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2. Suture versus open mesh repair for small umbilical hernia: Results of a propensity-matched cohort study

Author

Antor, M., Beck, M., Barrat, C., Berney, C., Binot, D., Bousquet, J., Blazquez, D., Bonan, A., Cas, O., Champault-Fezais, A., Chastan, P., Chollet, J.-M., Cossa, J.-P., Dabrowski, A., Delaunay, T., Démaret, S., Drissi, F., Demian, H., Dubuisson, V., Dugue, T., Fromont, G., Gillion, J.-F., Jacquin, C., Jurczak, F., Khalil, H., Launay-Savary, M., Lepère, M., Lépront, D., Longeville, J.H., Le Toux, N., Loriau, J., Magne, E., Ngo, P., Oberlin, O., Passot, G., Pavis d’Escurac, X., Putinier, J.B., Renard, Y., Romain, B., Soler, M., Roos, S., Thillois, J.-M., Tiry, P., Vu, P., Verhaeghe, R., Warlaumont, M., Zaranis, C., Frey, Samuel, Beauvais, Adrien, Soler, Marc, Beck, Mathieu, Dugué, Timothée, Pavis d’Escurac, Xavier, Dabrowski, André, Jurczak, Florent, and Gillion, Jean-François

Published
2023
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6. Functional outcomes in symptomatic versus asymptomatic patients undergoing incisional hernia repair: Replacing one problem with another? A prospective cohort study in 1312 patients

Author

Abet, E., Ain, J.-F., Arnalsteen, L., Baraket, O., Beck, M., Bellouard, A., Benizri, E., Berney, C., Bilem, D., Binot, D., Blanc, B., Blazquez, D., Bonan, A., Boukortt, T., Brehant, O., Cas, O., Champault-Fezais, A., Chau, A., Chollet, J.-M., Constantin, M., Cossa, J.-P., Dabrowski, A., David, A., Demaret, S., Dubuisson, V., Dugue, T., El Nakadi, I., Faure, J.-P., Frileux, P., Fromont, G., Gadiri, N., Gillion, J.-F., Glehen, O., Hennequin, S., Isambert, M., Jurczak, F., Khalil, H., Lamblin, A., Largenton, C., Lavy, M., Lepère, M., Le Toux, N., Magne, E., Manfredelli, S., Mariette, C., Marion, Y., Mercoli, H.-A., Mesli Smain, N., Moszkowicz, D., Najim, M., Oberlin, O., Odet, E., Ortega Deballon, P., Pavis d’Escurac, X., Pichot Delahaye, V., Putinier, J.B., Regimbeau, J.M., Renard, Y., Romain, B., Rouquie, D., Soler, M., Soufron, J., Roos, S., Thillois, J.-M., Tiry, P., Vauchaussade De Chaumont, A., Vinatier, E., Vu, P., Verhaeghe, R., Zaranis, C., Zeineb, M., de Smet, Gijs H.J., Sneiders, Dimitri, Yurtkap, Yagmur, Menon, Anand G., Jeekel, Johannes, Kleinrensink, Gert-Jan, Lange, Johan F., and Gillion, Jean-François

Published
2020
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7. The unrestricted global effort to complete the COOL trial

Author

Kirkpatrick, A, Coccolini, F, Tolonen, M, Minor, S, Catena, F, Gois, E, Doig, C, Hill, M, Ansaloni, L, Chiarugi, M, Tartaglia, D, Ioannidis, O, Sugrue, M, Colak, E, Hameed, S, Lampela, H, Agnoletti, V, Mckee, J, Garraway, N, Sartelli, M, Ball, C, Parry, N, Voght, K, Julien, L, Kroeker, J, Roberts, D, Faris, P, Tiruta, C, Moore, E, Ammons, L, Anestiadou, E, Bendinelli, C, Bouliaris, K, Carroll, R, Ceresoli, M, Favi, F, Gurrado, A, Rezende-Neto, J, Isik, A, Cremonini, C, Strambi, S, Koukoulis, G, Testini, M, Trpcic, S, Pasculli, A, Picariello, E, Abu-Zidan, F, Adeyeye, A, Augustin, G, Alconchel, F, Altinel, Y, Hernandez Amin, L, Aranda-Narvaez, J, Baraket, O, Biffl, W, Baiocchi, G, Bonavina, L, Brisinda, G, Cardinali, L, Celotti, A, Chaouch, M, Chiarello, M, Costa, G, De'Angelis, N, De Manzini, N, Delibegovic, S, Di Saverio, S, De Simone, B, Dubuisson, V, Fransvea, P, Garulli, G, Giordano, A, Gomes, C, Hayati, F, Huang, J, Ibrahim, A, Huei, T, Jailani, R, Khan, M, Luna, A, Malbrain, M, Marwah, S, Mcbeth, P, Mihailescu, A, Morello, A, Mulita, F, Murzi, V, Mohammad, A, Parmar, S, Pak, A, Wong, M, Pantalone, D, Podda, M, Puccioni, C, Rasa, K, Ren, J, Roscio, F, Gonzalez-Sanchez, A, Sganga, G, Scheiterle, M, Slavchev, M, Smirnov, D, Tosi, L, Trivedi, A, Vega, J, Waledziak, M, Xenaki, S, Winter, D, Wu, X, Zakaria, A, Zakaria, Z, Kirkpatrick A. W., Coccolini F., Tolonen M., Minor S., Catena F., Gois E., Doig C. J., Hill M. D., Ansaloni L., Chiarugi M., Tartaglia D., Ioannidis O., Sugrue M., Colak E., Hameed S. M., Lampela H., Agnoletti V., McKee J. L., Garraway N., Sartelli M., Ball C. G., Parry N. G., Voght K., Julien L., Kroeker J., Roberts D. J., Faris P., Tiruta C., Moore E. E., Ammons L. A., Anestiadou E., Bendinelli C., Bouliaris K., Carroll R., Ceresoli M., Favi F., Gurrado A., Rezende-Neto J., Isik A., Cremonini C., Strambi S., Koukoulis G., Testini M., Trpcic S., Pasculli A., Picariello E., Abu-Zidan F., Adeyeye A., Augustin G., Alconchel F., Altinel Y., Hernandez Amin L. A., Aranda-Narvaez J. M., Baraket O., Biffl W. L., Baiocchi G. L., Bonavina L., Brisinda G., Cardinali L., Celotti A., Chaouch M., Chiarello M., Costa G., de'Angelis N., De Manzini N., Delibegovic S., Di Saverio S., De Simone B., Dubuisson V., Fransvea P., Garulli G., Giordano A., Gomes C., Hayati F., Huang J., Ibrahim A. F., Huei T. J., Jailani R. F., Khan M., Luna A. P., Malbrain M. L. N. G., Marwah S., McBeth P., Mihailescu A., Morello A., Mulita F., Murzi V., Mohammad A. T., Parmar S., Pak A., Wong M. P. -K., Pantalone D., Podda M., Puccioni C., Rasa K., Ren J., Roscio F., Gonzalez-Sanchez A., Sganga G., Scheiterle M., Slavchev M., Smirnov D., Tosi L., Trivedi A., Vega J. A. G., Waledziak M., Xenaki S., Winter D., Wu X., Zakaria A. D., Zakaria Z., Kirkpatrick, A, Coccolini, F, Tolonen, M, Minor, S, Catena, F, Gois, E, Doig, C, Hill, M, Ansaloni, L, Chiarugi, M, Tartaglia, D, Ioannidis, O, Sugrue, M, Colak, E, Hameed, S, Lampela, H, Agnoletti, V, Mckee, J, Garraway, N, Sartelli, M, Ball, C, Parry, N, Voght, K, Julien, L, Kroeker, J, Roberts, D, Faris, P, Tiruta, C, Moore, E, Ammons, L, Anestiadou, E, Bendinelli, C, Bouliaris, K, Carroll, R, Ceresoli, M, Favi, F, Gurrado, A, Rezende-Neto, J, Isik, A, Cremonini, C, Strambi, S, Koukoulis, G, Testini, M, Trpcic, S, Pasculli, A, Picariello, E, Abu-Zidan, F, Adeyeye, A, Augustin, G, Alconchel, F, Altinel, Y, Hernandez Amin, L, Aranda-Narvaez, J, Baraket, O, Biffl, W, Baiocchi, G, Bonavina, L, Brisinda, G, Cardinali, L, Celotti, A, Chaouch, M, Chiarello, M, Costa, G, De'Angelis, N, De Manzini, N, Delibegovic, S, Di Saverio, S, De Simone, B, Dubuisson, V, Fransvea, P, Garulli, G, Giordano, A, Gomes, C, Hayati, F, Huang, J, Ibrahim, A, Huei, T, Jailani, R, Khan, M, Luna, A, Malbrain, M, Marwah, S, Mcbeth, P, Mihailescu, A, Morello, A, Mulita, F, Murzi, V, Mohammad, A, Parmar, S, Pak, A, Wong, M, Pantalone, D, Podda, M, Puccioni, C, Rasa, K, Ren, J, Roscio, F, Gonzalez-Sanchez, A, Sganga, G, Scheiterle, M, Slavchev, M, Smirnov, D, Tosi, L, Trivedi, A, Vega, J, Waledziak, M, Xenaki, S, Winter, D, Wu, X, Zakaria, A, Zakaria, Z, Kirkpatrick A. W., Coccolini F., Tolonen M., Minor S., Catena F., Gois E., Doig C. J., Hill M. D., Ansaloni L., Chiarugi M., Tartaglia D., Ioannidis O., Sugrue M., Colak E., Hameed S. M., Lampela H., Agnoletti V., McKee J. L., Garraway N., Sartelli M., Ball C. G., Parry N. G., Voght K., Julien L., Kroeker J., Roberts D. J., Faris P., Tiruta C., Moore E. E., Ammons L. A., Anestiadou E., Bendinelli C., Bouliaris K., Carroll R., Ceresoli M., Favi F., Gurrado A., Rezende-Neto J., Isik A., Cremonini C., Strambi S., Koukoulis G., Testini M., Trpcic S., Pasculli A., Picariello E., Abu-Zidan F., Adeyeye A., Augustin G., Alconchel F., Altinel Y., Hernandez Amin L. A., Aranda-Narvaez J. M., Baraket O., Biffl W. L., Baiocchi G. L., Bonavina L., Brisinda G., Cardinali L., Celotti A., Chaouch M., Chiarello M., Costa G., de'Angelis N., De Manzini N., Delibegovic S., Di Saverio S., De Simone B., Dubuisson V., Fransvea P., Garulli G., Giordano A., Gomes C., Hayati F., Huang J., Ibrahim A. F., Huei T. J., Jailani R. F., Khan M., Luna A. P., Malbrain M. L. N. G., Marwah S., McBeth P., Mihailescu A., Morello A., Mulita F., Murzi V., Mohammad A. T., Parmar S., Pak A., Wong M. P. -K., Pantalone D., Podda M., Puccioni C., Rasa K., Ren J., Roscio F., Gonzalez-Sanchez A., Sganga G., Scheiterle M., Slavchev M., Smirnov D., Tosi L., Trivedi A., Vega J. A. G., Waledziak M., Xenaki S., Winter D., Wu X., Zakaria A. D., and Zakaria Z.

Abstract

Background: Severe complicated intra-abdominal sepsis (SCIAS) has an increasing incidence with mortality rates over 80% in some settings. Mortality typically results from disruption of the gastrointestinal tract, progressive and self-perpetuating bio-mediator generation, systemic inflammation, and multiple organ failure. A further therapeutic option may be open abdomen (OA) management with negative peritoneal pressure therapy (NPPT) to remove inflammatory ascites and attenuate the systemic damage from SCIAS, although there are definite risks of leaving the abdomen open whenever it might possibly be closed. This potential therapeutic paradigm is the rationale being assessed in the Closed Or Open after Laparotomy (COOL trial) (https://clinicaltrials.gov/ct2/show/NCT03163095). Initially, the COOL trial received Industry sponsorship; however, this funding mandated the use of a specific trademarked and expensive NPPT device in half of the patients allocated to the intervention (open) arm. In August 2022, the 3 M/Acelity Corporation without consultation but within the terms of the contract canceled the financial support of the trial. Although creating financial difficulty, there is now no restriction on specific NPPT devices and removing a cost-prohibitive intervention creates an opportunity to expand the COOL trial to a truly global basis. This document describes the evolution of the COOL trial, with a focus on future opportunities for global growth of the study. Methods: The COOL trial is the largest prospective randomized controlled trial examining the random allocation of SCIAS patients intra-operatively to either formal closure of the fascia or the use of the OA with an application of an NPPT dressing. Patients are eligible if they have free uncontained intraperitoneal contamination and physiologic derangements exemplified by septic shock OR severely adverse predicted clinical outcomes. The primary outcome is intended to definitively inform global practice by co

Published
2023

9. Suture versus open mesh repair for small umbilical hernia: Results of a propensity-matched cohort study

Author

Frey, Samuel, primary, Beauvais, Adrien, additional, Soler, Marc, additional, Beck, Mathieu, additional, Dugué, Timothée, additional, Pavis d’Escurac, Xavier, additional, Dabrowski, André, additional, Jurczak, Florent, additional, Gillion, Jean-François, additional, Antor, M., additional, Beck, M., additional, Barrat, C., additional, Berney, C., additional, Binot, D., additional, Bousquet, J., additional, Blazquez, D., additional, Bonan, A., additional, Cas, O., additional, Champault-Fezais, A., additional, Chastan, P., additional, Chollet, J.-M., additional, Cossa, J.-P., additional, Dabrowski, A., additional, Delaunay, T., additional, Démaret, S., additional, Drissi, F., additional, Demian, H., additional, Dubuisson, V., additional, Dugue, T., additional, Fromont, G., additional, Gillion, J.-F., additional, Jacquin, C., additional, Jurczak, F., additional, Khalil, H., additional, Launay-Savary, M., additional, Lepère, M., additional, Lépront, D., additional, Longeville, J.H., additional, Le Toux, N., additional, Loriau, J., additional, Magne, E., additional, Ngo, P., additional, Oberlin, O., additional, Passot, G., additional, Pavis d’Escurac, X., additional, Putinier, J.B., additional, Renard, Y., additional, Romain, B., additional, Soler, M., additional, Roos, S., additional, Thillois, J.-M., additional, Tiry, P., additional, Vu, P., additional, Verhaeghe, R., additional, Warlaumont, M., additional, and Zaranis, C., additional

Published
2023
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20. Practice patterns in complex ventral hernia repair and place of biological grafts: A national survey among French digestive academic surgeons

Author

Mariette, C., Wind, P., Micelli Lupinacci, R., Tresallet, C., Adham, M., Arvieux, C., Benoist, S., Berdah, S., Berger, A., Briez, N., Brigand, C., Caiazzo, R., Carrere, N., Casa, C., Collet, D., Deguelte, S., Dousset, B., Dubuisson, V., Glehen, O., Gineste, J.-C., Hamy, A., Lacaine, F., Laurent, C., Lehur, P.-A., Mabrut, J.-Y., Mathieu, P., Mathonnet, M., Meunier, B., Michot, F., Ouaissi, M., Palot, J.-P., Parc, Y., Pattou, F., Paye, F., Pezet, D., Piessen, G., Pocard, M., Regenet, N., Regimbeau, J.-M., Sabbagh, C., Zerbib, P., and Toussaint, J.-M.

Published
2014
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21. Pratiques et place des prothèses biologiques dans la prise en charge des éventrations complexes de la paroi abdominale : résultats d’une enquête nationale chez les chirurgiens digestifs universitaires français

Author

Mariette, C., Wind, P., Micelli Lupinacci, R., Tresallet, C., Adham, M., Arvieux, C., Benoist, S., Berdah, S., Berger, A., Briez, N., Brigand, C., Caiazzo, R., Carrere, N., Casa, C., Collet, D., Deguelte, S., Dousset, B., Dubuisson, V., Glehen, O., Gineste, J.-C., Hamy, A., Lacaine, F., Laurent, C., Lehur, P.-A., Mabrut, J.-Y., Mathieu, P., Mathonnet, M., Meunier, B., Michot, F., Ouaissi, M., Palot, J.-P., Parc, Y., Pattou, F., Paye, F., Pezet, D., Piessen, G., Pocard, M., Regenet, N., Regimbeau, J.-M., Sabbagh, C., Zerbib, P., and Toussaint, J.-M.

Published
2014
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22. 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

23. 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

25. 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

26. 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

27. 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

31. Functional outcomes in symptomatic versus asymptomatic patients undergoing incisional hernia repair: Replacing one problem with another? A prospective cohort study in 1312 patients

Author

Smet, G.H.J. de, Sneiders, D. (Dimitri), Yurtkap, Y. (Yağmur), Menon, A.G. (Anand), Jeekel, J. (Hans), Kleinrensink, G.J. (Gert Jan), Lange, J.F. (Johan), Gillion, J.-F. (Jean-François), Abet, E. (E.), Ain, J.-F. (J. F.), Arnalsteen, L. (L.), Baraket, O. (O.), Beck, M. (M.), Bellouard, A. (A.), Benizri, E. (E.), Berney, C. (C.), Bilem, D. (D.), Binot, D. (D.), Blanc, B. (B.), Blazquez, D. (D.), Bonan, A. (A.), Boukortt, T. (T.), Brehant, O. (O.), Cas, O. (O.), Champault-Fezais, A. (A.), Chau, A. (A.), Chollet, J.-M. (J. M.), Constantin, M. (M.), Cossa, J.-P. (J. P.), Dabrowski, A. (A.), David, A. (A.), Demaret, S. (S.), Dubuisson, V. (V.), Dugue, T. (T.), El Nakadi, I., Faure, J.-P. (J. P.), Frileux, P. (P.), Fromont, G. (G.), Gadiri, N. (N.), Gillion, J.F. (Jean-Francois), Glehen, O. (O.), Hennequin, S. (S.), Isambert, M. (M.), Jurczak, F. (F.), Khalil, H. (H.), Lamblin, A. (A.), Largenton, C. (C.), Lavy, M. (M.), Lepère, M. (M.), Le Toux, N. (N.), Magne, E. (E.), Manfredelli, S. (S.), Mariette, C. (Christophe), Marion, Y. (Y.), Mercoli, H.-A. (H. A.), Mesli Smain, N. (N.), Moszkowicz, D. (D.), Najim, M. (M.), Oberlin, O. (O.), Odet, E. (E.), Ortega Deballon, P. (P.), Pavis d'Escurac, X. (X.), Pichot Delahaye, V. (V.), Putinier, J.B. (J. B.), Regimbeau, J.M. (J. M.), Renard, Y. (Y.), Romain, B. (B.), Rouquie, D. (D.), Soler, M. (M.), Soufron, J. (J.), Roos, S. (S.), Thillois, J.-M. (J. M.), Tiry, P. (P.), Vauchaussade De Chaumont, A. (A.), Vinatier, E. (E.), Vu, P. (P.), Verhaeghe, R. (R.), Zaranis, C. (C.), Zeineb, M. (M.), Smet, G.H.J. de, Sneiders, D. (Dimitri), Yurtkap, Y. (Yağmur), Menon, A.G. (Anand), Jeekel, J. (Hans), Kleinrensink, G.J. (Gert Jan), Lange, J.F. (Johan), Gillion, J.-F. (Jean-François), Abet, E. (E.), Ain, J.-F. (J. F.), Arnalsteen, L. (L.), Baraket, O. (O.), Beck, M. (M.), Bellouard, A. (A.), Benizri, E. (E.), Berney, C. (C.), Bilem, D. (D.), Binot, D. (D.), Blanc, B. (B.), Blazquez, D. (D.), Bonan, A. (A.), Boukortt, T. (T.), Brehant, O. (O.), Cas, O. (O.), Champault-Fezais, A. (A.), Chau, A. (A.), Chollet, J.-M. (J. M.), Constantin, M. (M.), Cossa, J.-P. (J. P.), Dabrowski, A. (A.), David, A. (A.), Demaret, S. (S.), Dubuisson, V. (V.), Dugue, T. (T.), El Nakadi, I., Faure, J.-P. (J. P.), Frileux, P. (P.), Fromont, G. (G.), Gadiri, N. (N.), Gillion, J.F. (Jean-Francois), Glehen, O. (O.), Hennequin, S. (S.), Isambert, M. (M.), Jurczak, F. (F.), Khalil, H. (H.), Lamblin, A. (A.), Largenton, C. (C.), Lavy, M. (M.), Lepère, M. (M.), Le Toux, N. (N.), Magne, E. (E.), Manfredelli, S. (S.), Mariette, C. (Christophe), Marion, Y. (Y.), Mercoli, H.-A. (H. A.), Mesli Smain, N. (N.), Moszkowicz, D. (D.), Najim, M. (M.), Oberlin, O. (O.), Odet, E. (E.), Ortega Deballon, P. (P.), Pavis d'Escurac, X. (X.), Pichot Delahaye, V. (V.), Putinier, J.B. (J. B.), Regimbeau, J.M. (J. M.), Renard, Y. (Y.), Romain, B. (B.), Rouquie, D. (D.), Soler, M. (M.), Soufron, J. (J.), Roos, S. (S.), Thillois, J.-M. (J. M.), Tiry, P. (P.), Vauchaussade De Chaumont, A. (A.), Vinatier, E. (E.), Vu, P. (P.), Verhaeghe, R. (R.), Zaranis, C. (C.), and Zeineb, M. (M.)

Abstract

Background: Incisional hernias can be associated with pain or discomfort. Surgical repair especially mesh reinforcement, may likewise induce pain. The primary objective was to assess the incidence of pain after hernia repair in patients with and without pre-operative pain or discomfort. The secondary objectives were to determine the preferred mesh type, mesh location and surgical technique in minimizing postoperative pain or discomfort. Materials and methods: A registry-based prospective cohort study was performed, including patients undergoing incisional hernia repair between September 2011 and May 2019. Patients with a minimum follow-up of 3–6 months were included. The incidence of hernia related pain and discomfort was recorded perioperatively. Results: A total of 1312 patients were included. Pre-operatively, 1091 (83%) patients reported pain or discomfort. After hernia repair, 961 (73%) patients did not report pain or discomfort (mean follow-up = 11.1 months). Of the pre-operative asymptomatic patients (n = 221), 44 (20%, moderate or severe pain: n = 14, 32%) reported pain or discomfort after mean follow-up of 10.5 months. Of those patients initially reporting pain or discomfort (n = 1091), 307 (28%, moderate or severe pain: n = 80, 26%) still reported pain or discomfort after a mean follow-up of 11.3 months postoperatively. Conclusion: In symptomatic incisional hernia patients, hernia related complaints may be resolved in the majority of cases undergoing surgical repair. In asymptomatic incisional hernia patients, pain or discomfort may be induced in a considerable number of patients due to surgical repair and one should be aware if this postoperative complication.

Published
2020
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32. 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

33. Functional outcomes in symptomatic versus asymptomatic patients undergoing incisional hernia repair: Replacing one problem with another? A prospective cohort study in 1312 patients

Author

de Smet, Gijs H.J., primary, Sneiders, Dimitri, additional, Yurtkap, Yagmur, additional, Menon, Anand G., additional, Jeekel, Johannes, additional, Kleinrensink, Gert-Jan, additional, Lange, Johan F., additional, Gillion, Jean-François, additional, Abet, E., additional, Ain, J.-F., additional, Arnalsteen, L., additional, Baraket, O., additional, Beck, M., additional, Bellouard, A., additional, Benizri, E., additional, Berney, C., additional, Bilem, D., additional, Binot, D., additional, Blanc, B., additional, Blazquez, D., additional, Bonan, A., additional, Boukortt, T., additional, Brehant, O., additional, Cas, O., additional, Champault-Fezais, A., additional, Chau, A., additional, Chollet, J.-M., additional, Constantin, M., additional, Cossa, J.-P., additional, Dabrowski, A., additional, David, A., additional, Demaret, S., additional, Dubuisson, V., additional, Dugue, T., additional, El Nakadi, I., additional, Faure, J.-P., additional, Frileux, P., additional, Fromont, G., additional, Gadiri, N., additional, Gillion, J.-F., additional, Glehen, O., additional, Hennequin, S., additional, Isambert, M., additional, Jurczak, F., additional, Khalil, H., additional, Lamblin, A., additional, Largenton, C., additional, Lavy, M., additional, Lepère, M., additional, Le Toux, N., additional, Magne, E., additional, Manfredelli, S., additional, Mariette, C., additional, Marion, Y., additional, Mercoli, H.-A., additional, Mesli Smain, N., additional, Moszkowicz, D., additional, Najim, M., additional, Oberlin, O., additional, Odet, E., additional, Ortega Deballon, P., additional, Pavis d’Escurac, X., additional, Pichot Delahaye, V., additional, Putinier, J.B., additional, Regimbeau, J.M., additional, Renard, Y., additional, Romain, B., additional, Rouquie, D., additional, Soler, M., additional, Soufron, J., additional, Roos, S., additional, Thillois, J.-M., additional, Tiry, P., additional, Vauchaussade De Chaumont, A., additional, Vinatier, E., additional, Vu, P., additional, Verhaeghe, R., additional, Zaranis, C., additional, and Zeineb, M., additional

Published
2020
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34. Ethical considerations in conducting surgical research in severe complicated intra-abdominal sepsis

Author

Doig, C. J., Page, S. A., Mckee, J. L., Moore, E. E., Abu-Zidan, F. M., Carroll, R., Marshall, J. C., Faris, P. D., Tolonen, M., Catena, F., Cocolini, F., Sartelli, M., Ansaloni, L., Minor, S. F., Peirera, B. M., Diaz, J. J., Kirkpatrick, A. W., Roberts, D. J., Leppaniemi, A., Jenne, C. N., Odobez, Chiara, Kubes, P., Manns, B., Kluger, Y., Fraga, G. P., Pereira, B. M., Sugrue, M., Holm, T., Ren, J., Ball, C. G., Coimbra, R., Balogh, Z. J., Dixon, E., Biffl, W., Maclean, A., Ball, I., Drover, J. W., Mcbeth, P. B., Posadas-Calleja, J. G., Parry, N. G., Di Saverio, S., Ordonez, C. A., Bendinelli, C., Macdonald, B., Dunham, M., Reso, A., Vogt, K. N., Blaser, A. R., Malbrain, M., Tartaglia, D., De Waele, J., Dubuisson, V., Lampela, H., Bodnar, Z., Isik, A., Picetti, E., Hameed, M., Garraway, N. R., Julien, L., Widder, S., Bradley, N. L., Engels, P. T., Leeper, W. R., Beckett, A., Supporting clinical sciences, and Intensive Care

Subjects
medicine.medical_specialty, Open-abdomen, lcsh:Surgery, Intra-peritoneal sepsis, multiple organ dysfunction, Review, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, Sepsis, Humans, Medicine, Prospective Studies, Digestive System Surgical Procedures, Medicine(all), Surgical research, Informed Consent, business.industry, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Correction, lcsh:RD1-811, lcsh:RC86-88.9, WAIVER, 3. Good health, Intra abdominal sepsis, Surgery, Research Design, Randomized Controlled Trial, Emergency Medicine, Consent, Multiple organ dysfunction, Randomized controlled trial, Waiver, consent, business
Abstract

Background Severe complicated intra-abdominal sepsis (SCIAS) has high mortality, thought due in part to progressive bio-mediator generation, systemic inflammation, and multiple organ failure. Treatment includes early antibiotics and operative source control. At surgery, open abdomen management with negative-peritoneal-pressure therapy (NPPT) has been hypothesized to mitigate MOF and death, although clinical equipoise for this operative approach exists. The Closed or Open after Laparotomy (COOL) study (https://clinicaltrials.gov/ct2/show/NCT03163095) will prospectively randomize eligible patients intra-operatively to formal abdominal closure or OA with NPTT. We review the ethical basis for conducting research in SCIAS. Main body Research in critically ill incapacitated patients is important to advance care. Conducting research among SCIAS is complicated due to the severity of illness including delirium, need for emergent interventions, diagnostic criteria confirmed only at laparotomy, and obtundation from anaesthesia. In other circumstances involving critically ill patients, clinical experts have worked closely with ethicists to apply principles that balance the rights of patients whilst simultaneously permitting inclusion in research. In Canada, the Tri-Council Policy Statement-2 (TCPS-2) describes six criteria that permit study enrollment and randomization in such situations: (a) serious threat to the prospective participant requires immediate intervention; (b) either no standard efficacious care exists or the research offers realistic possibility of direct benefit; (c) risks are not greater than that involved in standard care or are clearly justified by prospect for direct benefits; (d) prospective participant is unconscious or lacks capacity to understand the complexities of the research; (e) third-party authorization cannot be secured in sufficient time; and (f) no relevant prior directives are known to exist that preclude participation. TCPS-2 criteria are in principle not dissimilar to other (inter)national criteria. The COOL study will use waiver of consent to initiate enrollment and randomization, followed by surrogate or proxy consent, and finally delayed informed consent in subjects that survive and regain capacity. Conclusions A delayed consent mechanism is a practical and ethical solution to challenges in research in SCIAS. The ultimate goal of consent is to balance respect for patient participants and to permit participation in new trials with a reasonable opportunity for improved outcome and minimal risk of harm.

Published
2019

40. L’embolisation précoce dans le traitement non opératoire des traumatismes fermés de la rate. Étude rétrospective multicentrique

Author

Brugère, C., Arvieux, C., Dubuisson, V., Guillon, F., Sengel, C., Bricault, I., Régimbeau, Jean-Marc, Pilleul, F., Menegaux, F., Letoublon, C., Centre de Recherche et d'Application en Traitement de l'Image et du Signal (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-École Supérieure Chimie Physique Électronique de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
[SPI.ACOU]Engineering Sciences [physics]/Acoustics [physics.class-ph], [SPI.ELEC]Engineering Sciences [physics]/Electromagnetism, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV], [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, [SPI.OPTI]Engineering Sciences [physics]/Optics / Photonic, [PHYS.PHYS.PHYS-MED-PH]Physics [physics]/Physics [physics]/Medical Physics [physics.med-ph], [SDV.IB]Life Sciences [q-bio]/Bioengineering, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, [PHYS.MECA.ACOU]Physics [physics]/Mechanics [physics]/Acoustics [physics.class-ph]
Abstract

article; AIM OF THE STUDY: Splenic artery embolization has been used as an adjunct to the non-surgical management of blunt splenic injury. No consensus on its indications has emerged from the literature. This multicentric study aimed to evaluate the results of this technique in France. PATIENTS AND METHODS: Between March 2000 and April 2006, 22 patients older than 15 years of age (mean age 29, range: 15-59) with splenicv rupture due to blunt trauma underwent splenic artery embolization in six Level I Trauma Centers in France. Splenic rupture was classified Moore II in 3 cases, Moore III in 12 cases, and Moore IV in 7 cases. Angiography was performed within 4 hours of admission in half of the cases. The main indications for splenic artery embolization were: extravasation of contrast medium on CT scan (10 cases, 45%); early pseudo-aneurysm (6 cases, 23%); hypotension despite fluid resuscitation and/or progressive need for transfusion (5 cases, 22%). RESULTS: There was no mortality. Nine patients experienced complications (41%) including 6 (27%) who developed left pleural effusion. Two patients eventually underwent splenectomy (one for persistent hemorrhage, one for splenic necrosis). The overall splenic salvage rate was 91%. CONCLUSION: Splenic artery embolization is a valuable techniche that hels to lower the rate of splenectomy for traumatic splenic rupture with relatively low morbidity.

Published
2008

45. The unrestricted global effort to complete the COOL trial

Author

Andrew W. Kirkpatrick, Federico Coccolini, Matti Tolonen, Samuel Minor, Fausto Catena, Emanuel Gois, Christopher J. Doig, Michael D. Hill, Luca Ansaloni, Massimo Chiarugi, Dario Tartaglia, Orestis Ioannidis, Michael Sugrue, Elif Colak, S. Morad Hameed, Hanna Lampela, Vanni Agnoletti, Jessica L. McKee, Naisan Garraway, Massimo Sartelli, Chad G. Ball, Neil G. Parry, Kelly Voght, Lisa Julien, Jenna Kroeker, Derek J. Roberts, Peter Faris, Corina Tiruta, Ernest E. Moore, Lee Anne Ammons, Elissavet Anestiadou, Cino Bendinelli, Konstantinos Bouliaris, Rosemarry Carroll, Marco Ceresoli, Francesco Favi, Angela Gurrado, Joao Rezende-Neto, Arda Isik, Camilla Cremonini, Silivia Strambi, Georgios Koukoulis, Mario Testini, Sandy Trpcic, Alessandro Pasculli, Erika Picariello, Fikri Abu-Zidan, Ademola Adeyeye, Goran Augustin, Felipe Alconchel, Yuksel Altinel, Luz Adriana Hernandez Amin, José Manuel Aranda-Narváez, Oussama Baraket, Walter L. Biffl, Gian Luca Baiocchi, Luigi Bonavina, Giuseppe Brisinda, Luca Cardinali, Andrea Celotti, Mohamed Chaouch, Maria Chiarello, Gianluca Costa, Nicola de’Angelis, Nicolo De Manzini, Samir Delibegovic, Salomone Di Saverio, Belinda De Simone, Vincent Dubuisson, Pietro Fransvea, Gianluca Garulli, Alessio Giordano, Carlos Gomes, Firdaus Hayati, Jinjian Huang, Aini Fahriza Ibrahim, Tan Jih Huei, Ruhi Fadzlyana Jailani, Mansoor Khan, Alfonso Palmieri Luna, Manu L. N. G. Malbrain, Sanjay Marwah, Paul McBeth, Andrei Mihailescu, Alessia Morello, Francesk Mulita, Valentina Murzi, Ahmad Tarmizi Mohammad, Simran Parmar, Ajay Pak, Michael Pak-Kai Wong, Desire Pantalone, Mauro Podda, Caterina Puccioni, Kemal Rasa, Jianan Ren, Francesco Roscio, Antonio Gonzalez-Sanchez, Gabriele Sganga, Maximilian Scheiterle, Mihail Slavchev, Dmitry Smirnov, Lorenzo Tosi, Anand Trivedi, Jaime Andres Gonzalez Vega, Maciej Waledziak, Sofia Xenaki, Desmond Winter, Xiuwen Wu, Andee Dzulkarnean Zakaria, Zaidi Zakaria, Kirkpatrick, A, Coccolini, F, Tolonen, M, Minor, S, Catena, F, Gois, E, Doig, C, Hill, M, Ansaloni, L, Chiarugi, M, Tartaglia, D, Ioannidis, O, Sugrue, M, Colak, E, Hameed, S, Lampela, H, Agnoletti, V, Mckee, J, Garraway, N, Sartelli, M, Ball, C, Parry, N, Voght, K, Julien, L, Kroeker, J, Roberts, D, Faris, P, Tiruta, C, Moore, E, Ammons, L, Anestiadou, E, Bendinelli, C, Bouliaris, K, Carroll, R, Ceresoli, M, Favi, F, Gurrado, A, Rezende-Neto, J, Isik, A, Cremonini, C, Strambi, S, Koukoulis, G, Testini, M, Trpcic, S, Pasculli, A, Picariello, E, Abu-Zidan, F, Adeyeye, A, Augustin, G, Alconchel, F, Altinel, Y, Hernandez Amin, L, Aranda-Narvaez, J, Baraket, O, Biffl, W, Baiocchi, G, Bonavina, L, Brisinda, G, Cardinali, L, Celotti, A, Chaouch, M, Chiarello, M, Costa, G, De'Angelis, N, De Manzini, N, Delibegovic, S, Di Saverio, S, De Simone, B, Dubuisson, V, Fransvea, P, Garulli, G, Giordano, A, Gomes, C, Hayati, F, Huang, J, Ibrahim, A, Huei, T, Jailani, R, Khan, M, Luna, A, Malbrain, M, Marwah, S, Mcbeth, P, Mihailescu, A, Morello, A, Mulita, F, Murzi, V, Mohammad, A, Parmar, S, Pak, A, Wong, M, Pantalone, D, Podda, M, Puccioni, C, Rasa, K, Ren, J, Roscio, F, Gonzalez-Sanchez, A, Sganga, G, Scheiterle, M, Slavchev, M, Smirnov, D, Tosi, L, Trivedi, A, Vega, J, Waledziak, M, Xenaki, S, Winter, D, Wu, X, Zakaria, A, and Zakaria, Z

Subjects
Intraperitoneal sepsi, Laparotomy, Peritoniti, Randomized controlled trial, Septic shock, Emergency Medicine, Global health, Surgery, Open abdomen, Multiple organ dysfunction
Abstract

Background Severe complicated intra-abdominal sepsis (SCIAS) has an increasing incidence with mortality rates over 80% in some settings. Mortality typically results from disruption of the gastrointestinal tract, progressive and self-perpetuating bio-mediator generation, systemic inflammation, and multiple organ failure. A further therapeutic option may be open abdomen (OA) management with negative peritoneal pressure therapy (NPPT) to remove inflammatory ascites and attenuate the systemic damage from SCIAS, although there are definite risks of leaving the abdomen open whenever it might possibly be closed. This potential therapeutic paradigm is the rationale being assessed in the Closed Or Open after Laparotomy (COOL trial) (https://clinicaltrials.gov/ct2/show/NCT03163095). Initially, the COOL trial received Industry sponsorship; however, this funding mandated the use of a specific trademarked and expensive NPPT device in half of the patients allocated to the intervention (open) arm. In August 2022, the 3 M/Acelity Corporation without consultation but within the terms of the contract canceled the financial support of the trial. Although creating financial difficulty, there is now no restriction on specific NPPT devices and removing a cost-prohibitive intervention creates an opportunity to expand the COOL trial to a truly global basis. This document describes the evolution of the COOL trial, with a focus on future opportunities for global growth of the study. Methods The COOL trial is the largest prospective randomized controlled trial examining the random allocation of SCIAS patients intra-operatively to either formal closure of the fascia or the use of the OA with an application of an NPPT dressing. Patients are eligible if they have free uncontained intraperitoneal contamination and physiologic derangements exemplified by septic shock OR severely adverse predicted clinical outcomes. The primary outcome is intended to definitively inform global practice by conclusively evaluating 90-day survival. Initial recruitment has been lower than hoped but satisfactory, and the COOL steering committee and trial investigators intend with increased global support to continue enrollment until recruitment ensures a definitive answer. Discussion OA is mandated in many cases of SCIAS such as the risk of abdominal compartment syndrome associated with closure, or a planned second look as for example part of “damage control”; however, improved source control (locally and systemically) is the most uncertain indication for an OA. The COOL trial seeks to expand potential sites and proceed with the evaluation of NPPT agnostic to device, to properly examine the hypothesis that this treatment attenuates systemic damage and improves survival. This approach will not affect internal validity and should improve the external validity of any observed results of the intervention. Trial registration: National Institutes of Health (https://clinicaltrials.gov/ct2/show/NCT03163095).

Published
2023

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

Author

Stefano Rausei, Vincenzo Pappalardo, Marco Ceresoli, Fausto Catena, Massimo Sartelli, Massimo Chiarugi, Yoram Kluger, Andrew Kirkpatrick, Luca Ansaloni, Federico Coccolini, Giulia Montori, Fracensco Salvetti, Paola Fugazzola, Ionut Negoi, Monica Zese, Savino Occhionorelli, Sergei Shlyapnikov, 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, 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, Federico Lora, Ivan Sahderov, Boyko Atanasov, Sergio Zegarra, Luca Fattori, Rao Ivatury, Jimmy Xiao, Andrea Lippi, Mario Improta, Francesca Gubbiotti, Andrey Zharikov, Vincent Dubuisson, Michael Sugrue, 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, and Sugrue, M

Subjects
Male, medicine.medical_specialty, Sepsi, Peritonitis, NO, Sepsis, 03 medical and health sciences, Elderly, Intra-abdominal infection, Open abdomen management, Source control, 0302 clinical medicine, Postoperative Complications, Abdomen, Medicine, Humans, Prospective Studies, Registries, Open abdomen, Aged, Aged, 80 and over, Univariate analysis, business.industry, Potential risk, Age Factors, Mean age, General Medicine, medicine.disease, Surgery, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Observational study, Female, business, Cohort study
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

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

Author

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, and Ivatury, R

Subjects
Adult, Male, medicine.medical_specialty, Abdominal compartment syndrome, Fistula, open abdomen, NO, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Acute care, Abdomen, Female, Humans, Intensive Care Units, Length of Stay, Middle Aged, Obesity, Registries, medicine, business.industry, Fascia, medicine.disease, Cardiac surgery, Surgery, medicine.anatomical_structure, Cardiothoracic surgery, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, business, Trauma surgery, Abdominal surgery
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
2019

49. Pharmacokinetics of Piperacillin-Tazobactam in Critically Ill Patients with Open Abdomen and Vacuum-Assisted Wound Closure: Dosing Considerations Using Monte Carlo Simulation.

Author

Carrié C, Butruille J, Maingault S, Lannou A, Dubuisson V, Petit L, Biais M, and Breilh D

Abstract

Background: Open abdomen with vacuum-assisted wound closure therapy (OA/VAC) is frequently used in critically ill patients although the impact of OA/VAC on antibiotics pharmacokinetics (PK) remains unknown. We thus aimed to characterize the PK of piperacillin-tazobactam (PTZ) in critically ill patients with OA/VAC and assess the optimal dosing regimens based on pharmacodynamics (PD) target attainment., Methods: Over a 15-month study period, 45 patients with OA/VAC treated with PTZ administered continuously and adapted to 24 h creatinine clearance (CL CR ) underwent measurements of free concentrations in their plasma, urine, VAC exudate, and peritoneal fluid. Population PK modeling was performed considering the effect of covariates, and Monte Carlo simulations were employed to determine the probability of target attainment (PTA) for the PK/PD targets (100% fT > 16 mg/L) in the plasma and at the peritoneal site at steady state., Results: Piperacillin concentrations were described using a two-compartment model, with age and total body weight as significant covariates for central volume of distribution (V1) and estimated renal function for clearance (CL). Tazobactam concentrations were described using a two-compartment model with estimated renal function as a significant covariate. The central volume of distributions V1 of piperacillin and tazobactam were 21.2 and 23.2 L, respectively. The VAC-induced peritoneal clearance was negligible compared to renal clearance. Most patients achieved the desirable PK/PD target when using a CL CR -pondered PTZ dosing regimen from 12 g/1.5 g/day to 20 g/2.5 g/day., Conclusions: Despite a wide inter-individual variability, the influence of OA/VAC on piperacillin and tazobactam PK parameters is not straightforward. The use of a CL CR -pondered PTZ dosing regimen from 12 g/1.5 g/day to 20 g/2.5 g/day is needed to reach a PTA > 85%.

Published
2024
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50. The unrestricted global effort to complete the COOL trial.

Author

Kirkpatrick AW, Coccolini F, Tolonen M, Minor S, Catena F, Gois E Jr, Doig CJ, Hill MD, Ansaloni L, Chiarugi M, Tartaglia D, Ioannidis O, Sugrue M, Colak E, Hameed SM, Lampela H, Agnoletti V, McKee JL, Garraway N, Sartelli M, Ball CG, Parry NG, Voght K, Julien L, Kroeker J, Roberts DJ, Faris P, Tiruta C, Moore EE, Ammons LA, Anestiadou E, Bendinelli C, Bouliaris K, Carroll R, Ceresoli M, Favi F, Gurrado A, Rezende-Neto J, Isik A, Cremonini C, Strambi S, Koukoulis G, Testini M, Trpcic S, Pasculli A, Picariello E, Abu-Zidan F, Adeyeye A, Augustin G, Alconchel F, Altinel Y, Hernandez Amin LA, Aranda-Narváez JM, Baraket O, Biffl WL, Baiocchi GL, Bonavina L, Brisinda G, Cardinali L, Celotti A, Chaouch M, Chiarello M, Costa G, de'Angelis N, De Manzini N, Delibegovic S, Di Saverio S, De Simone B, Dubuisson V, Fransvea P, Garulli G, Giordano A, Gomes C, Hayati F, Huang J, Ibrahim AF, Huei TJ, Jailani RF, Khan M, Luna AP, Malbrain MLNG, Marwah S, McBeth P, Mihailescu A, Morello A, Mulita F, Murzi V, Mohammad AT, Parmar S, Pak A, Wong MP, Pantalone D, Podda M, Puccioni C, Rasa K, Ren J, Roscio F, Gonzalez-Sanchez A, Sganga G, Scheiterle M, Slavchev M, Smirnov D, Tosi L, Trivedi A, Vega JAG, Waledziak M, Xenaki S, Winter D, Wu X, Zakaria AD, and Zakaria Z

Subjects
Humans, Inflammation, Multiple Organ Failure etiology, Prospective Studies, United States, Abdomen, Laparotomy adverse effects
Abstract

Background: Severe complicated intra-abdominal sepsis (SCIAS) has an increasing incidence with mortality rates over 80% in some settings. Mortality typically results from disruption of the gastrointestinal tract, progressive and self-perpetuating bio-mediator generation, systemic inflammation, and multiple organ failure. A further therapeutic option may be open abdomen (OA) management with negative peritoneal pressure therapy (NPPT) to remove inflammatory ascites and attenuate the systemic damage from SCIAS, although there are definite risks of leaving the abdomen open whenever it might possibly be closed. This potential therapeutic paradigm is the rationale being assessed in the Closed Or Open after Laparotomy (COOL trial) ( https://clinicaltrials.gov/ct2/show/NCT03163095 ). Initially, the COOL trial received Industry sponsorship; however, this funding mandated the use of a specific trademarked and expensive NPPT device in half of the patients allocated to the intervention (open) arm. In August 2022, the 3 M/Acelity Corporation without consultation but within the terms of the contract canceled the financial support of the trial. Although creating financial difficulty, there is now no restriction on specific NPPT devices and removing a cost-prohibitive intervention creates an opportunity to expand the COOL trial to a truly global basis. This document describes the evolution of the COOL trial, with a focus on future opportunities for global growth of the study., Methods: The COOL trial is the largest prospective randomized controlled trial examining the random allocation of SCIAS patients intra-operatively to either formal closure of the fascia or the use of the OA with an application of an NPPT dressing. Patients are eligible if they have free uncontained intraperitoneal contamination and physiologic derangements exemplified by septic shock OR severely adverse predicted clinical outcomes. The primary outcome is intended to definitively inform global practice by conclusively evaluating 90-day survival. Initial recruitment has been lower than hoped but satisfactory, and the COOL steering committee and trial investigators intend with increased global support to continue enrollment until recruitment ensures a definitive answer., Discussion: OA is mandated in many cases of SCIAS such as the risk of abdominal compartment syndrome associated with closure, or a planned second look as for example part of "damage control"; however, improved source control (locally and systemically) is the most uncertain indication for an OA. The COOL trial seeks to expand potential sites and proceed with the evaluation of NPPT agnostic to device, to properly examine the hypothesis that this treatment attenuates systemic damage and improves survival. This approach will not affect internal validity and should improve the external validity of any observed results of the intervention., Trial Registration: National Institutes of Health ( https://clinicaltrials.gov/ct2/show/NCT03163095 )., (© 2023. The Author(s).)

Published
2023
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