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1. Management of complicated diaphragmatic hernia in the acute setting: a WSES position paper

Author: Giuffrida, M, Perrone, G, Abu-Zidan, F, Agnoletti, V, Ansaloni, L, Baiocchi, G, Bendinelli, C, Biffl, W, Bonavina, L, Bravi, F, Carcoforo, P, Ceresoli, M, Chichom-Mefire, A, Coccolini, F, Coimbra, R, De'Angelis, N, de Moya, M, De Simone, B, Di Saverio, S, Fraga, G, Galante, J, Ivatury, R, Kashuk, J, Kelly, M, Kirkpatrick, A, Kluger, Y, Koike, K, Leppaniemi, A, Maier, R, Moore, E, Peitzmann, A, Sakakushev, B, Sartelli, M, Sugrue, M, Tian, B, Broek, R, Vallicelli, C, Wani, I, Weber, D, Docimo, G, Catena, F, Giuffrida M., Perrone G., Abu-Zidan F., Agnoletti V., Ansaloni L., Baiocchi G. L., Bendinelli C., Biffl W. L., Bonavina L., Bravi F., Carcoforo P., Ceresoli M., Chichom-Mefire A., Coccolini F., Coimbra R., de'Angelis N., de Moya M., De Simone B., Di Saverio S., Fraga G. P., Galante J., Ivatury R., Kashuk J., Kelly M. D., Kirkpatrick A. W., Kluger Y., Koike K., Leppaniemi A., Maier R. V., Moore E. E., Peitzmann A., Sakakushev B., Sartelli M., Sugrue M., Tian B. W. C. A., Broek R. T., Vallicelli C., Wani I., Weber D. G., Docimo G., Catena F., Giuffrida, M, Perrone, G, Abu-Zidan, F, Agnoletti, V, Ansaloni, L, Baiocchi, G, Bendinelli, C, Biffl, W, Bonavina, L, Bravi, F, Carcoforo, P, Ceresoli, M, Chichom-Mefire, A, Coccolini, F, Coimbra, R, De'Angelis, N, de Moya, M, De Simone, B, Di Saverio, S, Fraga, G, Galante, J, Ivatury, R, Kashuk, J, Kelly, M, Kirkpatrick, A, Kluger, Y, Koike, K, Leppaniemi, A, Maier, R, Moore, E, Peitzmann, A, Sakakushev, B, Sartelli, M, Sugrue, M, Tian, B, Broek, R, Vallicelli, C, Wani, I, Weber, D, Docimo, G, Catena, F, Giuffrida M., Perrone G., Abu-Zidan F., Agnoletti V., Ansaloni L., Baiocchi G. L., Bendinelli C., Biffl W. L., Bonavina L., Bravi F., Carcoforo P., Ceresoli M., Chichom-Mefire A., Coccolini F., Coimbra R., de'Angelis N., de Moya M., De Simone B., Di Saverio S., Fraga G. P., Galante J., Ivatury R., Kashuk J., Kelly M. D., Kirkpatrick A. W., Kluger Y., Koike K., Leppaniemi A., Maier R. V., Moore E. E., Peitzmann A., Sakakushev B., Sartelli M., Sugrue M., Tian B. W. C. A., Broek R. T., Vallicelli C., Wani I., Weber D. G., Docimo G., and Catena F.
Abstract: BACKGROUND: Diaphragmatic hernia (DH) presenting acutely can be a potentially life-threatening condition. Its management continues to be debatable. METHODS: A bibliographic search using major databases was performed using the terms "emergency surgery" "diaphragmatic hernia," "traumatic diaphragmatic rupture" and "congenital diaphragmatic hernia." GRADE methodology was used to evaluate the evidence and give recommendations. RESULTS: CT scan of the chest and abdomen is the diagnostic gold standard to evaluate complicated DH. Appropriate preoperative assessment and prompt surgical intervention are important for a clinical success. Complicated DH repair is best performed via the use of biological and bioabsorbable meshes which have proven to reduce recurrence. The laparoscopic approach is the preferred technique in hemodynamically stable patients without significant comorbidities because it facilitates early diagnosis of small diaphragmatic injuries from traumatic wounds in the thoraco-abdominal area and reduces postoperative complications. Open surgery should be reserved for situations when skills and equipment for laparoscopy are not available, where exploratory laparotomy is needed, or if the patient is hemodynamically unstable. Damage Control Surgery is an option in the management of critical and unstable patients. CONCLUSIONS: Complicated diaphragmatic hernia is a rare life-threatening condition. CT scan of the chest and abdomen is the gold standard for diagnosing the diaphragmatic hernia. Laparoscopic repair is the best treatment option for stable patients with complicated diaphragmatic hernias. Open repair is considered necessary in majority of unstable patients in whom Damage Control Surgery can be life-saving.
Published: 2023

2. Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines

Author: Coccolini, F, Sartelli, M, Sawyer, R, Rasa, K, Viaggi, B, Abu-Zidan, F, Soreide, K, Hardcastle, T, Gupta, D, Bendinelli, C, Ceresoli, M, Shelat, V, Broek, R, Baiocchi, G, Moore, E, Sall, I, Podda, M, Bonavina, L, Kryvoruchko, I, Stahel, P, Inaba, K, Montravers, P, Sakakushev, B, Sganga, G, Ballestracci, P, Malbrain, M, Vincent, J, Pikoulis, M, Beka, S, Doklestic, K, Chiarugi, M, Falcone, M, Bignami, E, Reva, V, Demetrashvili, Z, Di Saverio, S, Tolonen, M, Navsaria, P, Bala, M, Balogh, Z, Litvin, A, Hecker, A, Wani, I, Fette, A, De Simone, B, Ivatury, R, Picetti, E, Khokha, V, Tan, E, Ball, C, Tascini, C, Cui, Y, Coimbra, R, Kelly, M, Martino, C, Agnoletti, V, Boermeester, M, De'Angelis, N, Chirica, M, Biffl, W, Ansaloni, L, Kluger, Y, Catena, F, Kirkpatrick, A, Coccolini F., Sartelli M., Sawyer R., Rasa K., Viaggi B., Abu-Zidan F., Soreide K., Hardcastle T., Gupta D., Bendinelli C., Ceresoli M., Shelat V. G., Broek R., Baiocchi G. L., Moore E. E., Sall I., Podda M., Bonavina L., Kryvoruchko I. A., Stahel P., Inaba K., Montravers P., Sakakushev B., Sganga G., Ballestracci P., Malbrain M. L. N. G., Vincent J. -L., Pikoulis M., Beka S. G., Doklestic K., Chiarugi M., Falcone M., Bignami E., Reva V., Demetrashvili Z., Di Saverio S., Tolonen M., Navsaria P., Bala M., Balogh Z., Litvin A., Hecker A., Wani I., Fette A., De Simone B., Ivatury R., Picetti E., Khokha V., Tan E., Ball C., Tascini C., Cui Y., Coimbra R., Kelly M., Martino C., Agnoletti V., Boermeester M. A., De'Angelis N., Chirica M., Biffl W. L., Ansaloni L., Kluger Y., Catena F., Kirkpatrick A. W., Coccolini, F, Sartelli, M, Sawyer, R, Rasa, K, Viaggi, B, Abu-Zidan, F, Soreide, K, Hardcastle, T, Gupta, D, Bendinelli, C, Ceresoli, M, Shelat, V, Broek, R, Baiocchi, G, Moore, E, Sall, I, Podda, M, Bonavina, L, Kryvoruchko, I, Stahel, P, Inaba, K, Montravers, P, Sakakushev, B, Sganga, G, Ballestracci, P, Malbrain, M, Vincent, J, Pikoulis, M, Beka, S, Doklestic, K, Chiarugi, M, Falcone, M, Bignami, E, Reva, V, Demetrashvili, Z, Di Saverio, S, Tolonen, M, Navsaria, P, Bala, M, Balogh, Z, Litvin, A, Hecker, A, Wani, I, Fette, A, De Simone, B, Ivatury, R, Picetti, E, Khokha, V, Tan, E, Ball, C, Tascini, C, Cui, Y, Coimbra, R, Kelly, M, Martino, C, Agnoletti, V, Boermeester, M, De'Angelis, N, Chirica, M, Biffl, W, Ansaloni, L, Kluger, Y, Catena, F, Kirkpatrick, A, Coccolini F., Sartelli M., Sawyer R., Rasa K., Viaggi B., Abu-Zidan F., Soreide K., Hardcastle T., Gupta D., Bendinelli C., Ceresoli M., Shelat V. G., Broek R., Baiocchi G. L., Moore E. E., Sall I., Podda M., Bonavina L., Kryvoruchko I. A., Stahel P., Inaba K., Montravers P., Sakakushev B., Sganga G., Ballestracci P., Malbrain M. L. N. G., Vincent J. -L., Pikoulis M., Beka S. G., Doklestic K., Chiarugi M., Falcone M., Bignami E., Reva V., Demetrashvili Z., Di Saverio S., Tolonen M., Navsaria P., Bala M., Balogh Z., Litvin A., Hecker A., Wani I., Fette A., De Simone B., Ivatury R., Picetti E., Khokha V., Tan E., Ball C., Tascini C., Cui Y., Coimbra R., Kelly M., Martino C., Agnoletti V., Boermeester M. A., De'Angelis N., Chirica M., Biffl W. L., Ansaloni L., Kluger Y., Catena F., and Kirkpatrick A. W.
Abstract: Intra-abdominal infections (IAI) are among the most common global healthcare challenges and they are usually precipitated by disruption to the gastrointestinal (GI) tract. Their successful management typically requires intensive resource utilization, and despite the best therapies, morbidity and mortality remain high. One of the main issues required to appropriately treat IAI that differs from the other etiologies of sepsis is the frequent requirement to provide physical source control. Fortunately, dramatic advances have been made in this aspect of treatment. Historically, source control was left to surgeons only. With new technologies non-surgical less invasive interventional procedures have been introduced. Alternatively, in addition to formal surgery open abdomen techniques have long been proposed as aiding source control in severe intra-abdominal sepsis. It is ironic that while a lack or even delay regarding source control clearly associates with death, it is a concept that remains poorly described. For example, no conclusive definition of source control technique or even adequacy has been universally accepted. Practically, source control involves a complex definition encompassing several factors including the causative event, source of infection bacteria, local bacterial flora, patient condition, and his/her eventual comorbidities. With greater understanding of the systemic pathobiology of sepsis and the profound implications of the human microbiome, adequate source control is no longer only a surgical issue but one that requires a multidisciplinary, multimodality approach. Thus, while any breach in the GI tract must be controlled, source control should also attempt to control the generation and propagation of the systemic biomediators and dysbiotic influences on the microbiome that perpetuate multi-system organ failure and death. Given these increased complexities, the present paper represents the current opinions and recommendations for future research of th
Published: 2023

3. 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

4. ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

Author: Frassini, S, Cobianchi, L, Fugazzola, P, Biffl, W, Coccolini, F, Damaskos, D, Moore, E, Kluger, Y, Ceresoli, M, Coimbra, R, Davies, J, Kirkpatrick, A, Di Carlo, I, Hardcastle, T, Isik, A, Chiarugi, M, Gurusamy, K, Maier, R, Segovia Lohse, H, Jeekel, H, Boermeester, M, Abu-Zidan, F, Inaba, K, Weber, D, Augustin, G, Bonavina, L, Velmahos, G, Sartelli, M, Di Saverio, S, Ten Broek, R, Granieri, S, Dal Mas, F, Fare, C, Peverada, J, Zanghi, S, Vigano, J, Tomasoni, M, Dominioni, T, Cicuttin, E, Hecker, A, Tebala, G, Galante, J, Wani, I, Khokha, V, Sugrue, M, Scalea, T, Tan, E, Malangoni, M, Pararas, N, Podda, M, De Simone, B, Ivatury, R, Cui, Y, Kashuk, J, Peitzman, A, Kim, F, Pikoulis, E, Sganga, G, Chiara, O, Kelly, M, Marzi, I, Picetti, E, Agnoletti, V, De'Angelis, N, Campanelli, G, de Moya, M, Litvin, A, Martinez-Perez, A, Sall, I, Rizoli, S, Tomadze, G, Sakakushev, B, Stahel, P, Civil, I, Shelat, V, Costa, D, Chichom-Mefire, A, Latifi, R, Chirica, M, Amico, F, Pardhan, A, Seenarain, V, Boyapati, N, Hatz, B, Ackermann, T, Abeyasundara, S, Fenton, L, Plani, F, Sarvepalli, R, Rouhbakhshfar, O, Caleo, P, Ho-Ching Yau, V, Clement, K, Christou, E, Castillo, A, Gosal, P, Balasubramaniam, S, Hsu, J, Banphawatanarak, K, Pisano, M, Adriana, T, Michele, A, Cioffi, S, Spota, A, Catena, F, Ansaloni, L, Frassini S., Cobianchi L., Fugazzola P., Biffl W. L., Coccolini F., Damaskos D., Moore E. E., Kluger Y., Ceresoli M., Coimbra R., Davies J., Kirkpatrick A., Di Carlo I., Hardcastle T. C., Isik A., Chiarugi M., Gurusamy K., Maier R. V., Segovia Lohse H. A., Jeekel H., Boermeester M. A., Abu-Zidan F., Inaba K., Weber D. G., Augustin G., Bonavina L., Velmahos G., Sartelli M., Di Saverio S., Ten Broek R. P. G., Granieri S., Dal Mas F., Fare C. N., Peverada J., Zanghi S., Vigano J., Tomasoni M., Dominioni T., Cicuttin E., Hecker A., Tebala G. D., Galante J. M., Wani I., Khokha V., Sugrue M., Scalea T. M., Tan E., Malangoni M. A., Pararas N., Podda M., De Simone B., Ivatury R., Cui Y., Kashuk J., Peitzman A., Kim F., Pikoulis E., Sganga G., Chiara O., Kelly M. D., Marzi I., Picetti E., Agnoletti V., De'Angelis N., Campanelli G., de Moya M., Litvin A., Martinez-Perez A., Sall I., Rizoli S., Tomadze G., Sakakushev B., Stahel P. F., Civil I., Shelat V., Costa D., Chichom-Mefire A., Latifi R., Chirica M., Amico F., Pardhan A., Seenarain V., Boyapati N., Hatz B., Ackermann T., Abeyasundara S., Fenton L., Plani F., Sarvepalli R., Rouhbakhshfar O., Caleo P., Ho-Ching Yau V., Clement K., Christou E., Castillo A. M. G., Gosal P. K. S., Balasubramaniam S., Hsu J., Banphawatanarak K., Pisano M., Adriana T., Michele A., Cioffi S. P. B., Spota A., Catena F., Ansaloni L., Frassini, S, Cobianchi, L, Fugazzola, P, Biffl, W, Coccolini, F, Damaskos, D, Moore, E, Kluger, Y, Ceresoli, M, Coimbra, R, Davies, J, Kirkpatrick, A, Di Carlo, I, Hardcastle, T, Isik, A, Chiarugi, M, Gurusamy, K, Maier, R, Segovia Lohse, H, Jeekel, H, Boermeester, M, Abu-Zidan, F, Inaba, K, Weber, D, Augustin, G, Bonavina, L, Velmahos, G, Sartelli, M, Di Saverio, S, Ten Broek, R, Granieri, S, Dal Mas, F, Fare, C, Peverada, J, Zanghi, S, Vigano, J, Tomasoni, M, Dominioni, T, Cicuttin, E, Hecker, A, Tebala, G, Galante, J, Wani, I, Khokha, V, Sugrue, M, Scalea, T, Tan, E, Malangoni, M, Pararas, N, Podda, M, De Simone, B, Ivatury, R, Cui, Y, Kashuk, J, Peitzman, A, Kim, F, Pikoulis, E, Sganga, G, Chiara, O, Kelly, M, Marzi, I, Picetti, E, Agnoletti, V, De'Angelis, N, Campanelli, G, de Moya, M, Litvin, A, Martinez-Perez, A, Sall, I, Rizoli, S, Tomadze, G, Sakakushev, B, Stahel, P, Civil, I, Shelat, V, Costa, D, Chichom-Mefire, A, Latifi, R, Chirica, M, Amico, F, Pardhan, A, Seenarain, V, Boyapati, N, Hatz, B, Ackermann, T, Abeyasundara, S, Fenton, L, Plani, F, Sarvepalli, R, Rouhbakhshfar, O, Caleo, P, Ho-Ching Yau, V, Clement, K, Christou, E, Castillo, A, Gosal, P, Balasubramaniam, S, Hsu, J, Banphawatanarak, K, Pisano, M, Adriana, T, Michele, A, Cioffi, S, Spota, A, Catena, F, Ansaloni, L, Frassini S., Cobianchi L., Fugazzola P., Biffl W. L., Coccolini F., Damaskos D., Moore E. E., Kluger Y., Ceresoli M., Coimbra R., Davies J., Kirkpatrick A., Di Carlo I., Hardcastle T. C., Isik A., Chiarugi M., Gurusamy K., Maier R. V., Segovia Lohse H. A., Jeekel H., Boermeester M. A., Abu-Zidan F., Inaba K., Weber D. G., Augustin G., Bonavina L., Velmahos G., Sartelli M., Di Saverio S., Ten Broek R. P. G., Granieri S., Dal Mas F., Fare C. N., Peverada J., Zanghi S., Vigano J., Tomasoni M., Dominioni T., Cicuttin E., Hecker A., Tebala G. D., Galante J. M., Wani I., Khokha V., Sugrue M., Scalea T. M., Tan E., Malangoni M. A., Pararas N., Podda M., De Simone B., Ivatury R., Cui Y., Kashuk J., Peitzman A., Kim F., Pikoulis E., Sganga G., Chiara O., Kelly M. D., Marzi I., Picetti E., Agnoletti V., De'Angelis N., Campanelli G., de Moya M., Litvin A., Martinez-Perez A., Sall I., Rizoli S., Tomadze G., Sakakushev B., Stahel P. F., Civil I., Shelat V., Costa D., Chichom-Mefire A., Latifi R., Chirica M., Amico F., Pardhan A., Seenarain V., Boyapati N., Hatz B., Ackermann T., Abeyasundara S., Fenton L., Plani F., Sarvepalli R., Rouhbakhshfar O., Caleo P., Ho-Ching Yau V., Clement K., Christou E., Castillo A. M. G., Gosal P. K. S., Balasubramaniam S., Hsu J., Banphawatanarak K., Pisano M., Adriana T., Michele A., Cioffi S. P. B., Spota A., Catena F., and Ansaloni L.
Abstract: Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy.
Published: 2023

5. WSES consensus guidelines on sigmoid volvulus management

Author: Tian, B, Vigutto, G, Tan, E, van Goor, H, Bendinelli, C, Abu-Zidan, F, Ivatury, R, Sakakushev, B, Di Carlo, I, Sganga, G, Maier, R, Coimbra, R, Leppaniemi, A, Litvin, A, Damaskos, D, Broek, R, Biffl, W, Di Saverio, S, De Simone, B, Ceresoli, M, Picetti, E, Galante, J, Tebala, G, Beka, S, Bonavina, L, Cui, Y, Khan, J, Cicuttin, E, Amico, F, Kenji, I, Hecker, A, Ansaloni, L, Sartelli, M, Moore, E, Kluger, Y, Testini, M, Weber, D, Agnoletti, V, Angelis, N, Coccolini, F, Sall, I, Catena, F, Tian B. W. C. A., Vigutto G., Tan E., van Goor H., Bendinelli C., Abu-Zidan F., Ivatury R., Sakakushev B., Di Carlo I., Sganga G., Maier R. V., Coimbra R., Leppaniemi A., Litvin A., Damaskos D., Broek R. T., Biffl W., Di Saverio S., De Simone B., Ceresoli M., Picetti E., Galante J., Tebala G. D., Beka S. G., Bonavina L., Cui Y., Khan J., Cicuttin E., Amico F., Kenji I., Hecker A., Ansaloni L., Sartelli M., Moore E. E., Kluger Y., Testini M., Weber D., Agnoletti V., Angelis N. D., Coccolini F., Sall I., Catena F., Tian, B, Vigutto, G, Tan, E, van Goor, H, Bendinelli, C, Abu-Zidan, F, Ivatury, R, Sakakushev, B, Di Carlo, I, Sganga, G, Maier, R, Coimbra, R, Leppaniemi, A, Litvin, A, Damaskos, D, Broek, R, Biffl, W, Di Saverio, S, De Simone, B, Ceresoli, M, Picetti, E, Galante, J, Tebala, G, Beka, S, Bonavina, L, Cui, Y, Khan, J, Cicuttin, E, Amico, F, Kenji, I, Hecker, A, Ansaloni, L, Sartelli, M, Moore, E, Kluger, Y, Testini, M, Weber, D, Agnoletti, V, Angelis, N, Coccolini, F, Sall, I, Catena, F, Tian B. W. C. A., Vigutto G., Tan E., van Goor H., Bendinelli C., Abu-Zidan F., Ivatury R., Sakakushev B., Di Carlo I., Sganga G., Maier R. V., Coimbra R., Leppaniemi A., Litvin A., Damaskos D., Broek R. T., Biffl W., Di Saverio S., De Simone B., Ceresoli M., Picetti E., Galante J., Tebala G. D., Beka S. G., Bonavina L., Cui Y., Khan J., Cicuttin E., Amico F., Kenji I., Hecker A., Ansaloni L., Sartelli M., Moore E. E., Kluger Y., Testini M., Weber D., Agnoletti V., Angelis N. D., Coccolini F., Sall I., and Catena F.
Abstract: Sigmoid volvulus is a common surgical emergency, especially in elderly patients. Patients can present with a wide range of clinical states: from asymptomatic, to frank peritonitis secondary to colonic perforation. These patients generally need urgent treatment, be it endoscopic decompression of the colon or an upfront colectomy. The World Society of Emergency Surgery united a worldwide group of international experts to review the current evidence and propose a consensus guidelines on the management of sigmoid volvulus.
Published: 2023

6. The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study

Author: De Simone, B, Kluger, Y, Moore, E, Sartelli, M, Abu-Zidan, F, Coccolini, F, Ansaloni, L, Tebala, G, Di Saverio, S, Di Carlo, I, Sakakushev, B, Bonavina, L, Sugrue, M, Galante, J, Ivatury, R, Picetti, E, Chirica, M, Wani, I, Bala, M, Sall, I, Kirkpatrick, A, Shelat, V, Pikoulis, E, Leppäniemi, A, Tan, E, Broek, R, Gurmu Beka, S, Litvin, A, Chouillard, E, Coimbra, R, Cui, Y, De’ Angelis, N, Sganga, G, Stahel, P, Agnoletti, V, Rampini, A, Damaskos, D, Carcoforo, P, Biffl, W, Hecker, A, Di Salomone, S, Balogh, Z, Beka, S, Velmahos, G, Ceresoli, M, Chiara, O, Leppaniemi, A, Marzi, I, Inaba, K, Khokha, V, Reva, V, Khan, M, Toro, A, de’ Angelis, N, Malangoni, M, Scozzafava, E, Civil, I, Maier, R, Weber, D, Chiarugi, M, Soreide, K, Testini, M, Bravi, F, Catena, F, De Simone B., Kluger Y., Moore E. E., Sartelli M., Abu-Zidan F. M., Coccolini F., Ansaloni L., Tebala G. D., Di Saverio S., Di Carlo I., Sakakushev B. E., Bonavina L., Sugrue M., Galante J. M., Ivatury R., Picetti E., Chirica M., Wani I., Bala M., Sall I., Kirkpatrick A. W., Shelat V. G., Pikoulis E., Leppäniemi A., Tan E., Broek R. P. G. t., Gurmu Beka S., Litvin A., Chouillard E., Coimbra R., Cui Y., De’ Angelis N., Sganga G., Stahel P. F., Agnoletti V., Rampini A., Shelat V., Damaskos D., Carcoforo P., Biffl W. L., Hecker A., Kirkpatrick A., Di Salomone S., Balogh Z., Beka S. G., Broek R. T., Velmahos G., Sakakushev B., Ceresoli M., Chiara O., Stahel P., Leppaniemi A., Marzi I., Inaba K., Khokha V., Reva V., Khan M., Toro A., de’ Angelis N., Malangoni M., Scozzafava E., Civil I., Maier R., Weber D., Chiarugi M., Soreide K., Testini M., Bravi F., Maier R. V., Catena F., De Simone, B, Kluger, Y, Moore, E, Sartelli, M, Abu-Zidan, F, Coccolini, F, Ansaloni, L, Tebala, G, Di Saverio, S, Di Carlo, I, Sakakushev, B, Bonavina, L, Sugrue, M, Galante, J, Ivatury, R, Picetti, E, Chirica, M, Wani, I, Bala, M, Sall, I, Kirkpatrick, A, Shelat, V, Pikoulis, E, Leppäniemi, A, Tan, E, Broek, R, Gurmu Beka, S, Litvin, A, Chouillard, E, Coimbra, R, Cui, Y, De’ Angelis, N, Sganga, G, Stahel, P, Agnoletti, V, Rampini, A, Damaskos, D, Carcoforo, P, Biffl, W, Hecker, A, Di Salomone, S, Balogh, Z, Beka, S, Velmahos, G, Ceresoli, M, Chiara, O, Leppaniemi, A, Marzi, I, Inaba, K, Khokha, V, Reva, V, Khan, M, Toro, A, de’ Angelis, N, Malangoni, M, Scozzafava, E, Civil, I, Maier, R, Weber, D, Chiarugi, M, Soreide, K, Testini, M, Bravi, F, Catena, F, De Simone B., Kluger Y., Moore E. E., Sartelli M., Abu-Zidan F. M., Coccolini F., Ansaloni L., Tebala G. D., Di Saverio S., Di Carlo I., Sakakushev B. E., Bonavina L., Sugrue M., Galante J. M., Ivatury R., Picetti E., Chirica M., Wani I., Bala M., Sall I., Kirkpatrick A. W., Shelat V. G., Pikoulis E., Leppäniemi A., Tan E., Broek R. P. G. t., Gurmu Beka S., Litvin A., Chouillard E., Coimbra R., Cui Y., De’ Angelis N., Sganga G., Stahel P. F., Agnoletti V., Rampini A., Shelat V., Damaskos D., Carcoforo P., Biffl W. L., Hecker A., Kirkpatrick A., Di Salomone S., Balogh Z., Beka S. G., Broek R. T., Velmahos G., Sakakushev B., Ceresoli M., Chiara O., Stahel P., Leppaniemi A., Marzi I., Inaba K., Khokha V., Reva V., Khan M., Toro A., de’ Angelis N., Malangoni M., Scozzafava E., Civil I., Maier R., Weber D., Chiarugi M., Soreide K., Testini M., Bravi F., Maier R. V., and Catena F.
Abstract: Background: Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The “timing in acute care surgery” (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts. Methods: This is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4–5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease. Results: Four polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority. Conclusion: The new TACS classificat
Published: 2023

7. WSES consensus guidelines on sigmoid volvulus management

Author: Tian, B.W.C.A., Vigutto, G., Tan, E.C.T.H., Goor, H. van, Bendinelli, C., Abu-Zidan, F., Ivatury, R., Sakakushev, B., Carlo, I. Di, Sganga, G., Maier, R.V., Coimbra, R., Leppäniemi, A., Litvin, A., Damaskos, D., Broek, R.P.G ten, Biffl, W., Saverio, S. Di, Simone, B. De, Ceresoli, M., Picetti, E., Galante, J., Tebala, G.D., Beka, S.G., Bonavina, L., Cui, Y., Khan, J., Cicuttin, E., Amico, F., Kenji, I., Hecker, A., Ansaloni, L., Sartelli, M., Moore, E.E., Kluger, Y., Testini, M., Weber, D., Agnoletti, V., Angelis, N.D., Coccolini, F., Sall, I., Catena, F., Tian, B, Vigutto, G, Tan, E, van Goor, H, Bendinelli, C, Abu-Zidan, F, Ivatury, R, Sakakushev, B, Di Carlo, I, Sganga, G, Maier, R, Coimbra, R, Leppaniemi, A, Litvin, A, Damaskos, D, Broek, R, Biffl, W, Di Saverio, S, De Simone, B, Ceresoli, M, Picetti, E, Galante, J, Tebala, G, Beka, S, Bonavina, L, Cui, Y, Khan, J, Cicuttin, E, Amico, F, Kenji, I, Hecker, A, Ansaloni, L, Sartelli, M, Moore, E, Kluger, Y, Testini, M, Weber, D, Agnoletti, V, Angelis, N, Coccolini, F, Sall, I, and Catena, F
Subjects: Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], All institutes and research themes of the Radboud University Medical Center, Emergency Medicine, sigmoid volvolus, Surgery
Abstract: Contains fulltext : 293045.pdf (Publisher’s version ) (Open Access) Sigmoid volvulus is a common surgical emergency, especially in elderly patients. Patients can present with a wide range of clinical states: from asymptomatic, to frank peritonitis secondary to colonic perforation. These patients generally need urgent treatment, be it endoscopic decompression of the colon or an upfront colectomy. The World Society of Emergency Surgery united a worldwide group of international experts to review the current evidence and propose a consensus guidelines on the management of sigmoid volvulus.
Published: 2023

8. The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study

Author: De Simone B., Kluger Y., Moore E. E., Sartelli M., Abu-Zidan F. M., Coccolini F., Ansaloni L., Tebala G. D., Di Saverio S., Di Carlo I., Sakakushev B. E., Bonavina L., Sugrue M., Galante J. M., Ivatury R., Picetti E., Chirica M., Wani I., Bala M., Sall I., Kirkpatrick A. W., Shelat V. G., Pikoulis E., Leppäniemi A., Tan E., Broek R. P. G. t., Gurmu Beka S., Litvin A., Chouillard E., Coimbra R., Cui Y., De’ Angelis N., Sganga G., Stahel P. F., Agnoletti V., Rampini A., Shelat V., Damaskos D., Carcoforo P., Biffl W. L., Hecker A., Kirkpatrick A., Di Salomone S., Balogh Z., Beka S. G., Broek R. T., Velmahos G., Sakakushev B., Ceresoli M., Chiara O., Stahel P., Leppaniemi A., Marzi I., Inaba K., Khokha V., Reva V., Khan M., Toro A., de’ Angelis N., Malangoni M., Scozzafava E., Civil I., Maier R., Weber D., Chiarugi M., Soreide K., Testini M., Bravi F., Maier R. V., Catena F., De Simone, B, Kluger, Y, Moore, E, Sartelli, M, Abu-Zidan, F, Coccolini, F, Ansaloni, L, Tebala, G, Di Saverio, S, Di Carlo, I, Sakakushev, B, Bonavina, L, Sugrue, M, Galante, J, Ivatury, R, Picetti, E, Chirica, M, Wani, I, Bala, M, Sall, I, Kirkpatrick, A, Shelat, V, Pikoulis, E, Leppäniemi, A, Tan, E, Broek, R, Gurmu Beka, S, Litvin, A, Chouillard, E, Coimbra, R, Cui, Y, De’ Angelis, N, Sganga, G, Stahel, P, Agnoletti, V, Rampini, A, Damaskos, D, Carcoforo, P, Biffl, W, Hecker, A, Di Salomone, S, Balogh, Z, Beka, S, Velmahos, G, Ceresoli, M, Chiara, O, Leppaniemi, A, Marzi, I, Inaba, K, Khokha, V, Reva, V, Khan, M, Toro, A, de’ Angelis, N, Malangoni, M, Scozzafava, E, Civil, I, Maier, R, Weber, D, Chiarugi, M, Soreide, K, Testini, M, Bravi, F, and Catena, F
Subjects: Healthcare system, Delay in surgery, Operating room management, Delphi method, Emergency surgery, Priority, Time to surgery, Timing in acute care surgery (TACS), Triage, Classification
Abstract: Background: Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The “timing in acute care surgery” (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts. Methods: This is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4–5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease. Results: Four polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority. Conclusion: The new TACS classification is a comprehensive, simple, clear and reproducible triage system which can be used to assess the severity of the patient and the surgical disease, to reduce the time to access to the operating room, and to manage the emergency surgical patients within a “safe” timeframe. By including well-defined surgical diseases in the different colour-code classes of priority, validated through a Delphi consensus, the new TACS improves communication among surgeons, between surgeons and anaesthesiologists and decreases conflicts and waste and waiting time in accessing the operating room for emergency surgical patients.
Published: 2023

9. The LIFE TRIAD of emergency general surgery

Author: Coccolini, F, Sartelli, M, Kluger, Y, Osipov, A, Cui, Y, Beka, S, Kirkpatrick, A, Sall, I, Moore, E, Biffl, W, Litvin, A, Pisano, M, Magnone, S, Picetti, E, de Angelis, N, Stahel, P, Ansaloni, L, Tan, E, Abu-Zidan, F, Ceresoli, M, Hecker, A, Chiara, O, Sganga, G, Khokha, V, di Saverio, S, Sakakushev, B, Campanelli, G, Fraga, G, Wani, I, Broek, R, Cicuttin, E, Cremonini, C, Tartaglia, D, Soreide, K, Galante, J, de Moya, M, Koike, K, De Simone, B, Balogh, Z, Amico, F, Shelat, V, Pikoulis, E, Di Carlo, I, Bonavina, L, Leppaniemi, A, Marzi, I, Ivatury, R, Khan, J, Maier, R, Hardcastle, T, Isik, A, Podda, M, Tolonen, M, Rasa, K, Navsaria, P, Demetrashvili, Z, Tarasconi, A, Carcoforo, P, Sibilla, M, Baiocchi, G, Pararas, N, Weber, D, Chiarugi, M, Catena, F, Coccolini F., Sartelli M., Kluger Y., Osipov A., Cui Y., Beka S. G., Kirkpatrick A., Sall I., Moore E. E., Biffl W. L., Litvin A., Pisano M., Magnone S., Picetti E., de Angelis N., Stahel P., Ansaloni L., Tan E., Abu-Zidan F., Ceresoli M., Hecker A., Chiara O., Sganga G., Khokha V., di Saverio S., Sakakushev B., Campanelli G., Fraga G., Wani I., Broek R., Cicuttin E., Cremonini C., Tartaglia D., Soreide K., Galante J., de Moya M., Koike K., De Simone B., Balogh Z., Amico F., Shelat V., Pikoulis E., Di Carlo I., Bonavina L., Leppaniemi A., Marzi I., Ivatury R., Khan J., Maier R. V., Hardcastle T. C., Isik A., Podda M., Tolonen M., Rasa K., Navsaria P. H., Demetrashvili Z., Tarasconi A., Carcoforo P., Sibilla M. G., Baiocchi G. L., Pararas N., Weber D., Chiarugi M., Catena F., Coccolini, F, Sartelli, M, Kluger, Y, Osipov, A, Cui, Y, Beka, S, Kirkpatrick, A, Sall, I, Moore, E, Biffl, W, Litvin, A, Pisano, M, Magnone, S, Picetti, E, de Angelis, N, Stahel, P, Ansaloni, L, Tan, E, Abu-Zidan, F, Ceresoli, M, Hecker, A, Chiara, O, Sganga, G, Khokha, V, di Saverio, S, Sakakushev, B, Campanelli, G, Fraga, G, Wani, I, Broek, R, Cicuttin, E, Cremonini, C, Tartaglia, D, Soreide, K, Galante, J, de Moya, M, Koike, K, De Simone, B, Balogh, Z, Amico, F, Shelat, V, Pikoulis, E, Di Carlo, I, Bonavina, L, Leppaniemi, A, Marzi, I, Ivatury, R, Khan, J, Maier, R, Hardcastle, T, Isik, A, Podda, M, Tolonen, M, Rasa, K, Navsaria, P, Demetrashvili, Z, Tarasconi, A, Carcoforo, P, Sibilla, M, Baiocchi, G, Pararas, N, Weber, D, Chiarugi, M, Catena, F, Coccolini F., Sartelli M., Kluger Y., Osipov A., Cui Y., Beka S. G., Kirkpatrick A., Sall I., Moore E. E., Biffl W. L., Litvin A., Pisano M., Magnone S., Picetti E., de Angelis N., Stahel P., Ansaloni L., Tan E., Abu-Zidan F., Ceresoli M., Hecker A., Chiara O., Sganga G., Khokha V., di Saverio S., Sakakushev B., Campanelli G., Fraga G., Wani I., Broek R., Cicuttin E., Cremonini C., Tartaglia D., Soreide K., Galante J., de Moya M., Koike K., De Simone B., Balogh Z., Amico F., Shelat V., Pikoulis E., Di Carlo I., Bonavina L., Leppaniemi A., Marzi I., Ivatury R., Khan J., Maier R. V., Hardcastle T. C., Isik A., Podda M., Tolonen M., Rasa K., Navsaria P. H., Demetrashvili Z., Tarasconi A., Carcoforo P., Sibilla M. G., Baiocchi G. L., Pararas N., Weber D., Chiarugi M., and Catena F.
Abstract: Emergency General Surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and non-traumatic acute conditions during the same admission in the hospital by general emergency surgeons and other specialists. It is the most diffused surgical discipline in the world. To live and grow strong EGS necessitates three fundamental parts: emergency and elective continuous surgical practice, evidence generation through clinical registries and data accrual, and indications and guidelines production: the LIFE TRIAD.
Published: 2022

10. Minimally invasive surgery in emergency surgery: a WSES survey

Author: Ceresoli, M, Pisano, M, Abu-Zidan, F, Allievi, N, Gurusamy, K, Biffl, W, Tebala, G, Catena, F, Ansaloni, L, Sartelli, M, Kluger, Y, Baiocchi, G, Fette, A, Hecker, A, Litvin, A, Forgione, A, Leppaniemi, A, De Simone, B, Sakakushev, B, Palmatier, C, Bendinelli, C, Damascos, D, Picetti, E, Tan, E, Poiasina, E, Pikoulis, E, Cicuttin, E, Moore, E, Velmahos, G, Fraga, G, Van Goor, H, Civil, I, Wani, I, Di Carlo, I, Galante, J, Soreide, K, Degrate, L, Zorcolo, L, De Moya, M, Braga, M, Cereda, M, Sugrue, M, Chirica, M, De Angelis, N, Stahel, P, Ivatury, R, Ten Broek, R, Di Saverio, S, Beka, S, Magnone, S, Cui, Y, Balogh, Z, Kelly, M, Inaba, K, Coccolini, F, Ceresoli M., Pisano M., Abu-Zidan F., Allievi N., Gurusamy K., Biffl W. L., Tebala G. D., Catena F., Ansaloni L., Sartelli M., Kluger Y., Baiocchi G., Fette A., Hecker A., Litvin A., Forgione A., Leppaniemi A., De Simone B., Sakakushev B., Palmatier C. R., Bendinelli C., Damascos D., Picetti E., Tan E., Poiasina E., Pikoulis E., Cicuttin E., Moore E. E., Velmahos G., Fraga G., Van Goor H., Civil I., Wani I., Di Carlo I., Galante J., Soreide K., Degrate L., Zorcolo L., De Moya M., Braga M., Cereda M., Sugrue M., Chirica M., De Angelis N., Stahel P. F., Ivatury R., Ten Broek R., Di Saverio S., Beka S. G., Magnone S., Cui Y., Balogh Z. J., Kelly M. D., Inaba K., Coccolini F., Ceresoli, M, Pisano, M, Abu-Zidan, F, Allievi, N, Gurusamy, K, Biffl, W, Tebala, G, Catena, F, Ansaloni, L, Sartelli, M, Kluger, Y, Baiocchi, G, Fette, A, Hecker, A, Litvin, A, Forgione, A, Leppaniemi, A, De Simone, B, Sakakushev, B, Palmatier, C, Bendinelli, C, Damascos, D, Picetti, E, Tan, E, Poiasina, E, Pikoulis, E, Cicuttin, E, Moore, E, Velmahos, G, Fraga, G, Van Goor, H, Civil, I, Wani, I, Di Carlo, I, Galante, J, Soreide, K, Degrate, L, Zorcolo, L, De Moya, M, Braga, M, Cereda, M, Sugrue, M, Chirica, M, De Angelis, N, Stahel, P, Ivatury, R, Ten Broek, R, Di Saverio, S, Beka, S, Magnone, S, Cui, Y, Balogh, Z, Kelly, M, Inaba, K, Coccolini, F, Ceresoli M., Pisano M., Abu-Zidan F., Allievi N., Gurusamy K., Biffl W. L., Tebala G. D., Catena F., Ansaloni L., Sartelli M., Kluger Y., Baiocchi G., Fette A., Hecker A., Litvin A., Forgione A., Leppaniemi A., De Simone B., Sakakushev B., Palmatier C. R., Bendinelli C., Damascos D., Picetti E., Tan E., Poiasina E., Pikoulis E., Cicuttin E., Moore E. E., Velmahos G., Fraga G., Van Goor H., Civil I., Wani I., Di Carlo I., Galante J., Soreide K., Degrate L., Zorcolo L., De Moya M., Braga M., Cereda M., Sugrue M., Chirica M., De Angelis N., Stahel P. F., Ivatury R., Ten Broek R., Di Saverio S., Beka S. G., Magnone S., Cui Y., Balogh Z. J., Kelly M. D., Inaba K., and Coccolini F.
Abstract: Background: The diffusion of minimally invasive surgery in emergency surgery still represents a developing challenge. Evidence about the use of minimally invasive surgery shows its feasibility and safety; however, the diffusion of these techniques is still poor. The aims of the present survey were to explore the diffusion and variations in the use of minimally invasive surgery among surgeons in the emergency setting. Methods: This is a web-based survey administered to all the WSES members investigating the diffusion of minimally invasive surgery in emergency. The survey investigated personal characteristics of participants, hospital characteristics, personal confidence in the use of minimally invasive surgery in emergency, limitations in the use of it and limitations to prosecute minimally invasive surgery in emergency surgery. Characteristics related to the use of minimally invasive surgery were studied with a multivariate ordinal regression. Results: The survey collected a total of 415 answers; 42.2% of participants declared a working experience > 15 years and 69.4% of responders worked in tertiary level center or academic hospital. In primary emergencies, only 28,7% of participants declared the use of laparoscopy in more than 50% of times. Personal confidence with minimally invasive techniques was the highest for appendectomy and cholecystectomy. At multivariate ordinal regression, a longer professional experience, the use of laparoscopy in major elective surgery and bariatric surgery expertise were related to a higher use of laparoscopy in emergency surgery. Conclusions: The survey shows that minimally invasive techniques in emergency surgery are still underutilized. Greater focus should be placed on the development of dedicated training in laparoscopy among emergency surgeons.
Published: 2022

11. 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

12. The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study.

Author: Simone, B. De, Kluger, Y., Moore, E.E., Sartelli, M., Abu-Zidan, F.M., Coccolini, F., Ansaloni, L., Tebala, G.D., Saverio, S. Di, Carlo, I. Di, Sakakushev, B.E., Bonavina, L., Sugrue, M., Galante, J.M., Ivatury, R., Picetti, E., Chirica, M., Wani, I., Bala, M., Sall, I., Kirkpatrick, A.W., Shelat, V.G., Pikoulis, E., Leppäniemi, A., Tan, E., Broek, R.P.G ten, Gurmu Beka, S., Litvin, A., Chouillard, E., Coimbra, R., Cui, Y., De' Angelis, N., Sganga, G., Stahel, P.F., Agnoletti, V., Rampini, A., Testini, M., Bravi, F., Maier, R.V., Biffl, W.L., Catena, F., Simone, B. De, Kluger, Y., Moore, E.E., Sartelli, M., Abu-Zidan, F.M., Coccolini, F., Ansaloni, L., Tebala, G.D., Saverio, S. Di, Carlo, I. Di, Sakakushev, B.E., Bonavina, L., Sugrue, M., Galante, J.M., Ivatury, R., Picetti, E., Chirica, M., Wani, I., Bala, M., Sall, I., Kirkpatrick, A.W., Shelat, V.G., Pikoulis, E., Leppäniemi, A., Tan, E., Broek, R.P.G ten, Gurmu Beka, S., Litvin, A., Chouillard, E., Coimbra, R., Cui, Y., De' Angelis, N., Sganga, G., Stahel, P.F., Agnoletti, V., Rampini, A., Testini, M., Bravi, F., Maier, R.V., Biffl, W.L., and Catena, F.
Abstract: Item does not contain fulltext, BACKGROUND: Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The "timing in acute care surgery" (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts. METHODS: This is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4-5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease. RESULTS: Four polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority. CONCLUSION: The new TACS classificat
Published: 2023

13. Management of complicated diaphragmatic hernia in the acute setting: a WSES position paper.

Author: Giuffrida, M., Perrone, G., Abu-Zidan, F., Agnoletti, V., Ansaloni, L., Baiocchi, G.L., Bendinelli, C., Biffl, W.L., Bonavina, L., Bravi, F., Carcoforo, P., Ceresoli, M., Chichom-Mefire, A., Coccolini, F., Coimbra, R., De'Angelis, N., Moya, M. de, Simone, B. De, Saverio, S. Di, Fraga, G.P., Galante, J., Ivatury, R., Kashuk, J., Kelly, M.D., Kirkpatrick, A.W., Kluger, Y., Koike, Kaoru, Leppaniemi, A., Maier, R.V., Moore, E.E., Peitzmann, A., Sakakushev, B., Sartelli, M., Sugrue, M., Tian, B.W.C.A., Broek, R.P.G ten, Vallicelli, C., Wani, I., Weber, D.G., Docimo, G., Catena, F., Giuffrida, M., Perrone, G., Abu-Zidan, F., Agnoletti, V., Ansaloni, L., Baiocchi, G.L., Bendinelli, C., Biffl, W.L., Bonavina, L., Bravi, F., Carcoforo, P., Ceresoli, M., Chichom-Mefire, A., Coccolini, F., Coimbra, R., De'Angelis, N., Moya, M. de, Simone, B. De, Saverio, S. Di, Fraga, G.P., Galante, J., Ivatury, R., Kashuk, J., Kelly, M.D., Kirkpatrick, A.W., Kluger, Y., Koike, Kaoru, Leppaniemi, A., Maier, R.V., Moore, E.E., Peitzmann, A., Sakakushev, B., Sartelli, M., Sugrue, M., Tian, B.W.C.A., Broek, R.P.G ten, Vallicelli, C., Wani, I., Weber, D.G., Docimo, G., and Catena, F.
Abstract: Contains fulltext : 296002.pdf (Publisher’s version ) (Open Access), BACKGROUND: Diaphragmatic hernia (DH) presenting acutely can be a potentially life-threatening condition. Its management continues to be debatable. METHODS: A bibliographic search using major databases was performed using the terms "emergency surgery" "diaphragmatic hernia," "traumatic diaphragmatic rupture" and "congenital diaphragmatic hernia." GRADE methodology was used to evaluate the evidence and give recommendations. RESULTS: CT scan of the chest and abdomen is the diagnostic gold standard to evaluate complicated DH. Appropriate preoperative assessment and prompt surgical intervention are important for a clinical success. Complicated DH repair is best performed via the use of biological and bioabsorbable meshes which have proven to reduce recurrence. The laparoscopic approach is the preferred technique in hemodynamically stable patients without significant comorbidities because it facilitates early diagnosis of small diaphragmatic injuries from traumatic wounds in the thoraco-abdominal area and reduces postoperative complications. Open surgery should be reserved for situations when skills and equipment for laparoscopy are not available, where exploratory laparotomy is needed, or if the patient is hemodynamically unstable. Damage Control Surgery is an option in the management of critical and unstable patients. CONCLUSIONS: Complicated diaphragmatic hernia is a rare life-threatening condition. CT scan of the chest and abdomen is the gold standard for diagnosing the diaphragmatic hernia. Laparoscopic repair is the best treatment option for stable patients with complicated diaphragmatic hernias. Open repair is considered necessary in majority of unstable patients in whom Damage Control Surgery can be life-saving.
Published: 2023

14. ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings.

Author: Frassini, S., Cobianchi, L., Fugazzola, P., Biffl, W.L., Coccolini, F., Damaskos, D., Moore, E.E., Kluger, Y., Ceresoli, M., Coimbra, R., Davies, J., Kirkpatrick, A., Carlo, I. Di, Hardcastle, T.C., Isik, A., Chiarugi, M., Gurusamy, K., Maier, R.V., Segovia Lohse, H.A., Jeekel, H., Boermeester, M.A., Abu-Zidan, F., Inaba, K., Weber, D.G., Augustin, G., Bonavina, L., Velmahos, G., Sartelli, M., Saverio, S. Di, Broek, R.P.G ten, Granieri, S., Mas, F. Dal, Farè, C.N., Peverada, J., Zanghì, S., Viganò, J., Tomasoni, M., Dominioni, T., Cicuttin, E., Hecker, A., Tebala, G.D., Galante, J.M., Wani, I., Khokha, V., Sugrue, M., Scalea, T.M., Tan, E.C.T.H., Malangoni, M.A., Pararas, N., Podda, M., Simone, B. De, Ivatury, R., Cui, Y., Kashuk, J., Peitzman, A., Kim, F., Pikoulis, E., Sganga, G., Chiara, O., Kelly, M.D., Marzi, I., Picetti, E., Agnoletti, V., De'Angelis, N., Campanelli, G., Moya, M. de, Litvin, A., Martínez-Pérez, A., Sall, I., Rizoli, S., Tomadze, G., Sakakushev, B., Stahel, P.F., Civil, I., Shelat, V., Costa, D., Chichom-Mefire, A., Latifi, R., Chirica, M., Amico, F., Pardhan, A., Seenarain, V., Boyapati, N., Hatz, B., Ackermann, T., Abeyasundara, S., Fenton, L., Plani, F., Sarvepalli, R., Rouhbakhshfar, O., Caleo, P., Ho-Ching Yau, V., Clement, K., Christou, E., Castillo, A.M.G., Gosal, P.K.S., Balasubramaniam, S., Hsu, J., Banphawatanarak, K., Pisano, M., Adriana, T., Michele, A., Cioffi, S.P.B., Spota, A., Catena, F., Ansaloni, L., Frassini, S., Cobianchi, L., Fugazzola, P., Biffl, W.L., Coccolini, F., Damaskos, D., Moore, E.E., Kluger, Y., Ceresoli, M., Coimbra, R., Davies, J., Kirkpatrick, A., Carlo, I. Di, Hardcastle, T.C., Isik, A., Chiarugi, M., Gurusamy, K., Maier, R.V., Segovia Lohse, H.A., Jeekel, H., Boermeester, M.A., Abu-Zidan, F., Inaba, K., Weber, D.G., Augustin, G., Bonavina, L., Velmahos, G., Sartelli, M., Saverio, S. Di, Broek, R.P.G ten, Granieri, S., Mas, F. Dal, Farè, C.N., Peverada, J., Zanghì, S., Viganò, J., Tomasoni, M., Dominioni, T., Cicuttin, E., Hecker, A., Tebala, G.D., Galante, J.M., Wani, I., Khokha, V., Sugrue, M., Scalea, T.M., Tan, E.C.T.H., Malangoni, M.A., Pararas, N., Podda, M., Simone, B. De, Ivatury, R., Cui, Y., Kashuk, J., Peitzman, A., Kim, F., Pikoulis, E., Sganga, G., Chiara, O., Kelly, M.D., Marzi, I., Picetti, E., Agnoletti, V., De'Angelis, N., Campanelli, G., Moya, M. de, Litvin, A., Martínez-Pérez, A., Sall, I., Rizoli, S., Tomadze, G., Sakakushev, B., Stahel, P.F., Civil, I., Shelat, V., Costa, D., Chichom-Mefire, A., Latifi, R., Chirica, M., Amico, F., Pardhan, A., Seenarain, V., Boyapati, N., Hatz, B., Ackermann, T., Abeyasundara, S., Fenton, L., Plani, F., Sarvepalli, R., Rouhbakhshfar, O., Caleo, P., Ho-Ching Yau, V., Clement, K., Christou, E., Castillo, A.M.G., Gosal, P.K.S., Balasubramaniam, S., Hsu, J., Banphawatanarak, K., Pisano, M., Adriana, T., Michele, A., Cioffi, S.P.B., Spota, A., Catena, F., and Ansaloni, L.
Abstract: Contains fulltext : 296003.pdf (Publisher’s version ) (Open Access), Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy.
Published: 2023

15. 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.A., Marchegiani, F., Reitano, E., Simone, B. De, Wong, G.Y.M., Martínez-Pérez, 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., Saverio, S. Di, Diana, M., oguardi Burgio, M. Di, 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., Leppäniemi, A., Maier, R.V., Memeo, R., Moore, E.E., Ordoñez, C.A., Peitzman, A.B., Pellino, G., Picetti, E., Pikoulis, M., Pisano, M., Podda, M., Romeo, O., Rosa, F., Tan, E.C.T.H., Broek, R.P. ten, Testini, M., Tian Wei Cheng, B.A., Weber, D., Sacco, E., Sartelli, M., Tonsi, A., Moro, F. Dal, Catena, F., De'Angelis, N., Schena, C.A., Marchegiani, F., Reitano, E., Simone, B. De, Wong, G.Y.M., Martínez-Pérez, 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., Saverio, S. Di, Diana, M., oguardi Burgio, M. Di, 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., Leppäniemi, A., Maier, R.V., Memeo, R., Moore, E.E., Ordoñez, C.A., Peitzman, A.B., Pellino, G., Picetti, E., Pikoulis, M., Pisano, M., Podda, M., Romeo, O., Rosa, F., Tan, E.C.T.H., Broek, R.P. ten, Testini, M., Tian Wei Cheng, B.A., Weber, D., Sacco, E., Sartelli, M., Tonsi, A., Moro, F. Dal, and Catena, F.
Abstract: Contains fulltext : 296327.pdf (Publisher’s version ) (Open Access), 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

16. Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines.

Author: Coccolini, F., Sartelli, M., Sawyer, R., Rasa, K., Viaggi, B., Abu-Zidan, F., Soreide, K., Hardcastle, T., Gupta, D., Bendinelli, C., Ceresoli, M., Shelat, V.G., Broek, R.P. ten, Baiocchi, G.L., Moore, E.E., Sall, I., Podda, M., Bonavina, L., Kryvoruchko, I.A., Stahel, P., Inaba, K., Montravers, P., Sakakushev, B., Sganga, G., Ballestracci, P., Malbrain, M.L.N.G., Vincent, J.L., Pikoulis, M., Beka, S.G., Doklestic, K., Chiarugi, M., Falcone, M., Bignami, E., Reva, V., Demetrashvili, Z., Saverio, S. Di, Tolonen, M., Navsaria, P., Bala, M., Balogh, Z., Litvin, A., Hecker, A., Wani, I., Fette, A., Simone, B. De, Ivatury, R., Picetti, E., Khokha, V., Tan, E.C.T.H., Ball, C., Tascini, C., Cui, Y., Coimbra, R., Kelly, M., Martino, C., Agnoletti, V., Boermeester, M.A., De'Angelis, N., Chirica, M., Biffl, W.L., Ansaloni, L., Kluger, Y., Catena, F., Kirkpatrick, A.W., Coccolini, F., Sartelli, M., Sawyer, R., Rasa, K., Viaggi, B., Abu-Zidan, F., Soreide, K., Hardcastle, T., Gupta, D., Bendinelli, C., Ceresoli, M., Shelat, V.G., Broek, R.P. ten, Baiocchi, G.L., Moore, E.E., Sall, I., Podda, M., Bonavina, L., Kryvoruchko, I.A., Stahel, P., Inaba, K., Montravers, P., Sakakushev, B., Sganga, G., Ballestracci, P., Malbrain, M.L.N.G., Vincent, J.L., Pikoulis, M., Beka, S.G., Doklestic, K., Chiarugi, M., Falcone, M., Bignami, E., Reva, V., Demetrashvili, Z., Saverio, S. Di, Tolonen, M., Navsaria, P., Bala, M., Balogh, Z., Litvin, A., Hecker, A., Wani, I., Fette, A., Simone, B. De, Ivatury, R., Picetti, E., Khokha, V., Tan, E.C.T.H., Ball, C., Tascini, C., Cui, Y., Coimbra, R., Kelly, M., Martino, C., Agnoletti, V., Boermeester, M.A., De'Angelis, N., Chirica, M., Biffl, W.L., Ansaloni, L., Kluger, Y., Catena, F., and Kirkpatrick, A.W.
Abstract: Item does not contain fulltext, Intra-abdominal infections (IAI) are among the most common global healthcare challenges and they are usually precipitated by disruption to the gastrointestinal (GI) tract. Their successful management typically requires intensive resource utilization, and despite the best therapies, morbidity and mortality remain high. One of the main issues required to appropriately treat IAI that differs from the other etiologies of sepsis is the frequent requirement to provide physical source control. Fortunately, dramatic advances have been made in this aspect of treatment. Historically, source control was left to surgeons only. With new technologies non-surgical less invasive interventional procedures have been introduced. Alternatively, in addition to formal surgery open abdomen techniques have long been proposed as aiding source control in severe intra-abdominal sepsis. It is ironic that while a lack or even delay regarding source control clearly associates with death, it is a concept that remains poorly described. For example, no conclusive definition of source control technique or even adequacy has been universally accepted. Practically, source control involves a complex definition encompassing several factors including the causative event, source of infection bacteria, local bacterial flora, patient condition, and his/her eventual comorbidities. With greater understanding of the systemic pathobiology of sepsis and the profound implications of the human microbiome, adequate source control is no longer only a surgical issue but one that requires a multidisciplinary, multimodality approach. Thus, while any breach in the GI tract must be controlled, source control should also attempt to control the generation and propagation of the systemic biomediators and dysbiotic influences on the microbiome that perpetuate multi-system organ failure and death. Given these increased complexities, the present paper represents the current opinions and recommendations for future research of th
Published: 2023

17. Open Abdomen and Fluid Instillation in the Septic Abdomen: Results from the IROA Study

Author: Coccolini F., Gubbiotti F., Ceresoli M., Tartaglia D., Fugazzola P., Ansaloni L., Sartelli M., Kluger Y., Kirkpatrick A., Amico F., Catena F., Chiarugi M., Montori G., Salvetti F., Negoi I., Zese M., Occhionorelli S., Shlyapnikov S., Sugrue M., Demetrashvili Z., Dondossola D., Ioannidis O., Novelli G., Nacoti M., Khor D., Inaba K., Demetriades D., Kaussen T., Jusoh A. C., Ghannam W., Sakakushev B., Guetta O., Dogjani A., Costa S., Singh S., Damaskos D., Isik A., Yuan K. -C., Trotta F., Rausei S., Martinez-Perez A., Bellanova G., Fonseca V. C., Hernandez F., Marinis A., Fernandes W., Quiodettis M., Bala M., Vereczkei A., Curado R., Fraga G. P., Pereira B. M., Gachabayov M., Chagerben G. P., Arellano M. L., Ozyazici S., Costa G., Tezcaner T., Porta M., Li Y., Karateke F., Manatakis D., Mariani F., Lora F., Sahderov I., Atanasov B., Zegarra S., Fattori L., Ivatury R., Xiao J., Ben-Ishay O., Lippi A., Improta M., Zharikov A., Dubuisson V., Coccolini, F, Gubbiotti, F, Ceresoli, M, Tartaglia, D, Fugazzola, P, Ansaloni, L, Sartelli, M, Kluger, Y, Kirkpatrick, A, Amico, F, Catena, F, Chiarugi, M, Montori, G, Salvetti, F, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Sugrue, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Ben-Ishay, O, Lippi, A, Improta, M, Zharikov, A, and Dubuisson, V
Subjects: Adult, Male, medicine.medical_specialty, Original Scientific Report, Fistula, medicine.medical_treatment, open abdomen, Peritonitis, 030230 surgery, NO, 03 medical and health sciences, 0302 clinical medicine, Sepsis, peritoneal resuscitation, Negative-pressure wound therapy, Abdomen, medicine, Humans, Surgical Wound Infection, Prospective Studies, fascial closure, peritoneal resuscitation, management, therapy, fascial closure, Digestive System Surgical Procedures, Aged, therapy, business.industry, Peritoneal fluid, Abdominal Cavity, Abdominal Wound Closure Techniques, Middle Aged, medicine.disease, Surgery, Cardiac surgery, Treatment Outcome, medicine.anatomical_structure, Cardiothoracic surgery, 030220 oncology & carcinogenesis, fluid instillation, Fluid Therapy, Female, business, Negative-Pressure Wound Therapy, management, Abdominal surgery
Abstract: Background Open abdomen (OA) is a surgical option that can be used in patients with severe peritonitis. Few evidences exist to recommend the use of intraperitoneal fluid instillation associated with OA in managing septic abdomen. Materials and methods A prospective analysis of adult patients enrolled in the International Register of Open Abdomen (trial registration: NCT02382770) was performed. Results A total of 387 patients were enrolled in two groups: 84 with peritoneal fluid instillation (FI) and 303 without (NFI). The groups were homogeneous for baseline characteristics. Overall complications were 92.9% in FI and 86.3% in NFI (p = 0.106). Complications during OA were 72.6% in FI and 59.9% in NFI (p = 0.034). Complications after definitive closure were 70.8% in FI and 61.1% in NFI (p = 0.133). Entero-atmospheric fistula was 13.1% in FI and 12% in NFI (p = 0.828). Fascial closure was 78.6% in FI and 63.7% in NFI (p = 0.02). Analysis of FI in negative pressure wound therapy (NPWT) showed: Overall morbidity in NPWT was 94% and in non-NPWT 91.2% (p = 0.622) and morbidity during OA was 68% and 79.4% (p = 0.25), respectively. Definitive fascial closure in NPWT was 87.8% and 96.8% in non-NPWT (p = 0.173). Overall mortality was 40% in NPWT and 29.4% in non-NPWT (p = 0.32) and morality during OA period was 18% and 8.8% (p = 0.238), respectively. Conclusion We found intraperitoneal fluid instillation during open abdomen in peritonitic patients to increase the complication rate during the open abdomen period, with no impact on mortality, entero-atmospheric fistula rate and opening time. Fascial closure rate is increased by instillation. Fluid instillation is feasible even when associated with nonnegative pressure temporary abdominal closure techniques.
Published: 2020

18. Minimally invasive surgery in emergency surgery: a WSES survey

Author: Ceresoli M., Pisano M., Abu-Zidan F., Allievi N., Gurusamy K., Biffl W. L., Tebala G. D., Catena F., Ansaloni L., Sartelli M., Kluger Y., Baiocchi G., Fette A., Hecker A., Litvin A., Forgione A., Leppaniemi A., De Simone B., Sakakushev B., Palmatier C. R., Bendinelli C., Damascos D., Picetti E., Tan E., Poiasina E., Pikoulis E., Cicuttin E., Moore E. E., Velmahos G., Fraga G., Van Goor H., Civil I., Wani I., Di Carlo I., Galante J., Soreide K., Degrate L., Zorcolo L., De Moya M., Braga M., Cereda M., Sugrue M., Chirica M., De Angelis N., Stahel P. F., Ivatury R., Ten Broek R., Di Saverio S., Beka S. G., Magnone S., Cui Y., Balogh Z. J., Kelly M. D., Inaba K., Coccolini F., Ceresoli, M, Pisano, M, Abu-Zidan, F, Allievi, N, Gurusamy, K, Biffl, W, Tebala, G, Catena, F, Ansaloni, L, Sartelli, M, Kluger, Y, Baiocchi, G, Fette, A, Hecker, A, Litvin, A, Forgione, A, Leppaniemi, A, De Simone, B, Sakakushev, B, Palmatier, C, Bendinelli, C, Damascos, D, Picetti, E, Tan, E, Poiasina, E, Pikoulis, E, Cicuttin, E, Moore, E, Velmahos, G, Fraga, G, Van Goor, H, Civil, I, Wani, I, Di Carlo, I, Galante, J, Soreide, K, Degrate, L, Zorcolo, L, De Moya, M, Braga, M, Cereda, M, Sugrue, M, Chirica, M, De Angelis, N, Stahel, P, Ivatury, R, Ten Broek, R, Di Saverio, S, Beka, S, Magnone, S, Cui, Y, Balogh, Z, Kelly, M, Inaba, K, and Coccolini, F
Subjects: Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], All institutes and research themes of the Radboud University Medical Center, Minimally invasive surgery, Emergency Medicine, Emergency surgery, Surgery, Laparoscopy, Survey
Abstract: Background The diffusion of minimally invasive surgery in emergency surgery still represents a developing challenge. Evidence about the use of minimally invasive surgery shows its feasibility and safety; however, the diffusion of these techniques is still poor. The aims of the present survey were to explore the diffusion and variations in the use of minimally invasive surgery among surgeons in the emergency setting. Methods This is a web-based survey administered to all the WSES members investigating the diffusion of minimally invasive surgery in emergency. The survey investigated personal characteristics of participants, hospital characteristics, personal confidence in the use of minimally invasive surgery in emergency, limitations in the use of it and limitations to prosecute minimally invasive surgery in emergency surgery. Characteristics related to the use of minimally invasive surgery were studied with a multivariate ordinal regression. Results The survey collected a total of 415 answers; 42.2% of participants declared a working experience > 15 years and 69.4% of responders worked in tertiary level center or academic hospital. In primary emergencies, only 28,7% of participants declared the use of laparoscopy in more than 50% of times. Personal confidence with minimally invasive techniques was the highest for appendectomy and cholecystectomy. At multivariate ordinal regression, a longer professional experience, the use of laparoscopy in major elective surgery and bariatric surgery expertise were related to a higher use of laparoscopy in emergency surgery. Conclusions The survey shows that minimally invasive techniques in emergency surgery are still underutilized. Greater focus should be placed on the development of dedicated training in laparoscopy among emergency surgeons.
Published: 2022

19. A pandemic recap: lessons we have learned

Author: Coccolini, F, Cicuttin, E, Cremonini, C, Tartaglia, D, Viaggi, B, Kuriyama, A, Picetti, E, Ball, C, Abu-Zidan, F, Ceresoli, M, Turri, B, Jain, S, Palombo, C, Guirao, X, Rodrigues, G, Gachabayov, M, Machado, F, Eftychios, L, Kanj, S, Di Carlo, I, Di Saverio, S, Khokha, V, Kirkpatrick, A, Massalou, D, Forfori, F, Corradi, F, Delibegovic, S, Machain Vega, G, Fantoni, M, Demetriades, D, Kapoor, G, Kluger, Y, Ansari, S, Maier, R, Leppaniemi, A, Hardcastle, T, Vereczkei, A, Karamagioli, E, Pikoulis, E, Pistello, M, Sakakushev, B, Navsaria, P, Galeiras, R, Yahya, A, Osipov, A, Dimitrov, E, Doklestic, K, Pisano, M, Malacarne, P, Carcoforo, P, Sibilla, M, Kryvoruchko, I, Bonavina, L, Kim, J, Shelat, V, Czepiel, J, Maseda, E, Marwah, S, Chirica, M, Biancofiore, G, Podda, M, Cobianchi, L, Ansaloni, L, Fugazzola, P, Seretis, C, Gomez, C, Tumietto, F, Malbrain, M, Reichert, M, Augustin, G, Amato, B, Puzziello, A, Hecker, A, Gemignani, A, Isik, A, Cucchetti, A, Nacoti, M, Kopelman, D, Mesina, C, Ghannam, W, Ben-Ishay, O, Dhingra, S, Coimbra, R, Moore, E, Cui, Y, Quiodettis, M, Bala, M, Testini, M, Diaz, J, Girardis, M, Biffl, W, Hecker, M, Sall, I, Boggi, U, Materazzi, G, Ghiadoni, L, Matsumoto, J, Zuidema, W, Ivatury, R, Enani, M, Litvin, A, Al-Hasan, M, Demetrashvili, Z, Baraket, O, Ordonez, C, Negoi, I, Kiguba, R, Memish, Z, Elmangory, M, Tolonen, M, Das, K, Ribeiro, J, O'Connor, D, Tan, B, Van Goor, H, Baral, S, De Simone, B, Corbella, D, Brambillasca, P, Scaglione, M, Basolo, F, De'Angelis, N, Bendinelli, C, Weber, D, Pagani, L, Monti, C, Baiocchi, G, Chiarugi, M, Catena, F, Sartelli, M, Coccolini F., Cicuttin E., Cremonini C., Tartaglia D., Viaggi B., Kuriyama A., Picetti E., Ball C., Abu-Zidan F., Ceresoli M., Turri B., Jain S., Palombo C., Guirao X., Rodrigues G., Gachabayov M., Machado F., Eftychios L., Kanj S. S., Di Carlo I., Di Saverio S., Khokha V., Kirkpatrick A., Massalou D., Forfori F., Corradi F., Delibegovic S., Machain Vega G. M., Fantoni M., Demetriades D., Kapoor G., Kluger Y., Ansari S., Maier R., Leppaniemi A., Hardcastle T., Vereczkei A., Karamagioli E., Pikoulis E., Pistello M., Sakakushev B. E., Navsaria P. H., Galeiras R., Yahya A. I., Osipov A. V., Dimitrov E., Doklestic K., Pisano M., Malacarne P., Carcoforo P., Sibilla M. G., Kryvoruchko I. A., Bonavina L., Kim J. I., Shelat V. G., Czepiel J., Maseda E., Marwah S., Chirica M., Biancofiore G., Podda M., Cobianchi L., Ansaloni L., Fugazzola P., Seretis C., Gomez C. A., Tumietto F., Malbrain M., Reichert M., Augustin G., Amato B., Puzziello A., Hecker A., Gemignani A., Isik A., Cucchetti A., Nacoti M., Kopelman D., Mesina C., Ghannam W., Ben-Ishay O., Dhingra S., Coimbra R., Moore E. E., Cui Y., Quiodettis M. A., Bala M., Testini M., Diaz J., Girardis M., Biffl W. L., Hecker M., Sall I., Boggi U., Materazzi G., Ghiadoni L., Matsumoto J., Zuidema W. P., Ivatury R., Enani M. A., Litvin A., Al-Hasan M. N., Demetrashvili Z., Baraket O., Ordonez C. A., Negoi I., Kiguba R., Memish Z. A., Elmangory M. M., Tolonen M., Das K., Ribeiro J., O'Connor D. B., Tan B. K., Van Goor H., Baral S., De Simone B., Corbella D., Brambillasca P., Scaglione M., Basolo F., De'Angelis N., Bendinelli C., Weber D., Pagani L., Monti C., Baiocchi G., Chiarugi M., Catena F., Sartelli M., Coccolini, F, Cicuttin, E, Cremonini, C, Tartaglia, D, Viaggi, B, Kuriyama, A, Picetti, E, Ball, C, Abu-Zidan, F, Ceresoli, M, Turri, B, Jain, S, Palombo, C, Guirao, X, Rodrigues, G, Gachabayov, M, Machado, F, Eftychios, L, Kanj, S, Di Carlo, I, Di Saverio, S, Khokha, V, Kirkpatrick, A, Massalou, D, Forfori, F, Corradi, F, Delibegovic, S, Machain Vega, G, Fantoni, M, Demetriades, D, Kapoor, G, Kluger, Y, Ansari, S, Maier, R, Leppaniemi, A, Hardcastle, T, Vereczkei, A, Karamagioli, E, Pikoulis, E, Pistello, M, Sakakushev, B, Navsaria, P, Galeiras, R, Yahya, A, Osipov, A, Dimitrov, E, Doklestic, K, Pisano, M, Malacarne, P, Carcoforo, P, Sibilla, M, Kryvoruchko, I, Bonavina, L, Kim, J, Shelat, V, Czepiel, J, Maseda, E, Marwah, S, Chirica, M, Biancofiore, G, Podda, M, Cobianchi, L, Ansaloni, L, Fugazzola, P, Seretis, C, Gomez, C, Tumietto, F, Malbrain, M, Reichert, M, Augustin, G, Amato, B, Puzziello, A, Hecker, A, Gemignani, A, Isik, A, Cucchetti, A, Nacoti, M, Kopelman, D, Mesina, C, Ghannam, W, Ben-Ishay, O, Dhingra, S, Coimbra, R, Moore, E, Cui, Y, Quiodettis, M, Bala, M, Testini, M, Diaz, J, Girardis, M, Biffl, W, Hecker, M, Sall, I, Boggi, U, Materazzi, G, Ghiadoni, L, Matsumoto, J, Zuidema, W, Ivatury, R, Enani, M, Litvin, A, Al-Hasan, M, Demetrashvili, Z, Baraket, O, Ordonez, C, Negoi, I, Kiguba, R, Memish, Z, Elmangory, M, Tolonen, M, Das, K, Ribeiro, J, O'Connor, D, Tan, B, Van Goor, H, Baral, S, De Simone, B, Corbella, D, Brambillasca, P, Scaglione, M, Basolo, F, De'Angelis, N, Bendinelli, C, Weber, D, Pagani, L, Monti, C, Baiocchi, G, Chiarugi, M, Catena, F, Sartelli, M, Coccolini F., Cicuttin E., Cremonini C., Tartaglia D., Viaggi B., Kuriyama A., Picetti E., Ball C., Abu-Zidan F., Ceresoli M., Turri B., Jain S., Palombo C., Guirao X., Rodrigues G., Gachabayov M., Machado F., Eftychios L., Kanj S. S., Di Carlo I., Di Saverio S., Khokha V., Kirkpatrick A., Massalou D., Forfori F., Corradi F., Delibegovic S., Machain Vega G. M., Fantoni M., Demetriades D., Kapoor G., Kluger Y., Ansari S., Maier R., Leppaniemi A., Hardcastle T., Vereczkei A., Karamagioli E., Pikoulis E., Pistello M., Sakakushev B. E., Navsaria P. H., Galeiras R., Yahya A. I., Osipov A. V., Dimitrov E., Doklestic K., Pisano M., Malacarne P., Carcoforo P., Sibilla M. G., Kryvoruchko I. A., Bonavina L., Kim J. I., Shelat V. G., Czepiel J., Maseda E., Marwah S., Chirica M., Biancofiore G., Podda M., Cobianchi L., Ansaloni L., Fugazzola P., Seretis C., Gomez C. A., Tumietto F., Malbrain M., Reichert M., Augustin G., Amato B., Puzziello A., Hecker A., Gemignani A., Isik A., Cucchetti A., Nacoti M., Kopelman D., Mesina C., Ghannam W., Ben-Ishay O., Dhingra S., Coimbra R., Moore E. E., Cui Y., Quiodettis M. A., Bala M., Testini M., Diaz J., Girardis M., Biffl W. L., Hecker M., Sall I., Boggi U., Materazzi G., Ghiadoni L., Matsumoto J., Zuidema W. P., Ivatury R., Enani M. A., Litvin A., Al-Hasan M. N., Demetrashvili Z., Baraket O., Ordonez C. A., Negoi I., Kiguba R., Memish Z. A., Elmangory M. M., Tolonen M., Das K., Ribeiro J., O'Connor D. B., Tan B. K., Van Goor H., Baral S., De Simone B., Corbella D., Brambillasca P., Scaglione M., Basolo F., De'Angelis N., Bendinelli C., Weber D., Pagani L., Monti C., Baiocchi G., Chiarugi M., Catena F., and Sartelli M.
Abstract: On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.
Published: 2021

20. 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

21. Trauma quality indicators: internationally approved core factors for trauma management quality evaluation

Author: Coccolini, F, Kluger, Y, Moore, E, Maier, R, Coimbra, R, Ordonez, C, Ivatury, R, Kirkpatrick, A, Biffl, W, Sartelli, M, Hecker, A, Ansaloni, L, Leppaniemi, A, Reva, V, Civil, I, Vega, F, Chiarugi, M, Chichom-Mefire, A, Sakakushev, B, Peitzman, A, Chiara, O, Abu-Zidan, F, Maegele, M, Miccoli, M, Chirica, M, Khokha, V, Sugrue, M, Fraga, G, Otomo, Y, Baiocchi, G, Catena, F, Kuliesius, Z, Conti, L, Dogjani, A, Lee, J, Consani, H, Russello, D, Bortul, M, Maurel, T, Kaf, H, Adamou, H, Alin, V, Robustelli, U, Sato, N, Seretis, C, Quiodettis, M, Gomes, C, Kong, V, Zakaria, A, Guner, A, Gachabayov, M, Chowdhury, S, Pata, F, Garcia, A, Rems, M, Das, K, Riedel, J, Lasithiotakis, K, Sydorchuk, R, Sydorchuk, L, Lostoridis, E, Buia, A, Mcfarlane, M, Ciani, R, Munoz-Cruzado, V, Tartaglia, D, Ioannidis, O, Muhrbeck, M, Reicher, M, Roscio, F, Ceresoli, M, Tsiftsis, D, Kavalakat, A, Pintar, T, Georgiou, G, Ricci, G, Mohan, R, Saar, S, Di Carlo, I, Isik, A, Ahmed, A, Gonsaga, R, Sammartano, F, Tallon-Aguilar, L, Shoko, T, Hsu, J, Kobe, Y, Romeo, C, Podda, M, Mingoli, A, Delgado, R, Ekwen, G, Aude, V, Olona, C, Boati, P, Magnone, S, Capaldi, M, Bala, M, Picetti, E, Negoi, I, Kok, K, Jusoh, A, Amato, B, Nita, G, de Beaux, A, Demetrashvili, Z, Davies, R, Kim, J, Pereira, A, Fattori, L, Paolillo, C, Ghannam, W, Rodriguez, F, Berardi, L, Florio, M, Hecker, M, Dubuisson, V, O'Connor, D, De'Angelis, N, Dobric, I, Massalou, D, Ortenwall, P, Pikoulis, E, Ugarte-Sierra, B, Zuidema, W, Kechagias, A, Marwah, S, Litvin, A, Nikolopoulos, I, Pesce, A, Uranues, S, Luppi, D, Flohe, S, Martinez-Perez, A, Lorenzo, M, Vergano, L, Manca, M, Malacarne, P, Kurihara, H, Widder, S, Pucciarelli, M, Monzani, F, Brambillasca, P, Corbella, D, Agresta, F, Moore, L, Buonomo, L, Adeleye, A, Kim, D, Veroux, M, Hardcastle, T, Di Saverio, S, Recordare, A, Rubio-Perez, I, Shlyapnikov, S, Rahim, R, Vega, G, Boris, K, Sawyer, R, Baraket, O, Soreide, K, Weber, C, Seak, C, Herman, S, Gamberini, E, Costa, S, Mazzocconi, G, Lozada, E, Manatakis, D, Lohsiriwat, V, Elbery, B, Tiberio, G, Santini, M, Mellace, L, Enoksen, C, Major, P, Parini, D, Improta, M, Fugazzola, P, Pini, S, Liberti, G, Martino, C, Cobianchi, L, Canzi, G, Cicuttin, E, Kenig, J, Zago, M, Giannessi, S, Scaglione, M, Orsitto, E, Cioni, R, Ghiadoni, L, Menichetti, F, Agnoletti, V, Sganga, G, Prosperi, P, Roviello, F, De Paolis, P, Gordini, G, Forfori, F, Ruscelli, P, Gabrielli, F, Puglisi, A, Bertolucci, A, Marchi, S, Bellini, M, Casagli, S, De Simone, B, Carmassi, F, Marchetti, S, Accorsini, M, Cremonini, C, Morelli, F, Romeo, L, Coccolini F., Kluger Y., Moore E. E., Maier R. V., Coimbra R., Ordonez C., Ivatury R., Kirkpatrick A. W., Biffl W., Sartelli M., Hecker A., Ansaloni L., Leppaniemi A., Reva V., Civil I., Vega F., Chiarugi M., Chichom-Mefire A., Sakakushev B., Peitzman A., Chiara O., Abu-Zidan F., Maegele M., Miccoli M., Chirica M., Khokha V., Sugrue M., Fraga G. P., Otomo Y., Baiocchi G. L., Catena F., Kuliesius Z., Conti L., Dogjani A., Lee J. G., Consani H., Russello D., Bortul M., Maurel T. G., Kaf H. S., Adamou H., Alin V., Robustelli U., Sato N., Seretis C., Quiodettis M., Gomes C. A., Kong V., Zakaria A. D., Guner A., Gachabayov M., Chowdhury S., Pata F., Garcia A., Rems M., Das K., Riedel J. G., Lasithiotakis K., Sydorchuk R., Sydorchuk L., Lostoridis E., Buia A., McFarlane M., Ciani R., Munoz-Cruzado V. M. D., Tartaglia D., Ioannidis O., Muhrbeck M., Reicher M., Roscio F., Ceresoli M., Tsiftsis D., Kavalakat A., Pintar T., Georgiou G., Ricci G., Mohan R., Saar S., Di Carlo I., Isik A., Ahmed A. Y. Y. M., Gonsaga R. A. T., Sammartano F., Tallon-Aguilar L., Shoko T., Hsu J., Kobe Y., Romeo C. G. L., Podda M., Mingoli A., Delgado R. C., Ekwen G., Aude V., Olona C., Boati P., Magnone S., Capaldi M., Bala M., Picetti E., Negoi I., Kok K. Y. Y., Jusoh A. C., Amato B., Nita G. E., de Beaux A., Demetrashvili Z., Davies R. J., Kim J. I., Pereira A., Fattori L., Paolillo C., Ghannam W., Rodriguez F. M., Berardi L., Florio M. G., Hecker M., Dubuisson V., O'Connor D. B., De'Angelis N., Dobric I., Massalou D., Ortenwall P., Pikoulis E., Ugarte-Sierra B., Zuidema W. P., Kechagias A., Marwah S., Litvin A., Nikolopoulos I., Pesce A., Uranues S., Luppi D., Flohe S., Martinez-Perez A., Lorenzo M., Vergano L. B., Manca M., Malacarne P., Kurihara H., Widder S., Pucciarelli M., Monzani F., Brambillasca P., Corbella D., Agresta F., Moore L., Buonomo L. A., Adeleye A. O., Kim D., Veroux M., Hardcastle T. C., Di Saverio S., Recordare A., Rubio-Perez I., Shlyapnikov S., Rahim R., Vega G. M. M., Boris K., Sawyer R., Baraket O., Soreide K., Weber C., Seak C. -J., Herman S., Gamberini E., Costa S., Mazzocconi G., Lozada E., Manatakis D., Lohsiriwat V., Ahmed A., Elbery B., Tiberio G. A. M., Santini M., Mellace L., Enoksen C. H., Major P., Parini D., Improta M., Fugazzola P., Pini S., Liberti G., Martino C., Cobianchi L., Canzi G., Cicuttin E., Kenig J., Zago M., Giannessi S., Scaglione M., Orsitto E., Cioni R., Ghiadoni L., Menichetti F., Agnoletti V., Sganga G., Prosperi P., Roviello F., De Paolis P., Gordini G., Forfori F., Ruscelli P., Gabrielli F., Puglisi A., Bertolucci A., Marchi S., Bellini M., Casagli S., De Simone B., Carmassi F., Marchetti S., Accorsini M., Cremonini C., Morelli F., Romeo L., Coccolini, F, Kluger, Y, Moore, E, Maier, R, Coimbra, R, Ordonez, C, Ivatury, R, Kirkpatrick, A, Biffl, W, Sartelli, M, Hecker, A, Ansaloni, L, Leppaniemi, A, Reva, V, Civil, I, Vega, F, Chiarugi, M, Chichom-Mefire, A, Sakakushev, B, Peitzman, A, Chiara, O, Abu-Zidan, F, Maegele, M, Miccoli, M, Chirica, M, Khokha, V, Sugrue, M, Fraga, G, Otomo, Y, Baiocchi, G, Catena, F, Kuliesius, Z, Conti, L, Dogjani, A, Lee, J, Consani, H, Russello, D, Bortul, M, Maurel, T, Kaf, H, Adamou, H, Alin, V, Robustelli, U, Sato, N, Seretis, C, Quiodettis, M, Gomes, C, Kong, V, Zakaria, A, Guner, A, Gachabayov, M, Chowdhury, S, Pata, F, Garcia, A, Rems, M, Das, K, Riedel, J, Lasithiotakis, K, Sydorchuk, R, Sydorchuk, L, Lostoridis, E, Buia, A, Mcfarlane, M, Ciani, R, Munoz-Cruzado, V, Tartaglia, D, Ioannidis, O, Muhrbeck, M, Reicher, M, Roscio, F, Ceresoli, M, Tsiftsis, D, Kavalakat, A, Pintar, T, Georgiou, G, Ricci, G, Mohan, R, Saar, S, Di Carlo, I, Isik, A, Ahmed, A, Gonsaga, R, Sammartano, F, Tallon-Aguilar, L, Shoko, T, Hsu, J, Kobe, Y, Romeo, C, Podda, M, Mingoli, A, Delgado, R, Ekwen, G, Aude, V, Olona, C, Boati, P, Magnone, S, Capaldi, M, Bala, M, Picetti, E, Negoi, I, Kok, K, Jusoh, A, Amato, B, Nita, G, de Beaux, A, Demetrashvili, Z, Davies, R, Kim, J, Pereira, A, Fattori, L, Paolillo, C, Ghannam, W, Rodriguez, F, Berardi, L, Florio, M, Hecker, M, Dubuisson, V, O'Connor, D, De'Angelis, N, Dobric, I, Massalou, D, Ortenwall, P, Pikoulis, E, Ugarte-Sierra, B, Zuidema, W, Kechagias, A, Marwah, S, Litvin, A, Nikolopoulos, I, Pesce, A, Uranues, S, Luppi, D, Flohe, S, Martinez-Perez, A, Lorenzo, M, Vergano, L, Manca, M, Malacarne, P, Kurihara, H, Widder, S, Pucciarelli, M, Monzani, F, Brambillasca, P, Corbella, D, Agresta, F, Moore, L, Buonomo, L, Adeleye, A, Kim, D, Veroux, M, Hardcastle, T, Di Saverio, S, Recordare, A, Rubio-Perez, I, Shlyapnikov, S, Rahim, R, Vega, G, Boris, K, Sawyer, R, Baraket, O, Soreide, K, Weber, C, Seak, C, Herman, S, Gamberini, E, Costa, S, Mazzocconi, G, Lozada, E, Manatakis, D, Lohsiriwat, V, Elbery, B, Tiberio, G, Santini, M, Mellace, L, Enoksen, C, Major, P, Parini, D, Improta, M, Fugazzola, P, Pini, S, Liberti, G, Martino, C, Cobianchi, L, Canzi, G, Cicuttin, E, Kenig, J, Zago, M, Giannessi, S, Scaglione, M, Orsitto, E, Cioni, R, Ghiadoni, L, Menichetti, F, Agnoletti, V, Sganga, G, Prosperi, P, Roviello, F, De Paolis, P, Gordini, G, Forfori, F, Ruscelli, P, Gabrielli, F, Puglisi, A, Bertolucci, A, Marchi, S, Bellini, M, Casagli, S, De Simone, B, Carmassi, F, Marchetti, S, Accorsini, M, Cremonini, C, Morelli, F, Romeo, L, Coccolini F., Kluger Y., Moore E. E., Maier R. V., Coimbra R., Ordonez C., Ivatury R., Kirkpatrick A. W., Biffl W., Sartelli M., Hecker A., Ansaloni L., Leppaniemi A., Reva V., Civil I., Vega F., Chiarugi M., Chichom-Mefire A., Sakakushev B., Peitzman A., Chiara O., Abu-Zidan F., Maegele M., Miccoli M., Chirica M., Khokha V., Sugrue M., Fraga G. P., Otomo Y., Baiocchi G. L., Catena F., Kuliesius Z., Conti L., Dogjani A., Lee J. G., Consani H., Russello D., Bortul M., Maurel T. G., Kaf H. S., Adamou H., Alin V., Robustelli U., Sato N., Seretis C., Quiodettis M., Gomes C. A., Kong V., Zakaria A. D., Guner A., Gachabayov M., Chowdhury S., Pata F., Garcia A., Rems M., Das K., Riedel J. G., Lasithiotakis K., Sydorchuk R., Sydorchuk L., Lostoridis E., Buia A., McFarlane M., Ciani R., Munoz-Cruzado V. M. D., Tartaglia D., Ioannidis O., Muhrbeck M., Reicher M., Roscio F., Ceresoli M., Tsiftsis D., Kavalakat A., Pintar T., Georgiou G., Ricci G., Mohan R., Saar S., Di Carlo I., Isik A., Ahmed A. Y. Y. M., Gonsaga R. A. T., Sammartano F., Tallon-Aguilar L., Shoko T., Hsu J., Kobe Y., Romeo C. G. L., Podda M., Mingoli A., Delgado R. C., Ekwen G., Aude V., Olona C., Boati P., Magnone S., Capaldi M., Bala M., Picetti E., Negoi I., Kok K. Y. Y., Jusoh A. C., Amato B., Nita G. E., de Beaux A., Demetrashvili Z., Davies R. J., Kim J. I., Pereira A., Fattori L., Paolillo C., Ghannam W., Rodriguez F. M., Berardi L., Florio M. G., Hecker M., Dubuisson V., O'Connor D. B., De'Angelis N., Dobric I., Massalou D., Ortenwall P., Pikoulis E., Ugarte-Sierra B., Zuidema W. P., Kechagias A., Marwah S., Litvin A., Nikolopoulos I., Pesce A., Uranues S., Luppi D., Flohe S., Martinez-Perez A., Lorenzo M., Vergano L. B., Manca M., Malacarne P., Kurihara H., Widder S., Pucciarelli M., Monzani F., Brambillasca P., Corbella D., Agresta F., Moore L., Buonomo L. A., Adeleye A. O., Kim D., Veroux M., Hardcastle T. C., Di Saverio S., Recordare A., Rubio-Perez I., Shlyapnikov S., Rahim R., Vega G. M. M., Boris K., Sawyer R., Baraket O., Soreide K., Weber C., Seak C. -J., Herman S., Gamberini E., Costa S., Mazzocconi G., Lozada E., Manatakis D., Lohsiriwat V., Ahmed A., Elbery B., Tiberio G. A. M., Santini M., Mellace L., Enoksen C. H., Major P., Parini D., Improta M., Fugazzola P., Pini S., Liberti G., Martino C., Cobianchi L., Canzi G., Cicuttin E., Kenig J., Zago M., Giannessi S., Scaglione M., Orsitto E., Cioni R., Ghiadoni L., Menichetti F., Agnoletti V., Sganga G., Prosperi P., Roviello F., De Paolis P., Gordini G., Forfori F., Ruscelli P., Gabrielli F., Puglisi A., Bertolucci A., Marchi S., Bellini M., Casagli S., De Simone B., Carmassi F., Marchetti S., Accorsini M., Cremonini C., Morelli F., and Romeo L.
Abstract: Introduction: Quality in medical care must be measured in order to be improved. Trauma management is part of health care, and by definition, it must be checked constantly. The only way to measure quality and outcomes is to systematically accrue data and analyze them. Material and methods: A systematic revision of the literature about quality indicators in trauma associated to an international consensus conference Results: An internationally approved base core set of 82 trauma quality indicators was obtained: Indicators were divided into 6 fields: prevention, structure, process, outcome, post-traumatic management, and society integrational effects. Conclusion: Present trauma quality indicator core set represents the result of an international effort aiming to provide a useful tool in quality evaluation and improvement. Further improvement may only be possible through international trauma registry development. This will allow for huge international data accrual permitting to evaluate results and compare outcomes.
Published: 2021

22. Trauma quality indicators: internationally approved core factors for trauma management quality evaluation

Author: Coccolini, F., Kluger, Y., Moore, E. E., Maier, R. V., Coimbra, R., Ordonez, C., Ivatury, R., Kirkpatrick, A. W., Biffl, W., Sartelli, M., Hecker, A., Ansaloni, L., Leppaniemi, A., Reva, V., Civil, I., Vega, F., Chiarugi, M., Chichom-Mefire, A., Sakakushev, B., Peitzman, A., Chiara, O., Abu-Zidan, F., Maegele, M., Miccoli, M., Chirica, M., Khokha, V., Sugrue, M., Fraga, G. P., Otomo, Y., Baiocchi, G. L., Catena, F., Kuliesius, Z., Conti, L., Dogjani, A., Lee, J. G., Consani, H., Russello, D., Bortul, M., Maurel, T. G., Kaf, H. S., Adamou, H., Alin, V., Robustelli, U., Sato, N., Seretis, C., Quiodettis, M., Gomes, C. A., Kong, V., Zakaria, A. D., Guner, A., Gachabayov, M., Chowdhury, S., Pata, F., Garcia, A., Rems, M., Das, K., Riedel, J. G., Lasithiotakis, K., Sydorchuk, R., Sydorchuk, L., Lostoridis, E., Buia, A., Mcfarlane, M., Ciani, R., Munoz-Cruzado, V. M. D., Tartaglia, D., Ioannidis, O., Muhrbeck, M., Reicher, M., Roscio, F., Ceresoli, M., Tsiftsis, D., Kavalakat, A., Pintar, T., Georgiou, G., Ricci, G., Mohan, R., Saar, S., Di Carlo, I., Isik, A., Ahmed, A. Y. Y. M., Gonsaga, R. A. T., Sammartano, F., Tallon-Aguilar, L., Shoko, T., Hsu, J., Kobe, Y., Romeo, C. G. L., Podda, M., Mingoli, A., Delgado, R. C., Ekwen, G., Aude, V., Olona, C., Boati, P., Magnone, S., Capaldi, M., Bala, M., Picetti, E., Negoi, I., Kok, K. Y. Y., Jusoh, A. C., Amato, B., Nita, G. E., de Beaux, A., Demetrashvili, Z., Davies, R. J., Kim, J. I., Pereira, A., Fattori, L., Paolillo, C., Ghannam, W., Rodriguez, F. M., Berardi, L., Florio, M. G., Hecker, M., Dubuisson, V., O'Connor, D. B., De'Angelis, N., Dobric, I., Massalou, D., Ortenwall, P., Pikoulis, E., Ugarte-Sierra, B., Zuidema, W. P., Kechagias, A., Marwah, S., Litvin, A., Nikolopoulos, I., Pesce, A., Uranues, S., Luppi, D., Flohe, S., Martinez-Perez, A., Lorenzo, M., Vergano, L. B., Manca, M., Malacarne, P., Kurihara, H., Widder, S., Pucciarelli, M., Monzani, F., Brambillasca, P., Corbella, D., Agresta, F., Moore, L., Buonomo, L. A., Adeleye, A. O., Kim, D., Veroux, M., Hardcastle, T. C., Di Saverio, S., Recordare, A., Rubio-Perez, I., Shlyapnikov, S., Rahim, R., Vega, G. M. M., Boris, K., Sawyer, R., Baraket, O., Soreide, K., Weber, C., Seak, C. -J., Herman, S., Gamberini, E., Costa, S., Mazzocconi, G., Lozada, E., Manatakis, D., Lohsiriwat, V., Ahmed, A., Elbery, B., Tiberio, G. A. M., Santini, M., Mellace, L., Enoksen, C. H., Major, P., Parini, D., Improta, M., Fugazzola, P., Pini, S., Liberti, G., Martino, C., Cobianchi, L., Canzi, G., Cicuttin, E., Kenig, J., Zago, M., Giannessi, S., Scaglione, M., Orsitto, E., Cioni, R., Ghiadoni, L., Menichetti, F., Agnoletti, V., Sganga, G., Prosperi, P., Roviello, F., De Paolis, P., Gordini, G., Forfori, F., Ruscelli, P., Gabrielli, F., Puglisi, A., Bertolucci, A., Marchi, S., Bellini, M., Casagli, S., De Simone, B., Carmassi, F., Marchetti, S., Accorsini, M., Cremonini, C., Morelli, F., Romeo, L., Coccolini F., Kluger Y., Moore E.E., Maier R.V., Coimbra R., Ordonez C., Ivatury R., Kirkpatrick A.W., Biffl W., Sartelli M., Hecker A., Ansaloni L., Leppaniemi A., Reva V., Civil I., Vega F., Chiarugi M., Chichom-Mefire A., Sakakushev B., Peitzman A., Chiara O., Abu-Zidan F., Maegele M., Miccoli M., Chirica M., Khokha V., Sugrue M., Fraga G.P., Otomo Y., Baiocchi G.L., Catena F., Kuliesius Z., Conti L., Dogjani A., Lee J.G., Consani H., Russello D., Bortul M., Maurel T.G., Kaf H.S., Adamou H., Alin V., Robustelli U., Sato N., Seretis C., Quiodettis M., Gomes C.A., Kong V., Zakaria A.D., Guner A., Gachabayov M., Chowdhury S., Pata F., Garcia A., Rems M., Das K., Riedel J.G., Lasithiotakis K., Sydorchuk R., Sydorchuk L., Lostoridis E., Buia A., McFarlane M., Ciani R., Munoz-Cruzado V.M.D., Tartaglia D., Ioannidis O., Muhrbeck M., Reicher M., Roscio F., Ceresoli M., Tsiftsis D., Kavalakat A., Pintar T., Georgiou G., Ricci G., Mohan R., Saar S., Di Carlo I., Isik A., Ahmed A.Y.Y.M., Gonsaga R.A.T., Sammartano F., Tallon-Aguilar L., Shoko T., Hsu J., Kobe Y., Romeo C.G.L., Podda M., Mingoli A., Delgado R.C., Ekwen G., Aude V., Olona C., Boati P., Magnone S., Capaldi M., Bala M., Picetti E., Negoi I., Kok K.Y.Y., Jusoh A.C., Amato B., Nita G.E., de Beaux A., Demetrashvili Z., Davies R.J., Kim J.I., Pereira A., Fattori L., Paolillo C., Ghannam W., Rodriguez F.M., Berardi L., Florio M.G., Hecker M., Dubuisson V., O'Connor D.B., De'Angelis N., Dobric I., Massalou D., Ortenwall P., Pikoulis E., Ugarte-Sierra B., Zuidema W.P., Kechagias A., Marwah S., Litvin A., Nikolopoulos I., Pesce A., Uranues S., Luppi D., Flohe S., Martinez-Perez A., Lorenzo M., Vergano L.B., Manca M., Malacarne P., Kurihara H., Widder S., Pucciarelli M., Monzani F., Brambillasca P., Corbella D., Agresta F., Moore L., Buonomo L.A., Adeleye A.O., Kim D., Veroux M., Hardcastle T.C., Di Saverio S., Recordare A., Rubio-Perez I., Shlyapnikov S., Rahim R., Vega G.M.M., Boris K., Sawyer R., Baraket O., Soreide K., Weber C., Seak C.-J., Herman S., Gamberini E., Costa S., Mazzocconi G., Lozada E., Manatakis D., Lohsiriwat V., Ahmed A., Elbery B., Tiberio G.A.M., Santini M., Mellace L., Enoksen C.H., Major P., Parini D., Improta M., Fugazzola P., Pini S., Liberti G., Martino C., Cobianchi L., Canzi G., Cicuttin E., Kenig J., Zago M., Giannessi S., Scaglione M., Orsitto E., Cioni R., Ghiadoni L., Menichetti F., Agnoletti V., Sganga G., Prosperi P., Roviello F., De Paolis P., Gordini G., Forfori F., Ruscelli P., Gabrielli F., Puglisi A., Bertolucci A., Marchi S., Bellini M., Casagli S., De Simone B., Carmassi F., Marchetti S., Accorsini M., Cremonini C., Morelli F., Romeo L., Coccolini, F, Kluger, Y, Moore, E, Maier, R, Coimbra, R, Ordonez, C, Ivatury, R, Kirkpatrick, A, Biffl, W, Sartelli, M, Hecker, A, Ansaloni, L, Leppaniemi, A, Reva, V, Civil, I, Vega, F, Chiarugi, M, Chichom-Mefire, A, Sakakushev, B, Peitzman, A, Chiara, O, Abu-Zidan, F, Maegele, M, Miccoli, M, Chirica, M, Khokha, V, Sugrue, M, Fraga, G, Otomo, Y, Baiocchi, G, Catena, F, Kuliesius, Z, Conti, L, Dogjani, A, Lee, J, Consani, H, Russello, D, Bortul, M, Maurel, T, Kaf, H, Adamou, H, Alin, V, Robustelli, U, Sato, N, Seretis, C, Quiodettis, M, Gomes, C, Kong, V, Zakaria, A, Guner, A, Gachabayov, M, Chowdhury, S, Pata, F, Garcia, A, Rems, M, Das, K, Riedel, J, Lasithiotakis, K, Sydorchuk, R, Sydorchuk, L, Lostoridis, E, Buia, A, Mcfarlane, M, Ciani, R, Munoz-Cruzado, V, Tartaglia, D, Ioannidis, O, Muhrbeck, M, Reicher, M, Roscio, F, Ceresoli, M, Tsiftsis, D, Kavalakat, A, Pintar, T, Georgiou, G, Ricci, G, Mohan, R, Saar, S, Di Carlo, I, Isik, A, Ahmed, A, Gonsaga, R, Sammartano, F, Tallon-Aguilar, L, Shoko, T, Hsu, J, Kobe, Y, Romeo, C, Podda, M, Mingoli, A, Delgado, R, Ekwen, G, Aude, V, Olona, C, Boati, P, Magnone, S, Capaldi, M, Bala, M, Picetti, E, Negoi, I, Kok, K, Jusoh, A, Amato, B, Nita, G, de Beaux, A, Demetrashvili, Z, Davies, R, Kim, J, Pereira, A, Fattori, L, Paolillo, C, Ghannam, W, Rodriguez, F, Berardi, L, Florio, M, Hecker, M, Dubuisson, V, O'Connor, D, De'Angelis, N, Dobric, I, Massalou, D, Ortenwall, P, Pikoulis, E, Ugarte-Sierra, B, Zuidema, W, Kechagias, A, Marwah, S, Litvin, A, Nikolopoulos, I, Pesce, A, Uranues, S, Luppi, D, Flohe, S, Martinez-Perez, A, Lorenzo, M, Vergano, L, Manca, M, Malacarne, P, Kurihara, H, Widder, S, Pucciarelli, M, Monzani, F, Brambillasca, P, Corbella, D, Agresta, F, Moore, L, Buonomo, L, Adeleye, A, Kim, D, Veroux, M, Hardcastle, T, Di Saverio, S, Recordare, A, Rubio-Perez, I, Shlyapnikov, S, Rahim, R, Vega, G, Boris, K, Sawyer, R, Baraket, O, Soreide, K, Weber, C, Seak, C, Herman, S, Gamberini, E, Costa, S, Mazzocconi, G, Lozada, E, Manatakis, D, Lohsiriwat, V, Elbery, B, Tiberio, G, Santini, M, Mellace, L, Enoksen, C, Major, P, Parini, D, Improta, M, Fugazzola, P, Pini, S, Liberti, G, Martino, C, Cobianchi, L, Canzi, G, Cicuttin, E, Kenig, J, Zago, M, Giannessi, S, Scaglione, M, Orsitto, E, Cioni, R, Ghiadoni, L, Menichetti, F, Agnoletti, V, Sganga, G, Prosperi, P, Roviello, F, De Paolis, P, Gordini, G, Forfori, F, Ruscelli, P, Gabrielli, F, Puglisi, A, Bertolucci, A, Marchi, S, Bellini, M, Casagli, S, De Simone, B, Carmassi, F, Marchetti, S, Accorsini, M, Cremonini, C, Morelli, F, Romeo, L, and HUS Abdominal Center
Subjects: System, Consensus, Internationality, Delphi Technique, Accrual, Process (engineering), media_common.quotation_subject, Performance, education, lcsh:Surgery, 030230 surgery, Analysis, Data, Morbidity, Mortality, Outcome, Planning, Product, World, 03 medical and health sciences, 0302 clinical medicine, Trauma management, Health care, Medicine, Humans, Operations management, Quality (business), Product (category theory), media_common, Quality Indicators, Health Care, Core set, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Analysi, lcsh:RD1-811, lcsh:RC86-88.9, CARE, 3126 Surgery, anesthesiology, intensive care, radiology, Core (game theory), Traumatology, Emergency Medicine, Surgery, business, Research Article
Abstract: Introduction Quality in medical care must be measured in order to be improved. Trauma management is part of health care, and by definition, it must be checked constantly. The only way to measure quality and outcomes is to systematically accrue data and analyze them. Material and methods A systematic revision of the literature about quality indicators in trauma associated to an international consensus conference Results An internationally approved base core set of 82 trauma quality indicators was obtained: Indicators were divided into 6 fields: prevention, structure, process, outcome, post-traumatic management, and society integrational effects. Conclusion Present trauma quality indicator core set represents the result of an international effort aiming to provide a useful tool in quality evaluation and improvement. Further improvement may only be possible through international trauma registry development. This will allow for huge international data accrual permitting to evaluate results and compare outcomes.
Published: 2021

23. Open Abdomen and Fluid Instillation in the Septic Abdomen: Results from the IROA Study

Author: Coccolini, F, Gubbiotti, F, Ceresoli, M, Tartaglia, D, Fugazzola, P, Ansaloni, L, Sartelli, M, Kluger, Y, Kirkpatrick, A, Amico, F, Catena, F, Chiarugi, M, Montori, G, Salvetti, F, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Sugrue, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Ben-Ishay, O, Lippi, A, Improta, M, Zharikov, A, Dubuisson, V, Coccolini F., Gubbiotti F., Ceresoli M., Tartaglia D., Fugazzola P., Ansaloni L., Sartelli M., Kluger Y., Kirkpatrick A., Amico F., Catena F., Chiarugi M., Montori G., Salvetti F., Negoi I., Zese M., Occhionorelli S., Shlyapnikov S., Sugrue M., Demetrashvili Z., Dondossola D., Ioannidis O., Novelli G., Nacoti M., Khor D., Inaba K., Demetriades D., Kaussen T., Jusoh A. C., Ghannam W., Sakakushev B., Guetta O., Dogjani A., Costa S., Singh S., Damaskos D., Isik A., Yuan K. -C., Trotta F., Rausei S., Martinez-Perez A., Bellanova G., Fonseca V. C., Hernandez F., Marinis A., Fernandes W., Quiodettis M., Bala M., Vereczkei A., Curado R., Fraga G. P., Pereira B. M., Gachabayov M., Chagerben G. P., Arellano M. L., Ozyazici S., Costa G., Tezcaner T., Porta M., Li Y., Karateke F., Manatakis D., Mariani F., Lora F., Sahderov I., Atanasov B., Zegarra S., Fattori L., Ivatury R., Xiao J., Ben-Ishay O., Lippi A., Improta M., Zharikov A., Dubuisson V., Coccolini, F, Gubbiotti, F, Ceresoli, M, Tartaglia, D, Fugazzola, P, Ansaloni, L, Sartelli, M, Kluger, Y, Kirkpatrick, A, Amico, F, Catena, F, Chiarugi, M, Montori, G, Salvetti, F, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Sugrue, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Ben-Ishay, O, Lippi, A, Improta, M, Zharikov, A, Dubuisson, V, Coccolini F., Gubbiotti F., Ceresoli M., Tartaglia D., Fugazzola P., Ansaloni L., Sartelli M., Kluger Y., Kirkpatrick A., Amico F., Catena F., Chiarugi M., Montori G., Salvetti F., Negoi I., Zese M., Occhionorelli S., Shlyapnikov S., Sugrue M., Demetrashvili Z., Dondossola D., Ioannidis O., Novelli G., Nacoti M., Khor D., Inaba K., Demetriades D., Kaussen T., Jusoh A. C., Ghannam W., Sakakushev B., Guetta O., Dogjani A., Costa S., Singh S., Damaskos D., Isik A., Yuan K. -C., Trotta F., Rausei S., Martinez-Perez A., Bellanova G., Fonseca V. C., Hernandez F., Marinis A., Fernandes W., Quiodettis M., Bala M., Vereczkei A., Curado R., Fraga G. P., Pereira B. M., Gachabayov M., Chagerben G. P., Arellano M. L., Ozyazici S., Costa G., Tezcaner T., Porta M., Li Y., Karateke F., Manatakis D., Mariani F., Lora F., Sahderov I., Atanasov B., Zegarra S., Fattori L., Ivatury R., Xiao J., Ben-Ishay O., Lippi A., Improta M., Zharikov A., and Dubuisson V.
Abstract: Background: Open abdomen (OA) is a surgical option that can be used in patients with severe peritonitis. Few evidences exist to recommend the use of intraperitoneal fluid instillation associated with OA in managing septic abdomen. Materials and methods: A prospective analysis of adult patients enrolled in the International Register of Open Abdomen (trial registration: NCT02382770) was performed. Results: A total of 387 patients were enrolled in two groups: 84 with peritoneal fluid instillation (FI) and 303 without (NFI). The groups were homogeneous for baseline characteristics. Overall complications were 92.9% in FI and 86.3% in NFI (p = 0.106). Complications during OA were 72.6% in FI and 59.9% in NFI (p = 0.034). Complications after definitive closure were 70.8% in FI and 61.1% in NFI (p = 0.133). Entero-atmospheric fistula was 13.1% in FI and 12% in NFI (p = 0.828). Fascial closure was 78.6% in FI and 63.7% in NFI (p = 0.02). Analysis of FI in negative pressure wound therapy (NPWT) showed: Overall morbidity in NPWT was 94% and in non-NPWT 91.2% (p = 0.622) and morbidity during OA was 68% and 79.4% (p = 0.25), respectively. Definitive fascial closure in NPWT was 87.8% and 96.8% in non-NPWT (p = 0.173). Overall mortality was 40% in NPWT and 29.4% in non-NPWT (p = 0.32) and morality during OA period was 18% and 8.8% (p = 0.238), respectively. Conclusion: We found intraperitoneal fluid instillation during open abdomen in peritonitic patients to increase the complication rate during the open abdomen period, with no impact on mortality, entero-atmospheric fistula rate and opening time. Fascial closure rate is increased by instillation. Fluid instillation is feasible even when associated with nonnegative pressure temporary abdominal closure techniques.
Published: 2020

24. 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

25. Open abdomen management for severe peritonitis in elderly. Results from the prospective International Register of Open Abdomen (IROA): Cohort study

Author: Rausei, S, Pappalardo, V, Ceresoli, M, Catena, F, Sartelli, M, Chiarugi, M, Kluger, Y, Kirkpatrick, A, Ansaloni, L, Coccolini, F, Montori, G, Salvetti, F, Fugazzola, P, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Lippi, A, Improta, M, Gubbiotti, F, Zharikov, A, Dubuisson, V, Sugrue, M, Rausei S., Pappalardo V., Ceresoli M., Catena F., Sartelli M., Chiarugi M., Kluger Y., Kirkpatrick A., Ansaloni L., Coccolini F., Montori G., Salvetti F., Fugazzola P., Negoi I., Zese M., Occhionorelli S., Shlyapnikov S., Demetrashvili Z., Dondossola D., Ioannidis O., Novelli G., Nacoti M., Khor D., Inaba K., Demetriades D., Kaussen T., Jusoh A. C., Ghannam W., Sakakushev B., Guetta O., Dogjani A., Costa S., Singh S., Damaskos D., Isik A., Yuan K. -C., Trotta F., Martinez-Perez A., Bellanova G., Fonseca V. C., Hernandez F., Marinis A., Fernandes W., Quiodettis M., Bala M., Vereczkei A., Curado R., Fraga G. P., Pereira B. M., Gachabayov M., Chagerben G. P., Arellano M. L., Ozyazici S., Costa G., Tezcaner T., Porta M., Li Y., Karateke F., Manatakis D., Mariani F., Lora F., Sahderov I., Atanasov B., Zegarra S., Fattori L., Ivatury R., Xiao J., Lippi A., Improta M., Gubbiotti F., Zharikov A., Dubuisson V., Sugrue M., Rausei, S, Pappalardo, V, Ceresoli, M, Catena, F, Sartelli, M, Chiarugi, M, Kluger, Y, Kirkpatrick, A, Ansaloni, L, Coccolini, F, Montori, G, Salvetti, F, Fugazzola, P, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Lippi, A, Improta, M, Gubbiotti, F, Zharikov, A, Dubuisson, V, Sugrue, M, Rausei S., Pappalardo V., Ceresoli M., Catena F., Sartelli M., Chiarugi M., Kluger Y., Kirkpatrick A., Ansaloni L., Coccolini F., Montori G., Salvetti F., Fugazzola P., Negoi I., Zese M., Occhionorelli S., Shlyapnikov S., Demetrashvili Z., Dondossola D., Ioannidis O., Novelli G., Nacoti M., Khor D., Inaba K., Demetriades D., Kaussen T., Jusoh A. C., Ghannam W., Sakakushev B., Guetta O., Dogjani A., Costa S., Singh S., Damaskos D., Isik A., Yuan K. -C., Trotta F., Martinez-Perez A., Bellanova G., Fonseca V. C., Hernandez F., Marinis A., Fernandes W., Quiodettis M., Bala M., Vereczkei A., Curado R., Fraga G. P., Pereira B. M., Gachabayov M., Chagerben G. P., Arellano M. L., Ozyazici S., Costa G., Tezcaner T., Porta M., Li Y., Karateke F., Manatakis D., Mariani F., Lora F., Sahderov I., Atanasov B., Zegarra S., Fattori L., Ivatury R., Xiao J., Lippi A., Improta M., Gubbiotti F., Zharikov A., Dubuisson V., and Sugrue M.
Abstract: Background: Analyzing the data of the International Register of Open Abdomen (IROA), the feasibility of open abdomen treatment has been demonstrated at every age. This new analysis on the IROA database investigates the risk factors for mortality in elderly patients treated with open abdomen for intra-abdominal infection. Methods: Data were derived from the IROA, a prospective observational international cohort study that enrolled patients treated with open abdomen worldwide. A univariate analysis of potential risk factors was performed. Inclusion criteria were patients older than 65 years and treated with open abdomen for intra-abdominal infection. End point was overall mortality, calculated within 30 days after open abdomen management, after 1-month and 1-year follow-up. Results: A total of 116 patients was analyzed with mean age of 76 ± 7 years. Definitive closure was achieved in 93 patients (93/116, 80.2%) for a mean open abdomen duration of 5.0 ± 5.0 days. Complicated patients were 101 (101/116, 87.1%) for a total of 201 complications. Overall, 62 out of 116 patients (53.4%) died: 23 patients (23/62, 37.1%) during open abdomen management, 29 patients (46.8%) within 30 days after abdominal closure, 9 patients (14.5%) after 1-month follow-up, and 1 patient (1.6%) after 1-year follow-up. Age did not affect mortality (75 ± 6 years in alive patients versus 77 ± 7 years in dead patients, p = 0.773). Definitive abdominal closure was the most important factor to prevent mortality. Conclusions: This study confirmed that age alone cannot be considered a determinant for death, even in elderly patients managed with open abdomen for severe intra-abdominal infection.
Published: 2020

26. 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

27. American Association for the Surgery of Trauma-World Society of Emergency Surgery guidelines on diagnosis and management of abdominal 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. M., Abu-Zidan F., Peitzman A. B., Ordonez C. A., 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. M., Abu-Zidan F., Peitzman A. B., Ordonez C. A., 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: Abdominal vascular trauma accounts for a small percentage of military and a moderate percentage of civilian trauma, affecting all age ranges and impacting young adult men most frequently. Penetrating causes are more frequent than blunt in adults, while blunt mechanisms are more common among pediatric populations. High rates of associated injuries, bleeding, and hemorrhagic shock ensure that, despite advances in both diagnostic and therapeutic technologies, immediate open surgical repair remains the mainstay of treatment for traumatic abdominal vascular injuries. Because of their devastating nature, abdominal vascular injuries remain a significant source of morbidity and mortality among trauma patients. The American Association for the Surgery of Trauma in conjunction with the World Society of Emergency Surgery seek to summarize the literature to date and provide guidelines on the presentation, diagnosis, and treatment of abdominal vascular injuries. LEVEL OF EVIDENCE Review study, level IV.
Published: 2020

28. Minimally invasive surgery in emergency surgery: a WSES survey

Author: Ceresoli, M. Pisano, M. Abu-Zidan, F. Allievi, N. Gurusamy, K. Biffl, W.L. Tebala, G.D. Catena, F. Ansaloni, L. Sartelli, M. Kluger, Y. Baiocchi, G. Fette, A. Hecker, A. Litvin, A. Forgione, A. Leppaniemi, A. De Simone, B. Sakakushev, B. Palmatier, C.R. Bendinelli, C. Damascos, D. Picetti, E. Tan, E. Poiasina, E. Pikoulis, E. Cicuttin, E. Moore, E.E. Velmahos, G. Fraga, G. Van Goor, H. Civil, I. Wani, I. Di Carlo, I. Galante, J. Søreide, K. Degrate, L. Zorcolo, L. De Moya, M. Braga, M. Cereda, M. Sugrue, M. Chirica, M. De Angelis, N. Stahel, P.F. Ivatury, R. Ten Broek, R. Di Saverio, S. Beka, S.G. Magnone, S. Cui, Y. Balogh, Z.J. Kelly, M.D. Inaba, K. Coccolini, F. WSES MIS working group WSES MIS consortia
Abstract: Background: The diffusion of minimally invasive surgery in emergency surgery still represents a developing challenge. Evidence about the use of minimally invasive surgery shows its feasibility and safety; however, the diffusion of these techniques is still poor. The aims of the present survey were to explore the diffusion and variations in the use of minimally invasive surgery among surgeons in the emergency setting. Methods: This is a web-based survey administered to all the WSES members investigating the diffusion of minimally invasive surgery in emergency. The survey investigated personal characteristics of participants, hospital characteristics, personal confidence in the use of minimally invasive surgery in emergency, limitations in the use of it and limitations to prosecute minimally invasive surgery in emergency surgery. Characteristics related to the use of minimally invasive surgery were studied with a multivariate ordinal regression. Results: The survey collected a total of 415 answers; 42.2% of participants declared a working experience > 15 years and 69.4% of responders worked in tertiary level center or academic hospital. In primary emergencies, only 28,7% of participants declared the use of laparoscopy in more than 50% of times. Personal confidence with minimally invasive techniques was the highest for appendectomy and cholecystectomy. At multivariate ordinal regression, a longer professional experience, the use of laparoscopy in major elective surgery and bariatric surgery expertise were related to a higher use of laparoscopy in emergency surgery. Conclusions: The survey shows that minimally invasive techniques in emergency surgery are still underutilized. Greater focus should be placed on the development of dedicated training in laparoscopy among emergency surgeons. © 2022, The Author(s).
Published: 2022

29. Decompressive laparotomy for abdominal compartment syndrome

Author: De Waele, J. J., Kimball, E., Malbrain, M., Nesbitt6, I., Cohen, J., Kaloiani, V., Ivatury, R., Mone, M., Debergh, D., and Björck, M.
Published: 2016
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30. Kidney and uro-trauma: WSES-AAST guidelines

Author: Coccolini, F, Moore, E, Kluger, Y, Biffl, W, Leppaniemi, A, Matsumura, Y, Kim, F, Peitzman, A, Fraga, G, Sartelli, M, Ansaloni, L, Augustin, G, Kirkpatrick, A, Abu-Zidan, F, Wani, I, Weber, D, Pikoulis, E, Larrea, M, Arvieux, C, Manchev, V, Reva, V, Coimbra, R, Khokha, V, Mefire, A, Ordonez, C, Chiarugi, M, Machado, F, Sakakushev, B, Matsumoto, J, Maier, R, Di Carlo, I, Catena, F, Fugazzola, P, Stommel, M, Rajashekar, M, Tan, E, Tolonen, M, Ceresoli, M, Gomez, C, Allievi, N, Chirica, M, Salvetti, F, Bertelli, R, Ben-Ishay, O, Bahouth, H, Baiocchi, G, Tarasconi, A, Cimbanassi, S, Chiara, O, Ten-Broek, R, Montori, G, Picariello, E, Solaini, L, Hecker, A, Tomasoni, M, Perfetti, P, Parry, N, Deangelis, N, Pereira, B, Bado, J, Romeo, O, Pikoulis, A, Bala, M, Napolitano, L, Galante, J, Rizoli, S, Ferrada, P, Horer, T, Brenner, M, Ivatury, R, Coccolini F., Moore E. E., Kluger Y., Biffl W., Leppaniemi A., Matsumura Y., Kim F., Peitzman A. B., Fraga G. P., Sartelli M., Ansaloni L., Augustin G., Kirkpatrick A., Abu-Zidan F., Wani I., Weber D., Pikoulis E., Larrea M., Arvieux C., Manchev V., Reva V., Coimbra R., Khokha V., Mefire A. C., Ordonez C., Chiarugi M., Machado F., Sakakushev B., Matsumoto J., Maier R., Di Carlo I., Catena F., Fugazzola P., Stommel M., Rajashekar M., Tan E., Tolonen M., Ceresoli M., Gomez C. A., Allievi N., Chirica M., Salvetti F., Bertelli R., Ben-Ishay O., Bahouth H., Baiocchi G., Tarasconi A., Cimbanassi S., Chiara O., Ten-Broek R., Montori G., Picariello E., Solaini L., Hecker A., Tomasoni M., Perfetti P., Parry N., Deangelis N., Pereira B. M., Bado J., Romeo O., Pikoulis A., Bala M., Napolitano L., Galante J., Rizoli S., Ferrada P., Horer T., Brenner M., Ivatury R., Coccolini, F, Moore, E, Kluger, Y, Biffl, W, Leppaniemi, A, Matsumura, Y, Kim, F, Peitzman, A, Fraga, G, Sartelli, M, Ansaloni, L, Augustin, G, Kirkpatrick, A, Abu-Zidan, F, Wani, I, Weber, D, Pikoulis, E, Larrea, M, Arvieux, C, Manchev, V, Reva, V, Coimbra, R, Khokha, V, Mefire, A, Ordonez, C, Chiarugi, M, Machado, F, Sakakushev, B, Matsumoto, J, Maier, R, Di Carlo, I, Catena, F, Fugazzola, P, Stommel, M, Rajashekar, M, Tan, E, Tolonen, M, Ceresoli, M, Gomez, C, Allievi, N, Chirica, M, Salvetti, F, Bertelli, R, Ben-Ishay, O, Bahouth, H, Baiocchi, G, Tarasconi, A, Cimbanassi, S, Chiara, O, Ten-Broek, R, Montori, G, Picariello, E, Solaini, L, Hecker, A, Tomasoni, M, Perfetti, P, Parry, N, Deangelis, N, Pereira, B, Bado, J, Romeo, O, Pikoulis, A, Bala, M, Napolitano, L, Galante, J, Rizoli, S, Ferrada, P, Horer, T, Brenner, M, Ivatury, R, Coccolini F., Moore E. E., Kluger Y., Biffl W., Leppaniemi A., Matsumura Y., Kim F., Peitzman A. B., Fraga G. P., Sartelli M., Ansaloni L., Augustin G., Kirkpatrick A., Abu-Zidan F., Wani I., Weber D., Pikoulis E., Larrea M., Arvieux C., Manchev V., Reva V., Coimbra R., Khokha V., Mefire A. C., Ordonez C., Chiarugi M., Machado F., Sakakushev B., Matsumoto J., Maier R., Di Carlo I., Catena F., Fugazzola P., Stommel M., Rajashekar M., Tan E., Tolonen M., Ceresoli M., Gomez C. A., Allievi N., Chirica M., Salvetti F., Bertelli R., Ben-Ishay O., Bahouth H., Baiocchi G., Tarasconi A., Cimbanassi S., Chiara O., Ten-Broek R., Montori G., Picariello E., Solaini L., Hecker A., Tomasoni M., Perfetti P., Parry N., Deangelis N., Pereira B. M., Bado J., Romeo O., Pikoulis A., Bala M., Napolitano L., Galante J., Rizoli S., Ferrada P., Horer T., Brenner M., and Ivatury R.
Abstract: Renal and urogenital injuries occur in approximately 10-20% of abdominal trauma in adults and children. Optimal management should take into consideration the anatomic injury, the hemodynamic status, and the associated injuries. The management of urogenital trauma aims to restore homeostasis and normal physiology especially in pediatric patients where non-operative management is considered the gold standard. As with all traumatic conditions, the management of urogenital trauma should be multidisciplinary including urologists, interventional radiologists, and trauma surgeons, as well as emergency and ICU physicians. The aim of this paper is to present the World Society of Emergency Surgery (WSES) and the American Association for the Surgery of Trauma (AAST) kidney and urogenital trauma management guidelines.
Published: 2019

31. A pandemic recap: lessons we have learned

Author: Coccolini, F., Cicuttin, E., Cremonini, C., Tartaglia, D., Viaggi, B., Kuriyama, A., Picetti, E., Ball, C., Abu-Zidan, F., Ceresoli, M., Turri, B., Jain, S., Palombo, C., Guirao, X., Rodrigues, G., Gachabayov, M., Machado, F., Eftychios, L., Kanj, S.S., Carlo, I. Di, Saverio, S. Di, Khokha, V., Kirkpatrick, A., Massalou, D., Forfori, F., Corradi, F., Delibegovic, S., Vega, G.M. Machain, Fantoni, M., Demetriades, D., Kapoor, G., Kluger, Y., Ansari, S., Maier, R., Leppaniemi, A., Hardcastle, T., Vereczkei, A., Karamagioli, E., Pikoulis, E., Pistello, M., Sakakushev, B.E., Navsaria, P.H., Galeiras, R., Yahya, A.I., Osipov, A.V., Dimitrov, E., Doklestić, K., Pisano, M., Malacarne, P., Carcoforo, P., Sibilla, M.G., Kryvoruchko, I.A., Bonavina, L., Kim, J.I., Shelat, V.G., Czepiel, J., Maseda, E., Marwah, S., Chirica, M., Biancofiore, G., Podda, M., Cobianchi, L., Ansaloni, L., Fugazzola, P., Seretis, C., Gomez, C.A., Tumietto, F., Malbrain, M., Reichert, M., Augustin, G., Amato, B., Puzziello, A., Hecker, A., Gemignani, A., Isik, A., Cucchetti, A., Nacoti, M., Kopelman, D., Mesina, C., Ghannam, W., Ben-Ishay, O., Dhingra, S., Coimbra, R., Moore, E.E., Cui, Y., Quiodettis, M.A., Bala, M., Testini, M., Diaz, J., Girardis, M., Biffl, W.L., Hecker, M., Sall, I., Boggi, U., Materazzi, G., Ghiadoni, L., Matsumoto, J., Zuidema, W.P., Ivatury, R., Enani, M.A., Goor, H. van, Catena, Fausto, Sartelli, M., Coccolini, F., Cicuttin, E., Cremonini, C., Tartaglia, D., Viaggi, B., Kuriyama, A., Picetti, E., Ball, C., Abu-Zidan, F., Ceresoli, M., Turri, B., Jain, S., Palombo, C., Guirao, X., Rodrigues, G., Gachabayov, M., Machado, F., Eftychios, L., Kanj, S.S., Carlo, I. Di, Saverio, S. Di, Khokha, V., Kirkpatrick, A., Massalou, D., Forfori, F., Corradi, F., Delibegovic, S., Vega, G.M. Machain, Fantoni, M., Demetriades, D., Kapoor, G., Kluger, Y., Ansari, S., Maier, R., Leppaniemi, A., Hardcastle, T., Vereczkei, A., Karamagioli, E., Pikoulis, E., Pistello, M., Sakakushev, B.E., Navsaria, P.H., Galeiras, R., Yahya, A.I., Osipov, A.V., Dimitrov, E., Doklestić, K., Pisano, M., Malacarne, P., Carcoforo, P., Sibilla, M.G., Kryvoruchko, I.A., Bonavina, L., Kim, J.I., Shelat, V.G., Czepiel, J., Maseda, E., Marwah, S., Chirica, M., Biancofiore, G., Podda, M., Cobianchi, L., Ansaloni, L., Fugazzola, P., Seretis, C., Gomez, C.A., Tumietto, F., Malbrain, M., Reichert, M., Augustin, G., Amato, B., Puzziello, A., Hecker, A., Gemignani, A., Isik, A., Cucchetti, A., Nacoti, M., Kopelman, D., Mesina, C., Ghannam, W., Ben-Ishay, O., Dhingra, S., Coimbra, R., Moore, E.E., Cui, Y., Quiodettis, M.A., Bala, M., Testini, M., Diaz, J., Girardis, M., Biffl, W.L., Hecker, M., Sall, I., Boggi, U., Materazzi, G., Ghiadoni, L., Matsumoto, J., Zuidema, W.P., Ivatury, R., Enani, M.A., Goor, H. van, Catena, Fausto, and Sartelli, M.
Abstract: Contains fulltext : 238976.pdf (Publisher’s version ) (Open Access), On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.
Published: 2021

32. Enterocutaneous fistulas: an overview

Author: Whelan, Jr., J. F. and Ivatury, R. R.
Published: 2011
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33. Open abdomen and entero-atmospheric fistulae: An interim analysis from the International Register of Open Abdomen (IROA)

Author: Coccolini F, Register of Open Abdomen (IROA)., Ceresoli, M, Kluger, Y, Kirkpatrick, A, Montori, G, Salvetti, F, Fugazzola, P, Tomasoni, M, Sartelli, M, Ansaloni, L1, Catena, F, Nego, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Galatioto, C, Chiarugi, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, Ac, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Ardaisik, Yuan, Kc, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernández, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, Gp, Pereira, Bm, Gachabayov, M, Chagerben, Gp, Arellano, Ml, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Gianotti, L, Fattori, L, Ivatury, R, IROA study group, Coccolini, F, Ceresoli, M, Kluger, Y, Kirkpatrick, A, Montori, G, Salvetti, F, Fugazzola, P, Tomasoni, M, Sartelli, M, Ansaloni, L, Catena, F, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Galatioto, C, Chiarugi, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernández, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Gianotti, L, Fattori, L, and Ivatury, R
Subjects: Adult, Male, medicine.medical_specialty, Fistula, medicine.medical_treatment, Peritonitis, Entero-atmospheric fistula, NO, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Negative-pressure wound therapy, MED/18 - CHIRURGIA GENERALE, Intestinal Fistula, Humans, Medicine, Orthopedics and Sports Medicine, Prospective Studies, Young adult, Open abdomen, Prospective cohort study, Digestive System Surgical Procedures, General Environmental Science, 030222 orthopedics, business.industry, Mortality rate, Abdominal Cavity, Abdominal Wound Closure Techniques, 030208 emergency & critical care medicine, Middle Aged, Interim analysis, medicine.disease, Surgery, IROA, Treatment Outcome, Parenteral nutrition, Emergency Medicine, General Earth and Planetary Sciences, Female, business, Negative-Pressure Wound Therapy
Abstract: Introduction No definitive data describing associations between cases of Open Abdomen (OA) and Entero-atmospheric fistulae (EAF) exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) thus analyzed the International Register of Open Abdomen (IROA) to assess this question. Material and methods A prospective analysis of adult patients enrolled in the IROA. Results Among 649 adult patients with OA 58 (8.9%) developed EAF. Indications for OA were peritonitis (51.2%) and traumatic-injury (16.8%). The most frequently utilized temporary abdominal closure techniques were Commercial-NPWT (46.8%) and Bogota-bag (21.9%). Mean OA days were 7.9 ± 18.22. Overall mortality rate was 29.7%, with EAF having no impact on mortality. Multivariate analysis associated cancer (p = 0.018), days of OA (p = 0.003) and time to provision-of-nutrition (p = 0.016) with EAF occurrence. Conclusion Entero-atmospheric fistulas are influenced by the duration of open abdomen treatment and by the nutritional status of the patient. Peritonitis, intestinal anastomosis, negative pressure and oral or enteral nutrition were not risk factors for EAF during OA treatment.
Published: 2019

34. The open abdomen in trauma and non-trauma patients: WSES guidelines

Author: Coccolini, F, Roberts, D, Ansaloni, L, Ivatury, R, Gamberini, E, Kluger, Y, Moore, E, Coimbra, R, Kirkpatrick, A, Pereira, B, Montori, G, Ceresoli, M, Abu-Zidan, F, Sartelli, M, Velmahos, G, Fraga, G, Leppaniemi, A, Tolonen, M, Galante, J, Razek, T, Maier, R, Bala, M, Sakakushev, B, Khokha, V, Malbrain, M, Agnoletti, V, Peitzman, A, Demetrashvili, Z, Sugrue, M, Di Saverio, S, Martzi, I, Soreide, K, Biffl, W, Ferrada, P, Parry, N, Montravers, P, Melotti, R, Salvetti, F, Valetti, T, Scalea, T, Chiara, O, Cimbanassi, S, Kashuk, J, Larrea, M, Hernandez, J, Lin, H, Chirica, M, Arvieux, C, Bing, C, Horer, T, De Simone, B, Masiakos, P, Reva, V, Deangelis, N, Kike, K, Balogh, Z, Fugazzola, P, Tomasoni, M, Latifi, R, Naidoo, N, Weber, D, Handolin, L, Inaba, K, Hecker, A, Kuo-Ching, Y, Ordonez, C, Rizoli, S, Gomes, C, De Moya, M, Wani, I, Mefire, A, Boffard, K, Napolitano, L, Catena, F, Coccolini F., Roberts D., Ansaloni L., Ivatury R., Gamberini E., Kluger Y., Moore E. E., Coimbra R., Kirkpatrick A. W., Pereira B. M., Montori G., Ceresoli M., Abu-Zidan F. M., Sartelli M., Velmahos G., Fraga G. P., Leppaniemi A., Tolonen M., Galante J., Razek T., Maier R., Bala M., Sakakushev B., Khokha V., Malbrain M., Agnoletti V., Peitzman A., Demetrashvili Z., Sugrue M., Di Saverio S., Martzi I., Soreide K., Biffl W., Ferrada P., Parry N., Montravers P., Melotti R. M., Salvetti F., Valetti T. M., Scalea T., Chiara O., Cimbanassi S., Kashuk J. L., Larrea M., Hernandez J. A. M., Lin H. -F., Chirica M., Arvieux C., Bing C., Horer T., De Simone B., Masiakos P., Reva V., DeAngelis N., Kike K., Balogh Z. J., Fugazzola P., Tomasoni M., Latifi R., Naidoo N., Weber D., Handolin L., Inaba K., Hecker A., Kuo-Ching Y., Ordonez C. A., Rizoli S., Gomes C. A., De Moya M., Wani I., Mefire A. C., Boffard K., Napolitano L., Catena F., Coccolini, F, Roberts, D, Ansaloni, L, Ivatury, R, Gamberini, E, Kluger, Y, Moore, E, Coimbra, R, Kirkpatrick, A, Pereira, B, Montori, G, Ceresoli, M, Abu-Zidan, F, Sartelli, M, Velmahos, G, Fraga, G, Leppaniemi, A, Tolonen, M, Galante, J, Razek, T, Maier, R, Bala, M, Sakakushev, B, Khokha, V, Malbrain, M, Agnoletti, V, Peitzman, A, Demetrashvili, Z, Sugrue, M, Di Saverio, S, Martzi, I, Soreide, K, Biffl, W, Ferrada, P, Parry, N, Montravers, P, Melotti, R, Salvetti, F, Valetti, T, Scalea, T, Chiara, O, Cimbanassi, S, Kashuk, J, Larrea, M, Hernandez, J, Lin, H, Chirica, M, Arvieux, C, Bing, C, Horer, T, De Simone, B, Masiakos, P, Reva, V, Deangelis, N, Kike, K, Balogh, Z, Fugazzola, P, Tomasoni, M, Latifi, R, Naidoo, N, Weber, D, Handolin, L, Inaba, K, Hecker, A, Kuo-Ching, Y, Ordonez, C, Rizoli, S, Gomes, C, De Moya, M, Wani, I, Mefire, A, Boffard, K, Napolitano, L, Catena, F, Coccolini F., Roberts D., Ansaloni L., Ivatury R., Gamberini E., Kluger Y., Moore E. E., Coimbra R., Kirkpatrick A. W., Pereira B. M., Montori G., Ceresoli M., Abu-Zidan F. M., Sartelli M., Velmahos G., Fraga G. P., Leppaniemi A., Tolonen M., Galante J., Razek T., Maier R., Bala M., Sakakushev B., Khokha V., Malbrain M., Agnoletti V., Peitzman A., Demetrashvili Z., Sugrue M., Di Saverio S., Martzi I., Soreide K., Biffl W., Ferrada P., Parry N., Montravers P., Melotti R. M., Salvetti F., Valetti T. M., Scalea T., Chiara O., Cimbanassi S., Kashuk J. L., Larrea M., Hernandez J. A. M., Lin H. -F., Chirica M., Arvieux C., Bing C., Horer T., De Simone B., Masiakos P., Reva V., DeAngelis N., Kike K., Balogh Z. J., Fugazzola P., Tomasoni M., Latifi R., Naidoo N., Weber D., Handolin L., Inaba K., Hecker A., Kuo-Ching Y., Ordonez C. A., Rizoli S., Gomes C. A., De Moya M., Wani I., Mefire A. C., Boffard K., Napolitano L., and Catena F.
Abstract: Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a "planned second-look" laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption. The open abdomen in trauma and non-trauma patients has been proposed to be effective in preventing or treating deranged physiology in patients with severe injuries or critical illness when no other perceived options exist. Its use, however, remains controversial as it is resource consuming and represents a non-anatomic situation with the potential for severe adverse effects. Its use, therefore, should only be considered in patients who would most benefit from it. Abdominal fascia-to-fascia closure should be done as soon as the patient can physiologically tolerate it. All precautions to minimize complications should be implemented.
Published: 2018

35. 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.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.
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. © Wolters Kluwer Health, Inc. All rights reserved.
Published: 2020

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

Author: Kobayashi, L. Coimbra, R. Goes, A.M.O. Reva, V. Santorelli, J. Moore, E.E. Galante, J.M. Abu-Zidan, F. Peitzman, A.B. Ordonez, C.A. 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.
Abstract: Abdominal vascular trauma accounts for a small percentage of military and a moderate percentage of civilian trauma, affecting all age ranges and impacting young adult men most frequently. Penetrating causes are more frequent than blunt in adults, while blunt mechanisms are more common among pediatric populations. High rates of associated injuries, bleeding, and hemorrhagic shock ensure that, despite advances in both diagnostic and therapeutic technologies, immediate open surgical repair remains the mainstay of treatment for traumatic abdominal vascular injuries. Because of their devastating nature, abdominal vascular injuries remain a significant source of morbidity and mortality among trauma patients. The American Association for the Surgery of Trauma in conjunction with the World Society of Emergency Surgery seek to summarize the literature to date and provide guidelines on the presentation, diagnosis, and treatment of abdominal vascular injuries. LEVEL OF EVIDENCE Review study, level IV. © Wolters Kluwer Health, Inc. All rights reserved.
Published: 2020

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

Author: Saverio, S. Di, Podda, M., Simone, B. De, Ceresoli, M., Augustin, G., Gori, A., Boermeester, M., Sartelli, M., Coccolini, F., Tarasconi, A., Angelis, N. De', Weber, D.G., Tolonen, M., Birindelli, A., Biffl, W., Moore, E.E., Kelly, M., Soreide, K., Kashuk, J., Broek, R.P. ten, Gomes, C.A., Sugrue, M., Davies, R.J., Damaskos, D., Leppäniemi, A., Kirkpatrick, A., Peitzman, A.B., Fraga, G.P., Maier, R.V., Coimbra, R., Chiarugi, M., Sganga, G., Pisanu, A., Angelis, G.L. De', Tan, E.C.T.H., Goor, H. van, Pata, F., Carlo, I. Di, 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., Saverio, S. Di, Podda, M., Simone, B. De, Ceresoli, M., Augustin, G., Gori, A., Boermeester, M., Sartelli, M., Coccolini, F., Tarasconi, A., Angelis, N. De', Weber, D.G., Tolonen, M., Birindelli, A., Biffl, W., Moore, E.E., Kelly, M., Soreide, K., Kashuk, J., Broek, R.P. ten, Gomes, C.A., Sugrue, M., Davies, R.J., Damaskos, D., Leppäniemi, A., Kirkpatrick, A., Peitzman, A.B., Fraga, G.P., Maier, R.V., Coimbra, R., Chiarugi, M., Sganga, G., Pisanu, A., Angelis, G.L. De', Tan, E.C.T.H., Goor, H. van, Pata, F., Carlo, I. Di, 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: Contains fulltext : 225845.pdf (publisher's version ) (Open Access), 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-hospital
Published: 2020

38. Open Abdomen in Obese Patients: Pay Attention! New Evidences from IROA, the International Register of Open Abdomen

Author: Ceresoli, M, Salvetti, F, Kluger, Y, Braga, M, Viganò, J, Fugazzola, P, Sartelli, M, Ansaloni, L, Catena, F, Coccolini, F, Negoi, I, Zese, M, Occhionorelli, S, Gubbiotti, F, Shlyapnikov, S, Galatioto, C, Chiarugi, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Che Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Cordeiro Fonseca, V, Hernández, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Pereira Fraga, G, M Pereira, B, Gachabayov, M, Perez Chagerben, G, Leon Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Nigro, A, Kirkpatrick, A, Parfenov, A, Montori, G, Dionigi, P, Sugrue, M, Dubuisson, V, Noutakdie Tochie, J, Ivatury, R, Marco Ceresoli, Francesco Salvetti, Yoram Kluger, Marco Braga, Jacopo Viganò, Paola Fugazzola, Massimo Sartelli, Luca Ansaloni, Fausto Catena, Federico Coccolini, Ionut Negoi, Monica Zese, Savino Occhionorelli, Francesca Gubbiotti, Sergei Shlyapnikov, Christian Galatioto, Massimo Chiarugi, Zaza Demetrashvili, Daniele Dondossola, Orestis Ioannidis, Giuseppe Novelli, Mirco Nacoti, Desmond Khor, Kenji Inaba, Demetrios Demetriades, Torsten Kaussen, Asri Che Jusoh, Wagih Ghannam, Boris Sakakushev, Ohad Guetta, Agron Dogjani, Stefano Costa, Sandeep Singh, Dimitrios Damaskos, Arda Isik, Kuo-Ching Yuan, Francesco Trotta, Stefano Rausei, Aleix Martinez-Perez, Giovanni Bellanova, Vinicius Cordeiro Fonseca, Fernando Hernández, Athanasios Marinis, Wellington Fernandes, Martha Quiodettis, Miklosh Bala, Andras Vereczkei, Rafael Curado, Gustavo Pereira Fraga, Bruno M Pereira, Mahir Gachabayov, Guillermo Perez Chagerben, Miguel Leon Arellano, Sefa Ozyazici, Gianluca Costa, Tugan Tezcaner, Matteo Porta, Yousheng Li, Faruk Karateke, Dimitrios Manatakis, Federico Mariani, Federic Lora, Ivan Sahderov, Boyko Atanasov, Sergio Zegarra, Luca Fattori, Alice Nigro, Andrew Kirkpatrick, Anton Parfenov, Giulia Montori, Paolo Dionigi, Michael Sugrue, Vincent Dubuisson, Joel Noutakdie Tochie, Rao Ivatury, Ceresoli, M, Salvetti, F, Kluger, Y, Braga, M, Viganò, J, Fugazzola, P, Sartelli, M, Ansaloni, L, Catena, F, Coccolini, F, Negoi, I, Zese, M, Occhionorelli, S, Gubbiotti, F, Shlyapnikov, S, Galatioto, C, Chiarugi, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Che Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Cordeiro Fonseca, V, Hernández, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Pereira Fraga, G, M Pereira, B, Gachabayov, M, Perez Chagerben, G, Leon Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Nigro, A, Kirkpatrick, A, Parfenov, A, Montori, G, Dionigi, P, Sugrue, M, Dubuisson, V, Noutakdie Tochie, J, Ivatury, R, Marco Ceresoli, Francesco Salvetti, Yoram Kluger, Marco Braga, Jacopo Viganò, Paola Fugazzola, Massimo Sartelli, Luca Ansaloni, Fausto Catena, Federico Coccolini, Ionut Negoi, Monica Zese, Savino Occhionorelli, Francesca Gubbiotti, Sergei Shlyapnikov, Christian Galatioto, Massimo Chiarugi, Zaza Demetrashvili, Daniele Dondossola, Orestis Ioannidis, Giuseppe Novelli, Mirco Nacoti, Desmond Khor, Kenji Inaba, Demetrios Demetriades, Torsten Kaussen, Asri Che Jusoh, Wagih Ghannam, Boris Sakakushev, Ohad Guetta, Agron Dogjani, Stefano Costa, Sandeep Singh, Dimitrios Damaskos, Arda Isik, Kuo-Ching Yuan, Francesco Trotta, Stefano Rausei, Aleix Martinez-Perez, Giovanni Bellanova, Vinicius Cordeiro Fonseca, Fernando Hernández, Athanasios Marinis, Wellington Fernandes, Martha Quiodettis, Miklosh Bala, Andras Vereczkei, Rafael Curado, Gustavo Pereira Fraga, Bruno M Pereira, Mahir Gachabayov, Guillermo Perez Chagerben, Miguel Leon Arellano, Sefa Ozyazici, Gianluca Costa, Tugan Tezcaner, Matteo Porta, Yousheng Li, Faruk Karateke, Dimitrios Manatakis, Federico Mariani, Federic Lora, Ivan Sahderov, Boyko Atanasov, Sergio Zegarra, Luca Fattori, Alice Nigro, Andrew Kirkpatrick, Anton Parfenov, Giulia Montori, Paolo Dionigi, Michael Sugrue, Vincent Dubuisson, Joel Noutakdie Tochie, and Rao Ivatury
Abstract: Background: Open abdomen is the cornerstone of damage control strategies in acute care and trauma surgery. The role of BMI has not been well investigated. The aim of the study was to assess the role of BMI in determining outcomes after open abdomen. Methods: This is an analysis of patients recorded into the International Register of Open Abdomen; patients were classified in two groups according to BMI using a cutoff of 30 kg/m2. The primary outcome was in-hospital mortality; secondary outcomes were primary fascia closure rate, length of treatment, complication rate, entero-atmospheric fistula rate and length of ICU stay. Results: A total of 591 patients were enrolled from 57 centers, and obese patients were 127 (21.5%). There was no difference in mortality between the two groups; complications developed during the open treatment were higher in obese patients (63.8% vs. 53.4%, p = 0.038) while post-closure complications rate was similar. Obese patients had a significantly longer duration of the open treatment (9.1 ± 11.5 days vs. 6.3 ± 7.5 days; p = 0,002) and lower primary fascia closure rate (75.5% vs. 89.5%; p < 0,001). No differences in fistula rate were found. There was a linear correlation between the duration of open abdomen and the BMI (Pearson’s linear correlation coefficient = 0,201; p < 0,001). Conclusions: Open abdomen in obese patients seems to be safe as in non-obese patients with similar mortality; however, in obese patients the length of open abdomen is significantly higher with higher complication rate, longer ICU length of stay and lower primary fascia closure rate. Trial registration number: ClinicalTrials.gov, Identifier: NCT02382770.
Published: 2020

39. 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. 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, Gabriele, 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., Sganga G. (ORCID:0000-0001-5079-0395), 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, Gabriele, 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., and Sganga G. (ORCID:0000-0001-5079-0395)
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

40. Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines

Author: Coccolini, F., Kobayashi, L., Kluger, Y., Moore, E. E., Ansaloni, L., Biffl, W., Leppaniemi, A., Augustin, G., Reva, V., Wani, I., Kirkpatrick, A., Abu-Zidan, F., Cicuttin, E., Fraga, G. P., Ordonez, C., Pikoulis, E., Sibilla, M. G., Maier, R., Matsumura, Y., Masiakos, P. T., Khokha, V., Mefire, A. C., Ivatury, R., Favi, F., Manchev, V., Sartelli, M., Machado, F., Matsumoto, J., Chiarugi, M., Arvieux, C., Catena, F., Coimbra, R., Ben-Ishay, O., Tolonen, M., Bertelli, R., Horer, T., Ferrada, P., Di Carlo, I., Pereira, B. M., Parini, D., Montori, G., De Simone, B., Chiara, O., Hecker, A., Deangelis, N., Gomes, C. A., Galante, J., Bala, M., Mylonas, K. S., Pikoulis, A., Perfetti, P., Chirica, M., Bado, J., Inaba, K., Parry, N., Romeo, O., Stommel, M., Rajashekar, M., Tan, E., Salvetti, F., and Sakakushev, B.
Subjects: Percutaneous, Biliary tree, Injury, Review, Abdominal Injuries, 0302 clinical medicine, Trauma Centers, Bile Ducts, Extrahepatic, Conservative, Ultrasonography, Pediatric, medicine.diagnostic_test, Bile duct, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Interventional radiology, Classification, Operative, 3. Good health, Ampulla, medicine.anatomical_structure, Emergency Medicine, 030211 gastroenterology & hepatology, Pancreatic injury, Pancreas, Pediatric trauma, Focused Assessment with Sonography for Trauma, Adult, medicine.medical_specialty, Duodenum, lcsh:Surgery, Peritonitis, Guidelines as Topic, Guidelines, Trauma, 03 medical and health sciences, Endoscopic retrograde cholangiopancreatography (ERCP), medicine, Non-operative, Humans, Endoscopy, Surgery, business.industry, General surgery, 030208 emergency & critical care medicine, lcsh:RD1-811, lcsh:RC86-88.9, medicine.disease, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], General Surgery, Triage, business, Tomography, X-Ray Computed
Abstract: Contains fulltext : 215782.pdf (Publisher’s version ) (Open Access) Duodeno-pancreatic and extrahepatic biliary tree injuries are rare in both adult and pediatric trauma patients, and due to their anatomical location, associated injuries are very common. Mortality is primarily related to associated injuries, but morbidity remains high even in isolated injuries. Optimal management of duodeno-bilio-pancreatic injuries is dictated primarily by hemodynamic stability, clinical presentation, and grade of injury. Endoscopic and percutaneous interventions have increased the ability to non-operatively manage these injuries. Late diagnosis and treatment are both associated to increased morbidity and mortality. Sequelae of late presentations of pancreatic injury and complications of severe pancreatic trauma are also increasingly addressed endoscopically and with interventional radiology procedures. However, for moderate and severe extrahepatic biliary and severe duodeno-pancreatic injuries, immediate operative intervention is preferred as associated injuries are frequent and commonly present with hemodynamic instability or peritonitis. The aim of this paper is to present the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) duodenal, pancreatic, and extrahepatic biliary tree trauma management guidelines.
Published: 2019

41. IROA: International Register of Open Abdomen, preliminary results

Author: Coccolini, F, Montori, G, Ceresoli, M, Catena, F, Ivatury, R, Sugrue, M, Sartelli, M, Fugazzola, P, Corbella, D, Salvetti, F, Negoi, I, Zese, M, Occhionorelli, S, Maccatrozzo, S, Shlyapnikov, S, Galatioto, C, Chiarugi, M, Demetrashvili, Z, Dondossola, D, Yovtchev, Y, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Ansaloni, L, Coccolini F., Montori G., Ceresoli M., Catena F., Ivatury R., Sugrue M., Sartelli M., Fugazzola P., Corbella D., Salvetti F., Negoi I., Zese M., Occhionorelli S., Maccatrozzo S., Shlyapnikov S., Galatioto C., Chiarugi M., Demetrashvili Z., Dondossola D., Yovtchev Y., Ioannidis O., Novelli G., Nacoti M., Khor D., Inaba K., Demetriades D., Kaussen T., Jusoh A. C., Ghannam W., Sakakushev B., Guetta O., Dogjani A., Costa S., Singh S., Damaskos D., Isik A., Yuan K. -C., Trotta F., Rausei S., Martinez-Perez A., Bellanova G., Fonseca V. C., Hernandez F., Marinis A., Fernandes W., Quiodettis M., Bala M., Vereczkei A., Curado R. L., Fraga G. P., Pereira B. M., Gachabayov M., Chagerben G. P., Arellano M. L., Ozyazici S., Costa G., Tezcaner T., Ansaloni L., Coccolini, F, Montori, G, Ceresoli, M, Catena, F, Ivatury, R, Sugrue, M, Sartelli, M, Fugazzola, P, Corbella, D, Salvetti, F, Negoi, I, Zese, M, Occhionorelli, S, Maccatrozzo, S, Shlyapnikov, S, Galatioto, C, Chiarugi, M, Demetrashvili, Z, Dondossola, D, Yovtchev, Y, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Ansaloni, L, Coccolini F., Montori G., Ceresoli M., Catena F., Ivatury R., Sugrue M., Sartelli M., Fugazzola P., Corbella D., Salvetti F., Negoi I., Zese M., Occhionorelli S., Maccatrozzo S., Shlyapnikov S., Galatioto C., Chiarugi M., Demetrashvili Z., Dondossola D., Yovtchev Y., Ioannidis O., Novelli G., Nacoti M., Khor D., Inaba K., Demetriades D., Kaussen T., Jusoh A. C., Ghannam W., Sakakushev B., Guetta O., Dogjani A., Costa S., Singh S., Damaskos D., Isik A., Yuan K. -C., Trotta F., Rausei S., Martinez-Perez A., Bellanova G., Fonseca V. C., Hernandez F., Marinis A., Fernandes W., Quiodettis M., Bala M., Vereczkei A., Curado R. L., Fraga G. P., Pereira B. M., Gachabayov M., Chagerben G. P., Arellano M. L., Ozyazici S., Costa G., Tezcaner T., and Ansaloni L.
Abstract: Background: No definitive data about open abdomen (OA) epidemiology and outcomes exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) promoted the International Register of Open Abdomen (IROA). Methods: A prospective observational cohort study including patients with an OA treatment. Data were recorded on a web platform (Clinical Registers®) through a dedicated website: www.clinicalregisters.org. Results: Four hundred two patients enrolled. Adult patients: 369 patients; Mean age: 57.39±18.37; 56% male; Mean BMI: 36±5.6. OA indication: Peritonitis (48.7%), Trauma (20.5%), Vascular Emergencies/Hemorrhage (9.4%), Ischemia (9.1%), Pancreatitis (4.2%),Post-operative abdominal-compartment-syndrome (3.9%), Others (4.2%). The most adopted Temporary-abdominal-closure systems were the commercial negative pressure ones (44.2%). During OA 38% of patients had complications; among them 10.5% had fistula. Definitive closure: 82.8%; Mortality during treatment: 17.2%. Mean duration of OA: 5.39(±4.83) days; Mean number of dressing changes: 0.88(±0.88). After-closure complications: (49.5%) and Mortality: (9%). No significant associations among TACT, indications, mortality, complications and fistula. A linear correlationexists between days of OA and complications (Pearson linear correlation = 0.326 p<0.0001) and with the fistula development (Pearson = 0.146 p= 0.016). Pediatric patients: 33 patients. Mean age: 5.91±(3.68) years; 60% male. Mortality: 3.4%; Complications: 44.8%; Fistula: 3.4%. Mean duration of OA: 3.22(±3.09) days. Conclusion: Temporary abdominal closure is reliable and safe. The different techniques account for different results according to the different indications. In peritonitis commercial negative pressure temporary closure seems to improve results. In trauma skin-closure and Bogotà-bag seem to improve results. Trial registration: ClinicalTrials.gov NCT02382770
Published: 2017

42. Pelvic trauma: WSES classification and guidelines

Author: Coccolini, F, Stahel, P, Montori, G, Biffl, W, Horer, T, Catena, F, Kluger, Y, Moore, E, Peitzman, A, Ivatury, R, Coimbra, R, Fraga, G, Pereira, B, Rizoli, S, Kirkpatrick, A, Leppaniemi, A, Manfredi, R, Magnone, S, Chiara, O, Solaini, L, Ceresoli, M, Allievi, N, Arvieux, C, Velmahos, G, Balogh, Z, Naidoo, N, Weber, D, Abu-Zidan, F, Sartelli, M, Ansaloni, L, Coccolini F., Stahel P. F., Montori G., Biffl W., Horer T. M., Catena F., Kluger Y., Moore E. E., Peitzman A. B., Ivatury R., Coimbra R., Fraga G. P., Pereira B., Rizoli S., Kirkpatrick A., Leppaniemi A., Manfredi R., Magnone S., Chiara O., Solaini L., Ceresoli M., Allievi N., Arvieux C., Velmahos G., Balogh Z., Naidoo N., Weber D., Abu-Zidan F., Sartelli M., Ansaloni L., Coccolini, F, Stahel, P, Montori, G, Biffl, W, Horer, T, Catena, F, Kluger, Y, Moore, E, Peitzman, A, Ivatury, R, Coimbra, R, Fraga, G, Pereira, B, Rizoli, S, Kirkpatrick, A, Leppaniemi, A, Manfredi, R, Magnone, S, Chiara, O, Solaini, L, Ceresoli, M, Allievi, N, Arvieux, C, Velmahos, G, Balogh, Z, Naidoo, N, Weber, D, Abu-Zidan, F, Sartelli, M, Ansaloni, L, Coccolini F., Stahel P. F., Montori G., Biffl W., Horer T. M., Catena F., Kluger Y., Moore E. E., Peitzman A. B., Ivatury R., Coimbra R., Fraga G. P., Pereira B., Rizoli S., Kirkpatrick A., Leppaniemi A., Manfredi R., Magnone S., Chiara O., Solaini L., Ceresoli M., Allievi N., Arvieux C., Velmahos G., Balogh Z., Naidoo N., Weber D., Abu-Zidan F., Sartelli M., and Ansaloni L.
Abstract: Complex pelvic injuries are among the most dangerous and deadly trauma related lesions. Different classification systems exist, some are based on the mechanism of injury, some on anatomic patterns and some are focusing on the resulting instability requiring operative fixation. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic impairment of pelvic ring function and the associated injuries. The management of pelvic trauma patients aims definitively to restore the homeostasis and the normal physiopathology associated to the mechanical stability of the pelvic ring. Thus the management of pelvic trauma must be multidisciplinary and should be ultimately based on the physiology of the patient and the anatomy of the injury. This paper presents the World Society of Emergency Surgery (WSES) classification of pelvic trauma and the management Guidelines.
Published: 2017

43. The role of open abdomen in non-trauma patient: WSES Consensus Paper

Author: Coccolini, F, Montori, G, Ceresoli, M, Catena, F, Moore, E, Ivatury, R, Biffl, W, Peitzman, A, Coimbra, R, Rizoli, S, Kluger, Y, Abu-Zidan, F, Sartelli, M, Moya, M, Velmahos, G, Fraga, G, Pereira, B, Leppaniemi, A, Boermeester, M, Kirkpatrick, A, Maier, R, Bala, M, Sakakushev, B, Khokha, V, Malbrain, M, Agnoletti, V, Martin-Loeches, I, Sugrue, M, Saverio, S, Griffiths, E, Soreide, K, Mazuski, J, May, A, Montravers, P, Melotti, R, Pisano, M, Salvetti, F, Marchesi, G, Valetti, T, Scalea, T, Chiara, O, Kashuk, J, Ansaloni, L, Coccolini F., Montori G., Ceresoli M., Catena F., Moore E. E., Ivatury R., Biffl W., Peitzman A., Coimbra R., Rizoli S., Kluger Y., Abu-Zidan F. M., Sartelli M., Moya M. D., Velmahos G., Fraga G. P., Pereira B. M., Leppaniemi A., Boermeester M. A., Kirkpatrick A. W., Maier R., Bala M., Sakakushev B., Khokha V., Malbrain M., Agnoletti V., Martin-Loeches I., Sugrue M., Saverio S. D., Griffiths E., Soreide K., Mazuski J. E., May A. K., Montravers P., Melotti R. M., Pisano M., Salvetti F., Marchesi G., Valetti T. M., Scalea T., Chiara O., Kashuk J. L., Ansaloni L., Coccolini, F, Montori, G, Ceresoli, M, Catena, F, Moore, E, Ivatury, R, Biffl, W, Peitzman, A, Coimbra, R, Rizoli, S, Kluger, Y, Abu-Zidan, F, Sartelli, M, Moya, M, Velmahos, G, Fraga, G, Pereira, B, Leppaniemi, A, Boermeester, M, Kirkpatrick, A, Maier, R, Bala, M, Sakakushev, B, Khokha, V, Malbrain, M, Agnoletti, V, Martin-Loeches, I, Sugrue, M, Saverio, S, Griffiths, E, Soreide, K, Mazuski, J, May, A, Montravers, P, Melotti, R, Pisano, M, Salvetti, F, Marchesi, G, Valetti, T, Scalea, T, Chiara, O, Kashuk, J, Ansaloni, L, Coccolini F., Montori G., Ceresoli M., Catena F., Moore E. E., Ivatury R., Biffl W., Peitzman A., Coimbra R., Rizoli S., Kluger Y., Abu-Zidan F. M., Sartelli M., Moya M. D., Velmahos G., Fraga G. P., Pereira B. M., Leppaniemi A., Boermeester M. A., Kirkpatrick A. W., Maier R., Bala M., Sakakushev B., Khokha V., Malbrain M., Agnoletti V., Martin-Loeches I., Sugrue M., Saverio S. D., Griffiths E., Soreide K., Mazuski J. E., May A. K., Montravers P., Melotti R. M., Pisano M., Salvetti F., Marchesi G., Valetti T. M., Scalea T., Chiara O., Kashuk J. L., and Ansaloni L.
Abstract: The open abdomen (OA) is defined as intentional decision to leave the fascial edges of the abdomen un-approximated after laparotomy (laparostomy). The abdominal contents are potentially exposed and therefore must be protected with a temporary coverage, which is referred to as temporal abdominal closure (TAC). OA use remains widely debated with many specific details deserving detailed assessment and clarification. To date, in patients with intra-abdominal emergencies, the OA has not been formally endorsed for routine utilization; although, utilization is seemingly increasing. Therefore, the World Society of Emergency Surgery (WSES), Abdominal Compartment Society (WSACS) and the Donegal Research Academy united a worldwide group of experts in an international consensus conference to review and thereafter propose the basis for evidence-directed utilization of OA management in non-trauma emergency surgery and critically ill patients. In addition to utilization recommendations, questions with insufficient evidence urgently requiring future study were identified.
Published: 2017

44. Splenic trauma: WSES classification and guidelines for adult and pediatric patients

Author: Coccolini, F, Montori, G, Catena, F, Kluger, Y, Biffl, W, Moore, E, Reva, V, Bing, C, Bala, M, Fugazzola, P, Bahouth, H, Marzi, I, Velmahos, G, Ivatury, R, Soreide, K, Horer, T, ten Broek, R, Pereira, B, Fraga, G, Inaba, K, Kashuk, J, Parry, N, Masiakos, P, Mylonas, K, Kirkpatrick, A, Abu-Zidan, F, Gomes, C, Benatti, S, Naidoo, N, Salvetti, F, Maccatrozzo, S, Agnoletti, V, Gamberini, E, Solaini, L, Costanzo, A, Celotti, A, Tomasoni, M, Khokha, V, Arvieux, C, Napolitano, L, Handolin, L, Pisano, M, Magnone, S, Spain, D, de Moya, M, Davis, K, De Angelis, N, Leppaniemi, A, Ferrada, P, Latifi, R, Navarro, D, Otomo, Y, Coimbra, R, Maier, R, Moore, F, Rizoli, S, Sakakushev, B, Galante, J, Chiara, O, Cimbanassi, S, Mefire, A, Weber, D, Ceresoli, M, Peitzman, A, Wehlie, L, Sartelli, M, Di Saverio, S, Ansaloni, L, Coccolini F., Montori G., Catena F., Kluger Y., Biffl W., Moore E. E., Reva V., Bing C., Bala M., Fugazzola P., Bahouth H., Marzi I., Velmahos G., Ivatury R., Soreide K., Horer T., ten Broek R., Pereira B. M., Fraga G. P., Inaba K., Kashuk J., Parry N., Masiakos P. T., Mylonas K. S., Kirkpatrick A., Abu-Zidan F., Gomes C. A., Benatti S. V., Naidoo N., Salvetti F., Maccatrozzo S., Agnoletti V., Gamberini E., Solaini L., Costanzo A., Celotti A., Tomasoni M., Khokha V., Arvieux C., Napolitano L., Handolin L., Pisano M., Magnone S., Spain D. A., de Moya M., Davis K. A., De Angelis N., Leppaniemi A., Ferrada P., Latifi R., Navarro D. C., Otomo Y., Coimbra R., Maier R. V., Moore F., Rizoli S., Sakakushev B., Galante J. M., Chiara O., Cimbanassi S., Mefire A. C., Weber D., Ceresoli M., Peitzman A. B., Wehlie L., Sartelli M., Di Saverio S., Ansaloni L., Coccolini, F, Montori, G, Catena, F, Kluger, Y, Biffl, W, Moore, E, Reva, V, Bing, C, Bala, M, Fugazzola, P, Bahouth, H, Marzi, I, Velmahos, G, Ivatury, R, Soreide, K, Horer, T, ten Broek, R, Pereira, B, Fraga, G, Inaba, K, Kashuk, J, Parry, N, Masiakos, P, Mylonas, K, Kirkpatrick, A, Abu-Zidan, F, Gomes, C, Benatti, S, Naidoo, N, Salvetti, F, Maccatrozzo, S, Agnoletti, V, Gamberini, E, Solaini, L, Costanzo, A, Celotti, A, Tomasoni, M, Khokha, V, Arvieux, C, Napolitano, L, Handolin, L, Pisano, M, Magnone, S, Spain, D, de Moya, M, Davis, K, De Angelis, N, Leppaniemi, A, Ferrada, P, Latifi, R, Navarro, D, Otomo, Y, Coimbra, R, Maier, R, Moore, F, Rizoli, S, Sakakushev, B, Galante, J, Chiara, O, Cimbanassi, S, Mefire, A, Weber, D, Ceresoli, M, Peitzman, A, Wehlie, L, Sartelli, M, Di Saverio, S, Ansaloni, L, Coccolini F., Montori G., Catena F., Kluger Y., Biffl W., Moore E. E., Reva V., Bing C., Bala M., Fugazzola P., Bahouth H., Marzi I., Velmahos G., Ivatury R., Soreide K., Horer T., ten Broek R., Pereira B. M., Fraga G. P., Inaba K., Kashuk J., Parry N., Masiakos P. T., Mylonas K. S., Kirkpatrick A., Abu-Zidan F., Gomes C. A., Benatti S. V., Naidoo N., Salvetti F., Maccatrozzo S., Agnoletti V., Gamberini E., Solaini L., Costanzo A., Celotti A., Tomasoni M., Khokha V., Arvieux C., Napolitano L., Handolin L., Pisano M., Magnone S., Spain D. A., de Moya M., Davis K. A., De Angelis N., Leppaniemi A., Ferrada P., Latifi R., Navarro D. C., Otomo Y., Coimbra R., Maier R. V., Moore F., Rizoli S., Sakakushev B., Galante J. M., Chiara O., Cimbanassi S., Mefire A. C., Weber D., Ceresoli M., Peitzman A. B., Wehlie L., Sartelli M., Di Saverio S., and Ansaloni L.
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

45. Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines

Author: Coccolini, F. Kobayashi, L. Kluger, Y. Moore, E.E. Ansaloni, L. Biffl, W. Leppaniemi, A. Augustin, G. Reva, V. Wani, I. Kirkpatrick, A. Abu-Zidan, F. Cicuttin, E. Fraga, G.P. Ordonez, C. Pikoulis, E. Sibilla, M.G. Maier, R. Matsumura, Y. Masiakos, P.T. Khokha, V. Mefire, A.C. Ivatury, R. Favi, F. Manchev, V. Sartelli, M. Machado, F. Matsumoto, J. Chiarugi, M. Arvieux, C. Catena, F. Coimbra, R. Ben-Ishay, O. Tolonen, M. Bertelli, R. Horer, T. Ferrada, P. Di Carlo, I. Pereira, B.M. Parini, D. Montori, G. De Simone, B. Chiara, O. Hecker, A. Deangelis, N. Gomes, C.A. Galante, J. Bala, M. Mylonas, K.S. Pikoulis, A. Perfetti, P. Chirica, M. Bado, J. Inaba, K. Parry, N. Romeo, O. Stommel, M. Rajashekar, M. Tan, E. Salvetti, F. Sakakushev, B.
Abstract: Duodeno-pancreatic and extrahepatic biliary tree injuries are rare in both adult and pediatric trauma patients, and due to their anatomical location, associated injuries are very common. Mortality is primarily related to associated injuries, but morbidity remains high even in isolated injuries. Optimal management of duodeno-bilio-pancreatic injuries is dictated primarily by hemodynamic stability, clinical presentation, and grade of injury. Endoscopic and percutaneous interventions have increased the ability to non-operatively manage these injuries. Late diagnosis and treatment are both associated to increased morbidity and mortality. Sequelae of late presentations of pancreatic injury and complications of severe pancreatic trauma are also increasingly addressed endoscopically and with interventional radiology procedures. However, for moderate and severe extrahepatic biliary and severe duodeno-pancreatic injuries, immediate operative intervention is preferred as associated injuries are frequent and commonly present with hemodynamic instability or peritonitis. The aim of this paper is to present the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) duodenal, pancreatic, and extrahepatic biliary tree trauma management guidelines. © 2019 The Author(s).
Published: 2019

46. Selective celiotomy for missile wounds of the abdomen based on laparoscopy

Author: Ivatury, R. R., Simon, R. J., and Stahl, W. M.
Published: 1994
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47. Open abdomen and entero-atmospheric fistulae: An interim analysis from the International Register of Open Abdomen (IROA)

Author: Coccolini, F, Ceresoli, M, Kluger, Y, Kirkpatrick, A, Montori, G, Salvetti, F, Fugazzola, P, Tomasoni, M, Sartelli, M, Ansaloni, L, Catena, F, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Galatioto, C, Chiarugi, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernández, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Gianotti, L, Fattori, L, Ivatury, R, Coccolini, Federico, Ceresoli, Marco, Kluger, Yoram, Kirkpatrick, Andrew, Montori, Giulia, Salvetti, Fracensco, Fugazzola, Paola, Tomasoni, Matteo, Sartelli, Massimo, Ansaloni, Luca, Catena, Fausto, Negoi, Ionut, Zese, Monica, Occhionorelli, Savino, Shlyapnikov, Sergei, Galatioto, Christian, Chiarugi, Massimo, Demetrashvili, Zaza, Dondossola, Daniele, Ioannidis, Orestis, Novelli, Giuseppe, Nacoti, Mirco, Khor, Desmond, Inaba, Kenji, Demetriades, Demetrios, Kaussen, Torsten, Jusoh, Asri Che, Ghannam, Wagih, Sakakushev, Boris, Guetta, Ohad, Dogjani, Agron, Costa, Stefano, Singh, Sandeep, Damaskos, Dimitrios, Isik, Arda, Yuan, Kuo-Ching, Trotta, Francesco, Rausei, Stefano, Martinez-Perez, Aleix, Bellanova, Giovanni, Fonseca, ViniciusCordeiro, Hernández, Fernando, Marinis, Athanasios, Fernandes, Wellington, Quiodettis, Martha, Bala, Miklosh, Vereczkei, Andras, Curado, Rafael, Fraga, Gustavo Pereira, Pereira, Bruno M, Gachabayov, Mahir, Chagerben, Guillermo Perez, Arellano, Miguel Leon, Ozyazici, Sefa, Costa, Gianluca, Tezcaner, Tugan, Porta, Matteo, Li, Yousheng, Karateke, Faruk, Manatakis, Dimitrios, Mariani, Federico, Lora, Federic, Sahderov, Ivan, Atanasov, Boyko, Zegarra, Sergio, Gianotti, Luca, Fattori, Luca, Ivatury, Rao, Coccolini, F, Ceresoli, M, Kluger, Y, Kirkpatrick, A, Montori, G, Salvetti, F, Fugazzola, P, Tomasoni, M, Sartelli, M, Ansaloni, L, Catena, F, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Galatioto, C, Chiarugi, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernández, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Gianotti, L, Fattori, L, Ivatury, R, Coccolini, Federico, Ceresoli, Marco, Kluger, Yoram, Kirkpatrick, Andrew, Montori, Giulia, Salvetti, Fracensco, Fugazzola, Paola, Tomasoni, Matteo, Sartelli, Massimo, Ansaloni, Luca, Catena, Fausto, Negoi, Ionut, Zese, Monica, Occhionorelli, Savino, Shlyapnikov, Sergei, Galatioto, Christian, Chiarugi, Massimo, Demetrashvili, Zaza, Dondossola, Daniele, Ioannidis, Orestis, Novelli, Giuseppe, Nacoti, Mirco, Khor, Desmond, Inaba, Kenji, Demetriades, Demetrios, Kaussen, Torsten, Jusoh, Asri Che, Ghannam, Wagih, Sakakushev, Boris, Guetta, Ohad, Dogjani, Agron, Costa, Stefano, Singh, Sandeep, Damaskos, Dimitrios, Isik, Arda, Yuan, Kuo-Ching, Trotta, Francesco, Rausei, Stefano, Martinez-Perez, Aleix, Bellanova, Giovanni, Fonseca, ViniciusCordeiro, Hernández, Fernando, Marinis, Athanasios, Fernandes, Wellington, Quiodettis, Martha, Bala, Miklosh, Vereczkei, Andras, Curado, Rafael, Fraga, Gustavo Pereira, Pereira, Bruno M, Gachabayov, Mahir, Chagerben, Guillermo Perez, Arellano, Miguel Leon, Ozyazici, Sefa, Costa, Gianluca, Tezcaner, Tugan, Porta, Matteo, Li, Yousheng, Karateke, Faruk, Manatakis, Dimitrios, Mariani, Federico, Lora, Federic, Sahderov, Ivan, Atanasov, Boyko, Zegarra, Sergio, Gianotti, Luca, Fattori, Luca, and Ivatury, Rao
Abstract: Introduction: No definitive data describing associations between cases of Open Abdomen (OA) and Entero-atmospheric fistulae (EAF) exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) thus analyzed the International Register of Open Abdomen (IROA) to assess this question. Material and methods: A prospective analysis of adult patients enrolled in the IROA. Results: Among 649 adult patients with OA 58 (8.9%) developed EAF. Indications for OA were peritonitis (51.2%) and traumatic-injury (16.8%). The most frequently utilized temporary abdominal closure techniques were Commercial-NPWT (46.8%) and Bogotà-bag (21.9%). Mean OA days were 7.9 ± 18.22. Overall mortality rate was 29.7%, with EAF having no impact on mortality. Multivariate analysis associated cancer (p = 0.018), days of OA (p = 0.003) and time to provision-of-nutrition (p = 0.016) with EAF occurrence. Conclusion: Entero-atmospheric fistulas are influenced by the duration of open abdomen treatment and by the nutritional status of the patient. Peritonitis, intestinal anastomosis, negative pressure and oral or enteral nutrition were not risk factors for EAF during OA treatment
Published: 2019

48. 90th Annual Convention Poster Presentations and Abstracts

Author: Ellis, C. N., Coyle, D. J., Boggs, H. W., Slagle, G. W., Cole, P. A., Kuramoto, S., Ihara, O., Oohara, T., Nichols, J., Opelka, F., Gathright, J. B., Green, J. B., Poulard, J. B., Ott, A., Bank, S., Margolis, I. B., Meagher, A., Stuart, M., Heine, J. A., Rothenberger, D. A., Nemer, F. D., Christenson, C. E., Saad, R. C., Church, J. M., Fazio, V. W., Lavery, I. C., Oakley, J. R., Milsom, J. W., Schroeder, T. K., Påhlman, L., Frykholm, G., Glimelius, B., Kashtan, H., Papa, M., Wilson, B., Stern, H., Zelnick, R., Haas, P., Ajlouni, M., Fox, T., Szilagy, E., Cummings, B. J., Fleshman, J. W., Dreznick, Z., Fry, R. D., Kodner, I. J., Perry, R. E., Pemberton, J. H., Litchy, W. L., Ferrara, A., Levin, K. E., Hanson, R. B., Cali, R. L., Blatchford, G. J., Thorson, A. G., Christenson, M. A., Pitsch, R. M., Jensen, L. L., Lowry, A. C., Keighley, M. R. B., Oya, M., Oritz, J., Pinho, M., Asperer, J., Chattaphaday, G., Baeten, C., Konsten, J., Spaans, F., Soeters, P., Habets, A., Schouten, W. R., Ruseler van Embden, J. G. H., Auwerda, J. J. A., Sagar, P. M., Goodwin, P., Holdsworth, P. J., Johnston, D., Bundy, C. A., Jacobs, D. M., Bubrick, M. P., Kashiwagi, H., Konishi, F., Kanazawa, K., Woodland, D. O., Saclarides, T. J., Bapna, M. S., Kubota, Y., Sunouchi, K., Ono, M., Muto, T., Masaki, T., Suzuki, K., Adachi, M., Wong, W. D., Goldberg, S. M., Wexner, S. D., Daniel, N., Jagelman, D. G., Christiansen, J., Rasmussen, O., Zhu, B. -W., Williams, J. G., Schottler, J. L., Heyman, S., Marchetti, F., Timmcke, A. E., Hicks, T. C., Ray, J. E., Bernstein, M. A., Madoff, R. D., Caushaj, P. F., Zarbo, R. J., Ma, C. K., Shida, H., Yamamoto, T., Machida, T., Imanari, T., Wang, J. Y., You, Y. T., Tang, R. P., Chen, J. S., Chang-Chien, C. R., Sugihara, K., Hojo, K., Moriya, Y., Hasegawa, H., Krueger, B., Warren, W., Faber, L. P., Abel, M. E., Chiu, Y. S. Y., Russell, T. R., Volpe, P. A., Frazee, R. C., Roberts, J., Symmonds, S., Snyder, S., Hendricks, J., Smith, R., Merchant, N., Hashmi, H., Scalea, T., Whelan, R., Longo, W. E., Gusberg, B. J., Ballantyne, G. H., Davidson, T., Allen-Mersh, T. G., Gazzard, B., Miles, A. J. G., Wastell, C., Viponde, M., Stotter, A., Miller, R. F., Fieldman, N., Slack, W. W., Tjandra, J., Savoca, P. E., Flannery, J. T., Modlin, I. M., Tsukada, K., Tazawa, K., Lavery, E. C., Voeller, G. R., Bunch, G., Britt, L. G., Neto, J. A. Reis, Quilici, F. A., Cordeiro, F., Reis, Jr, J. A., Wojcik, J. B., Banerjee, S. R., Walters, D. L., Cherry, D. A., Bleday, R., Pena, J. P., Buls, J. G., Pascual, R., Tripodi, G., Padmanabhan, A., Schouter, W. R., Blankensteijn, J. D., Moenning, S., Huber, P., Simonton, C., Odom, C., Kaplan, E., Nightengale, S., Shah, P. C., Hashami, H. F., Kottmeier, P., Velcek, F., Klotz, D., Whelan, R. L., Sher, M. E., Bauer, J. J., Gelernt, I., Launer, D. P., Gerber, A., Nogueras, J. J., Finne, C. O., Sohn, N., Weinstein, M. A., Lugo, R. N., Eisenberg, M. M., Tsao, J., Galandiuk, S., Tuckson, W. B., Strong, S., Oakey, J. R., Ambroze, W. L., Dozois, R. R., Carpenter, H. A., Kartheuser, A. H., LaRusso, N. F., Wiesner, R. H., Ilstrup, D. M., Schleck, C. D., Ambroze, W., Beart, R., Dozois, R., Wolff, B., Pemberton, J., Kelly, K., Devine, R., Nivatvongs, S., Metzger, P., Phillips, S. F., Zinmeister, A. R., Pezim, M. E., Vignati, P., Cohen, J., Stahl, T. J., Roberts, P. L., Schoetz, Jr., D. J., Murray, J. J., Coller, J. A., Veidenheimer, M. C., Yamazaki, Y., Ribeiro, M. B., Sachar, D., Heimann, T. M., Aufses, A. H., Greenstein, A. J., Stryker, S. J., Green, D., McLeod, R. S., Cohen, Z., Cullen, J., Greenberg, G. R., Ho, C. S., Reznick, R., Wolff, B. G., Cangemi, J., Carryer, P., Jeejeebhoy, K. N., MacCarty, R., Weilland, L., Senagore, A. J., MacKeigan, J. M., Guillem, J., Ondrula, D. P., Prasad, M. L., Nelson, R. L., Abcarian, H., Coughlin, R. J., Corman, M. L., Prager, E. D., Borison, D. I., Bloom, A. D., Pritchard, T. J., McGannon, E., Sivak, M. V., van Stolk, R., Hull-Boiner, S., Milson, J. W., Sullivan, M., Rosato, G. O., Jorge, J. M., Durdey, P., Kennedy, M. J., Oster, M., Murray, J., Cirocco, W. C., Rusin, L. C., Brown, A. C., Reilly, J. C., Cataldo, P., Luchtefeld, M. A., Mazier, W. P., Wolkomir, A. F., Ruiz-Moreno, F., Alvarado-Cerna, R., Rodriguez, U., Amaro, J., Kerner, B. A., Oliver, G. C., Eisenstat, T. E., Rubin, R. J., Salvati, E. P., Dominguez, J. M., Coon, J. S., Weinstein, R. S., Kameyama, M., Fukuda, I., Imaoka, S., Iwanga, T., Kyzer, S., Mitmaker, B., Gordon, P. H., Wang, E., Grace, R. H., Gibbons, P., Scott, K. M. W., Berger, A., Mischinger, H. J., Arian-Schad, K., Davis, M., Miller, D., Fielding, L. P., Begin, L. R., Bell, A. M., Shafik, A., Abdel-Moneim, K., Khalid, A., Devine, R. M., Beart, Jr., R. W., Melton, L. J., Ngoi, S. S., Chia, J., Goh, P., Sim, E., Godwin, P., Quirke, P., Barrett, R. C., Koltun, W. A., Smith, R. J., Loehner, D., Roberts, P., Veidenheimer, M., Schoetz, D., Chattopadhyay, G., Kumar, D., Hosie, K., Kmiot, W., Mostaf, A., Tulley, N., Harding, I., Falcone, R. E., Wanamaker, S., Santanello, S. A., Carey, L. C., Rivera, D. E., Durdley, P., Gross, P. T., Sarles, J. C., Arnaud, A., Sielezneff, I., Orsoni, P., Joly, A., Limberg, B., Stolfi, V. M., Lavery, I., Oakley, J., Church, J., Fazio, V., Asbun, H. J., Castellanos, H., Asbun, J., Franko, E. R., Ivatury, R. R., Schwalb, D., Saad, R., Schroeder, T., Reis, Jr., J. A., Dziki, A. J., Duncan, M. D., Harmon, J. W., Saini, N., Malthaner, R. A., Fernicola, M. T., Hakki, F. Z., Trad, K. S., Ugarte, R. M., Ryan, P., Chang, H. R., Chavoshan, B., Barsoum, G., Bonardi, R., Scaramelo, A., Possebon, A., Peres, C., Röhrig, C., Kappas, A. M., Ortiz, J., Fan, H. A., Milsom, J., Lechner, P., Lind, P., Cesnik, H., Venkatesh, K. S., Larson, D. M., Morrison, D. N., Ramanujam, P. J., Rubbini, M., Mascoli, F., Mari, C., Bresadola, V., and Donini, I.
Published: 1991
Full Text: View/download PDF

49. Erratum: Antimicrobials: A global alliance for optimizing their rational use in intra-abdominal infections (AGORA). [World J Emerg Surg. 11, (2016) (33)] DOI: 10.1186/s13017-016-0089-y

Author: Sartelli, M., Weber, D. G., Ruppé, E., Bassetti, M., Wright, B. J., Ansaloni, L., Catena, F., Coccolini, F., Abu-Zidan, F. M., Coimbra, R., Moore, E. E., Moore, F. A., Maier, R. V., De Waele, J. J., Kirkpatrick, A. W., Griffiths, E. A., Eckmann, C., Brink, A. J., Mazuski, J. E., May, A. K., Sawyer, R. G., Mertz, D., Montravers, P., Kumar, A., Roberts, J. A., Vincent, J. L., Watkins, R. R., Lowman, W., Spellberg, B., Abbott, I. J., Adesunkanmi, A. K., Al-Dahir, S., Al-Hasan, M. N., Agresta, F., Althani, A. A., Ansari, S., Ansumana, R., Augustin, G., Bala, M., Balogh, Z. J., Baraket, O., Bhangu, A., Beltrán, M. A., Bernhard, M., Biffl, W. L., Boermeester, M. A., Brecher, S. M., Cherry-Bukowiec, J. R., Buyne, O. R., Cainzos, M. A., Cairns, K. A., Camacho-Ortiz, A., Chandy, S. J., Che Jusoh, A., Chichom-Mefire, A., Colijn, C., Corcione, F., Cui, Y., Curcio, D., Delibegovic, S., Demetrashvili, Z., De Simone, B., Dhingra, S., Diaz, J. J., Di Carlo, I., Dillip, A., Di Saverio, S., Doyle, M. P., Dorj, G., Dogjani, A., Dupont, H., Eachempati, S. R., Enani, M. A., Egiev, V. N., Elmangory, M. M., Ferrada, P., Fitchett, J. R., Fraga, G. P., Guessennd, N., Giamarellou, H., Ghnnam, W., Gkiokas, G., Goldberg, S. R., Gomes, C. A., Gomi, H., Guzmán-Blanco, M., Haque, M., Hansen, S., Hecker, A., Heizmann, W. R., Herzog, T., Hodonou, A. M., Hong, S. K., Kafka-Ritsch, R., Kaplan, L. J., Kapoor, G., Karamarkovic, A., Kees, M. G., Kenig, J., Kiguba, R., Kim, P. K., Kluger, Y., Khokha, V., Koike, K., Kok, K. Y., Kong, V., Knox, M. C., Inaba, K., Isik, A., Iskandar, K., Ivatury, R. R., Labbate, M., Labricciosa, F. M., Laterre, P. F., Latifi, R., Lee, J. G., Lee, Y. R., Leone, M., Leppaniemi, A., Li, Y., Liang, S. Y., Loho, T., Maegele, M., Malama, S., Marei, H. E., Martin-Loeches, I., Marwah, S., Massele, A., Mcfarlane, M., Melo, R. B., Negoi, I., Nicolau, D. P., Nord, C. E., Ofori-Asenso, R., Omari, A. H., Ordonez, C. A., Ouadii, M., Pereira Júnior, G. A., Piazza, D., Pupelis, G., Rawson, T. M., Rems, M., Rizoli, S., Rocha, C., Sakakushev, B., Sanchez-Garcia, M., Sato, N., Segovia Lohse, H. A., Sganga, G., Siribumrungwong, B., Shelat, V. G., Soreide, K., Soto, R., Talving, P., Tilsed, J. V., Timsit, J. F., Trueba, G., Trung, N. T., Ulrych, J., van Goor, H., Vereczkei, A., Vohra, R. S., Wani, I., Uhl, W., Xiao, Y., Yuan, K. C., Zachariah, S. K., Zahar, J. R., Zakrison, T. L., Corcione, A., Melotti, R. M., Viscoli, C., Viale, P., Sartelli, M., Weber, D. G., Ruppé, E., Bassetti, M., Wright, B. J., Ansaloni, L., Catena, F., Coccolini, F., Abu-Zidan, F. M., Coimbra, R., Moore, E. E., Moore, F. A., Maier, R. V., De Waele, J. J., Kirkpatrick, A. W., Griffiths, E. A., Eckmann, C., Brink, A. J., Mazuski, J. E., May, A. K., Sawyer, R. G., Mertz, D., Montravers, P., Kumar, A., Roberts, J. A., Vincent, J. L., Watkins, R. R., Lowman, W., Spellberg, B., Abbott, I. J., Adesunkanmi, A. K., Al-Dahir, S., Al-Hasan, M. N., Agresta, F., Althani, A. A., Ansari, S., Ansumana, R., Augustin, G., Bala, M., Balogh, Z. J., Baraket, O., Bhangu, A., Beltrán, M. A., Bernhard, M., Biffl, W. L., Boermeester, M. A., Brecher, S. M., Cherry-Bukowiec, J. R., Buyne, O. R., Cainzos, M. A., Cairns, K. A., Camacho-Ortiz, A., Chandy, S. J., Che Jusoh, A., Chichom-Mefire, A., Colijn, C., Corcione, F., Cui, Y., Curcio, D., Delibegovic, S., Demetrashvili, Z., De Simone, B., Dhingra, S., Diaz, J. J., Di Carlo, I., Dillip, A., Di Saverio, S., Doyle, M. P., Dorj, G., Dogjani, A., Dupont, H., Eachempati, S. R., Enani, M. A., Egiev, V. N., Elmangory, M. M., Ferrada, P., Fitchett, J. R., Fraga, G. P., Guessennd, N., Giamarellou, H., Ghnnam, W., Gkiokas, G., Goldberg, S. R., Gomes, C. A., Gomi, H., Guzmán-Blanco, M., Haque, M., Hansen, S., Hecker, A., Heizmann, W. R., Herzog, T., Hodonou, A. M., Hong, S. K., Kafka-Ritsch, R., Kaplan, L. J., Kapoor, G., Karamarkovic, A., Kees, M. G., Kenig, J., Kiguba, R., Kim, P. K., Kluger, Y., Khokha, V., Koike, K., Kok, K. Y., Kong, V., Knox, M. C., Inaba, K., Isik, A., Iskandar, K., Ivatury, R. R., Labbate, M., Labricciosa, F. M., Laterre, P. F., Latifi, R., Lee, J. G., Lee, Y. R., Leone, M., Leppaniemi, A., Li, Y., Liang, S. Y., Loho, T., Maegele, M., Malama, S., Marei, H. E., Martin-Loeches, I., Marwah, S., Massele, A., Mcfarlane, M., Melo, R. B., Negoi, I., Nicolau, D. P., Nord, C. E., Ofori-Asenso, R., Omari, A. H., Ordonez, C. A., Ouadii, M., Pereira Júnior, G. A., Piazza, D., Pupelis, G., Rawson, T. M., Rems, M., Rizoli, S., Rocha, C., Sakakushev, B., Sanchez-Garcia, M., Sato, N., Segovia Lohse, H. A., Sganga, G., Siribumrungwong, B., Shelat, V. G., Soreide, K., Soto, R., Talving, P., Tilsed, J. V., Timsit, J. F., Trueba, G., Trung, N. T., Ulrych, J., van Goor, H., Vereczkei, A., Vohra, R. S., Wani, I., Uhl, W., Xiao, Y., Yuan, K. C., Zachariah, S. K., Zahar, J. R., Zakrison, T. L., Corcione, A., Melotti, R. M., Viscoli, C., and Viale, P.
Subjects: Settore MED/18 - CHIRURGIA GENERALE, Surgery, Emergency Medicine
Published: 2017

50. 2016 WSES guidelines on acute calculous cholecystitis

Author: Ansaloni, L, Pisano, M, Coccolini, F, Peitzmann, A, Fingerhut, A, Catena, F, Agresta, F, Allegri, A, Bailey, I, Balogh, Z, Bendinelli, C, Biffl, W, Bonavina, L, Borzellino, G, Brunetti, F, Burlew, C, Camapanelli, G, Campanile, F, Ceresoli, M, Chiara, O, Civil, I, Coimbra, R, De Moya, M, Di Saverio, S, Fraga, G, Gupta, S, Kashuk, J, Kelly, M, Koka, V, Jeekel, H, Latifi, R, Leppaniemi, A, Maier, R, Marzi, I, Moore, F, Piazzalunga, D, Sakakushev, B, Sartelli, M, Scalea, T, Stahel, P, Taviloglu, K, Tugnoli, G, Uraneus, S, Velmahos, G, Wani, I, Weber, D, Viale, P, Sugrue, M, Ivatury, R, Kluger, Y, Gurusamy, K, Moore, E, Ansaloni L., Pisano M., Coccolini F., Peitzmann A. B., Fingerhut A., Catena F., Agresta F., Allegri A., Bailey I., Balogh Z. J., Bendinelli C., Biffl W., Bonavina L., Borzellino G., Brunetti F., Burlew C. C., Camapanelli G., Campanile F. C., Ceresoli M., Chiara O., Civil I., Coimbra R., De Moya M., Di Saverio S., Fraga G. P., Gupta S., Kashuk J., Kelly M. D., Koka V., Jeekel H., Latifi R., Leppaniemi A., Maier R. V., Marzi I., Moore F., Piazzalunga D., Sakakushev B., Sartelli M., Scalea T., Stahel P. F., Taviloglu K., Tugnoli G., Uraneus S., Velmahos G. C., Wani I., Weber D. G., Viale P., Sugrue M., Ivatury R., Kluger Y., Gurusamy K. S., Moore E. E., Ansaloni, L, Pisano, M, Coccolini, F, Peitzmann, A, Fingerhut, A, Catena, F, Agresta, F, Allegri, A, Bailey, I, Balogh, Z, Bendinelli, C, Biffl, W, Bonavina, L, Borzellino, G, Brunetti, F, Burlew, C, Camapanelli, G, Campanile, F, Ceresoli, M, Chiara, O, Civil, I, Coimbra, R, De Moya, M, Di Saverio, S, Fraga, G, Gupta, S, Kashuk, J, Kelly, M, Koka, V, Jeekel, H, Latifi, R, Leppaniemi, A, Maier, R, Marzi, I, Moore, F, Piazzalunga, D, Sakakushev, B, Sartelli, M, Scalea, T, Stahel, P, Taviloglu, K, Tugnoli, G, Uraneus, S, Velmahos, G, Wani, I, Weber, D, Viale, P, Sugrue, M, Ivatury, R, Kluger, Y, Gurusamy, K, Moore, E, Ansaloni L., Pisano M., Coccolini F., Peitzmann A. B., Fingerhut A., Catena F., Agresta F., Allegri A., Bailey I., Balogh Z. J., Bendinelli C., Biffl W., Bonavina L., Borzellino G., Brunetti F., Burlew C. C., Camapanelli G., Campanile F. C., Ceresoli M., Chiara O., Civil I., Coimbra R., De Moya M., Di Saverio S., Fraga G. P., Gupta S., Kashuk J., Kelly M. D., Koka V., Jeekel H., Latifi R., Leppaniemi A., Maier R. V., Marzi I., Moore F., Piazzalunga D., Sakakushev B., Sartelli M., Scalea T., Stahel P. F., Taviloglu K., Tugnoli G., Uraneus S., Velmahos G. C., Wani I., Weber D. G., Viale P., Sugrue M., Ivatury R., Kluger Y., Gurusamy K. S., and Moore E. E.
Abstract: Acute calculus , is a very common disease with several area of uncertainty. The World Society of Emergency Surgery developed extensive guidelines in order to cover grey areas. The diagnostic criteria, the antimicrobial therapy, the evaluation of associated common bile duct stones, the identification of "high risk" patients, the surgical timing, the type of surgery, and the alternatives to surgery are discussed. Moreover the algorithm is proposed: as soon as diagnosis is made and after the evaluation of choledocholitiasis risk, laparoscopic cholecystectomy should be offered to all patients exception of those with high risk of morbidity or mortality. These Guidelines must be considered as an adjunctive tool for decision but they are not substitute of the clinical judgement for the individual patient.
Published: 2016

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