ten Broek, Richard P.
Published: 2021
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21. Prehospital Use of Nonsteroidal Anti-inflammatory Drugs (NSAIDs) Is Associated With a Reduced Incidence of Trauma-Induced Coagulopathy

Author: Neal, Matthew D, Brown, Joshua B, Moore, Ernest E, Cuschieri, Joseph, Maier, Ronald V, Minei, Joseph P, Billiar, Timothy R, Peitzman, Andrew B, Cohen, Mitchell J, and Sperry, Jason L
Subjects: Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Physical Injury - Accidents and Adverse Effects, Aetiology, 2.1 Biological and endogenous factors, Adult, Anti-Inflammatory Agents, Non-Steroidal, Blood Coagulation Disorders, Blood Transfusion, Comorbidity, Female, Humans, Incidence, International Normalized Ratio, Male, Middle Aged, Risk Assessment, Risk Factors, Trauma Severity Indices, Wounds and Injuries, acute coagulopathy of trauma, Glue Grant, inflammation, NSAID, trauma, Inflammation and Host Response to Injury Investigators, Medical and Health Sciences, Surgery, Clinical sciences
Abstract: ObjectiveTo determine whether prehospital nonsteroidal anti-inflammatory drug (NSAID) use may lead to a reduced incidence of trauma-induced coagulopathy (TIC) in severely injured patients.BackgroundTIC is present in up to a quarter of severely injured trauma patients and is linked to worse outcomes after injury. Evidence linking TIC to inflammation has emerged; however, the mechanism behind this association is still under investigation. NSAIDs are commonly used anti-inflammatory drugs, but their effects on TIC and outcomes after injury are largely unexplored.MethodsWe performed a secondary analysis of the Inflammation and the Host Response to Injury Large Scale Collaborative Program (Glue Grant) data set. Prehospital medications and comorbidities were analyzed by logistic regression analysis for association with TIC as defined by laboratory (international normalized ratio >1.5) or clinical (transfusion >2 units of fresh frozen plasma or >1 pack of platelets in 6 hours) parameters.ResultsPrehospital NSIAD use was independently associated with a 72% lower risk of TIC and was the only medication among 15 analyzed to retain significance in the model. Stepwise logistic regression also demonstrated that preadmission use of NSAIDs was independently associated with a 66% lower risk of clinically significant coagulopathy. These findings were independent of comorbid conditions linked to NSAID use.ConclusionsNSAID use before admission for severe injury is associated with a reduced incidence of TIC. These findings provide further evidence to a potential leak between TIC and inflammation.
Published: 2014

22. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Author: Di Saverio, Salomone, Podda, Mauro, De Simone, Belinda, Ceresoli, Marco, Augustin, Goran, Gori, Alice, Boermeester, Marja, Sartelli, Massimo, Coccolini, Federico, Tarasconi, Antonio, de’ Angelis, Nicola, Weber, Dieter G., Tolonen, Matti, Birindelli, Arianna, Biffl, Walter, Moore, Ernest E., Kelly, Michael, Soreide, Kjetil, Kashuk, Jeffry, Ten Broek, Richard, Gomes, Carlos Augusto, Sugrue, Michael, Davies, Richard Justin, Damaskos, Dimitrios, Leppäniemi, Ari, Kirkpatrick, Andrew, Peitzman, Andrew B., Fraga, Gustavo P., Maier, Ronald V., Coimbra, Raul, Chiarugi, Massimo, Sganga, Gabriele, Pisanu, Adolfo, de’ Angelis, Gian Luigi, Tan, Edward, Van Goor, Harry, Pata, Francesco, Di Carlo, Isidoro, Chiara, Osvaldo, Litvin, Andrey, Campanile, Fabio C., Sakakushev, Boris, Tomadze, Gia, Demetrashvili, Zaza, Latifi, Rifat, Abu-Zidan, Fakri, Romeo, Oreste, Segovia-Lohse, Helmut, Baiocchi, Gianluca, Costa, David, Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Scalea, Thomas, Ivatury, Rao, Velmahos, George, Andersson, Roland, Kluger, Yoram, Ansaloni, Luca, and Catena, Fausto
Published: 2020
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23. 2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery

Author: De'Angelis, Nicola, Schena, Carlo Alberto, Marchegiani, Francesco, Reitano, Elisa, De Simone, Belinda, Wong, Geoffrey Yuet Mun, Martínez-Pérez, Aleix, Abu-Zidan, Fikri M, Agnoletti, Vanni, Aisoni, Filippo, Ammendola, Michele, Ansaloni, Luca, Bala, Miklosh, Biffl, Walter, Ceccarelli, Graziano, Ceresoli, Marco, Chiara, Osvaldo, Chiarugi, Massimo, Cimbanassi, Stefania, Coccolini, Federico, Coimbra, Raul, Di Saverio, Salomone, Diana, Michele, Dioguardi Burgio, Marco, Fraga, Gustavo, Gavriilidis, Paschali, Gurrado, Angela, Inchingolo, Riccardo, Ingels, Alexandre, Ivatury, Rao, Kashuk, Jeffry L, Khan, Jim, Kirkpatrick, Andrew W, Kim, Fernando J, Kluger, Yoram, Lakkis, Zaher, Leppäniemi, Ari, Maier, Ronald V, Memeo, Riccardo, Moore, Ernest E, Ordoñez, Carlos A, Peitzman, Andrew B, Pellino, Gianluca, Picetti, Edoardo, Pikoulis, Mano, Pisano, Michele, Podda, Mauro, Romeo, Oreste, Rosa, Fausto, Tan, Edward, Ten Broek, Richard P, Testini, Mario, Tian Wei Cheng, Brian Anthony, Weber, Dieter, Sacco, Emilio, Sartelli, Massimo, Tonsi, Alfredo, Dal Moro, Fabrizio, Catena, Fausto, Rosa, Fausto (ORCID:0000-0002-7280-8354), Sacco, Emilio (ORCID:0000-0003-4640-8354), De'Angelis, Nicola, Schena, Carlo Alberto, Marchegiani, Francesco, Reitano, Elisa, De Simone, Belinda, Wong, Geoffrey Yuet Mun, Martínez-Pérez, Aleix, Abu-Zidan, Fikri M, Agnoletti, Vanni, Aisoni, Filippo, Ammendola, Michele, Ansaloni, Luca, Bala, Miklosh, Biffl, Walter, Ceccarelli, Graziano, Ceresoli, Marco, Chiara, Osvaldo, Chiarugi, Massimo, Cimbanassi, Stefania, Coccolini, Federico, Coimbra, Raul, Di Saverio, Salomone, Diana, Michele, Dioguardi Burgio, Marco, Fraga, Gustavo, Gavriilidis, Paschali, Gurrado, Angela, Inchingolo, Riccardo, Ingels, Alexandre, Ivatury, Rao, Kashuk, Jeffry L, Khan, Jim, Kirkpatrick, Andrew W, Kim, Fernando J, Kluger, Yoram, Lakkis, Zaher, Leppäniemi, Ari, Maier, Ronald V, Memeo, Riccardo, Moore, Ernest E, Ordoñez, Carlos A, Peitzman, Andrew B, Pellino, Gianluca, Picetti, Edoardo, Pikoulis, Mano, Pisano, Michele, Podda, Mauro, Romeo, Oreste, Rosa, Fausto, Tan, Edward, Ten Broek, Richard P, Testini, Mario, Tian Wei Cheng, Brian Anthony, Weber, Dieter, Sacco, Emilio, Sartelli, Massimo, Tonsi, Alfredo, Dal Moro, Fabrizio, Catena, Fausto, Rosa, Fausto (ORCID:0000-0002-7280-8354), and Sacco, Emilio (ORCID:0000-0003-4640-8354)
Abstract: Iatrogenic urinary tract injury (IUTI) is a severe complication of emergency digestive surgery. It can lead to increased postoperative morbidity and mortality and have a long-term impact on the quality of life. The reported incidence of IUTIs varies greatly among the studies, ranging from 0.3 to 1.5%. Given the high volume of emergency digestive surgery performed worldwide, there is a need for well-defined and effective strategies to prevent and manage IUTIs. Currently, there is a lack of consensus regarding the prevention, detection, and management of IUTIs in the emergency setting. The present guidelines, promoted by the World Society of Emergency Surgery (WSES), were developed following a systematic review of the literature and an international expert panel discussion. The primary aim of these WSES guidelines is to provide evidence-based recommendations to support clinicians and surgeons in the prevention, detection, and management of IUTIs during emergency digestive surgery. The following key aspects were considered: (1) effectiveness of preventive interventions for IUTIs during emergency digestive surgery; (2) intra-operative detection of IUTIs and appropriate management strategies; (3) postoperative detection of IUTIs and appropriate management strategies and timing; and (4) effectiveness of antibiotic therapy (including type and duration) in case of IUTIs.
Published: 2023

24. Prospective validation of the Israeli Score for the prediction of common bile duct stones in patients with acute calculous cholecystitis

Author: Fugazzola, P, Cobianchi, L, Dal Mas, F, Cicuttin, E, Dominioni, T, Frassini, S, Tomasoni, M, Vigano, J, Catena, F, Ansaloni, L, Augustin, G, Moric, T, Awad, S, Alzahrani, A, Elbahnasawy, M, Massalou, D, De Simone, B, Demetrashvili, Z, Kimpizi, A, Schizas, D, Balalis, D, Tasis, N, Papadoliopoulou, M, Georgios, P, Lasithiotakis, K, Ioannidis, O, Bains, L, Magnoli, M, Cianci, P, Conversano, N, Pasculli, A, Andreuccetti, J, Arici, E, Pignata, G, Tiberio, G, Podda, M, Murru, C, Veroux, M, Distefano, C, Centonze, D, Favi, F, Bova, R, Convertini, G, Agnoletti, V, Balla, A, Sasia, D, Giraudo, G, Gabriele, A, Tartaglia, N, Pavone, G, D'Acapito, F, Fabbri, N, Ferrara, F, Cimbanassi, S, Ferrario, L, Cioffi, S, Ceresoli, M, Fumagalli, C, Degrate, L, Degiuli, M, Sofia, S, Licari, L, Anderloni, A, Maestri, M, Fare, C, Sargenti, B, Improta, M, Musella, V, Gambini, G, Patriti, A, Coletta, D, Conti, L, Malerba, M, Andrea, M, Calabro, M, De Zolt, B, Bellio, G, Giordano, A, Luppi, D, Corbellini, C, Sampietro, G, Marafante, C, Rossi, S, Mingoli, A, Lapolla, P, Cicerchia, P, Siragusa, L, Grande, M, Arcudi, C, Antonelli, A, Vinci, D, De Martino, C, Armellino, M, Bisogno, E, Visconti, D, Santarelli, M, Montanari, E, Biloslavo, A, Germani, P, Zaghi, C, Oka, N, Fathi, M, Rios-Cruz, D, Hernandez, E, Garzali, I, Duarte, L, Negoi, I, Litvin, A, Chowdhury, S, Alshahrani, S, Carbonell-Morote, S, Rubio-Garcia, J, Moreira, C, Ponce, I, Mendoza-Moreno, F, Campana, A, Bayo, H, Serra, A, Estraviz-Mateos, B, Markinez-Gordobil, I, Landaluce-Olavarria, A, Serradilla-Martin, M, Cano-Paredero, A, Dobon-Rascon, M, Hamid, H, Baraket, O, Gonullu, E, Leventoglu, S, Turk, Y, Buyukkasap, C, Aday, U, Kara, Y, Kabuli, H, Atici, S, Colak, E, Chooklin, S, Chuklin, S, Martin-Perez, E, de la Hoz Rodriguez, A, Di Martino, M, Di Saverio, S, Leppaniemi, A, Moore, E, Peitzman, A, Sartelli, M, Biffl, W, Fugazzola P., Cobianchi L., Dal Mas F., Cicuttin E., Dominioni T., Frassini S., Tomasoni M., Vigano J., Catena F., Ansaloni L., Augustin G., Moric T., Awad S., Alzahrani A. M., Elbahnasawy M., Massalou D., De Simone B., Demetrashvili Z., Kimpizi A. -D., Schizas D., Balalis D., Tasis N., Papadoliopoulou M., Georgios P., Lasithiotakis K., Ioannidis O., Bains L., Magnoli M., Cianci P., Conversano N. I., Pasculli A., Andreuccetti J., Arici E., Pignata G., Tiberio G. A. M., Podda M., Murru C., Veroux M., Distefano C., Centonze D., Favi F., Bova R., Convertini G., Agnoletti V., Balla A., Sasia D., Giraudo G., Gabriele A., Tartaglia N., Pavone G., D'Acapito F., Fabbri N., Ferrara F., Cimbanassi S., Ferrario L., Cioffi S., Ceresoli M., Fumagalli C., Degrate L., Degiuli M., Sofia S., Licari L., Anderloni A., Maestri M., Fare C. N., Sargenti B., Improta M., Musella V., Gambini G., Patriti A., Coletta D., Conti L., Malerba M., Andrea M., Calabro M., De Zolt B., Bellio G., Giordano A., Luppi D., Corbellini C., Sampietro G. M., Marafante C., Rossi S., Mingoli A., Lapolla P., Cicerchia P. M., Siragusa L., Grande M., Arcudi C., Antonelli A., Vinci D., De Martino C., Armellino M. F., Bisogno E., Visconti D., Santarelli M., Montanari E., Biloslavo A., Germani P., Zaghi C., Oka N., Fathi M. A., Rios-Cruz D., Hernandez E. E. L., Garzali I. U., Duarte L., Negoi I., Litvin A., Chowdhury S., Alshahrani S. M., Carbonell-Morote S., Rubio-Garcia J. J., Moreira C. C. L., Ponce I. A., Mendoza-Moreno F., Campana A. M., Bayo H. L., Serra A. C., Estraviz-Mateos B., Markinez-Gordobil I., Landaluce-Olavarria A., Serradilla-Martin M., Cano-Paredero A., Dobon-Rascon M. A., Hamid H., Baraket O., Gonullu E., Leventoglu S., Turk Y., Buyukkasap C., Aday U., Kara Y., Kabuli H. A., Atici S. D., Colak E., Chooklin S., Chuklin S., Martin-Perez E., de la Hoz Rodriguez A., Di Martino M., Di Saverio S., Leppaniemi A., Moore E. E., Peitzman A. B., Sartelli M., Biffl W., Fugazzola, P, Cobianchi, L, Dal Mas, F, Cicuttin, E, Dominioni, T, Frassini, S, Tomasoni, M, Vigano, J, Catena, F, Ansaloni, L, Augustin, G, Moric, T, Awad, S, Alzahrani, A, Elbahnasawy, M, Massalou, D, De Simone, B, Demetrashvili, Z, Kimpizi, A, Schizas, D, Balalis, D, Tasis, N, Papadoliopoulou, M, Georgios, P, Lasithiotakis, K, Ioannidis, O, Bains, L, Magnoli, M, Cianci, P, Conversano, N, Pasculli, A, Andreuccetti, J, Arici, E, Pignata, G, Tiberio, G, Podda, M, Murru, C, Veroux, M, Distefano, C, Centonze, D, Favi, F, Bova, R, Convertini, G, Agnoletti, V, Balla, A, Sasia, D, Giraudo, G, Gabriele, A, Tartaglia, N, Pavone, G, D'Acapito, F, Fabbri, N, Ferrara, F, Cimbanassi, S, Ferrario, L, Cioffi, S, Ceresoli, M, Fumagalli, C, Degrate, L, Degiuli, M, Sofia, S, Licari, L, Anderloni, A, Maestri, M, Fare, C, Sargenti, B, Improta, M, Musella, V, Gambini, G, Patriti, A, Coletta, D, Conti, L, Malerba, M, Andrea, M, Calabro, M, De Zolt, B, Bellio, G, Giordano, A, Luppi, D, Corbellini, C, Sampietro, G, Marafante, C, Rossi, S, Mingoli, A, Lapolla, P, Cicerchia, P, Siragusa, L, Grande, M, Arcudi, C, Antonelli, A, Vinci, D, De Martino, C, Armellino, M, Bisogno, E, Visconti, D, Santarelli, M, Montanari, E, Biloslavo, A, Germani, P, Zaghi, C, Oka, N, Fathi, M, Rios-Cruz, D, Hernandez, E, Garzali, I, Duarte, L, Negoi, I, Litvin, A, Chowdhury, S, Alshahrani, S, Carbonell-Morote, S, Rubio-Garcia, J, Moreira, C, Ponce, I, Mendoza-Moreno, F, Campana, A, Bayo, H, Serra, A, Estraviz-Mateos, B, Markinez-Gordobil, I, Landaluce-Olavarria, A, Serradilla-Martin, M, Cano-Paredero, A, Dobon-Rascon, M, Hamid, H, Baraket, O, Gonullu, E, Leventoglu, S, Turk, Y, Buyukkasap, C, Aday, U, Kara, Y, Kabuli, H, Atici, S, Colak, E, Chooklin, S, Chuklin, S, Martin-Perez, E, de la Hoz Rodriguez, A, Di Martino, M, Di Saverio, S, Leppaniemi, A, Moore, E, Peitzman, A, Sartelli, M, Biffl, W, Fugazzola P., Cobianchi L., Dal Mas F., Cicuttin E., Dominioni T., Frassini S., Tomasoni M., Vigano J., Catena F., Ansaloni L., Augustin G., Moric T., Awad S., Alzahrani A. M., Elbahnasawy M., Massalou D., De Simone B., Demetrashvili Z., Kimpizi A. -D., Schizas D., Balalis D., Tasis N., Papadoliopoulou M., Georgios P., Lasithiotakis K., Ioannidis O., Bains L., Magnoli M., Cianci P., Conversano N. I., Pasculli A., Andreuccetti J., Arici E., Pignata G., Tiberio G. A. M., Podda M., Murru C., Veroux M., Distefano C., Centonze D., Favi F., Bova R., Convertini G., Agnoletti V., Balla A., Sasia D., Giraudo G., Gabriele A., Tartaglia N., Pavone G., D'Acapito F., Fabbri N., Ferrara F., Cimbanassi S., Ferrario L., Cioffi S., Ceresoli M., Fumagalli C., Degrate L., Degiuli M., Sofia S., Licari L., Anderloni A., Maestri M., Fare C. N., Sargenti B., Improta M., Musella V., Gambini G., Patriti A., Coletta D., Conti L., Malerba M., Andrea M., Calabro M., De Zolt B., Bellio G., Giordano A., Luppi D., Corbellini C., Sampietro G. M., Marafante C., Rossi S., Mingoli A., Lapolla P., Cicerchia P. M., Siragusa L., Grande M., Arcudi C., Antonelli A., Vinci D., De Martino C., Armellino M. F., Bisogno E., Visconti D., Santarelli M., Montanari E., Biloslavo A., Germani P., Zaghi C., Oka N., Fathi M. A., Rios-Cruz D., Hernandez E. E. L., Garzali I. U., Duarte L., Negoi I., Litvin A., Chowdhury S., Alshahrani S. M., Carbonell-Morote S., Rubio-Garcia J. J., Moreira C. C. L., Ponce I. A., Mendoza-Moreno F., Campana A. M., Bayo H. L., Serra A. C., Estraviz-Mateos B., Markinez-Gordobil I., Landaluce-Olavarria A., Serradilla-Martin M., Cano-Paredero A., Dobon-Rascon M. A., Hamid H., Baraket O., Gonullu E., Leventoglu S., Turk Y., Buyukkasap C., Aday U., Kara Y., Kabuli H. A., Atici S. D., Colak E., Chooklin S., Chuklin S., Martin-Perez E., de la Hoz Rodriguez A., Di Martino M., Di Saverio S., Leppaniemi A., Moore E. E., Peitzman A. B., Sartelli M., and Biffl W.
Abstract: Background: Existing guidelines for predicting common bile duct stones (CBDS) are not specific for acute calculous cholecystitis (ACC). This paper is a posthoc analysis of the S.P.Ri.M.A.C.C study aiming to prospectively validate on a large independent cohort of patients the Israeli Score (IS) in predicting CBDS in patients with ACC. Methods: The S.P.Ri.M.A.C.C. study is an observational multicenter prospective study endorsed by the World Society of Emergency Surgery (WSES). Between September 1st, 2021, and September 1st, 2022, 1201 participants were included. The Chi-Square test was used to compare categorical data. A Cochran-Armitage test was run to determine whether a linear trend existed between the IS and the presence of CBDS. To assess the accuracy of the prediction model, the receiver operating characteristic (ROC) curve was generated, and the area under the ROC curve (AUC) was calculated. Logistic regression was run to obtain Odds Ratio (OR). A two-tailed p < 0.05 was considered statistically significant. Results: The rate of CBDS was 1.8% in patients with an IS of 0, 4.2% in patients with an IS of 1, 24.5% in patients with 2 and 56.3% in patients with 3 (p < 0.001). The Cochran-Armitage test of trend showed a statistically significant linear trend, p < 0.001. Patients with an IS of 3 had 64.4 times (95% CI 24.8–166.9) higher odds of having associated CBDS than patients with an IS of 0. The AUC of the ROC curve of IS for the prediction of CBDS was 0.809 (95% CI 0.752–0.865, p < 0.001). By applying the highest cut-off point (3), the specificity reached 99%, while using the lowest cut-off value (0), the sensitivity reached 100%. Conclusion: The IS is a reliable tool to predict CBDS associated with ACC. The algorithm derived from the IS could optimize the management of patients with ACC.
Published: 2023

25. 2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery

Author: De'Angelis, N, Schena, C, Marchegiani, F, Reitano, E, De Simone, B, Wong, G, Martinez-Perez, A, Abu-Zidan, F, Agnoletti, V, Aisoni, F, Ammendola, M, Ansaloni, L, Bala, M, Biffl, W, Ceccarelli, G, Ceresoli, M, Chiara, O, Chiarugi, M, Cimbanassi, S, Coccolini, F, Coimbra, R, Di Saverio, S, Diana, M, Dioguardi Burgio, M, Fraga, G, Gavriilidis, P, Gurrado, A, Inchingolo, R, Ingels, A, Ivatury, R, Kashuk, J, Khan, J, Kirkpatrick, A, Kim, F, Kluger, Y, Lakkis, Z, Leppaniemi, A, Maier, R, Memeo, R, Moore, E, Ordonez, C, Peitzman, A, Pellino, G, Picetti, E, Pikoulis, M, Pisano, M, Podda, M, Romeo, O, Rosa, F, Tan, E, Ten Broek, R, Testini, M, Tian Wei Cheng, B, Weber, D, Sacco, E, Sartelli, M, Tonsi, A, Dal Moro, F, Catena, F, de'Angelis N., Schena C. A., Marchegiani F., Reitano E., De Simone B., Wong G. Y. M., Martinez-Perez A., Abu-Zidan F. M., Agnoletti V., Aisoni F., Ammendola M., Ansaloni L., Bala M., Biffl W., Ceccarelli G., Ceresoli M., Chiara O., Chiarugi M., Cimbanassi S., Coccolini F., Coimbra R., Di Saverio S., Diana M., Dioguardi Burgio M., Fraga G., Gavriilidis P., Gurrado A., Inchingolo R., Ingels A., Ivatury R., Kashuk J. L., Khan J., Kirkpatrick A. W., Kim F. J., Kluger Y., Lakkis Z., Leppaniemi A., Maier R. V., Memeo R., Moore E. E., Ordonez C. A., Peitzman A. B., Pellino G., Picetti E., Pikoulis M., Pisano M., Podda M., Romeo O., Rosa F., Tan E., Ten Broek R. P., Testini M., Tian Wei Cheng B. A., Weber D., Sacco E., Sartelli M., Tonsi A., Dal Moro F., Catena F., De'Angelis, N, Schena, C, Marchegiani, F, Reitano, E, De Simone, B, Wong, G, Martinez-Perez, A, Abu-Zidan, F, Agnoletti, V, Aisoni, F, Ammendola, M, Ansaloni, L, Bala, M, Biffl, W, Ceccarelli, G, Ceresoli, M, Chiara, O, Chiarugi, M, Cimbanassi, S, Coccolini, F, Coimbra, R, Di Saverio, S, Diana, M, Dioguardi Burgio, M, Fraga, G, Gavriilidis, P, Gurrado, A, Inchingolo, R, Ingels, A, Ivatury, R, Kashuk, J, Khan, J, Kirkpatrick, A, Kim, F, Kluger, Y, Lakkis, Z, Leppaniemi, A, Maier, R, Memeo, R, Moore, E, Ordonez, C, Peitzman, A, Pellino, G, Picetti, E, Pikoulis, M, Pisano, M, Podda, M, Romeo, O, Rosa, F, Tan, E, Ten Broek, R, Testini, M, Tian Wei Cheng, B, Weber, D, Sacco, E, Sartelli, M, Tonsi, A, Dal Moro, F, Catena, F, de'Angelis N., Schena C. A., Marchegiani F., Reitano E., De Simone B., Wong G. Y. M., Martinez-Perez A., Abu-Zidan F. M., Agnoletti V., Aisoni F., Ammendola M., Ansaloni L., Bala M., Biffl W., Ceccarelli G., Ceresoli M., Chiara O., Chiarugi M., Cimbanassi S., Coccolini F., Coimbra R., Di Saverio S., Diana M., Dioguardi Burgio M., Fraga G., Gavriilidis P., Gurrado A., Inchingolo R., Ingels A., Ivatury R., Kashuk J. L., Khan J., Kirkpatrick A. W., Kim F. J., Kluger Y., Lakkis Z., Leppaniemi A., Maier R. V., Memeo R., Moore E. E., Ordonez C. A., Peitzman A. B., Pellino G., Picetti E., Pikoulis M., Pisano M., Podda M., Romeo O., Rosa F., Tan E., Ten Broek R. P., Testini M., Tian Wei Cheng B. A., Weber D., Sacco E., Sartelli M., Tonsi A., Dal Moro F., and Catena F.
Abstract: Iatrogenic urinary tract injury (IUTI) is a severe complication of emergency digestive surgery. It can lead to increased postoperative morbidity and mortality and have a long-term impact on the quality of life. The reported incidence of IUTIs varies greatly among the studies, ranging from 0.3 to 1.5%. Given the high volume of emergency digestive surgery performed worldwide, there is a need for well-defined and effective strategies to prevent and manage IUTIs. Currently, there is a lack of consensus regarding the prevention, detection, and management of IUTIs in the emergency setting. The present guidelines, promoted by the World Society of Emergency Surgery (WSES), were developed following a systematic review of the literature and an international expert panel discussion. The primary aim of these WSES guidelines is to provide evidence-based recommendations to support clinicians and surgeons in the prevention, detection, and management of IUTIs during emergency digestive surgery. The following key aspects were considered: (1) effectiveness of preventive interventions for IUTIs during emergency digestive surgery; (2) intra-operative detection of IUTIs and appropriate management strategies; (3) postoperative detection of IUTIs and appropriate management strategies and timing; and (4) effectiveness of antibiotic therapy (including type and duration) in case of IUTIs.
Published: 2023

26. Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the S.P.Ri.M.A.C.C. study

Author: Fugazzola, P, Cobianchi, L, Di Martino, M, Tomasoni, M, Dal Mas, F, Abu-Zidan, F, Agnoletti, V, Ceresoli, M, Coccolini, F, Di Saverio, S, Dominioni, T, Farè, C, Frassini, S, Gambini, G, Leppäniemi, A, Maestri, M, Martín-Pérez, E, Moore, E, Musella, V, Peitzman, A, de la Hoz Rodríguez, Á, Sargenti, B, Sartelli, M, Viganò, J, Anderloni, A, Biffl, W, Catena, F, Ansaloni, L, Fugazzola P., Cobianchi L., Di Martino M., Tomasoni M., Dal Mas F., Abu-Zidan F. M., Agnoletti V., Ceresoli M., Coccolini F., Di Saverio S., Dominioni T., Farè C. N., Frassini S., Gambini G., Leppäniemi A., Maestri M., Martín-Pérez E., Moore E. E., Musella V., Peitzman A. B., de la Hoz Rodríguez Á., Sargenti B., Sartelli M., Viganò J., Anderloni A., Biffl W., Catena F., Ansaloni L., Fugazzola, P, Cobianchi, L, Di Martino, M, Tomasoni, M, Dal Mas, F, Abu-Zidan, F, Agnoletti, V, Ceresoli, M, Coccolini, F, Di Saverio, S, Dominioni, T, Farè, C, Frassini, S, Gambini, G, Leppäniemi, A, Maestri, M, Martín-Pérez, E, Moore, E, Musella, V, Peitzman, A, de la Hoz Rodríguez, Á, Sargenti, B, Sartelli, M, Viganò, J, Anderloni, A, Biffl, W, Catena, F, Ansaloni, L, Fugazzola P., Cobianchi L., Di Martino M., Tomasoni M., Dal Mas F., Abu-Zidan F. M., Agnoletti V., Ceresoli M., Coccolini F., Di Saverio S., Dominioni T., Farè C. N., Frassini S., Gambini G., Leppäniemi A., Maestri M., Martín-Pérez E., Moore E. E., Musella V., Peitzman A. B., de la Hoz Rodríguez Á., Sargenti B., Sartelli M., Viganò J., Anderloni A., Biffl W., Catena F., and Ansaloni L.
Abstract: BACKGROUND: Less invasive alternatives than early cholecystectomy (EC) for acute calculous cholecystitis (ACC) treatment have been spreading in recent years. We still lack a reliable tool to select high-risk patients who could benefit from these alternatives. Our study aimed to prospectively validate the Chole-risk score in predicting postoperative complications in patients undergoing EC for ACC compared with other preoperative risk prediction models. METHOD: The S.P.Ri.M.A.C.C. study is a World Society of Emergency Surgery prospective multicenter observational study. From 1st September 2021 to 1st September 2022, 1253 consecutive patients admitted in 79 centers were included. The inclusion criteria were a diagnosis of ACC and to be a candidate for EC. A Cochran-Armitage test of the trend was run to determine whether a linear correlation existed between the Chole-risk score and a complicated postoperative course. To assess the accuracy of the analyzed prediction models-POSSUM Physiological Score (PS), modified Frailty Index, Charlson Comorbidity Index, American Society of Anesthesiologist score (ASA), APACHE II score, and ACC severity grade-receiver operating characteristic (ROC) curves were generated. The area under the ROC curve (AUC) was used to compare the diagnostic abilities. RESULTS: A 30-day major morbidity of 6.6% and 30-day mortality of 1.1% were found. Chole-risk was validated, but POSSUM PS was the best risk prediction model for a complicated course after EC for ACC (in-hospital mortality: AUC 0.94, p < 0.001; 30-day mortality: AUC 0.94, p < 0.001; in-hospital major morbidity: AUC 0.73, p < 0.001; 30-day major morbidity: AUC 0.70, p < 0.001). POSSUM PS with a cutoff of 25 (defined in our study as a 'Chole-POSSUM' score) was then validated in a separate cohort of patients. It showed a 100% sensitivity and a 100% negative predictive value for mortality and a 96-97% negative predictive value for major complications. CONCLUSIONS: The Chole-risk s
Published: 2023

27. Prehospital low titer group O whole blood is feasible and safe: Results of a prospective randomized pilot trial

Author: Guyette, Frank X., Zenati, Mazen, Triulzi, Darrell J., Yazer, Mark H., Skroczky, Hunter, Early, Barbara J., Adams, Peter W., Brown, Joshua B., Alarcon, Louis, Neal, Matthew D., Forsythe, Raquel M., Zuckerbraun, Brian S., Peitzman, Andrew B., Billiar, Timothy R., and Sperry, Jason L.
Subjects: Surgery, Critical Care and Intensive Care Medicine, Article
Abstract: INTRODUCTION: Low titer group O whole blood (LTOWB) resuscitation is increasingly common in both military and civilian settings. Data regarding the safety and efficacy of prehospital LTOWB remains limited. METHODS: We performed a single center, prospective, cluster randomized, prehospital thru in-hospital whole blood pilot trial for injured air medical patients. We compared standard prehospital air medical care including red cell transfusion and crystalloids followed by in-hospital component transfusion to prehospital and in-hospital LTOWB resuscitation. Prehospital vital signs were used as inclusion criteria (SBP ≤ 90 mmHg and HR ≥ 108 bpm) or (SBP ≤ 70 mmHg) for patients at risk of hemorrhage. Primary outcome was feasibility. Secondary outcomes included 28-day and 24 hour mortality, multiple organ failure, nosocomial infection, 24hr transfusion requirements and arrival coagulation parameters. RESULTS: Between November 2018 thru October 2020, 86 injured patients were cluster randomized by helicopter base. The trial has halted early at 77% enrollment. Overall, 28-day mortality for the cohort was 26%. Injured patients randomized to prehospital LTOWB (n=40) relative to standard care (n=46) were similar in demographics and injury characteristics. Intent to treat Kaplan-Meier survival analysis demonstrated no statistical mortality benefit at 28 days (25.0% vs. 26.1%, p= 0.85). Patients randomized to prehospital LTOWB relative to standard care had lower red cell transfusion requirements at 24 hours (p
Published: 2022
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28. Additional file 1 of Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the S.P.Ri.M.A.C.C. study

Author: Fugazzola, Paola, Cobianchi, Lorenzo, Di Martino, Marcello, Tomasoni, Matteo, Dal Mas, Francesca, Abu-Zidan, Fikri M., Agnoletti, Vanni, Ceresoli, Marco, Coccolini, Federico, Di Saverio, Salomone, Dominioni, Tommaso, Farè, Camilla Nikita, Frassini, Simone, Gambini, Giulia, Leppäniemi, Ari, Maestri, Marcello, Martín-Pérez, Elena, Moore, Ernest E., Musella, Valeria, Peitzman, Andrew B., de la Hoz Rodríguez, Ángela, Sargenti, Benedetta, Sartelli, Massimo, Viganò, Jacopo, Anderloni, Andrea, Biffl, Walter, Catena, Fausto, and Ansaloni, Luca
Abstract: Additional file 1. Centers included in S.P.Ri.M.A.C.C. study with number of patients.
Published: 2023
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29. Anterior Thoracic Surgical Approaches in the Treatment of Spinal Infections and Neoplasms

Author: Schuchert, Matthew J., McCormick, Kristen N., Abbas, Ghulam, Pennathur, Arjun, Landreneau, Joshua P., Landreneau, James R., Pitanga, Andre, Gomes, Jamilly, Franca, Felipè, El-Kadi, Matthew, Peitzman, Andrew B., Ferson, Peter F., Luketich, James D., and Landreneau, Rodney J.
Published: 2014
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30. Blunt cerebrovascular injury in elderly fall patients: are we screening enough?

Author: Anto, Vincent P., Brown, Joshua B., Peitzman, Andrew B., Zuckerbraun, Brian S., Neal, Matthew D., Watson, Gregory, Forsythe, Raquel, Billiar, Timothy R., and Sperry, Jason L.
Published: 2018
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31. Lipidomic signatures align with inflammatory patterns and outcomes in critical illness

Author: Wu, Junru, Cyr, Anthony, Gruen, Danielle S., Lovelace, Tyler C., Benos, Panayiotis V., Das, Jishnu, Kar, Upendra K., Chen, Tianmeng, Guyette, Francis X., Yazer, Mark H., Daley, Brian J., Miller, Richard S., Harbrecht, Brian G., Claridge, Jeffrey A., Phelan, Herb A., Zuckerbraun, Brian S., Neal, Matthew D., Johansson, Pär I., Stensballe, Jakob, Namas, Rami A., Vodovotz, Yoram, Sperry, Jason L., Billiar, Timothy R., Zenati, Mazen S., Brown, Joshua B., Triulzi, Darrell J., Young, Barbara J.Early, Adams, Peter W., Alarcon, Louis H., Callaway, Clifton W., Forsythe, Raquel M., Yealy, Donald M., Peitzman, Andrew B., Buck, Meghan L., Ryman, Ashley M., Gimbel, Elizabeth A., Gilchrist, Erin G., Buhay, Meghan, Chang, Chung Chou H., Talisa, Victor B., Xu, Tianyuan, Kalloway, Kyle, Yates, Andrew, Rawn, Susan, Jenkins, Judith M., Trachtenberg, Laura S., Eden, Randi K., Fraifogl, Joanne, Bates, Craig, and Howard, Christina
Subjects: Inflammation, Inflammation biomarkers, Multidisciplinary, Coronavirus disease 2019 (COVID-19), business.industry, Critical Illness, Clinical course, COVID-19, General Physics and Astronomy, Lipid metabolism, General Chemistry, Lipidome, Bioinformatics, Article, General Biochemistry, Genetics and Molecular Biology, Critical illness, Lipogenesis, Lipidomics, Medicine, Humans, Fresh frozen plasma, business, Biomarkers
Abstract: Alterations in lipid metabolism have the potential to be markers as well as drivers of the pathobiology of acute critical illness. Here, we took advantage of the temporal precision offered by trauma as a common cause of critical illness to identify the dynamic patterns in the circulating lipidome in critically ill humans. The major findings include an early loss of all classes of circulating lipids followed by a delayed and selective lipogenesis in patients destined to remain critically ill. Early in the clinical course, Fresh Frozen Plasma administration led to improved survival in association with preserved lipid levels that related to favorable changes in coagulation and inflammation biomarkers. Late over-representation of phosphatidylethanolamines with critical illness led to the validation of a Lipid Reprogramming Score that was prognostic not only in trauma but also severe COVID-19 patients. Our lipidomic findings provide a new paradigm for the lipid response underlying critical illness.
Published: 2022
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32. Optimal Prehospital Crystalloid Resuscitation Volume in Trauma Patients at Risk for Hemorrhagic Shock.

Author: Deeb, Andrew-Paul, Liling Lu, Guyette, Frank X., Peitzman, Andrew B., Daley, Brian J., Miller, Richard S., Harbrecht, Brian G., Phelan, Herb A., Sperry, Jason L., and Brown, Joshua B.
Published: 2023
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33. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery

Author: Bala, M, Catena, F, Kashuk, J, De Simone, B, Gomes, C, Weber, D, Sartelli, M, Coccolini, F, Kluger, Y, Abu-Zidan, F, Picetti, E, Ansaloni, L, Augustin, G, Biffl, W, Ceresoli, M, Chiara, O, Chiarugi, M, Coimbra, R, Cui, Y, Damaskos, D, Di Saverio, S, Galante, J, Khokha, V, Kirkpatrick, A, Inaba, K, Leppaniemi, A, Litvin, A, Peitzman, A, Shelat, V, Sugrue, M, Tolonen, M, Rizoli, S, Sall, I, Beka, S, Di Carlo, I, Ten Broek, R, Mircea, C, Tebala, G, Pisano, M, van Goor, H, Maier, R, Jeekel, H, Civil, I, Hecker, A, Tan, E, Soreide, K, Lee, M, Wani, I, Bonavina, L, Malangoni, M, Koike, K, Velmahos, G, Fraga, G, Fette, A, De'Angelis, N, Balogh, Z, Scalea, T, Sganga, G, Kelly, M, Khan, J, Stahel, P, Moore, E, Bala M., Catena F., Kashuk J., De Simone B., Gomes C. A., Weber D., Sartelli M., Coccolini F., Kluger Y., Abu-Zidan F. M., Picetti E., Ansaloni L., Augustin G., Biffl W. L., Ceresoli M., Chiara O., Chiarugi M., Coimbra R., Cui Y., Damaskos D., Di Saverio S., Galante J. M., Khokha V., Kirkpatrick A. W., Inaba K., Leppaniemi A., Litvin A., Peitzman A. B., Shelat V. G., Sugrue M., Tolonen M., Rizoli S., Sall I., Beka S. G., Di Carlo I., Ten Broek R., Mircea C., Tebala G., Pisano M., van Goor H., Maier R. V., Jeekel H., Civil I., Hecker A., Tan E., Soreide K., Lee M. J., Wani I., Bonavina L., Malangoni M. A., Koike K., Velmahos G. C., Fraga G. P., Fette A., de'Angelis N., Balogh Z. J., Scalea T. M., Sganga G., Kelly M. D., Khan J., Stahel P. F., Moore E. E., Bala, M, Catena, F, Kashuk, J, De Simone, B, Gomes, C, Weber, D, Sartelli, M, Coccolini, F, Kluger, Y, Abu-Zidan, F, Picetti, E, Ansaloni, L, Augustin, G, Biffl, W, Ceresoli, M, Chiara, O, Chiarugi, M, Coimbra, R, Cui, Y, Damaskos, D, Di Saverio, S, Galante, J, Khokha, V, Kirkpatrick, A, Inaba, K, Leppaniemi, A, Litvin, A, Peitzman, A, Shelat, V, Sugrue, M, Tolonen, M, Rizoli, S, Sall, I, Beka, S, Di Carlo, I, Ten Broek, R, Mircea, C, Tebala, G, Pisano, M, van Goor, H, Maier, R, Jeekel, H, Civil, I, Hecker, A, Tan, E, Soreide, K, Lee, M, Wani, I, Bonavina, L, Malangoni, M, Koike, K, Velmahos, G, Fraga, G, Fette, A, De'Angelis, N, Balogh, Z, Scalea, T, Sganga, G, Kelly, M, Khan, J, Stahel, P, Moore, E, Bala M., Catena F., Kashuk J., De Simone B., Gomes C. A., Weber D., Sartelli M., Coccolini F., Kluger Y., Abu-Zidan F. M., Picetti E., Ansaloni L., Augustin G., Biffl W. L., Ceresoli M., Chiara O., Chiarugi M., Coimbra R., Cui Y., Damaskos D., Di Saverio S., Galante J. M., Khokha V., Kirkpatrick A. W., Inaba K., Leppaniemi A., Litvin A., Peitzman A. B., Shelat V. G., Sugrue M., Tolonen M., Rizoli S., Sall I., Beka S. G., Di Carlo I., Ten Broek R., Mircea C., Tebala G., Pisano M., van Goor H., Maier R. V., Jeekel H., Civil I., Hecker A., Tan E., Soreide K., Lee M. J., Wani I., Bonavina L., Malangoni M. A., Koike K., Velmahos G. C., Fraga G. P., Fette A., de'Angelis N., Balogh Z. J., Scalea T. M., Sganga G., Kelly M. D., Khan J., Stahel P. F., and Moore E. E.
Abstract: Acute mesenteric ischemia (AMI) is a group of diseases characterized by an interruption of the blood supply to varying portions of the intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process may progress to life-threatening intestinal necrosis. The incidence is low, estimated at 0.09–0.2% of all acute surgical admissions, but increases with age. Although the entity is an uncommon cause of abdominal pain, diligence is required because if untreated, mortality remains in the range of 50%. Early diagnosis and timely surgical intervention are the cornerstones of modern treatment to reduce the high mortality associated with this entity. The advent of endovascular approaches in parallel with modern imaging techniques is evolving and provides new treatment options. Lastly, a focused multidisciplinary approach based on early diagnosis and individualized treatment is essential. Thus, we believe that updated guidelines from World Society of Emergency Surgery are warranted, in order to provide the most recent and practical recommendations for diagnosis and treatment of AMI.
Published: 2022

34. Acute mesenteric ischemia:updated guidelines of the World Society of Emergency Surgery

Author: Bala, Miklosh, Catena, Fausto, Kashuk, Jeffry, De Simone, Belinda, Gomes, Carlos Augusto, Weber, Dieter, Sartelli, Massimo, Coccolini, Federico, Kluger, Yoram, Abu-Zidan, Fikri M., Picetti, Edoardo, Ansaloni, Luca, Augustin, Goran, Biffl, Walter L., Ceresoli, Marco, Chiara, Osvaldo, Chiarugi, Massimo, Coimbra, Raul, Cui, Yunfeng, Damaskos, Dimitris, Di Saverio, Salomone, Galante, Joseph M., Khokha, Vladimir, Kirkpatrick, Andrew W., Inaba, Kenji, Leppäniemi, Ari, Litvin, Andrey, Peitzman, Andrew B., Shelat, Vishal G., Sugrue, Michael, Tolonen, Matti, Rizoli, Sandro, Sall, Ibrahima, Beka, Solomon G., Di Carlo, Isidoro, Ten Broek, Richard, Mircea, Chirika, Tebala, Giovanni, Pisano, Michele, van Goor, Harry, Maier, Ronald V., Jeekel, Hans, Civil, Ian, Hecker, Andreas, Tan, Edward, Soreide, Kjetil, Lee, Matthew J., Wani, Imtiaz, Bonavina, Luigi, Malangoni, Mark A., Koike, Kaoru, Velmahos, George C., Fraga, Gustavo P., Fette, Andreas, de’Angelis, Nicola, Balogh, Zsolt J., Scalea, Thomas M., Sganga, Gabriele, Kelly, Michael D., Khan, Jim, Stahel, Philip F., Moore, Ernest E., Bala, Miklosh, Catena, Fausto, Kashuk, Jeffry, De Simone, Belinda, Gomes, Carlos Augusto, Weber, Dieter, Sartelli, Massimo, Coccolini, Federico, Kluger, Yoram, Abu-Zidan, Fikri M., Picetti, Edoardo, Ansaloni, Luca, Augustin, Goran, Biffl, Walter L., Ceresoli, Marco, Chiara, Osvaldo, Chiarugi, Massimo, Coimbra, Raul, Cui, Yunfeng, Damaskos, Dimitris, Di Saverio, Salomone, Galante, Joseph M., Khokha, Vladimir, Kirkpatrick, Andrew W., Inaba, Kenji, Leppäniemi, Ari, Litvin, Andrey, Peitzman, Andrew B., Shelat, Vishal G., Sugrue, Michael, Tolonen, Matti, Rizoli, Sandro, Sall, Ibrahima, Beka, Solomon G., Di Carlo, Isidoro, Ten Broek, Richard, Mircea, Chirika, Tebala, Giovanni, Pisano, Michele, van Goor, Harry, Maier, Ronald V., Jeekel, Hans, Civil, Ian, Hecker, Andreas, Tan, Edward, Soreide, Kjetil, Lee, Matthew J., Wani, Imtiaz, Bonavina, Luigi, Malangoni, Mark A., Koike, Kaoru, Velmahos, George C., Fraga, Gustavo P., Fette, Andreas, de’Angelis, Nicola, Balogh, Zsolt J., Scalea, Thomas M., Sganga, Gabriele, Kelly, Michael D., Khan, Jim, Stahel, Philip F., and Moore, Ernest E.
Abstract: Acute mesenteric ischemia (AMI) is a group of diseases characterized by an interruption of the blood supply to varying portions of the intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process may progress to life-threatening intestinal necrosis. The incidence is low, estimated at 0.09–0.2% of all acute surgical admissions, but increases with age. Although the entity is an uncommon cause of abdominal pain, diligence is required because if untreated, mortality remains in the range of 50%. Early diagnosis and timely surgical intervention are the cornerstones of modern treatment to reduce the high mortality associated with this entity. The advent of endovascular approaches in parallel with modern imaging techniques is evolving and provides new treatment options. Lastly, a focused multidisciplinary approach based on early diagnosis and individualized treatment is essential. Thus, we believe that updated guidelines from World Society of Emergency Surgery are warranted, in order to provide the most recent and practical recommendations for diagnosis and treatment of AMI.
Published: 2022

35. The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly

Author: Fugazzola, P, Ceresoli, M, Coccolini, F, Gabrielli, F, Puzziello, A, Monzani, F, Amato, B, Sganga, G, Sartelli, M, Menichetti, F, Puglisi, G, Tartaglia, D, Carcoforo, P, Avenia, N, Kluger, Y, Paolillo, C, Zago, M, Leppaniemi, A, Tomasoni, M, Cobianchi, L, Dal Mas, F, Improta, M, Moore, E, Peitzman, A, Sugrue, M, Agnoletti, V, Fraga, G, Weber, D, Damaskos, D, Abu-Zidan, F, Wani, I, Kirkpatrick, A, Pikoulis, M, Pararas, N, Tan, E, Broek, R, Maier, R, Davies, R, Kashuk, J, Shelat, V, Mefire, A, Augustin, G, Magnone, S, Poiasina, E, De Simone, B, Chiarugi, M, Biffl, W, Baiocchi, G, Catena, F, Ansaloni, L, Fugazzola P., Ceresoli M., Coccolini F., Gabrielli F., Puzziello A., Monzani F., Amato B., Sganga G., Sartelli M., Menichetti F., Puglisi G. A., Tartaglia D., Carcoforo P., Avenia N., Kluger Y., Paolillo C., Zago M., Leppaniemi A., Tomasoni M., Cobianchi L., Dal Mas F., Improta M., Moore E. E., Peitzman A. B., Sugrue M., Agnoletti V., Fraga G. P., Weber D. G., Damaskos D., Abu-Zidan F. M., Wani I., Kirkpatrick A. W., Pikoulis M., Pararas N., Tan E., Broek R. T., Maier R. V., Davies R. J., Kashuk J., Shelat V. G., Mefire A. C., Augustin G., Magnone S., Poiasina E., De Simone B., Chiarugi M., Biffl W., Baiocchi G. L., Catena F., Ansaloni L., Fugazzola, P, Ceresoli, M, Coccolini, F, Gabrielli, F, Puzziello, A, Monzani, F, Amato, B, Sganga, G, Sartelli, M, Menichetti, F, Puglisi, G, Tartaglia, D, Carcoforo, P, Avenia, N, Kluger, Y, Paolillo, C, Zago, M, Leppaniemi, A, Tomasoni, M, Cobianchi, L, Dal Mas, F, Improta, M, Moore, E, Peitzman, A, Sugrue, M, Agnoletti, V, Fraga, G, Weber, D, Damaskos, D, Abu-Zidan, F, Wani, I, Kirkpatrick, A, Pikoulis, M, Pararas, N, Tan, E, Broek, R, Maier, R, Davies, R, Kashuk, J, Shelat, V, Mefire, A, Augustin, G, Magnone, S, Poiasina, E, De Simone, B, Chiarugi, M, Biffl, W, Baiocchi, G, Catena, F, Ansaloni, L, Fugazzola P., Ceresoli M., Coccolini F., Gabrielli F., Puzziello A., Monzani F., Amato B., Sganga G., Sartelli M., Menichetti F., Puglisi G. A., Tartaglia D., Carcoforo P., Avenia N., Kluger Y., Paolillo C., Zago M., Leppaniemi A., Tomasoni M., Cobianchi L., Dal Mas F., Improta M., Moore E. E., Peitzman A. B., Sugrue M., Agnoletti V., Fraga G. P., Weber D. G., Damaskos D., Abu-Zidan F. M., Wani I., Kirkpatrick A. W., Pikoulis M., Pararas N., Tan E., Broek R. T., Maier R. V., Davies R. J., Kashuk J., Shelat V. G., Mefire A. C., Augustin G., Magnone S., Poiasina E., De Simone B., Chiarugi M., Biffl W., Baiocchi G. L., Catena F., and Ansaloni L.
Abstract: Acute left colonic diverticulitis (ALCD) in the elderly presents with unique epidemiological features when compared with younger patients. The clinical presentation is more nuanced in the elderly population, having higher in-hospital and postoperative mortality. Furthermore, geriatric comorbidities are a risk factor for complicated diverticulitis. Finally, elderly patients have a lower risk of recurrent episodes and, in case of recurrence, a lower probability of requiring urgent surgery than younger patients. The aim of the present work is to study age-related factors that may support a unique approach to the diagnosis and treatment of this problem in the elderly when compared with the WSES guidelines for the management of acute left-sided colonic diverticulitis. During the 1° Pisa Workshop of Acute Care & Trauma Surgery held in Pisa (Italy) in September 2019, with the collaboration of the World Society of Emergency Surgery (WSES), the Italian Society of Geriatric Surgery (SICG), the Italian Hospital Surgeons Association (ACOI), the Italian Emergency Surgery and Trauma Association (SICUT), the Academy of Emergency Medicine and Care (AcEMC) and the Italian Society of Surgical Pathophysiology (SIFIPAC), three panel members presented a number of statements developed for each of the four themes regarding the diagnosis and management of ALCD in older patients, formulated according to the GRADE approach, at a Consensus Conference where a panel of experts participated. The statements were subsequently debated, revised, and finally approved by the Consensus Conference attendees. The current paper is a summary report of the definitive guidelines statements on each of the following topics: diagnosis, management, surgical technique and antibiotic therapy.
Published: 2022

36. WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections

Author: Sartelli, M, Coccolini, F, Kluger, Y, Agastra, E, Abu-Zidan, F, Abbas, A, Ansaloni, L, Adesunkanmi, A, Augustin, G, Bala, M, Baraket, O, Biffl, W, Ceresoli, M, Cerutti, E, Chiara, O, Cicuttin, E, Chiarugi, M, Coimbra, R, Corsi, D, Cortese, F, Cui, Y, Damaskos, D, De'Angelis, N, Delibegovic, S, Demetrashvili, Z, De Simone, B, de Jonge, S, Di Bella, S, Di Saverio, S, Duane, T, Fugazzola, P, Galante, J, Ghnnam, W, Gkiokas, G, Gomes, C, Griffiths, E, Hardcastle, T, Hecker, A, Herzog, T, Karamarkovic, A, Khokha, V, Kim, P, Kim, J, Kirkpatrick, A, Kong, V, Koshy, R, Inaba, K, Isik, A, Ivatury, R, Labricciosa, F, Lee, Y, Leppaniemi, A, Litvin, A, Luppi, D, Maier, R, Marinis, A, Marwah, S, Mesina, C, Moore, E, Moore, F, Negoi, I, Olaoye, I, Ordonez, C, Ouadii, M, Peitzman, A, Perrone, G, Pintar, T, Pipitone, G, Podda, M, Rasa, K, Ribeiro, J, Rodrigues, G, Rubio-Perez, I, Sall, I, Sato, N, Sawyer, R, Shelat, V, Sugrue, M, Tarasconi, A, Tolonen, M, Viaggi, B, Celotti, A, Casella, C, Pagani, L, Dhingra, S, Baiocchi, G, Catena, F, Sartelli M., Coccolini F., Kluger Y., Agastra E., Abu-Zidan F. M., Abbas A. E. S., Ansaloni L., Adesunkanmi A. K., Augustin G., Bala M., Baraket O., Biffl W. L., Ceresoli M., Cerutti E., Chiara O., Cicuttin E., Chiarugi M., Coimbra R., Corsi D., Cortese F., Cui Y., Damaskos D., de'Angelis N., Delibegovic S., Demetrashvili Z., De Simone B., de Jonge S. W., Di Bella S., Di Saverio S., Duane T. M., Fugazzola P., Galante J. M., Ghnnam W., Gkiokas G., Gomes C. A., Griffiths E. A., Hardcastle T. C., Hecker A., Herzog T., Karamarkovic A., Khokha V., Kim P. K., Kim J. I., Kirkpatrick A. W., Kong V., Koshy R. M., Inaba K., Isik A., Ivatury R., Labricciosa F. M., Lee Y. Y., Leppaniemi A., Litvin A., Luppi D., Maier R. V., Marinis A., Marwah S., Mesina C., Moore E. E., Moore F. A., Negoi I., Olaoye I., Ordonez C. A., Ouadii M., Peitzman A. B., Perrone G., Pintar T., Pipitone G., Podda M., Rasa K., Ribeiro J., Rodrigues G., Rubio-Perez I., Sall I., Sato N., Sawyer R. G., Shelat V. G., Sugrue M., Tarasconi A., Tolonen M., Viaggi B., Celotti A., Casella C., Pagani L., Dhingra S., Baiocchi G. L., Catena F., Sartelli, M, Coccolini, F, Kluger, Y, Agastra, E, Abu-Zidan, F, Abbas, A, Ansaloni, L, Adesunkanmi, A, Augustin, G, Bala, M, Baraket, O, Biffl, W, Ceresoli, M, Cerutti, E, Chiara, O, Cicuttin, E, Chiarugi, M, Coimbra, R, Corsi, D, Cortese, F, Cui, Y, Damaskos, D, De'Angelis, N, Delibegovic, S, Demetrashvili, Z, De Simone, B, de Jonge, S, Di Bella, S, Di Saverio, S, Duane, T, Fugazzola, P, Galante, J, Ghnnam, W, Gkiokas, G, Gomes, C, Griffiths, E, Hardcastle, T, Hecker, A, Herzog, T, Karamarkovic, A, Khokha, V, Kim, P, Kim, J, Kirkpatrick, A, Kong, V, Koshy, R, Inaba, K, Isik, A, Ivatury, R, Labricciosa, F, Lee, Y, Leppaniemi, A, Litvin, A, Luppi, D, Maier, R, Marinis, A, Marwah, S, Mesina, C, Moore, E, Moore, F, Negoi, I, Olaoye, I, Ordonez, C, Ouadii, M, Peitzman, A, Perrone, G, Pintar, T, Pipitone, G, Podda, M, Rasa, K, Ribeiro, J, Rodrigues, G, Rubio-Perez, I, Sall, I, Sato, N, Sawyer, R, Shelat, V, Sugrue, M, Tarasconi, A, Tolonen, M, Viaggi, B, Celotti, A, Casella, C, Pagani, L, Dhingra, S, Baiocchi, G, Catena, F, Sartelli M., Coccolini F., Kluger Y., Agastra E., Abu-Zidan F. M., Abbas A. E. S., Ansaloni L., Adesunkanmi A. K., Augustin G., Bala M., Baraket O., Biffl W. L., Ceresoli M., Cerutti E., Chiara O., Cicuttin E., Chiarugi M., Coimbra R., Corsi D., Cortese F., Cui Y., Damaskos D., de'Angelis N., Delibegovic S., Demetrashvili Z., De Simone B., de Jonge S. W., Di Bella S., Di Saverio S., Duane T. M., Fugazzola P., Galante J. M., Ghnnam W., Gkiokas G., Gomes C. A., Griffiths E. A., Hardcastle T. C., Hecker A., Herzog T., Karamarkovic A., Khokha V., Kim P. K., Kim J. I., Kirkpatrick A. W., Kong V., Koshy R. M., Inaba K., Isik A., Ivatury R., Labricciosa F. M., Lee Y. Y., Leppaniemi A., Litvin A., Luppi D., Maier R. V., Marinis A., Marwah S., Mesina C., Moore E. E., Moore F. A., Negoi I., Olaoye I., Ordonez C. A., Ouadii M., Peitzman A. B., Perrone G., Pintar T., Pipitone G., Podda M., Rasa K., Ribeiro J., Rodrigues G., Rubio-Perez I., Sall I., Sato N., Sawyer R. G., Shelat V. G., Sugrue M., Tarasconi A., Tolonen M., Viaggi B., Celotti A., Casella C., Pagani L., Dhingra S., Baiocchi G. L., and Catena F.
Abstract: Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections. Together, the World Society of Emergency Surgery, the Global Alliance for Infections in Surgery, the Surgical Infection Society-Europe, The World Surgical Infection Society, and the American Association for the Surgery of Trauma have jointly completed an international multi-society document to promote global standards of care in SSTIs guiding clinicians by describing reasonable approaches to the management of SSTIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting evidence was shared by an international task force with different clinical backgrounds.
Published: 2022

37. The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly

Author: Fugazzola, Paola Ceresoli, Marco Coccolini, Federico and Gabrielli, Francesco Puzziello, Alessandro Monzani, Fabio and Amato, Bruno Sganga, Gabriele Sartelli, Massimo Menichetti, Francesco Puglisi, Gabriele Adolfo Tartaglia, Dario and Carcoforo, Paolo Avenia, Nicola Kluger, Yoram Paolillo, Ciro and Zago, Mauro Leppaniemi, Ari Tomasoni, Matteo Cobianchi, Lorenzo Dal Mas, Francesca Improta, Mario Moore, Ernest E. and Peitzman, Andrew B. Sugrue, Michael Agnoletti, Vanni and Fraga, Gustavo P. Weber, Dieter G. Damaskos, Dimitrios and Abu-Zidan, Fikri M. Wani, Imtiaz Kirkpatrick, Andrew W. and Pikoulis, Manos Pararas, Nikolaos Tan, Edward Ten Broek, Richard Maier, V, Ronald Davies, R. Justin Kashuk, Jeffry and Shelat, Vishal G. Mefire, Alain Chicom Augustin, Goran and Magnone, Stefano Poiasina, Elia De Simone, Belinda Chiarugi, Massimo Biffl, Walt Baiocchi, Gian Luca Catena, Fausto and Ansaloni, Luca
Abstract: Acute left colonic diverticulitis (ALCD) in the elderly presents with unique epidemiological features when compared with younger patients. The clinical presentation is more nuanced in the elderly population, having higher in-hospital and postoperative mortality. Furthermore, geriatric comorbidities are a risk factor for complicated diverticulitis. Finally, elderly patients have a lower risk of recurrent episodes and, in case of recurrence, a lower probability of requiring urgent surgery than younger patients. The aim of the present work is to study age-related factors that may support a unique approach to the diagnosis and treatment of this problem in the elderly when compared with the WSES guidelines for the management of acute left-sided colonic diverticulitis. During the 1 degrees Pisa Workshop of Acute Care & Trauma Surgery held in Pisa (Italy) in September 2019, with the collaboration of the World Society of Emergency Surgery (WSES), the Italian Society of Geriatric Surgery (SICG), the Italian Hospital Surgeons Association (ACOI), the Italian Emergency Surgery and Trauma Association (SICUT), the Academy of Emergency Medicine and Care (AcEMC) and the Italian Society of Surgical Pathophysiology (SIFIPAC), three panel members presented a number of statements developed for each of the four themes regarding the diagnosis and management of ALCD in older patients, formulated according to the GRADE approach, at a Consensus Conference where a panel of experts participated. The statements were subsequently debated, revised, and finally approved by the Consensus Conference attendees. The current paper is a summary report of the definitive guidelines statements on each of the following topics: diagnosis, management, surgical technique and antibiotic therapy.
Published: 2022

38. Additional file 1 of Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery

Author: Bala, Miklosh, Catena, Fausto, Kashuk, Jeffry, De Simone, Belinda, Gomes, Carlos Augusto, Weber, Dieter, Sartelli, Massimo, Coccolini, Federico, Kluger, Yoram, Abu-Zidan, Fikri M., Picetti, Edoardo, Ansaloni, Luca, Augustin, Goran, Biffl, Walter L., Ceresoli, Marco, Chiara, Osvaldo, Chiarugi, Massimo, Coimbra, Raul, Cui, Yunfeng, Damaskos, Dimitris, Di Saverio, Salomone, Galante, Joseph M., Khokha, Vladimir, Kirkpatrick, Andrew W., Inaba, Kenji, Leppäniemi, Ari, Litvin, Andrey, Peitzman, Andrew B., Shelat, Vishal G., Sugrue, Michael, Tolonen, Matti, Rizoli, Sandro, Sall, Ibrahima, Beka, Solomon G., Di Carlo, Isidoro, Ten Broek, Richard, Mircea, Chirika, Tebala, Giovanni, Pisano, Michele, van Goor, Harry, Maier, Ronald V., Jeekel, Hans, Civil, Ian, Hecker, Andreas, Tan, Edward, Soreide, Kjetil, Lee, Matthew J., Wani, Imtiaz, Bonavina, Luigi, Malangoni, Mark A., Koike, Kaoru, Velmahos, George C., Fraga, Gustavo P., Fette, Andreas, de’Angelis, Nicola, Balogh, Zsolt J., Scalea, Thomas M., Sganga, Gabriele, Kelly, Michael D., Khan, Jim, Stahel, Philip F., and Moore, Ernest E.
Abstract: Additional file 1: Table S3. Summary of the updated 2022 guidelines for AMI: statements and recommendations.
Published: 2022
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39. WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections

Author: Sartelli, Massimo Coccolini, Federico Kluger, Yoram Agastra, Ervis Abu-Zidan, Fikri M. Abbas, Ashraf El Sayed Ansaloni, Luca Adesunkanmi, Abdulrashid Kayode Augustin, Goran Bala, Miklosh Baraket, Oussama Biffl, Walter L. Ceresoli, Marco and Cerutti, Elisabetta Chiara, Osvaldo Cicuttin, Enrico and Chiarugi, Massimo Coimbra, Raul Corsi, Daniela Cortese, Francesco Cui, Yunfeng Damaskos, Dimitris de'Angelis, Nicola and Delibegovic, Samir Demetrashvili, Zaza De Simone, Belinda and de Jonge, Stijn W. Di Bella, Stefano Di Saverio, Salomone and Duane, Therese M. Fugazzola, Paola Galante, Joseph M. and Ghnnam, Wagih Gkiokas, George Gomes, Carlos Augusto and Griffiths, Ewen A. Hardcastle, Timothy C. Hecker, Andreas and Herzog, Torsten Karamarkovic, Aleksandar Khokha, Vladimir and Kim, Peter K. Kim, Jae Il Kirkpatrick, Andrew W. Kong, Victor Koshy, Renol M. Inaba, Kenji Isik, Arda Ivatury, Rao Labricciosa, Francesco M. Lee, Yeong Yeh Leppaniemi, Ari and Litvin, Andrey Luppi, Davide Maier, Ronald V. Marinis, Athanasios Marwah, Sanjay Mesina, Cristian Moore, Ernest E. and Moore, Frederick A. Negoi, Ionut Olaoye, Iyiade Ordonez, Carlos A. Ouadii, Mouaqit Peitzman, Andrew B. Perrone, Gennaro Pintar, Tadeja Pipitone, Giuseppe Podda, Mauro and Rasa, Kemal Ribeiro, Julival Rodrigues, Gabriel Rubio-Perez, Ines Sall, Ibrahima Sato, Norio Sawyer, Robert G. and Shelat, Vishal G. Sugrue, Michael Tarasconi, Antonio and Tolonen, Matti Viaggi, Bruno Celotti, Andrea Casella, Claudio Pagani, Leonardo Dhingra, Sameer Baiocchi, Gian Luca and Catena, Fausto
Abstract: Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections. Together, the World Society of Emergency Surgery, the Global Alliance for Infections in Surgery, the Surgical Infection Society-Europe, The World Surgical Infection Society, and the American Association for the Surgery of Trauma have jointly completed an international multi-society document to promote global standards of care in SSTIs guiding clinicians by describing reasonable approaches to the management of SSTIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting evidence was shared by an international task force with different clinical backgrounds.
Published: 2022

40. Making the Call in the Field: Validating EMS Identification of Anatomic Trauma Triage Criteria

Author: Deeb, Andrew-Paul, Phelos, Heather M., Peitzman, Andrew B., Billiar, Timothy R., Sperry, Jason L., and Brown, Joshua B.
Subjects: Adult, Male, Emergency Medical Services, Trauma Severity Indices, Clinical Coding, Middle Aged, Article, Trauma Centers, Predictive Value of Tests, Practice Guidelines as Topic, Humans, Wounds and Injuries, Female, Triage, Aged, Retrospective Studies
Abstract: The National Field Triage Guidelines were created to inform triage decisions by emergency medical services (EMS) providers and include eight anatomic injuries that prompt transportation to a Level I/II trauma center. It is unclear how accurately EMS providers recognize these injuries. Our objective was to compare EMS-identified anatomic triage criteria with International Classification of Diseases-10th revision (ICD-10) coding of these criteria, as well as their association with trauma center need (TCN).Scene patients 16 years and older in the NTDB during 2017 were included. National Field Triage Guidelines anatomic criteria were classified based on EMS documentation and ICD-10 diagnosis codes. The primary outcome was TCN, a composite of Injury Severity Score greater than 15, intensive care unit admission, urgent surgery, or emergency department death. Prevalence of anatomic criteria and their association with TCN was compared in EMS-identified versus ICD-10-coded criteria. Diagnostic performance to predict TCN was compared.There were 669,795 patients analyzed. The ICD-10 coding demonstrated a greater prevalence of injury detection. Emergency medical service-identified versus ICD-10-coded anatomic criteria were less sensitive (31% vs. 59%), but more specific (91% vs. 73%) and accurate (71% vs. 68%) for predicting TCN. Emergency medical service providers demonstrated a marked reduction in false positives (9% vs. 27%) but higher rates of false negatives (69% vs. 42%) in predicting TCN from anatomic criteria. Odds of TCN were significantly greater for EMS-identified criteria (adjusted odds ratio, 4.5; 95% confidence interval, 4.46-4.58) versus ICD-10 coding (adjusted odds ratio 3.7; 95% confidence interval, 3.71-3.79). Of EMS-identified injuries, penetrating injury, flail chest, and two or more proximal long bone fractures were associated with greater TCN than ICD-10 coding.When evaluating the anatomic criteria, EMS demonstrate greater specificity and accuracy in predicting TCN, as well as reduced false positives compared with ICD-10 coding. Emergency medical services identification is less sensitive for anatomic criteria; however, EMS identify the most clinically significant injuries. Further study is warranted to identify the most clinically important anatomic triage criteria to improve our triage protocols.Care management, Level IV; Prognostic, Level III.
Published: 2021

41. Necrotizing Soft Tissue Infections, the Challenge Remains

Author: Nawijn, Femke, primary, Hietbrink, Falco, additional, Peitzman, Andrew B., additional, and Leenen, Luke P. H., additional
Published: 2021
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42. Technical Challenges and Utility of Anterior Exposure for Thoracic Spine Pathology

Author: Pettiford, Brian L., Schuchert, Matthew J., Jeyabalan, Geetha, Landreneau, James R., Kilic, Arman, Landreneau, Joshua P., Awais, Omar, Kent, Michael S., Ferson, Peter F., Luketich, James D., Peitzman, Andrew B., and Landreneau, Rodney J.
Published: 2008
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43. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections

Author: Sartelli, Massimo Coccolini, Federico Kluger, Yoram Agastra, Ervis Abu-Zidan, Fikri M. Abbas, Ashraf El Sayed Ansaloni, Luca Adesunkanmi, Abdulrashid Kayode Atanasov, Boyko and Augustin, Goran Bala, Miklosh Baraket, Oussama Baral, Suman and Biffl, Walter L. Boermeester, Marja A. Ceresoli, Marco and Cerutti, Elisabetta Chiara, Osvaldo Cicuttin, Enrico and Chiarugi, Massimo Coimbra, Raul Colak, Elif Corsi, Daniela and Cortese, Francesco Cui, Yunfeng Damaskos, Dimitris and Angelis, Nicola De' Delibegovic, Samir Demetrashvili, Zaza and De Simone, Belinda de Jonge, Stijn W. Dhingra, Sameer Di Bella, Stefano Di Marzo, Francesco Di Saverio, Salomone and Dogjani, Agron Duane, Therese M. Enani, Mushira Abdulaziz and Fugazzola, Paola Galante, Joseph M. Gachabayov, Mahir and Ghnnam, Wagih Gkiokas, George Gomes, Carlos Augusto and Griffiths, Ewen A. Hardcastle, Timothy C. Hecker, Andreas and Herzog, Torsten Kabir, Syed Mohammad Umar Karamarkovic, Aleksandar Khokha, Vladimir Kim, Peter K. Il Kim, Jae and Kirkpatrick, Andrew W. Kong, Victor Koshy, Renol M. and Kryvoruchko, Igor A. Inaba, Kenji Isik, Arda Iskandar, Katia and Ivatury, Rao Labricciosa, Francesco M. Lee, Yeong Yeh and Leppaniemi, Ari Litvin, Andrey Luppi, Davide Machain, Gustavo M. Maier, V, Ronald Marinis, Athanasios Marmorale, Cristina Marwah, Sanjay Mesina, Cristian Moore, Ernest E. and Moore, Frederick A. Negoi, Ionut Olaoye, Iyiade Ordonez, Carlos A. Ouadii, Mouaqit Peitzman, Andrew B. Perrone, Gennaro Pikoulis, Manos Pintar, Tadeja Pipitone, Giuseppe and Podda, Mauro Rasa, Kemal Ribeiro, Julival Rodrigues, Gabriel Rubio-Perez, Ines Sall, Ibrahima Sato, Norio and Sawyer, Robert G. Lohse, Helmut Segovia Sganga, Gabriele and Shelat, Vishal G. Stephens, Ian Sugrue, Michael Tarasconi, Antonio Tochie, Joel Noutakdie Tolonen, Matti Tomadze, Gia and Ulrych, Jan Vereczkei, Andras Viaggi, Bruno Gurioli, Chiara Casella, Claudio Pagani, Leonardo Baiocchi, Gian Luca and Catena, Fausto
Subjects: embryonic structures
Abstract: Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in hospitals worldwide. The cornerstones of effective treatment of IAIs include early recognition, adequate source control, appropriate antimicrobial therapy, and prompt physiologic stabilization using a critical care environment, combined with an optimal surgical approach. Together, the World Society of Emergency Surgery (WSES), the Global Alliance for Infections in Surgery (GAIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), and the American Association for the Surgery of Trauma (AAST) have jointly completed an international multi-society document in order to facilitate clinical management of patients with IAIs worldwide building evidence-based clinical pathways for the most common IAIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting information was shared by an international task force from 46 countries with different clinical backgrounds. The aim of the document is to promote global standards of care in IAIs providing guidance to clinicians by describing reasonable approaches to the management of IAIs.
Published: 2021

44. 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

Author: DeAngelis, Nicola, Catena, Fausto, Memeo, Riccardo, Coccolini, Federico, Martinez-Perez, Aleix, Romeo, Oreste M., De Simone, Belinda, Di Saverio, Salomone, Brustia, Raffaele, Rhaiem, Rami, Piardi, Tullio, Conticchio, Maria, Marchegiani, Francesco, Beghdadi, Nassiba, Abu-Zidan, Fikri M., Alikhanov, Ruslan, Allard, Marc-Antoine, Allievi, Niccolo, Amaddeo, Giuliana, Ansaloni, Luca, Andersson, Roland, Andolfi, Enrico, Azfar, Mohammad, Bala, Miklosh, Benkabbou, Amine, Ben-Ishay, Offir, Bianchi, Giorgio, Biffl, Walter L., Brunetti, Francesco, Carra, Maria Clotilde, Casanova, Daniel, Celentano, Valerio, Ceresoli, Marco, Chiara, Osvaldo, Cimbanassi, Stefania, Bini, Roberto, Coimbra, Raul, Luigi deAngelis, Gianm, Decembrino, Francesco, De Palma, Andrea, de Reuver, Philip R., Domingo, Carlos, Cotsoglou, Christian, Ferrero, Alessandro, Fraga, Gustavo P., Gaiani, Federica, Gheza, Federico, Gurrado, Angela, Harrison, Ewen, Henriquez, Angel, Hofmeyr, Stefan, Iadarola, Roberta, Kashuk, Jeffry L., Kianmanesh, Reza, Kirkpatrick, Andrew W., Kluger, Yoram, Landi, Filippo, Langella, Serena, Lapointe, Real, Le Roy, Bertrand, Luciani, Alain, Machado, Fernando, Maggi, Umberto, Maier, Ronald V., Mefire, Alain Chichom, Hiramatsu, Kazuhiro, Ordonez, Carlos, Patrizi, Franca, Planells, Manuel, Peitzman, Andrew B., Pekolj, Juan, Perdigao, Fabiano, Pereira, Bruno M., Pessaux, Patrick, Pisano, Michele, Puyana, Juan Carlos, Rizoli, Sandro, Portigliotti, Luca, Romito, Raffaele, Sakakushev, Boris, Sanei, Behnam, Scatton, Olivier, Serradilla-Martin, Mario, Schneck, Anne-Sophie, Sissoko, Mohammed Lamine, Sobhani, Iradj, ten Broek, Richard P., Testini, Mario, Valinas, Roberto, Veloudis, Giorgos, Vitali, Giulio Cesare, Weber, Dieter, Zorcolo, Luigi, Giuliante, Felice, Gavriilidis, Paschalis, Fuks, David, Sommacale, Daniele, DeAngelis, Nicola, Catena, Fausto, Memeo, Riccardo, Coccolini, Federico, Martinez-Perez, Aleix, Romeo, Oreste M., De Simone, Belinda, Di Saverio, Salomone, Brustia, Raffaele, Rhaiem, Rami, Piardi, Tullio, Conticchio, Maria, Marchegiani, Francesco, Beghdadi, Nassiba, Abu-Zidan, Fikri M., Alikhanov, Ruslan, Allard, Marc-Antoine, Allievi, Niccolo, Amaddeo, Giuliana, Ansaloni, Luca, Andersson, Roland, Andolfi, Enrico, Azfar, Mohammad, Bala, Miklosh, Benkabbou, Amine, Ben-Ishay, Offir, Bianchi, Giorgio, Biffl, Walter L., Brunetti, Francesco, Carra, Maria Clotilde, Casanova, Daniel, Celentano, Valerio, Ceresoli, Marco, Chiara, Osvaldo, Cimbanassi, Stefania, Bini, Roberto, Coimbra, Raul, Luigi deAngelis, Gianm, Decembrino, Francesco, De Palma, Andrea, de Reuver, Philip R., Domingo, Carlos, Cotsoglou, Christian, Ferrero, Alessandro, Fraga, Gustavo P., Gaiani, Federica, Gheza, Federico, Gurrado, Angela, Harrison, Ewen, Henriquez, Angel, Hofmeyr, Stefan, Iadarola, Roberta, Kashuk, Jeffry L., Kianmanesh, Reza, Kirkpatrick, Andrew W., Kluger, Yoram, Landi, Filippo, Langella, Serena, Lapointe, Real, Le Roy, Bertrand, Luciani, Alain, Machado, Fernando, Maggi, Umberto, Maier, Ronald V., Mefire, Alain Chichom, Hiramatsu, Kazuhiro, Ordonez, Carlos, Patrizi, Franca, Planells, Manuel, Peitzman, Andrew B., Pekolj, Juan, Perdigao, Fabiano, Pereira, Bruno M., Pessaux, Patrick, Pisano, Michele, Puyana, Juan Carlos, Rizoli, Sandro, Portigliotti, Luca, Romito, Raffaele, Sakakushev, Boris, Sanei, Behnam, Scatton, Olivier, Serradilla-Martin, Mario, Schneck, Anne-Sophie, Sissoko, Mohammed Lamine, Sobhani, Iradj, ten Broek, Richard P., Testini, Mario, Valinas, Roberto, Veloudis, Giorgos, Vitali, Giulio Cesare, Weber, Dieter, Zorcolo, Luigi, Giuliante, Felice, Gavriilidis, Paschalis, Fuks, David, and Sommacale, Daniele
Abstract: Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4-1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.
Published: 2021
Full Text: View/download PDF

45. 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

Author: De'Angelis, N, Catena, F, Memeo, R, Coccolini, F, Martinez-Perez, A, Romeo, O, De Simone, B, Di Saverio, S, Brustia, R, Rhaiem, R, Piardi, T, Conticchio, M, Marchegiani, F, Beghdadi, N, Abu-Zidan, F, Alikhanov, R, Allard, M, Allievi, N, Amaddeo, G, Ansaloni, L, Andersson, R, Andolfi, E, Azfar, M, Bala, M, Benkabbou, A, Ben-Ishay, O, Bianchi, G, Biffl, W, Brunetti, F, Carra, M, Casanova, D, Celentano, V, Ceresoli, M, Chiara, O, Cimbanassi, S, Bini, R, Coimbra, R, Luigi de'Angelis, G, Decembrino, F, De Palma, A, de Reuver, P, Domingo, C, Cotsoglou, C, Ferrero, A, Fraga, G, Gaiani, F, Gheza, F, Gurrado, A, Harrison, E, Henriquez, A, Hofmeyr, S, Iadarola, R, Kashuk, J, Kianmanesh, R, Kirkpatrick, A, Kluger, Y, Landi, F, Langella, S, Lapointe, R, Le Roy, B, Luciani, A, Machado, F, Maggi, U, Maier, R, Mefire, A, Hiramatsu, K, Ordonez, C, Patrizi, F, Planells, M, Peitzman, A, Pekolj, J, Perdigao, F, Pereira, B, Pessaux, P, Pisano, M, Puyana, J, Rizoli, S, Portigliotti, L, Romito, R, Sakakushev, B, Sanei, B, Scatton, O, Serradilla-Martin, M, Schneck, A, Sissoko, M, Sobhani, I, ten Broek, R, Testini, M, Valinas, R, Veloudis, G, Vitali, G, Weber, D, Zorcolo, L, Giuliante, F, Gavriilidis, P, Fuks, D, Sommacale, D, de'Angelis N., Catena F., Memeo R., Coccolini F., Martinez-Perez A., Romeo O. M., De Simone B., Di Saverio S., Brustia R., Rhaiem R., Piardi T., Conticchio M., Marchegiani F., Beghdadi N., Abu-Zidan F. M., Alikhanov R., Allard M. -A., Allievi N., Amaddeo G., Ansaloni L., Andersson R., Andolfi E., Azfar M., Bala M., Benkabbou A., Ben-Ishay O., Bianchi G., Biffl W. L., Brunetti F., Carra M. C., Casanova D., Celentano V., Ceresoli M., Chiara O., Cimbanassi S., Bini R., Coimbra R., Luigi de'Angelis G., Decembrino F., De Palma A., de Reuver P. R., Domingo C., Cotsoglou C., Ferrero A., Fraga G. P., Gaiani F., Gheza F., Gurrado A., Harrison E., Henriquez A., Hofmeyr S., Iadarola R., Kashuk J. L., Kianmanesh R., Kirkpatrick A. W., Kluger Y., Landi F., Langella S., Lapointe R., Le Roy B., Luciani A., Machado F., Maggi U., Maier R. V., Mefire A. C., Hiramatsu K., Ordonez C., Patrizi F., Planells M., Peitzman A. B., Pekolj J., Perdigao F., Pereira B. M., Pessaux P., Pisano M., Puyana J. C., Rizoli S., Portigliotti L., Romito R., Sakakushev B., Sanei B., Scatton O., Serradilla-Martin M., Schneck A. -S., Sissoko M. L., Sobhani I., ten Broek R. P., Testini M., Valinas R., Veloudis G., Vitali G. C., Weber D., Zorcolo L., Giuliante F., Gavriilidis P., Fuks D., Sommacale D., De'Angelis, N, Catena, F, Memeo, R, Coccolini, F, Martinez-Perez, A, Romeo, O, De Simone, B, Di Saverio, S, Brustia, R, Rhaiem, R, Piardi, T, Conticchio, M, Marchegiani, F, Beghdadi, N, Abu-Zidan, F, Alikhanov, R, Allard, M, Allievi, N, Amaddeo, G, Ansaloni, L, Andersson, R, Andolfi, E, Azfar, M, Bala, M, Benkabbou, A, Ben-Ishay, O, Bianchi, G, Biffl, W, Brunetti, F, Carra, M, Casanova, D, Celentano, V, Ceresoli, M, Chiara, O, Cimbanassi, S, Bini, R, Coimbra, R, Luigi de'Angelis, G, Decembrino, F, De Palma, A, de Reuver, P, Domingo, C, Cotsoglou, C, Ferrero, A, Fraga, G, Gaiani, F, Gheza, F, Gurrado, A, Harrison, E, Henriquez, A, Hofmeyr, S, Iadarola, R, Kashuk, J, Kianmanesh, R, Kirkpatrick, A, Kluger, Y, Landi, F, Langella, S, Lapointe, R, Le Roy, B, Luciani, A, Machado, F, Maggi, U, Maier, R, Mefire, A, Hiramatsu, K, Ordonez, C, Patrizi, F, Planells, M, Peitzman, A, Pekolj, J, Perdigao, F, Pereira, B, Pessaux, P, Pisano, M, Puyana, J, Rizoli, S, Portigliotti, L, Romito, R, Sakakushev, B, Sanei, B, Scatton, O, Serradilla-Martin, M, Schneck, A, Sissoko, M, Sobhani, I, ten Broek, R, Testini, M, Valinas, R, Veloudis, G, Vitali, G, Weber, D, Zorcolo, L, Giuliante, F, Gavriilidis, P, Fuks, D, Sommacale, D, de'Angelis N., Catena F., Memeo R., Coccolini F., Martinez-Perez A., Romeo O. M., De Simone B., Di Saverio S., Brustia R., Rhaiem R., Piardi T., Conticchio M., Marchegiani F., Beghdadi N., Abu-Zidan F. M., Alikhanov R., Allard M. -A., Allievi N., Amaddeo G., Ansaloni L., Andersson R., Andolfi E., Azfar M., Bala M., Benkabbou A., Ben-Ishay O., Bianchi G., Biffl W. L., Brunetti F., Carra M. C., Casanova D., Celentano V., Ceresoli M., Chiara O., Cimbanassi S., Bini R., Coimbra R., Luigi de'Angelis G., Decembrino F., De Palma A., de Reuver P. R., Domingo C., Cotsoglou C., Ferrero A., Fraga G. P., Gaiani F., Gheza F., Gurrado A., Harrison E., Henriquez A., Hofmeyr S., Iadarola R., Kashuk J. L., Kianmanesh R., Kirkpatrick A. W., Kluger Y., Landi F., Langella S., Lapointe R., Le Roy B., Luciani A., Machado F., Maggi U., Maier R. V., Mefire A. C., Hiramatsu K., Ordonez C., Patrizi F., Planells M., Peitzman A. B., Pekolj J., Perdigao F., Pereira B. M., Pessaux P., Pisano M., Puyana J. C., Rizoli S., Portigliotti L., Romito R., Sakakushev B., Sanei B., Scatton O., Serradilla-Martin M., Schneck A. -S., Sissoko M. L., Sobhani I., ten Broek R. P., Testini M., Valinas R., Veloudis G., Vitali G. C., Weber D., Zorcolo L., Giuliante F., Gavriilidis P., Fuks D., and Sommacale D.
Abstract: Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4–1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.
Published: 2021

46. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections

Author: Sartelli, M, Coccolini, F, Kluger, Y, Agastra, E, Abu-Zidan, F, Abbas, A, Ansaloni, L, Adesunkanmi, A, Atanasov, B, Augustin, G, Bala, M, Baraket, O, Baral, S, Biffl, W, Boermeester, M, Ceresoli, M, Cerutti, E, Chiara, O, Cicuttin, E, Chiarugi, M, Coimbra, R, Colak, E, Corsi, D, Cortese, F, Cui, Y, Damaskos, D, de' Angelis, N, Delibegovic, S, Demetrashvili, Z, De Simone, B, de Jonge, S, Dhingra, S, Di Bella, S, Di Marzo, F, Di Saverio, S, Dogjani, A, Duane, T, Enani, M, Fugazzola, P, Galante, J, Gachabayov, M, Ghnnam, W, Gkiokas, G, Gomes, C, Griffiths, E, Hardcastle, T, Hecker, A, Herzog, T, Kabir, S, Karamarkovic, A, Khokha, V, Kim, P, Kim, J, Kirkpatrick, A, Kong, V, Koshy, R, Kryvoruchko, I, Inaba, K, Isik, A, Iskandar, K, Ivatury, R, Labricciosa, F, Lee, Y, Leppaniemi, A, Litvin, A, Luppi, D, Machain, G, Maier, R, Marinis, A, Marmorale, C, Marwah, S, Mesina, C, Moore, E, Moore, F, Negoi, I, Olaoye, I, Ordonez, C, Ouadii, M, Peitzman, A, Perrone, G, Pikoulis, M, Pintar, T, Pipitone, G, Podda, M, Rasa, K, Ribeiro, J, Rodrigues, G, Rubio-Perez, I, Sall, I, Sato, N, Sawyer, R, Segovia Lohse, H, Sganga, G, Shelat, V, Stephens, I, Sugrue, M, Tarasconi, A, Tochie, J, Tolonen, M, Tomadze, G, Ulrych, J, Vereczkei, A, Viaggi, B, Gurioli, C, Casella, C, Pagani, L, Baiocchi, G, Catena, F, Sartelli M., Coccolini F., Kluger Y., Agastra E., Abu-Zidan F. M., Abbas A. E. S., Ansaloni L., Adesunkanmi A. K., Atanasov B., Augustin G., Bala M., Baraket O., Baral S., Biffl W. L., Boermeester M. A., Ceresoli M., Cerutti E., Chiara O., Cicuttin E., Chiarugi M., Coimbra R., Colak E., Corsi D., Cortese F., Cui Y., Damaskos D., de' Angelis N., Delibegovic S., Demetrashvili Z., De Simone B., de Jonge S. W., Dhingra S., Di Bella S., Di Marzo F., Di Saverio S., Dogjani A., Duane T. M., Enani M. A., Fugazzola P., Galante J. M., Gachabayov M., Ghnnam W., Gkiokas G., Gomes C. A., Griffiths E. A., Hardcastle T. C., Hecker A., Herzog T., Kabir S. M. U., Karamarkovic A., Khokha V., Kim P. K., Kim J. I., Kirkpatrick A. W., Kong V., Koshy R. M., Kryvoruchko I. A., Inaba K., Isik A., Iskandar K., Ivatury R., Labricciosa F. M., Lee Y. Y., Leppaniemi A., Litvin A., Luppi D., Machain G. M., Maier R. V., Marinis A., Marmorale C., Marwah S., Mesina C., Moore E. E., Moore F. A., Negoi I., Olaoye I., Ordonez C. A., Ouadii M., Peitzman A. B., Perrone G., Pikoulis M., Pintar T., Pipitone G., Podda M., Rasa K., Ribeiro J., Rodrigues G., Rubio-Perez I., Sall I., Sato N., Sawyer R. G., Segovia Lohse H., Sganga G., Shelat V. G., Stephens I., Sugrue M., Tarasconi A., Tochie J. N., Tolonen M., Tomadze G., Ulrych J., Vereczkei A., Viaggi B., Gurioli C., Casella C., Pagani L., Baiocchi G. L., Catena F., Sartelli, M, Coccolini, F, Kluger, Y, Agastra, E, Abu-Zidan, F, Abbas, A, Ansaloni, L, Adesunkanmi, A, Atanasov, B, Augustin, G, Bala, M, Baraket, O, Baral, S, Biffl, W, Boermeester, M, Ceresoli, M, Cerutti, E, Chiara, O, Cicuttin, E, Chiarugi, M, Coimbra, R, Colak, E, Corsi, D, Cortese, F, Cui, Y, Damaskos, D, de' Angelis, N, Delibegovic, S, Demetrashvili, Z, De Simone, B, de Jonge, S, Dhingra, S, Di Bella, S, Di Marzo, F, Di Saverio, S, Dogjani, A, Duane, T, Enani, M, Fugazzola, P, Galante, J, Gachabayov, M, Ghnnam, W, Gkiokas, G, Gomes, C, Griffiths, E, Hardcastle, T, Hecker, A, Herzog, T, Kabir, S, Karamarkovic, A, Khokha, V, Kim, P, Kim, J, Kirkpatrick, A, Kong, V, Koshy, R, Kryvoruchko, I, Inaba, K, Isik, A, Iskandar, K, Ivatury, R, Labricciosa, F, Lee, Y, Leppaniemi, A, Litvin, A, Luppi, D, Machain, G, Maier, R, Marinis, A, Marmorale, C, Marwah, S, Mesina, C, Moore, E, Moore, F, Negoi, I, Olaoye, I, Ordonez, C, Ouadii, M, Peitzman, A, Perrone, G, Pikoulis, M, Pintar, T, Pipitone, G, Podda, M, Rasa, K, Ribeiro, J, Rodrigues, G, Rubio-Perez, I, Sall, I, Sato, N, Sawyer, R, Segovia Lohse, H, Sganga, G, Shelat, V, Stephens, I, Sugrue, M, Tarasconi, A, Tochie, J, Tolonen, M, Tomadze, G, Ulrych, J, Vereczkei, A, Viaggi, B, Gurioli, C, Casella, C, Pagani, L, Baiocchi, G, Catena, F, Sartelli M., Coccolini F., Kluger Y., Agastra E., Abu-Zidan F. M., Abbas A. E. S., Ansaloni L., Adesunkanmi A. K., Atanasov B., Augustin G., Bala M., Baraket O., Baral S., Biffl W. L., Boermeester M. A., Ceresoli M., Cerutti E., Chiara O., Cicuttin E., Chiarugi M., Coimbra R., Colak E., Corsi D., Cortese F., Cui Y., Damaskos D., de' Angelis N., Delibegovic S., Demetrashvili Z., De Simone B., de Jonge S. W., Dhingra S., Di Bella S., Di Marzo F., Di Saverio S., Dogjani A., Duane T. M., Enani M. A., Fugazzola P., Galante J. M., Gachabayov M., Ghnnam W., Gkiokas G., Gomes C. A., Griffiths E. A., Hardcastle T. C., Hecker A., Herzog T., Kabir S. M. U., Karamarkovic A., Khokha V., Kim P. K., Kim J. I., Kirkpatrick A. W., Kong V., Koshy R. M., Kryvoruchko I. A., Inaba K., Isik A., Iskandar K., Ivatury R., Labricciosa F. M., Lee Y. Y., Leppaniemi A., Litvin A., Luppi D., Machain G. M., Maier R. V., Marinis A., Marmorale C., Marwah S., Mesina C., Moore E. E., Moore F. A., Negoi I., Olaoye I., Ordonez C. A., Ouadii M., Peitzman A. B., Perrone G., Pikoulis M., Pintar T., Pipitone G., Podda M., Rasa K., Ribeiro J., Rodrigues G., Rubio-Perez I., Sall I., Sato N., Sawyer R. G., Segovia Lohse H., Sganga G., Shelat V. G., Stephens I., Sugrue M., Tarasconi A., Tochie J. N., Tolonen M., Tomadze G., Ulrych J., Vereczkei A., Viaggi B., Gurioli C., Casella C., Pagani L., Baiocchi G. L., and Catena F.
Abstract: Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in hospitals worldwide. The cornerstones of effective treatment of IAIs include early recognition, adequate source control, appropriate antimicrobial therapy, and prompt physiologic stabilization using a critical care environment, combined with an optimal surgical approach. Together, the World Society of Emergency Surgery (WSES), the Global Alliance for Infections in Surgery (GAIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), and the American Association for the Surgery of Trauma (AAST) have jointly completed an international multi-society document in order to facilitate clinical management of patients with IAIs worldwide building evidence-based clinical pathways for the most common IAIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting information was shared by an international task force from 46 countries with different clinical backgrounds. The aim of the document is to promote global standards of care in IAIs providing guidance to clinicians by describing reasonable approaches to the management of IAIs.
Published: 2021

47. Necrotizing Soft Tissue Infections, the Challenge Remains

Author: Zorgeenheid Traumatologie, Infection & Immunity, Nawijn, Femke, Hietbrink, Falco, Peitzman, Andrew B., Leenen, Luke P.H., Zorgeenheid Traumatologie, Infection & Immunity, Nawijn, Femke, Hietbrink, Falco, Peitzman, Andrew B., and Leenen, Luke P.H.
Published: 2021

48. Additional file 1 of Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Author: Salomone Di Saverio, Podda, Mauro, Simone, Belinda De, Ceresoli, Marco, Augustin, Goran, Gori, Alice, Boermeester, Marja, Sartelli, Massimo, Coccolini, Federico, Tarasconi, Antonio, Angelis, Nicola De’, Weber, Dieter G., Tolonen, Matti, Birindelli, Arianna, Biffl, Walter, Moore, Ernest E., Kelly, Michael, Soreide, Kjetil, Kashuk, Jeffry, Broek, Richard Ten, Gomes, Carlos Augusto, Sugrue, Michael, Davies, Richard Justin, Damaskos, Dimitrios, Leppäniemi, Ari, Kirkpatrick, Andrew, Peitzman, Andrew B., Fraga, Gustavo P., Maier, Ronald V., Coimbra, Raul, Chiarugi, Massimo, Sganga, Gabriele, Pisanu, Adolfo, Angelis, Gian Luigi De’, Tan, Edward, Goor, Harry Van, Pata, Francesco, Carlo, Isidoro Di, Chiara, Osvaldo, Litvin, Andrey, Campanile, Fabio C., Sakakushev, Boris, Tomadze, Gia, Demetrashvili, Zaza, Latifi, Rifat, Fakri Abu-Zidan, Romeo, Oreste, Segovia-Lohse, Helmut, Baiocchi, Gianluca, Costa, David, Rizoli, Sandro, Balogh, Zsolt J., Bendinelli, Cino, Scalea, Thomas, Ivatury, Rao, Velmahos, George, Andersson, Roland, Kluger, Yoram, Ansaloni, Luca, and Catena, Fausto
Subjects: TheoryofComputation_MATHEMATICALLOGICANDFORMALLANGUAGES, Data_FILES, Software_PROGRAMMINGLANGUAGES
Abstract: Additional file 1. Search Syntaxes.
Published: 2020
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49. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Author: Di Saverio, S, Podda, M, De Simone, B, Ceresoli, M, Augustin, G, Gori, A, Boermeester, M, Sartelli, M, Coccolini, F, Tarasconi, A, De' Angelis, N, Weber, D, Tolonen, M, Birindelli, A, Biffl, W, Moore, E, Kelly, M, Soreide, K, Kashuk, J, Ten Broek, R, Gomes, C, Sugrue, M, Davies, R, Damaskos, D, Leppaniemi, A, Kirkpatrick, A, Peitzman, A, Fraga, G, Maier, R, Coimbra, R, Chiarugi, M, Sganga, G, Pisanu, A, De' Angelis, G, Tan, E, Van Goor, H, Pata, F, Di Carlo, I, Chiara, O, Litvin, A, Campanile, F, Sakakushev, B, Tomadze, G, Demetrashvili, Z, Latifi, R, Abu-Zidan, F, Romeo, O, Segovia-Lohse, H, Baiocchi, G, Costa, D, Rizoli, S, Balogh, Z, Bendinelli, C, Scalea, T, Ivatury, R, Velmahos, G, Andersson, R, Kluger, Y, Ansaloni, L, Catena, F, Di Saverio S., Podda M., De Simone B., Ceresoli M., Augustin G., Gori A., Boermeester M., Sartelli M., Coccolini F., Tarasconi A., De' Angelis N., Weber D. G., Tolonen M., Birindelli A., Biffl W., Moore E. E., Kelly M., Soreide K., Kashuk J., Ten Broek R., Gomes C. A., Sugrue M., Davies R. J., Damaskos D., Leppaniemi A., Kirkpatrick A., Peitzman A. B., Fraga G. P., Maier R. V., Coimbra R., Chiarugi M., Sganga G., Pisanu A., De' Angelis G. L., Tan E., Van Goor H., Pata F., Di Carlo I., Chiara O., Litvin A., Campanile F. C., Sakakushev B., Tomadze G., Demetrashvili Z., Latifi R., Abu-Zidan F., Romeo O., Segovia-Lohse H., Baiocchi G., Costa D., Rizoli S., Balogh Z. J., Bendinelli C., Scalea T., Ivatury R., Velmahos G., Andersson R., Kluger Y., Ansaloni L., Catena F., Di Saverio, S, Podda, M, De Simone, B, Ceresoli, M, Augustin, G, Gori, A, Boermeester, M, Sartelli, M, Coccolini, F, Tarasconi, A, De' Angelis, N, Weber, D, Tolonen, M, Birindelli, A, Biffl, W, Moore, E, Kelly, M, Soreide, K, Kashuk, J, Ten Broek, R, Gomes, C, Sugrue, M, Davies, R, Damaskos, D, Leppaniemi, A, Kirkpatrick, A, Peitzman, A, Fraga, G, Maier, R, Coimbra, R, Chiarugi, M, Sganga, G, Pisanu, A, De' Angelis, G, Tan, E, Van Goor, H, Pata, F, Di Carlo, I, Chiara, O, Litvin, A, Campanile, F, Sakakushev, B, Tomadze, G, Demetrashvili, Z, Latifi, R, Abu-Zidan, F, Romeo, O, Segovia-Lohse, H, Baiocchi, G, Costa, D, Rizoli, S, Balogh, Z, Bendinelli, C, Scalea, T, Ivatury, R, Velmahos, G, Andersson, R, Kluger, Y, Ansaloni, L, Catena, F, Di Saverio S., Podda M., De Simone B., Ceresoli M., Augustin G., Gori A., Boermeester M., Sartelli M., Coccolini F., Tarasconi A., De' Angelis N., Weber D. G., Tolonen M., Birindelli A., Biffl W., Moore E. E., Kelly M., Soreide K., Kashuk J., Ten Broek R., Gomes C. A., Sugrue M., Davies R. J., Damaskos D., Leppaniemi A., Kirkpatrick A., Peitzman A. B., Fraga G. P., Maier R. V., Coimbra R., Chiarugi M., Sganga G., Pisanu A., De' Angelis G. L., Tan E., Van Goor H., Pata F., Di Carlo I., Chiara O., Litvin A., Campanile F. C., Sakakushev B., Tomadze G., Demetrashvili Z., Latifi R., Abu-Zidan F., Romeo O., Segovia-Lohse H., Baiocchi G., Costa D., Rizoli S., Balogh Z. J., Bendinelli C., Scalea T., Ivatury R., Velmahos G., Andersson R., Kluger Y., Ansaloni L., and Catena F.
Abstract: Background and aims: Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: Use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of non-operative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and peri-operative antibiotic therapy. Methods: This executive manuscript summarizes the WSES guidelines for the diagnosis and treatment of AA. Literature search has been updated up to 2019 and statements and recommendations have been developed according to the GRADE methodology. The statements were voted, eventually modified, and finally approved by the participants to the consensus conference and by the board of co-authors, using a Delphi methodology for voting whenever there was controversy on a statement or a recommendation. Several tables highlighting the research topics and questions, search syntaxes, and the statements and the WSES evidence-based recommendations are provided. Finally, two different practical clinical algorithms are provided in the form of a flow chart for both adults and pediatric (< 16 years old) patients. Conclusions: The 2020 WSES guidelines on AA aim to provide updated evidence-based statements and recommendations on each of the following topics: (1) diagnosis, (2) non-operative management for uncomplicated AA, (3) timing of appendectomy and in-hospi
Published: 2020

50. American Association for the Surgery of Trauma-World Society of Emergency Surgery guidelines on diagnosis and management of peripheral vascular injuries

Author: Kobayashi, L, Coimbra, R, Goes, A, Reva, V, Santorelli, J, Moore, E, Galante, J, Abu-Zidan, F, Peitzman, A, Ordonez, C, Maier, R, Di Saverio, S, Ivatury, R, De Angelis, N, Scalea, T, Catena, F, Kirkpatrick, A, Khokha, V, Parry, N, Civil, I, Leppaniemi, A, Chirica, M, Pikoulis, E, Fraga, G, Chiarugi, M, Damaskos, D, Cicuttin, E, Ceresoli, M, De Simone, B, Vega-Rivera, F, Sartelli, M, Biffl, W, Ansaloni, L, Weber, D, Coccolini, F, Kobayashi L., Coimbra R., Goes A. M. O., Reva V., Santorelli J., Moore E. E., Galante J., Abu-Zidan F., Peitzman A. B., Ordonez C., Maier R. V., Di Saverio S., Ivatury R., De Angelis N., Scalea T., Catena F., Kirkpatrick A., Khokha V., Parry N., Civil I., Leppaniemi A., Chirica M., Pikoulis E., Fraga G. P., Chiarugi M., Damaskos D., Cicuttin E., Ceresoli M., De Simone B., Vega-Rivera F., Sartelli M., Biffl W., Ansaloni L., Weber D. G., Coccolini F., Kobayashi, L, Coimbra, R, Goes, A, Reva, V, Santorelli, J, Moore, E, Galante, J, Abu-Zidan, F, Peitzman, A, Ordonez, C, Maier, R, Di Saverio, S, Ivatury, R, De Angelis, N, Scalea, T, Catena, F, Kirkpatrick, A, Khokha, V, Parry, N, Civil, I, Leppaniemi, A, Chirica, M, Pikoulis, E, Fraga, G, Chiarugi, M, Damaskos, D, Cicuttin, E, Ceresoli, M, De Simone, B, Vega-Rivera, F, Sartelli, M, Biffl, W, Ansaloni, L, Weber, D, Coccolini, F, Kobayashi L., Coimbra R., Goes A. M. O., Reva V., Santorelli J., Moore E. E., Galante J., Abu-Zidan F., Peitzman A. B., Ordonez C., Maier R. V., Di Saverio S., Ivatury R., De Angelis N., Scalea T., Catena F., Kirkpatrick A., Khokha V., Parry N., Civil I., Leppaniemi A., Chirica M., Pikoulis E., Fraga G. P., Chiarugi M., Damaskos D., Cicuttin E., Ceresoli M., De Simone B., Vega-Rivera F., Sartelli M., Biffl W., Ansaloni L., Weber D. G., and Coccolini F.
Abstract: The peripheral arteries and veins of the extremities are among the most commonly injured vessels in both civilian and military vascular trauma. Blunt causes are more frequent than penetrating except during military conflicts and in certain geographic areas. Physical examination and simple bedside investigations of pulse pressures are key in early identification of these injuries. In stable patients with equivocal physical examinations, computed tomography angiograms have become the mainstay of screening and diagnosis. Immediate open surgical repair remains the first-line therapy in most patients. However, advances in endovascular therapies and more widespread availability of this technology have resulted in an increase in the range of injuries and frequency of utilization of minimally invasive treatments for vascular injuries in stable patients. Prevention of and early detection and treatment of compartment syndrome remain essential in the recovery of patients with significant peripheral vascular injuries. The decision to perform amputation in patients with mangled extremities remains difficult with few clear indicators. The American Association for the Surgery of Trauma in conjunction with the World Society of Emergency Surgery seeks to summarize the literature to date and provide guidelines on the presentation, diagnosis, and treatment of peripheral vascular injuries. LEVEL OF EVIDENCE Review study, level IV.
Published: 2020

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