Author: "Victor Kong" - Searchworks@Jio Institute Digital Library Search Results

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109 results on '"Victor Kong"'

1. Broad Responses and Attitudes to Having Music in Surgery (The BRAHMS Study): An Australia and Aotearoa New Zealand Perspective

Author: Anantha Narayanan, MBChB, Maheshwar Naidoo, MBChB, FCS (SA), Victor Kong, MBChB, MRCS, MS, PhD, FRACS, Lydia Pearson, MBBS BSc(Hons), Kevin Mani, MD, PhD, FEBVS, James P. Fisher, PhD, and Manar Khashram, MBChB PhD FRACS
Subjects: Surgery, Music, Intra-operative, Stress, Survey, RD1-811
Abstract: Background: Surgery is a stressful exercise, and the experience of occupational stress may have impacts on surgical performance, and surgeon well-being. Music is played in operating theatres (OTs) throughout the world, and while it may improve surgical performance, and reduce clinician stress within the OT, concerns exist over its distracting and noise-creating properties. Methods: In this prospective observational study, between May to August 2022, Vascular, General and Paediatric surgeons and registrars in Australia and Aotearoa New Zealand (AoNZ) responded to a survey investigating the way they use music, and their perceptions and attitudes towards its effect on the OT environment. Binomial logistic regression and Chi squared tests of association were performed, accepting p
Published: 2024
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2. The 'weekend effect' does not impact on outcome of trauma laparotomy – Experience from a level 1 trauma centre in New Zealand

Author: Jonathan Ko, Victor Kong, Janet Amey, Damien Ah Yen, Damian Clarke, and Grant Christey
Subjects: Wounds and injuries, General surgery, Trauma surgery, Abdominal trauma, Systematic factors, Medicine (General), R5-920
Abstract: Purpose: Trauma centres have been proven to provide better outcomes in developed countries for overall trauma, but there is limited literature on the systematic factors that describe any discrepancies in outcomes for trauma laparotomies in these centres. This study was conducted to examine and interrogate the effect of systematic factors on patients undergoing a trauma laparotomy in a developed country, intending to identify potential discrepancies in the outcome. Methods: This was a retrospective study of all laparotomies performed for trauma at a level 1 trauma centre in New Zealand. All adult patients who had undergone an index laparotomy for trauma between February 2012 and November 2020 were identified and laparotomies for both blunt and penetrating trauma were included. Repeat laparotomies and trauma laparotomies in children were excluded. The primary clinical outcomes reviewed included morbidity, length of hospital stay, and mortality. All statistical analysis was performed using R v.4.0.3. Results: During the 9-year study period, 204 trauma laparotomies were performed at Waikato hospital. The majority (83.3%) were performed during office hours (170/204), and the remaining 16.7% were performed after hours (34/204). And 61.3% were performed on a weekday (125/204), whilst 38.7% were performed on the weekend/public holiday (79/204). Most of the parameters in office hours and after hours groups had no statistically significant difference, except lactate (p = 0.026). Most of the variables in weekday and weekend groups had no statistically significant difference, except pH, lactate, length of stay, and gastrointestinal complications (p = 0.012, p
Published: 2023
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3. Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries

Author: Mwayi Kachapila, Mark Monahan, Adesoji O. Ademuyiwa, Yakubu Momohsani Adinoyi, Bruce M. Biccard, Christina George, Dhruva N. Ghosh, James Glasbey, Dion G. Morton, Osaheni Osayomwanbo, Rupert Pearse, Tracy E. Roberts, Atul Suroy, Saidu Yusuf Yakubu, Raymond Oppong, Aneel Bhangu, Maria Lorena Aguilera, Philip Alexander, Sara W. Al-Saqqa, Giuliano Borda-Luque, Ainhoa Costas-Chavarri, Thomas M. Drake, Faustin Ntirenganya, J. Edward Fitzgerald, Stuart J. Fergusson, J.C. Allen Ingabire, Lawani Ismaïl, Hosni Khairy Salem, Anyomih Theophilus Teddy Kojo, Marie Carmela Lapitan, Richard Lilford, Andre L. Mihaljevic, Dion Morton, Alphonse Zeta Mutabazi, Dmitri Nepogodiev, Adewale O. Adisa, Riinu Ots, Francesco Pata, Thomas Pinkney, Tomas Poškus, Ahmad Uzair Qureshi, Antonio Ramos-De la Medina, Sarah Rayne, Catherine A. Shaw, Sebastian Shu, Richard Spence, Neil Smart, Stephen Tabiri, Ewen M. Harrison, Azmina Verjee, Emmy Runigamugabo, Chetan Khatri, Midhun Mohan, Zahra Jaffry, Afnan Altamini, Andrew Kirby, Kjetil Søreide, Gustavo Recinos, Jen Cornick, Maria Marta Modolo, Dushyant Iyer, Sebastian King, Tom Arthur, Sayeda Nazmum Nahar, Ade Waterman, Michael Walsh, Arnav Agarwal, Augusto Zani, Mohammed Firdouse, Tyler Rouse, Qinyang Liu, Juan Camilo Correa, Peep Talving, Mengistu Worku, Alexis Arnaud, Vassilis Kalles, Basant Kumar, Sunil Kumar, Radhian Amandito, Roy Quek, Luca Ansaloni, Ahmed Altibi, Donatas Venskutonis, Justas Zilinskas, Tomas Poskus, John Whitaker, Vanessa Msosa, Yong Yong Tew, Alexia Farrugia, Elaine Borg, Zineb Bentounsi, Tanzeela Gala, Ibrahim Al-Slaibi, Haya Tahboub, Osaid H. Alser, Diego Romani, Sebestian Shu, Piotr Major, Aurel Mironescu, Matei Bratu, Amar Kourdouli, Aliyu Ndajiwo, Abdulaziz Altwijri, Mohammed Ubaid Alsaggaf, Ahmad Gudal, Al Faifi Jubran, Sam Seisay, Bettina Lieske, Irene Ortega, Jenifa Jeyakumar, Kithsiri J. Senanayake, Omar Abdulbagi, Yucel Cengiz, Dmitri Raptis, Yuksel Altinel, Chia Kong, Ella Teasdale, Gareth Irwin, Michael Stoddart, Rakan Kabariti, Sukrit Suresh, Katherine Gash, Ragavan Narayanan, Mayaba Maimbo, Besmir Grizhja, Shpetim Ymeri, Gezim Galiqi, Roberto Klappenbach, Diego Antezana, Alvaro Enrique Mendoza Beleño, Cecilia Costa, Belen Sanchez, Susan Aviles, Claudio Gabriel Fermani, Rubén Balmaceda, Santiago Villalobos, Juan Manuel Carmona, Daniel Hamill, Peter Deutschmann, Simone Sandler, Daniel Cox, Ram Nataraja, Claire Sharpin, Damir Ljuhar, Demi Gray, Morgan Haines, Dush Iyer, Nithya Niranjan, Scott D'Amours, Morvarid Ashtari, Helena Franco, Ashrarur Rahman Mitul, Sabbir Karim, Nowrin F. Aman, Mahnuma Mahfuz Estee, Umme Salma, Joyeta Razzaque, Tasnia Hamid Kanta, Sayeeda Aktar Tori, Shadid Alamin, Swapnil Roy, Shadid Al Amin, Rezaul Karim, Muhtarima Haque, Amreen Faruq, Farhana Iftekhar, Margaret O'Shea, Greg Padmore, Ramesh Jonnalagadda, Andrey Litvin, Aliaksandr Filatau, Dzmitry Paulouski, Maryna Shubianok, Tatsiana Shachykava, Dzianis Khokha, Vladimir Khokha, Fernande Djivoh, Francis Dossou, Djifid Morel Seto, Dansou Gaspard Gbessi, Bruno Noukpozounkou, Yacoubou Imorou Souaibou, Kpèmahouton René Keke, Fred Hodonou, Ernest Yemalin Stephane Ahounou, Thierry Alihonou, Max Dénakpo, Germain Ahlonsou, Alemayehu Ginbo Bedada, Carlos Nsengiyumva, Sandrine Kwizera, Venerand Barendegere, Philip Choi, Simon Stock, Luai Jamal, Georges Azzie, Sameer Kushwaha, Tzu-Ling Chen, Chingwan Yip, Irene Montes, Felipe Zapata, Sebastian Sierra, Maria Isabel Villegas Lanau, Maria Clara Mendoza Arango, Ivan Mendoza Restrepo, Ruben Santiago Restrepo Giraldo, Edgar Domini, Robert Karlo, Jakov Mihanovic, Mohamed Youssef, Hossam Elfeki, Waleed Thabet, Aly Sanad, Gehad Tawfik, Ahmed Zaki, Noran Abdel-Hameed, Mohamed Mostafa, Muhammad Fathi Waleed Omar, Ahmed Ghanem, Emad Abdallah, Adel Denewar, Eman Emara, Eman Rashad, Ahmad Sakr, Rehab Elashry, Sameh Emile, Toqa Khafagy, Sara Elhamouly, Arwa Elfarargy, Amna Mamdouh Mohamed, Ghada Saied Nagy, Abeer Esam, Eman Elwy, Aya Hammad, Salwa Khallaf, Eman Ibrahim, Ahmed Saidbadr, Ahmed Moustafa, Amany Eldosouky Mohammed, Mohammed Elgheriany, Eman Abdelmageed, Eman Abd Al Raouf, Esraa Samir Elbanby, Maha Elmasry, Mahitab Morsy Farahat, Eman Yahya Mansor, Eman Magdy Hegazy, Esraa Gamal, Heba Gamal, Hend Kandil, Doaa Maher Abdelrouf, Mohamed Moaty, Dina Gamal, Nada El-Sagheer, Mohamed Salah, Salma Magdy, Asmaa Salah, Ahmed Essam, Ahmed Ali, Mahmoud Badawy, Sara Ahmed, Mazed Mohamed, Abdelrahman Assal, Mohamed Sleem, Mai Ebidy, Aly Abd Elrazek, Diaaaldin Zahran, Nourhan Adam, Mohamed Nazir, Adel B. Hassanein, Ahmed Ismail, Amira Elsawy, Rana Mamdouh, Mohamed Mabrouk, Lopna Ahmed Mohamed Ahmed, Mohamed Hassab Alnaby, Eman Magdy, Manar Abd-Elmawla, Marwan Fahim, Bassant Mowafy, Moustafa Ibrahim Mahmoud, Meran Allam, Muhammad Alkelani, Noran Halim El Gendy, Mariam Saad Aboul-Naga, Reham Alaa El-Din, Alyaa Halim Elgendy, Mohamed Ismail, Mahmoud Shalaby, Aya Adel Elsharkawy, Mahmoud Elsayed Moghazy, Khaled Hesham Elbisomy, Hend Adel Gawad Shakshouk, Mohamed Fouad Hamed, Mai Mohamed Ebidy, Mostafa Abdelkader, Mohamed Karkeet, Hayam Ahmed, Israa Adel, Mohammad Elsayed Omar, Mohamed Ibrahim, Omar Ghoneim, Omar Hesham, Shimaa Gamal, Karim Hilal, Omar Arafa, Sawsan Adel Awad, Menatalla Salem, Fawzia Abdellatif Elsherif, Nourhan Elsabbagh, Moustafa R. Aboelsoud, Ahmed Hossam Eldin Fouad Rida, Amr Hossameldin, Ethar Hany, Yomna Hosny Asar, Nourhan Anwar, Mohamed Gadelkarim, Samar Abdelhady, Eman Mohamed Morshedy, Reham Saad, Nourhan Soliman, Mahmoud Salama, Eslam Ezzat, Arwa Mohamed, Arwa Ibrahim, Alaa Fergany, Sara Mohammed, Aya Reda, Yomna Allam, Hanan Adel Saad, Afnan Abdelfatah, Aya Mohamed Fathy, Ahmed El-Sehily, Esraa Abdalmageed Kasem, Ahmed Tarek Abdelbaset Hassan, Ahmed Rabeih Mohammed, Abdalla Gamal Saad, Yasmin Elfouly, Nesma Elfouly, Arij Ibrahim, Amr Hassaan, Mohammed Mustafa Mohammed, Ghada Elhoseny, Mohamed Magdy, Esraa Abd Elkhalek, Yehia Zakaria, Tarek Ezzat, Ali Abo El Dahab, Mohamed Kelany, Sara Arafa, Osama Mokhtar Mohamed Hassan, Nermin Mohamed Badwi, Ahmad Saber Sleem, Hussien Ahmed, Kholoud Abdelbadeai, Mohamed Abozed Abdullah, Muhammad Amsyar Auni Lokman, Suraya Bahar, Anan Rady Abdelazeam, Abdelrahman Adelshone, Muhammad Bin Hasnan, Athirah Zulkifli, Siti Nur Alia Kamarulzamil, Abdelaziz Elhendawy, Aliang Latif, Ahmad Bin Adnan, Shahadatul Shaharuddin, Aminah Hanum Haji Abdul Majid, Mahmoud Amreia, Dina Al-Marakby, Mahmoud Salma, Mohamad Jeffrey Bin Ismail, Elissa Rifhan Mohd Basir, Citra Dewi, Mohd Ali, Aya Yehia Ata, Maha Nasr, Asmaa Rezq, Ahmed Sheta, Sherif Tariq, Abd Elkhalek Sallam, Abdelrhman K.Z. Darwish, Sohaila Elmihy, Shady Elhadry, Ahmed Farag, Haidar Hajeh, Abdelaziz Abdelaal, Amro Aglan, Ahmed Zohair, Mahitab Essam, Omar Moussa, Esraa El-Gizawy, Mostafa Samy, Safia Ali, Esraa Elhalawany, Ahmed Ata, Mohamed El Halawany, Mohamed Nashat, Samar Soliman, Alaa Elazab, Mostada Samy, Mohamed A. Abdelaziz, Khaled Ibrahim, Ahmed mohamed Ibrahim, Ammar Gado, Usama Hantour, Esraa Alm Eldeen, Mohamed Reda loaloa, Arwa Abouzaid, Mostafa Ahmed Bahaa Eldin, Eman Hashad, Fathy Sroor, Doaa Gamil, Eman Mahmoud Abdulhakeem, Mahmoud Zakaria, Fawzy Mohamed, Marwan Abubakr, Elsayed Ali, Hesham Magdy, Menna Tallah Ramadan, Mohamed Abdelaty Mohamed, Salma Mansour, Hager Abdul Aziz Amin, Ahmed Rabie Mohamed, Mahmoud Saami, Nada Ahmed Reda Elsayed, Adham Tarek, Sabry Mohy Eldeen Mahmoud, Islam Magdy El Sayed, Amira Reda, Martina Yusuf Shawky, Mohammed Mousa Salem, Shahinaz Alaa El-Din, Noha Abdullah Soliman, Muhammed Talaat, Shahinaz Alaael-Dein, Ahmed Abd Elmoen Elhusseiny, Noha Abdullah, Mohammed Elshaar, Aya AbdelFatah Ibraheem, Hager Abdulaziz, Mohammed Kamal Ismail, Mona Hamdy Madkor, Mohamed Abdelaty, Sara Mahmoud Abdel-Kader, Osama Mohamed Salah, Mahmoud Eldafrawy, Ahmed Zaki Eldeeb, Mostafa Mahmoud Eid, Attia Attia, Khalid Salah El-Dien, Ayman Shwky, Mohamed Adel Badenjki, Abdelrahman Soliman, Samaa Mahmoud Al Attar, Farrag Sayed, Fahd Abdel Sabour, Mohammed G. Azizeldine, Muhammad Shawqi, Abdullah Hashim, Ahmed Aamer, Ahmed Mahmoud Abdelraouf, Mahmoud Abdelshakour, Amal Ibrahim, Basma Mahmoud, Mohamed Ali Mahmoud, Mostafa Qenawy, Ahmed M. Rashed, Ahmed Dahy, Marwa Sayed, Ahmed W. Shamsedine, Bakeer Mohamed, Ahmad Hasan, Mahmoud M. Saad, Khalil Abdul Bassit, Nadia Khalid Abd El-Latif, Nada Elzahed, Ahmed El Kashash, Nada Mohamed Bekhet, Sarah Hafez, Ahmed Gad, Mahmoud Elkhadragy Maher, Ahmed Abd Elsameea, Mohamed Hafez, Ahmad Sabe, Ataa Ahmed, Ahmed Shahine, Khaled Dawood, Shireen Gaafar, Reem Husseiny, Omnia Aboelmagd, Ahmed Soliman, Nourhan Mesbah, Hossam Emadeldin, Amgad Al Meligy, Amira Hassan Bekhet, Doaa Hasan, Khaled Alhady, Ahmad Khaled Sabe, Mahmoud A. Elnajjar, Majed Aboelella, Ward Hamsho, Ihab Hassan, Hala Saad, Galaleldin Abdelazim, Hend Mahmoud, Noha Wael, Ahmedali M. Kandil, Ahmed Magdy, Shimaa Said Elkholy, Badr Eldin Adel, Kareem Dabbour, Saged Elsherbiney, Omar Mattar, Abdulshafi Khaled Abdrabou, Mohammed Yahia Mohamed Aly, Abdelrahman Geuoshy, Ahmedglal Elnagar, Saraibrahim Ahmed, Ibrahem Abdelmotaleb, Amr Ahmed Saleh, Manar Saeed, Shady Mahmoud, Badreldin Adel Tawfik, Samar Adel Ismail, Esraay Zakaria, Mariam O. Gad, Mohamed Salah Elhelbawy, Monica Bassem, Noha Maraie, Nourhan Medhat Elhadary, Nourhan Semeda, Shaza Rabie Mohamed, Hesham Mohammed Bakry, A.A. Essam, Dina Tarek, Khlood Ashour, Alaa Elhadad, Abdulrahman Abdel-Aty, Ibrahim Rakha, Sara Mamdouh Matter, Rasha Abdelhamed, Omar Abdelkader, Ayat Hassaan, Yasmin Soliman, Amna Mohamed, Sara Ghanem, Sara Amr Mohamed Farouk, Eman Mohamed Ibrahim, Esraa El-Taher, Merna Mostafa, Mohamed Fawzy Mahrous Badr, Rofida Elsemelawy, Aya El-Sawy, Ahmad Bakr, Ahmad Abdel Razaq Al Rafati, Sten Saar, Arvo Reinsoo, Nebyou Seyoum, Tewodros Worku, Agazi Fitsum, Matti Tolonen, Ari Leppäniemi, Ville Sallinen, Benoît Parmentier, Matthieu Peycelon, Sabine Irtan, Sabrina Dardenne, Elsa Robert, Betty Maillot, Etienne Courboin, Alexis Pierre Arnaud, Juliette Hascoet, Olivier Abbo, Amir Ait Kaci, Thomas Prudhomme, Quentin Ballouhey, Céline Grosos, Laurent Fourcade, Tolg Cecilia, Colombani Jean-Francois, Francois-Coridon Helene, Xavier Delforge, Elodie Haraux, Bertrand Dousset, Roberto Schiavone, Sebastien Gaujoux, Jean-Baptiste Marret, Aurore Haffreingue, Julien Rod, Mariette Renaux-Petel, Jean-François Lecompte, Jean Bréaud, Pauline Gastaldi, Chouikh Taieb, Raquillet Claire, Echaieb Anis, Nasir Bustangi, Manuel Lopezv, Aurelien Scalabre, Maria Giovanna Grella, Aurora Mariani, Guillaume Podevin, Françoise Schmitt, Erik Hervieux, Aline Broch, Cecile Muller, Dickson Bandoh, Francis Abantanga, Martin Kyereh, Hamza Asumah, Eric Kofi Appiah, Paul Wondoh, Adam Gyedu, Charles Dally, Kwabena Agbedinu, Michael Amoah, Abiboye Yifieyeh, Frank Owusu, Mabel Amoako-Boateng, Makafui Dayie, Richmond Hagan, Sam Debrah, Micheal Ohene-Yeboah, Joe-Nat Clegg-Lampety, Victor Etwire, Jonathan Dakubo, Samuel Essoun, William Bonney, Hope Glover-Addy, Samuel Osei-Nketiah, Joachim Amoako, Niiarmah Adu-Aryee, William Appeadu-Mensah, Antoinette Bediako-Bowan, Florence Dedey, Mattew Ekow, Emmanuel Akatibo, Musah Yakubu, Hope Edem Kofi Kordorwu, Kwasi Asare-Bediako, Enoch Tackie, Kenneth Aaniana, Emmanuel Acquah, Richard Opoku-Agyeman, Anthony Avoka, Kwasi Kusi, Kwame Maison, Frank Enoch Gyamfi, Gandau Naa Barnabas, Saiba Abdul-Latif, Philip Taah Amoako, Anthony Davor, Victor Dassah, Enoch Dagoe, Prince Kwakyeafriyie, Elliot Akoto, Eric Ackom, Ekow Mensah, Ebenezer Takyi Atkins, Christian Lari Coompson, Nikolaos Ivros, Christoforos Ferousis, Vasileios Kalles, Christos Agalianos, Ioannis Kyriazanos, Christos Barkolias, Angelos Tselos, Georgios Tzikos, Evangelos Voulgaris, Dimitrios Lytras, Athanasia Bamicha, Kyriakos Psarianos, Anastasios Stefanopoulos, Ioannis Patoulias, Dimitrios Sfougaris, Ioannis Valioulis, Dimitrios Balalis, Dimitrios Korkolis, Dimitrios K. Manatakis, Georgios Kyrou, Georgios Karabelias, Iason-Antonios Papaskarlatos, Kolonia Konstantina, Nikolaos Zampitis, Stylianos Germanos, Aspasia Papailia, Theodosios Theodosopoulos, Georgios Gkiokas, Magdalini Mitroudi, Christina Panteli, Thomas Feidantsis, Konstantinos Farmakis, Dimitrios Kyziridis, Orestis Ioannidis, Styliani Parpoudi, Georgios Gemenetzis, Stavros Parasyris, Christos Anthoulakis, Nikolaos Nikoloudis, Michail Margaritis, Maria-Lorena Aguilera-Arevalo, Otto Coyoy-Gaitan, Javier Rosales, Luis Tale, Rafael Soley, Emmanuel Barrios, Servio Tulio Torres Rodriguez, Carlos Paz Galvez, Danilo Herrera Cruz, Guillermo Sanchez Rosenberg, Alejandro Matheu, David Monterroso Cohen, Marie Paul, Angeline Charles, Justin Chak Yiu Lam, Man Hon Andrew Yeung, Chi Ying Jacquelyn Fok, Ka Hin Gabriel Li, Anthony Chuk-Him Lai, Yuk Hong Eric Cheung, Hong Yee Wong, Ka Wai Leung, Tien Seng Bryan Lee, Wai Him Lam, Weihei Dao, Stephanie Hiu-wai Kwok, Tsz-Yan Katie Chan, Yung Kok Ng, T.W.C. Mak, Chi Chung Foo, James Yang, Ankur Bhatnagar, Vijaid Upadhyaya, Uday Muddebihal, Wasim Dar, K.C. Janardha, Neerav Aruldas, Fidelis Jacklyn Adella, Anthonius Santoso Rulie, Ferdy Iskandar, Jonny Setiawan, Cicilia Viany Evajelista, Hani Natalie, Arlindawati Suyadi, Rudy Gunawan, Herlin Karismaningtyas, Lusi Padma Sulistianingsih Mata, Ferry Fitriya Ayu Andika, Afifatun Hasanah, T. Ariani Widiastini, Nurlaila Ayu Purwaningsih, Annisa Dewi Fitriana Mukin, Dina Faizatur Rahmah, Hazmi Dwinanda Nurqistan, Hasbi Maulana Arsyad, Novia Adhitama, Wifanto Saditya Jeo, Nathania Sutandi, Audrey Clarissa, Phebe Anggita Gultom, Matthew Billy, Andreass Haloho, Nadya Johanna, Felix Lee, Radin Mohd Nurrahman Radin Dorani, Martha Glynn, Mohammad Alherz, Wennweoi Goh, Haaris A. Shiwani, Lorraine Sproule, Kevin C. Conlon, Miklosh Bala, Asaf Kedar, Luca Turati, Federica Bianco, Francesca Steccanella, Gaetano Gallo, Mario Trompetto, Giuseppe Clerico, Matteo Papandrea, Giuseppe Sammarco, Rosario Sacco, Angelo Benevento, Luisa Giavarini, Mariano Cesare Giglio, Luigi Bucci, Gianluca Pagano, Viviana Sollazzo, Roberto Peltrini, Gaetano Luglio, Arianna Birindelli, Salomone Di Saverio, Gregorio Tugnoli, Miguel Angel Paludi, Pietro Mingrone, Domenica Pata, Francesco Selvaggi, Lucio Selvaggi, Gianluca Pellino, Natale Di Martino, Gianluca Curletti, Paolo Aonzo, Raffaele Galleano, Stefano Berti, Elisa Francone, Silvia Boni, Laura Lorenzon, Annalisa lo Conte, Genoveffa Balducci, Gianmaria Confalonieri, Giovanni Pesenti, Laura Gavagna, Giorgio Vasquez, Simone Targa, Savino Occhionorelli, Dario Andreotti, Giacomo Pata, Andrea Armellini, Deborah Chiesa, Fabrizio Aquilino, Nicola Chetta, Arcangelo Picciariello, Mohamed Abdelkhalek, Andrea Belli, Silvia De Franciscis, Annamaria Bigaran, Alessandro Favero, Stefano M.M. Basso, Paola Salusso, Martina Perino, Sylvie Mochet, Diego Sasia, Francesco Riente, Marco Migliore, David Merlini, Silvia Basilicò, Carlo Corbellini, Veronica Lazzari, Yuri Macchitella, Luigi Bonavina, Daniele Angelieri, Diego Coletta, Federica Falaschi, Marco Catani, Claudia Reali, Mariastella Malavenda, Celeste Del Basso, Sergio Ribaldi, Massimo Coletti, Andrea Natili, Norma Depalma, Immacolata Iannone, Angelo Antoniozzi, Davide Rossi, Daniele Gui, Gerardo Perrotta, Matteo Ripa, Francesco Ruben Giardino, Maurizio Foco, Erika Vicario, Federico Coccolini, Gabriela Elisa Nita, Nicoletta Leone, Andrea Bondurri, Anna Maffioli, Andrea Simioni, Davide De Boni, Sandro Pasquali, Elena Goldin, Elena Vendramin, Eleonora Ciccioli, Umberto Tedeschi, Luca Bortolasi, Paola Violi, Tommaso Campagnaro, Simone Conci, Giovanni Lazzari, Calogero Iacono, Alfredo Gulielmi, Serena Manfreda, Anna Rinaldi, Maria Novella Ringressi, Beatrice Brunoni, Giuseppe Salamone, Mirko Mangiapane, Paolino De Marco, Antonella La Brocca, Roberta Tutino, Vania Silvestri, Leo Licari, Tommaso Fontana, Nicolò Falco, Gianfranco Cocorullo, Mostafa Shalaby, Pierpaolo Sileri, Claudio Arcudi, Isam Bsisu, Khaled Aljboor, Lana Abusalem, Aseel Alnusairat, Ahmad Qaissieh, Emad Al-Dakka, Ali Ababneh, Oday Halhouli, Taha Yusufali, Hussein Mohammed, Justus Lando, Robert Parker, Wairimu Ndegwa, Mantas Jokubauskas, Jolanta Gribauskaite, Justas Kuliavas, Audrius Dulskas, Narimantas E. Samalavicius, Kristijonas Jasaitis, Audrius Parseliunas, Viktorija Nevieraite, Margarita Montrimaite, Evelina Slapelyte, Edvinas Dainius, Romualdas Riauka, Zilvinas Dambrauskas, Andrejus Subocius, Linas Venclauskas, Antanas Gulbinas, Saulius Bradulskis, Simona Kasputyte, Deimante Mikuckyte, Mindaugas Kiudelis, Tomas Jankus, Steponas Petrikenas, Matas Pažuskis, Zigmantas Urniežius, Mantas Vilčinskas, Vincas Jonas Banaitis, Vytautas Gaižauskas, Edvard Grisin, Povilas Mazrimas, Rokas Rackauskas, Mantas Drungilas, Karolis Lagunavicius, Vytautas Lipnickas, Dovilè Majauskyté, Valdemaras Jotautas, Tomas Abaliksta, Laimonas Uščinas, Gintaras Simutis, Adomas Ladukas, Donatas Danys, Erikas Laugzemys, Saulius Mikalauskas, Elena Zdanyte Sruogiene, Petras Višinskas, Reda Žilinskienė, Deividas Dragatas, Andrius Burmistrovas, Zygimantas Tverskis, Arturas Vaicius, Ruta Mazelyte, Antanas Zadoroznas, Nerijus Kaselis, Greta Žiubrytė, Finaritra Casimir Fleur Prudence Rahantasoa, Luc Hervé Samison, Fanjandrainy Rasoaherinomenjanahary, Todisoa Emmanuella Christina Tolotra, Cornelius Mukuzunga, Chimwemwe Kwatiwani, Nelson Msiska, Feng Yih Chai, Siti Mohd Desa Asilah, Khuzaimah Zahid Syibrah, Pui Xin Chin, Afizah Salleh, Nur Zulaika Riswan, April Camilla Roslani, Hoong-Yin Chong, Nora Abdul Aziz, Keat-Seong Poh, Chu-Ann Chai, Sandip Kumar, Mustafa Mohammed Taher, Nik Ritza Kosai, Dayang Nita Abdul Aziz, Reynu Rajan, Rokayah Julaihi, Durvesh Lacthman Jethwani, Muhammad Taqiyuddin Yahaya, Nik Azim Nik Abdullah, Susan Wndy Mathew, Kuet Jun Chung, Milaksh Kumar Nirumal, R. Goh Ern Tze, Syed Abdul Wahhab Eusoffee Wan Ali, Yiing Yee Gan, Jesse Ron Swire Ting, Samuel S.Y. Sii, Kean Leong Koay, Yi Koon Tan, Alvin Ee Zhiun Cheah, Chui Yee Wong, Tuan Nur'Azmah Tuan Mat, Crystal Yern Nee Chow, Prisca A.L. Har, Yishan Der, Fitjerald Henry, Xinwei Low, Ya Theng Neo, Hian Ee Heng, Shu Ning Kong, Cheewei Gan, Yi Ting Mok, Yee Wen Tan, Kandasami Palayan, Mahadevan Deva Tata, Yih Jeng Cheong, Kuhaendran Gunaseelan, Wan Nurul 'Ain Wan Mohd Nasir, Pigeneswaren Yoganathan, Eu Xian Lee, Jian Er Saw, Li Jing Yeang, Pei Ying Koh, Shyang Yee Lim, Shuang Yi Teo, Nicole Grech, Daniela Magri, Kristina Cassar, Christine Mizzi, Malcolm Falzon, Nihaal Shaikh, Ruth Scicluna, Stefan Zammit, Sean Mizzi, Svetlana Doris Brincat, Thelma Tembo, Vu Thanh Hien Le, Tara Grima, Keith Sammut, Kurt Carabott, Ciskje Zarb, Andre Navarro, Thea Dimech, Georgette Marie Camilleri, Isaac Bertuello, Jeffrey Dalli, Karl Bonavia, Samantha Corro-Diaz, Marisol Manriquez-Reyes, Amina Abdelhamid, Abdelmalek Hrora, Sarah Benammi, Houda Bachri, Meryem Abbouch, Khaoula Boukhal, Redouane Mammar Bennai, Abdelkader Belkouchi, Mohamed Sobhi Jabal, Chaymae Benyaiche, Maarten Vermaas, Lucia Duinhouwer, Javier Pastora, Greta Wood, Maria Soledad Merlo, Akinlabi Ajao, Omobolaji Ayandipo, Taiwo Lawal, Abdussemiu Abdurrazzaaq, Muslimat Alada, Abdulrasheed Nasir, James Adeniran, Olufemi Habeeb, Ademola Popoola, Ademola Adeyeye, Ademola Adebanjo, Opeoluwa Adesanya, Adewale Adeniyi, Henry Mendel, Bashir Bello, Umar Muktar, Adedapo Osinowo, Thomas Olagboyega Olajide, Oyindamola Oshati, George Ihediwa, Babajide Adenekan, Victor Nwinee, Felix Alakaloko, Adesoji Ademuyiwa, Olumide Elebute, Abdulrazzaq Lawal, Chris Bode, Mojolaoluwa Olugbemi, Alaba Adesina, Olubukola Faturoti, Oluwatomi Odutola, Oluwaseyi Adebola, Clement Onuoha, Ogechukwu Taiwo, Omolara Williams, Fatai Balogun, Olalekan Ajai, Mobolaji Oludara, Iloba Njokanma, Roland Osuoji, Stephen Kache, Jonathan Ajah, Jerry Makama, Ahmed Adamu, Suleiman Baba, Mohammad Aliyu, Shamsudeen Aliyu, Yahaya Ukwenya, Halima Aliyu, Tunde Sholadoye, Muhammad Daniyan, Oluseyi Ogunsua, Lofty-John Anyanwu, Abdurrahaman Sheshe, Aminu Mohammad, Samson Olori, Philip Mshelbwala, Babatunde Odeyemi, Garba Samson, Oyediran Kehinde Timothy, Sani Ali Samuel, Anthony Ajiboye, Isaac Amole, Olajide Abiola, Akin Olaolorun, Torhild Veen, Arezo Kanani, Kristian Styles, Ragnar Herikstad, Johannes Wiik Larsen, Jon Arne Søreide, Elisabeth Jensen, Mads Gran, Eirik Kjus Aahlin, Tina Gaarder, Peter Wiel Monrad-Hansen, Pål Aksel Næss, Giedrius Lauzikas, Joachim Wiborg, Silje Holte, Knut Magne Augestad, Gurpreet Singh Banipal, Michela Monteleone, Thomas Tetens Moe, Johannes Kurt Schultz, Taher Al-Taher, Ayah Hamdan, Ayman Salman, Rana Saadeh, Aseel Musleh, Dana Jaradat, Soha Abushamleh, Sakhaa Hanoun, Amjad Abu Qumbos, Aseel Hamarshi, Ayman, Taher, Israa Qawasmi, Khalid Qurie, Marwa Altarayra, Mohammad Ghannam, Alaa Shaheen, Azher Herebat, Aram Abdelhaq, Ahmad Shalabi, Maram Abu-Toyour, Fatema Asi, Ala Shamasneh, Anwar Atiyeh, Mousa Mustafa, Rula Zaa'treh, Majd Dabboor, Enas Alaloul, Heba Baraka, Jehad Meqbil, Alaa Al-Buhaisi, Mohamedraed Elshami, Samah Afana, Sahar Jaber, Said Alyacoubi, Yousef Abuowda, Tasneem Idress, Eman Abuqwaider, Sara Al-Saqqa, Alaa Bowabsak, Alaa El Jamassi, Doaa Hasanain, Hadeel Al-Farram, Maram Salah, Aya Firwana, Marwa Hamdan, Israa Awad, Ahmad Ashour, Fayez Elian Al Barrawi, Ahmed Al-Khatib, Maha Al-Faqawi, Mohamed Fares, Amjad Elmashala, Mohammad Adawi, Ihdaa Adawi, Reem Khreishi, Rose Khreishi, Ahed Ghaben, Najwa Nadeem, Muhammad Saqlain, Jibran Abbasy, Abdul Rehman Alvi, Noman Shahzad, Kamran Faisal Bhopal, Zainab Iftikhar, Muhammad Talha Butt, Syed Asaat Ul Razi, Asdaq Ahmed, Ali Khan Niazi, Ibrahim Raza, Fatima Baluch, Ahmed Raza, Ahmad Bani-Sadar, Muhammad Adil, Awais Raza, Mahnoor Javaid, Muhammad Waqar, Maryam Ali Khan, Mohammad Mohsin Arshad, Mohammadasim Amjad, Gustavo Miguel Machain Vega, Jorge Torres Cardozo, Marcelo O´Higgins Roche, Gustavo Rodolfo Pertersen Servin, Helmut Alfredo Segovia Lohse, Larissa Ines Páez Lopez, Ramón Augusto Melo Cardozo, Fernando Espinoza, Angel David Pérez Rojas, Diana Sanchez, Camila Sanchez Samaniego, Shalon Guevara Torres, Alexander Canta Calua, Cesar Razuri, Nadia Ortiz, Xianelle Rodriguez, Nahilia Carrasco, Fridiz Saravia, Hector Shibao Miyasato, María Valcarcel-Saldaña, Ysabel Esthefany Alejos Bermúdez, Juan Carpio, Walter Ruiz Panez, Pedro Angel Toribio Orbegozo, Carolina Guzmán Dueñas, Kevin Turpo Espinoza, Ana Maria Sandoval Barrantes, Jorge Armando Chungui Bravo, Lorena Fuentes-Rivera, Carmen Fernández, Bárbara Málaga, Joselyn Ye, Ricardo Velasquez, Jannin Salcedo, Ana Lucia Contreras-Vergara, Angelica Genoveva Vergara Mejia, Maria Soledad Gonzales Montejo, Marilia Del Carmen Escalante Salas, Willy Alcca Ticona, Marvin Vargas, George Christian Manrique Sila, Robinson Mas, Arazzelly del Pilar Paucar, Armando José Román Velásquez, Alina Robledo-Rabanal, Ludwing Alexander Zeta Solis, Kenny Turpo Espinoza, José Luis Hamasaki Hamaguchi, Erick Samuel Florez Farfan, Linda Alvi Madrid Barrientos, Juan Jaime Herrera Matta, John Jemuel V. Mora, Menold Archee P. Redota, Manuel Francisco Roxas, Maria Jesusa B. Maño, Marie Dione Parreno-Sacdalan, Christel Leanne Almanon, Maciej Walędziak, Rafał Roszkowski, Michał Janik, Anna Lasek, Dorota Radkowiak, Mateusz Rubinkiewicz, Cristina Fernandes, Jose Costa-Maia, Renato Melo, Liviu Muntean, Aurel Sandu Mironescu, Lucian Corneliu Vida, Mariuca Popa, Hogea Mircea, Mihaela Vartic, Bogdan Diaconescu, Matei Razvan Bratu, Ionut Negoi, Mircea Beuran, Cezar Ciubotaru, Norbert Uzabumwana, Dieudonne Duhoranenayo, Elio Jovine, Nicola Zanini, Giovanni Landolfo, Murad Aljiffry, Faisal Idris, Mohammed Saleh A. Alghamdi, Ashraf Maghrabi, Abdulmalik Altaf, Aroub Alkaaki, Ahmad Khoja, Abrar Nawawi, Sondos Turkustani, Eyad Khalifah, Adel Albiety, Sarah Sahel, Reham Alshareef, Mohammed Najjar, Ahmed Alzahrani, Ahmed Alghamdi, Wedyan Alhazmi, Ghiath Al Saied, Mohammed Alamoudi, Muhammed Masood Riaz, Mazen Hassanain, Basmah Alhassan, Abdullah Altamimi, Reem Alyahya, Norah Al Subaie, Fatema Al Bastawis, Afnan Altamimi, Thamer Nouh, Roaa Khan, Milan Radojkovic, Ljiljana Jeremic, Milica Nestorovic, Jia Hao Law, Keith Say Kwang Tan, Ryan Choon Kiat Tan, Joel Kin Tan, Lau Wen Liang Joel, Xue Wei Chan, Faith Qi Hui Leong, Choon Seng Chong, Sharon Koh, Kai Yin Lee, Kuok Chung Lee, Kent Pluke, Britta Dedekind, Puyearashid Nashidengo, Mark Ian Hampton, Johanna Joosten, Sanju Sobnach, Liana Roodt, Anthony Sander, James Pape, Niveshni Maistry, Phumudzo Ndwambi, Kamau Kinandu, Myint Tun, Frederick Du Toit, Quinn Ellison, D.C. Grobler, Sule Burger, Lawrence Bongani Khulu, Rachel Moore, Vicky Jennings, Astrid Leusink, Nazmie Kariem, Juan Gouws, Kathryn Chu, Heather Bougard, Fazlin Noor, Angela Dell, Stephanie Van Straten, Arvin Khamajeet, Serge Kapenda Tshisola, Kalangu Kabongo, Victor Kong, Yoshan Moodley, Frank Anderson, Thandinkosi Madiba, Flip du Plooy, Leila Hartford, Gareth Chilton, Parveen Karjiker, Matlou Ernest Mabitsela, Sibongile Ruth Ndlovu, Maria Badicel, Robert Jaich, Jaime Ruiz-Tovar, Luis Garcia-Florez, Jorge L. Otero-Díez, Virginia Ramos Pérez, Nuria Aguado Suárez, Javier Minguez García, Sara Corral Moreno, Maria Vicenta Collado, Virginia Jiménez Carneros, Javier García Septiem, Mariana Gonzalez, Antonio Picardo, Enrique Esteban, Esther Ferrero, Eloy Espin-Basany, Ruth Blanco-Colino, Valeria Andriola, Lorena Solar García, Elisa Contreras, Carmen García Bernardo, Janet Pagnozzi, Sandra Sanz, Alberto Miyar de León, Asnel Dorismé, Joseluis Rodicio, Aida Suarez, Jessica Stuva, Tamara Diaz Vico, Laura Fernandez-Vega, Carla Soldevila-Verdeguer, Fatima Sena-Ruiz, Natalia Pujol-Cano, Paula Diaz-Jover, José Maria Garcia-Perez, Juan Jose Segura-Sampedro, Cristina Pineño-Flores, David Ambrona-Zafra, Andrea Craus-Miguel, Patricia Jimenez-Morillas, Angela Mazzella, A.B. Jayathilake, S.P.B. Thalgaspitiya, L.S. Wijayarathna, P.M.S.N. Wimalge, Hakeem Ayomi Sanni, Ogheneochuko Okenabirhie, Anmar Homeida, Abobaker Younis, Omer Abdelbagi Omer, Mustafa Abdulaziz, Ali Mussad, Ali Adam, Ida Björklund, Sandra Ahlqvist, Anders Thorell, Fredrik Wogensen, Arestis Sokratous, Michaela Breistrand, Hildur Thorarinsdottir, Johanna Sigurdadottir, Maziar Nikberg, Abbas Chabok, Maria Hjertberg, Peter Elbe, Deborah Saraste, Wiktor Rutkowski, Louise Forlin, Karoliina Niska, Malin Sund, Dennis Oswald, Georgios Peros, Rafael Bluelle, Katharina Reinisch, Daniel Frey, Adrian Palma, Dimitri Aristotle Raptis, Lucius Zumbühl, Markus Zuber, Roger Schmid, Gabriela Werder, Antonio Nocito, Alexandra Gerosa, Silke Mahanty, Lukas Werner Widmer, Julia Müller, Alissa Gübeli, Grzegorz Zuk, Osman Bilgin Gulcicek, Talar Vartanoglu, Emin Kose, Servet Rustu Karahan, Mehmet Can Aydin, Nuri Alper Sahbaz, Ilkay Halicioglu, Halil Alis, Ipek Sapci, Can Adıyaman, Ahmet Murat Pektaş, Turgut Bora Cengiz, Ilkan Tansoker, Vedatcan Işler, Muazzez Cevik, Deniz Mutlu, Volkan Ozben, Berk Baris Ozmen, Sefa Bayram, Sinem Yolcu, Berna Buse Kobal, Ömer Faruk Toto, Haluk Cem Çakaloğlu, Kagan Karabulut, Vahit Mutlu, Bahar Busra Ozkan, Saban Celik, Anil Semiz, Selim Bodur, Enisburak Gül, Busra Murutoglu, Reyyan Yildirim, Bahadir Emre Baki, Ekin Arslan, Mehmet Ulusahin, Ali Guner, Nathan Walker, Nikhita Shrimanker, Simon Cole, Ryan Breslin, Ravi Srinivasan, Mohamed Elshaer, Kristina Hunter, Ahmed Al-Bahrani, Ignatius Liew, Nora Grace Mairs, Alistair Rocke, Lachlan Dick, Mobeen Qureshi, Debkumar Chowdhury, Naomi Wright, Clare Skerritt, Dorothy Kufeji, Adrienne Ho, Tharindra Dissanayake, Athula Tennakoon, Wadah Ali, Shujing Jane Lim, Charlene Tan, Stephen O'Neill, Catrin Jones, Stephen Knight, Dima Nassif, Abhishek Sharma, Oliver Warren, Rebecca White, Aia Mehdi, Nathan Post, Eliana Kalakouti, Enkhbat Dashnyam, Frederick Stourton, Ioannis Mykoniatis, Chelise Currow, Francisca Wong, Ashish Gupta, Veeranna Shatkar, Joshua Luck, Suraj Kadiwar, Alexander Smedley, Rebecca Wakefield, Philip Herrod, James Blackwell, Jonathan Lund, Fraser Cohen, Ashwath Bandi, Stefano Giuliani, Giles Bond-Smith, Theodore Pezas, Neda Farhangmehr, Tomas Urbonas, Miklos Perenyei, Philip Ireland, Natalie Blencowe, Kirk Bowling, David Bunting, Lydia Longstaff, Kenneth Keogh, Hyunjin Jeon, Muhammad Rafaih Iqbal, Shivun Khosla, Anna Jeffery, James Perera, Ahmad Aboelkassem Ibrahem, Tariq Alhammali, Yahya Salama, Shaun Oram, Thomas Kidd, Fraser Cullen, Christopher Owen, Michael Wilson, Seehui Chiu, Hannah Sarafilovic, Jennifer Ploski, Elizabeth Evans, Athar Abbas, Sylvia Kamya, Norzawani Ishak, Carly Bisset, Cedar Andress, Ye Ru Chin, Priya Patel, David Evans, Aidan Haslegrave, Adam Boggon, Kirsten Laurie, Katie Connor, Thomas Mann, Anahita Mansuri, Rachel Davies, Ewen Griffiths, Aized Raza Shahbaz, Calvin Eng, Farhat Din, Ariadne L'Heveder, Esther H.G. Park, Ramanish Ravishankar, Kirsten McIntosh, Jih Dar Yau, Luke Chan, Susan McGarvie, Lingshan Tang, Hui Lim, Suhhuey Yap, Jay Park, Zhan Herr Ng, Shahrukh Mirza, Yun Lin Ang, Luke Walls, Chloe Roy, Simon Paterson-Brown, Julian Camilleri-Brennan, Kenneth Mclean, Michelle S. D'Souza, Savva Pronin, David Ewart Henshall, Eunice Zuling Ter, Dina Fouad, Ashish Minocha, William English, Catrin Morgan, Dominic Townsend, Laura Maciejec, Shareef Mahdi, Onyinye Akpenyi, Elisabeth Hall, Hanaan Caydiid, Zakaria Rob, Tom Abbott, Hew D. Torrance, Robin Johnston, Mohammed Akil Gani, Gianpiero Gravante, Shivanchan Rajmohan, Kiran Majid, Shiva Dindyal, Christopher Smith, Madanmohan Palliyil, Sanjay Patel, Luke Nicholson, Neil Harvey, Katie Baillie, Sam Shillito, Suzanne Kershaw, Rebecca Bamford, Peter Orton, Elke Reunis, Robert Tyler, Wai Cheong Soon, Guled M. Jama, Dharminder Dhillon, Khyati Patel, Shayanthan Nanthakumaran, Rachel Heard, Kar Yan Chen, Behrad Barmayehvar, Uttaran Datta, Sivesh K. Kamarajah, Sharad Karandikar, Sobhana Iftekhar Tani, Eimear Monaghan, Philippa Donnelly, Michael Walker, Jehangirshaw Parakh, Sarah Blacker, Anil Kaul, Arjun Paramasivan, Sameh Farag, Ashrafun Nessa, Salwa Awadallah, Jieqi Lim, James Chean Khun Ng, Ravi P. Kiran, Alice Murray, Eric Etchill, Mohini Dasari, Juan Puyana, Nadeem Haddad, Martin Zielinski, Asad Choudhry, Celeste Caliman, Mieshia Beamon, Therese Duane, Mamta Swaroop, Jonathan Myers, Rebecca Deal, Erik Schadde, Mark Hemmila, Lena Napolitano, Kathleen To, Alex Makupe, Joseph Musowoya, Niels Van Der Naald, Dayson Kumwenda, Alex Reece-Smith, Kars Otten, Anna Verbeek, Marloes Prins, Alibeth Andres Baquero Suarez, Ruben Balmaceda, Chelsea Deane, Emilio Dijan, Mahmoud Elfiky, Laura Koskenvuo, Aurore Thollot, Bernard Limoges, Carmen Capito, Challine Alexandre, Henri Kotobi, Julien Leroux, Kalitha Pinnagoda, Nicolas Henric, Olivier Azzis, Olivier Rosello, Poddevin Francois, Sara Etienne, Philippe Buisson, Sophian Hmila, Joe-Nat Clegg-Lamptey, Osman Imoro, Owusu Emmanuel Abem, Dimitrios Papageorgiou, Vasiliki Soulou, Sabrina Asturias, Lenin Peña, Donal B. O’Connor, Alberto Realis Luc, Alfio Alessandro Russo, Andrea Ruzzenente, Antonio Taddei, Camilla Cona, Corrado Bottini, Giovanni Pascale, Giuseppe Rotunno, Leonardo Solaini, Marco Maria Pascale, Margherita Notarnicola, Mario Corbellino, Michele Sacco, Paolo Ubiali, Roberto Cautiero, Tommaso Bocchetti, Elena Muzio, Vania Guglielmo, Eugenio Morandi, Patrizio Mao, Emilia De Luca, Farah Mahmoud Ali, Justas Žilinskas, Kestutis Strupas, Paulius Kondrotas, Robertas Baltrunas, Juozas Kutkevicius, Povilas Ignatavicius, Choy Ling Tan, Jia Yng Siaw, Sir Young Yam, Ling Wilson, Mohamed Rezal Abdul Aziz, John Bondin, Carmina Diaz Zorrilla, Anass Majbar, Danjuma Sale, Lawal Abdullahi, Olabisi Osagie, Omolara Faboya, Adedeji Fatuga, Agboola Taiwo, Emeka Nwabuoku, Marte Bliksøen, Zain Ali Khan, Jazmin Coronel, Cesar Miranda, Idelso Vasquez, Luis M. Helguero-Santin, Jennifer Rickard, Adesina Adedeji, Saleh Alqahtani, Max Rath, Michael Van Niekerk, Modise Zacharia Koto, Roel Matos-Puig, Leif Israelsson, Tobias Schuetz, Mahmut Arif Yuksek, Meric Mericliler, Mehmet Uluşahin, Bernhard Wolf, Cameron Fairfield, Guo Liang Yong, Katharine Whitehurst, Natalie Redgrave, Caroluce K. Musyoka, James Olivier, Kathryn Lee, Michael Cox, Muhamed M.H. Farhan-Alanie, Rory Callan, Chali Chibuye, Tebian Hassanein Ahmed Ali, Syrine Rekhis, Muna Rommaneh, Zi Hao Sam, Thays Brunelli Pugliesi, Gabriel Pardo, and Ruth Blanco
Subjects: abdominal surgery, cost-effectiveness analysis, global surgery, high fraction of inspired oxygen, low-and middle-income countries, surgical site infection, Anesthesiology, RD78.3-87.3
Abstract: Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was $216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with $195 for low FiO2 leading to a −$11 (95% CI: −$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was $1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this.
Published: 2023
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4. The association between rural or urban setting and outcomes in geriatric trauma patients in South Africa: a retrospective cohort study

Author: Bogo Lee, Victor Kong, Cynthia Cheung, Nigel Rajaretnam, John Bruce, Vasel Manchev, Robert Mills, and Damian Clarke
Subjects: Trauma, Geriatric, Urban, Rural, Surgery, RD1-811
Abstract: Introduction: This study compares outcomes between rural and urban geriatric trauma patients at a major trauma centre in South Africa. Materials and Methods: This retrospective cohort study from a prospectively entered data set, reviewed all patients aged 65 years or above admitted between January 2013 to December 2020 to our trauma centre at Grey's Hospital, South Africa. Results: Over the 8-year study period, a total of 323 patients aged ≥ 65 years were included (201 males (62%), mean age: 72 years. Mechanism of injury: 257 blunt (80%), 52 penetrating (16%) and 14 others (4%). The median Injury Severity Score (ISS) was 9. The median Charlson Comorbidity Index (CCI) for all 323 cases was 3. The median length of hospital stay was two days. The overall mortality was 12%. The crude odds ratio (OR) for death in rural vs urban patients was 2.51 (95% CI 1.27 – 4.94). After propensity score stratification for ISS, heart rate (HR), respiratory rate (RR), Glasgow Coma Scale (GCS) and temperature, and adjustment for mechanism, operation, Intensive Care Unit (ICU) and need for mechanical ventilation, the risk of death among the rural patients remained higher than in urban patients at 2.46 times (p=0.063), however, it was not statistically significant. Those who were operated on were significantly less likely to die after adjustment for confounding factors. Admission to ICU and the need for mechanical ventilation were significantly associated with mortality. Conclusion: Rural geriatric trauma patients have worse outcomes than urban geriatric trauma even after adjustment for differences in demographic and injury profile.
Published: 2023
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5. Contemporary management of blunt colonic injuries – Experience from a level one trauma centre in New Zealand

Author: Jeffrey Tan, Nat Joe, Victor Kong, Damian Clarke, Jonathan Ko, Janet Amey, Bronwyn Denize, Gina Marsden, Damien Ah Yen, and Grant Christey
Subjects: Wounds and injuries, General surgery, Blunt abdominal trauma, Colonic Injury, Surgery, RD1-811
Abstract: Introduction: Blunt colonic injury (BCI) is relatively rare, and literature on the topic is sparse. This study reviews our contemporary experience in its management at a level-one trauma centre in New Zealand. Materials and Methods: This was a retrospective study (January 2012 to December 2020) that included all patients who sustained a BCI managed at Waikato Hospital, New Zealand. Results: Of the total of 1181 patients with blunt abdominal trauma, 69 (6%) of them sustained a BCI (49% male, mean age: 36 years). 78 separate colonic injuries were identified in the 69 cases. The most commonly injured segment was the ascending colon 49% (38/78). Eighty percent (55/69) underwent a CT scan, with only 16 showing definite evidence of a colonic injury. AAST Grade 1 was the most common (81%). Fifteen patients underwent damage control surgery. All 11 grade 1 injuries were repaired primarily, whilst the other four grade 4 and 5 colonic injuries were resected, with 3 having a subsequent stoma formation and one delayed anastomosis. There were four mortalities. Patients who had negative or equivocal admission CT findings for colonic injury had delays to the operating theatre and had poorer outcomes. Conclusion: BCI is rare but is associated with a prolonged hospital stay. The treatment of BCI is similar to that of penetrating colonic injury. CT appeared inaccurate in many cases.
Published: 2023
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6. Ten year analysis of missed injuries at a major trauma centre in South Africa

Author: Howard Wain, Damian L Clarke, Shelley Wall, Wanda Bekker, Victor Kong, and John L Bruce
Subjects: Missed injury, Interpretation, Trauma, Missed, Patient safety, Surgery, RD1-811
Abstract: Introduction: This analysis retrospectively reviews a tertiary trauma service's experience with missed injuries over a decade. Methods: The Pietermaritzburg Metropolitan Trauma Service (PMTS) has accumulated electronic data on all admissions since 2012. This data informs the monthly morbidity and mortality conference, where adverse events are discussed. Records of all missed injuries were reviewed. Results: During the study period there were 17 254 individual patient admissions and 4 624 surgical procedures. A total of 159 missed injuries were identified. Ninety-six were injuries missed on investigation; 60 were missed on CT, 27 missed on x-ray, 1 on blood test, and 8 occurred during an unknown investigation. Thirty-nine injuries were missed during surgery; including thirteen colonic, five small bowel, five gastric, four duodenal, three vascular and three diaphragmatic injuries. Twenty-four injuries were missed on initial assessment, the majority of which were soft tissue injuries. Intraoperative missed injuries resulted in the greatest morbidity. Conclusion: Missed injuries remain a problem in modern trauma care. Injuries missed during initial clinical assessment and on imaging must be excluded by detailed secondary surveys and in depth review of all imaging. Injuries missed at operation carry greater morbidity than those missed outside the operating room. Ongoing vigilance is necessary to reduce the incidence of these injuries.
Published: 2023
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7. Contemporary management of abdominal stab wound with retained knife – A practical guide

Author: Victor Kong
Subjects: Medicine (General), R5-920
Abstract: The incidence of penetrating abdominal trauma (PAT) varies widely depending on geography. In New Zealand, where the proportion of major trauma secondary to penetrating injury is approximately 5%, the overall volume of stab wounds (SW) is relatively low compared with countries such as the United States of America and South Africa. There is no current national guideline for the management of abdominal SW and thus the treatment is largely clinician dependent. The specific clinical scenario of abdominal SW with an associated retained knife is even rarer, but is challenging to manage. Most literature on the topic consists of anecdotal case reports. Very few centres will have accumulated sufficient experience to formulate management algorithms for this particular scenario. This article focuses on the general principles and management strategies for this specific injury. This is based on the author’s personal published and institutional experience over a decade from a high-volume major trauma centre in South Africa. It is aimed at medical students and qualified clinicians who may encounter such injury in the emergency department.
Published: 2023
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8. Serum lactate level is an independent predictor of mortality in cardiac stab wounds – A South African experience

Author: Victor Kong, Jonathan Ko, Anantha Narayan, Summer Hassan, Priscilla Leow, Jia Lim, John Bruce, Grant Laing, and Damian Clarke
Subjects: Cardiac, Stab wound, Lactate, Mortality prediction, Surgery, RD1-811
Abstract: Introduction: Despite dramatic advances in the care of trauma patients over the last fifty years, cardiac stab wounds (CSW) remain highly lethal, and the specific relationship between serum lactate level and mortality is unknown. Methods: A retrospective review was conducted on all patients who presented with intraoperatively confirmed CSW from January 2008 to January 2020 at a major trauma centre in South Africa. Admission serum lactate level and patients' clinical outcomes were reviewed. Results: During the 12-year study period, a total of 236 patients were included (84% male, mean age: 28 years). Mean value of admission physiology: Systolic Blood Pressure: 79 mmHg, pH: 7.2, Serum Lactate: 6 mmol/l. Surgical access was via: median sternotomy in 65% (153/236) and the remaining 35% (83/236) via lateral thoracotomy. In 92% (217/236), there was a single cardiac chamber injury; in the remaining 8% (19/236), multiple cardiac chambers were injured. The overall mortality was 18% (43/236). Lactate was a significant predictor of mortality (AUC 93.8, p
Published: 2023
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9. Surgical Registrars as Primary Operators Have Acceptable Outcomes for Trauma Laparotomy

Author: Jonathan Ko, Victor Kong, Janet Amey, Damian Clarke, Damien Ah Yen, and Grant Christey
Subjects: wounds and injuries, laparotomy, general surgery, internship and residency, Psychology, BF1-990
Abstract: Background: The literature has suggested that acceptable outcomes in elective general surgery can be achieved with registrars operating but is less clear with trauma surgery. Methods: This was a retrospective study of all laparotomies performed for adult trauma between 2012 and 2020 at a Level 1 Trauma Centre in New Zealand to identify potential differences in clinical outcomes between primary operators. The primary operator of each operation was identified, along with the presence or absence of a consultant and the clinical outcome. Results: During the 9-year study period, a total of 204 trauma laparotomies were performed at Waikato Hospital. The groups of the primary operators were: a registrar with a consultant present (27%), a registrar without a consultant present (22%), a registrar assisting a consultant (48%), and a consultant who operated without a registrar (3%). Direct comparison was made between the three groups where registrars were involved in the laparotomy. There was no significant difference in the clinical outcomes, whether a consultant was present or not. Conclusions: Surgical registrars have acceptable outcomes for trauma laparotomy in the appropriate patients. A consultant surgeon should still operate on patients with more significant physiological derangements.
Published: 2022
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10. WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections

Author: Massimo Sartelli, Federico Coccolini, Yoram Kluger, Ervis Agastra, Fikri M. Abu-Zidan, Ashraf El Sayed Abbas, Luca Ansaloni, Abdulrashid Kayode Adesunkanmi, Goran Augustin, Miklosh Bala, Oussama Baraket, Walter L. Biffl, Marco Ceresoli, Elisabetta Cerutti, Osvaldo Chiara, Enrico Cicuttin, Massimo Chiarugi, Raul Coimbra, Daniela Corsi, Francesco Cortese, Yunfeng Cui, Dimitris Damaskos, Nicola de’Angelis, Samir Delibegovic, Zaza Demetrashvili, Belinda De Simone, Stijn W. de Jonge, Stefano Di Bella, Salomone Di Saverio, Therese M. Duane, Paola Fugazzola, Joseph M. Galante, Wagih Ghnnam, George Gkiokas, Carlos Augusto Gomes, Ewen A. Griffiths, Timothy C. Hardcastle, Andreas Hecker, Torsten Herzog, Aleksandar Karamarkovic, Vladimir Khokha, Peter K. Kim, Jae Il Kim, Andrew W. Kirkpatrick, Victor Kong, Renol M. Koshy, Kenji Inaba, Arda Isik, Rao Ivatury, Francesco M. Labricciosa, Yeong Yeh Lee, Ari Leppäniemi, Andrey Litvin, Davide Luppi, Ronald V. Maier, Athanasios Marinis, Sanjay Marwah, Cristian Mesina, Ernest E. Moore, Frederick A. Moore, Ionut Negoi, Iyiade Olaoye, Carlos A. Ordoñez, Mouaqit Ouadii, Andrew B. Peitzman, Gennaro Perrone, Tadeja Pintar, Giuseppe Pipitone, Mauro Podda, Kemal Raşa, Julival Ribeiro, Gabriel Rodrigues, Ines Rubio-Perez, Ibrahima Sall, Norio Sato, Robert G. Sawyer, Vishal G. Shelat, Michael Sugrue, Antonio Tarasconi, Matti Tolonen, Bruno Viaggi, Andrea Celotti, Claudio Casella, Leonardo Pagani, Sameer Dhingra, Gian Luca Baiocchi, and Fausto Catena
Subjects: Skin and soft-tissue infections, Necrotizing soft-tissue infections, Necrotizing infections, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections. Together, the World Society of Emergency Surgery, the Global Alliance for Infections in Surgery, the Surgical Infection Society-Europe, The World Surgical Infection Society, and the American Association for the Surgery of Trauma have jointly completed an international multi-society document to promote global standards of care in SSTIs guiding clinicians by describing reasonable approaches to the management of SSTIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting evidence was shared by an international task force with different clinical backgrounds.
Published: 2022
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11. In-Hospital Mortality Following Traumatic Injury in South Africa

Author: Erik Storm, MD, Michelle Smith, MD, Victor Kong, MD, Grant L. Laing, MD, John L. Bruce, MD, Wanda Bekker, MD, Johan Svensson, PhD, Vassil Manchev, MD, Karl A. Franklin, MD, PhD, and Damian L. Clarke, MD
Subjects: Surgery, RD1-811
Abstract: Objectives:. Trauma is a leading cause of death worldwide and in South Africa. We aimed to quantify the in-hospital trauma mortality rate in Pietermaritzburg, South Africa. Background:. The in-hospital trauma mortality rate in South Africa remains unknown, and it is unclear whether deficits in hospital care are contributing to the high level of trauma-related mortality. Methods:. All patients hospitalized because of trauma at the Department of Surgery at Grey’s Hospital, Pietermaritzburg Metropolitan Trauma Service, were prospectively entered in an electronic database starting in 2013 and the data were retrospectively analyzed. The trauma service adheres to Advanced Trauma Life Support and the doctors have attended basic and advanced courses in trauma care. The primary outcome was in-hospital mortality. Results:. Of 9795 trauma admissions, 412 (4.2%) patients died during hospital care between January 2013 and January 2019. Forty-six percent died after road traffic accidents, 19% after gunshot wounds, 13% after stab wounds, and 10% after assaults. Sixteen percent were classified as avoidable deaths due to inappropriate care and resource limitations. Fifty percent died because of traumatic brain injury and 80% of them were unavoidable. Conclusions:. In conclusion, the in-hospital trauma mortality rate at a South African trauma center using systematic trauma care is lower than that reported from other trauma centers in the world during the past 20 years. Nevertheless, 16% of death cases were assessed as avoidable if there had been better access to intensive care, dialysis, advanced respiratory care, blood for transfusion, and improvements in surgery and medical care.
Published: 2022
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12. Managing the acutely threatened airway following head and neck trauma – Requiem for cricothyroidotomy?

Author: Cheyaanthan Haran, Victor Kong, Cynthia Cheung, Nigel Rajaretnam, John Bruce, Grant Laing, Vasil Manchev, and Damian Clarke
Subjects: Trauma, Emergency airway, Surgical airway, Cricothyroidotomy, Tracheostomy, Surgery, RD1-811
Abstract: Introduction: Trauma to the head and neck results in acute facial trauma and swelling, which may occlude the airway and result in fatal hypoxia. The management is the establishment of a definitive airway. This paper reviews our experience with this clinical scenario. Materials & Methods: A retrospective study was conducted over a seven-year period from December 2012 to January 2020 at a major trauma centre in South Africa on all adult trauma patients who required a surgical airway procedure (surgical cricothyroidotomy (SC) or surgical tracheostomy (ST)). Results: From December 2012 to January 2020, 12243 trauma patients were admitted. Of those, 242 patients required a surgical airway: 98% (238/242) underwent ST and 2% (4/242) underwent SC. A total of 3271 patients sustained trauma predominantly confined to the face and neck. The mechanism was penetrating trauma in 1077 and blunt trauma in 2194. Total of 51 patients required an emergency airway for acute head and neck trauma. There were four SCs and 47 STs. Of the four SC, three were inserted secondary to multiple failed attempts at intubation and one was inserted directly into an open tracheal injury. All of these were performed in the resuscitation room. The 47 STs were performed under conscious sedation in the operating theatre. There were eight failed intubations in the 51 patients with head and neck trauma, and of those three required an emergency SC and five required an emergency ST. Conclusion: The use of cricothyroidotomy in modern trauma care in our environment appears to be very limited.
Published: 2022
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13. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections

Author: Massimo Sartelli, Federico Coccolini, Yoram Kluger, Ervis Agastra, Fikri M. Abu-Zidan, Ashraf El Sayed Abbas, Luca Ansaloni, Abdulrashid Kayode Adesunkanmi, Boyko Atanasov, Goran Augustin, Miklosh Bala, Oussama Baraket, Suman Baral, Walter L. Biffl, Marja A. Boermeester, Marco Ceresoli, Elisabetta Cerutti, Osvaldo Chiara, Enrico Cicuttin, Massimo Chiarugi, Raul Coimbra, Elif Colak, Daniela Corsi, Francesco Cortese, Yunfeng Cui, Dimitris Damaskos, Nicola de’ Angelis, Samir Delibegovic, Zaza Demetrashvili, Belinda De Simone, Stijn W. de Jonge, Sameer Dhingra, Stefano Di Bella, Francesco Di Marzo, Salomone Di Saverio, Agron Dogjani, Therese M. Duane, Mushira Abdulaziz Enani, Paola Fugazzola, Joseph M. Galante, Mahir Gachabayov, Wagih Ghnnam, George Gkiokas, Carlos Augusto Gomes, Ewen A. Griffiths, Timothy C. Hardcastle, Andreas Hecker, Torsten Herzog, Syed Mohammad Umar Kabir, Aleksandar Karamarkovic, Vladimir Khokha, Peter K. Kim, Jae Il Kim, Andrew W. Kirkpatrick, Victor Kong, Renol M. Koshy, Igor A. Kryvoruchko, Kenji Inaba, Arda Isik, Katia Iskandar, Rao Ivatury, Francesco M. Labricciosa, Yeong Yeh Lee, Ari Leppäniemi, Andrey Litvin, Davide Luppi, Gustavo M. Machain, Ronald V. Maier, Athanasios Marinis, Cristina Marmorale, Sanjay Marwah, Cristian Mesina, Ernest E. Moore, Frederick A. Moore, Ionut Negoi, Iyiade Olaoye, Carlos A. Ordoñez, Mouaqit Ouadii, Andrew B. Peitzman, Gennaro Perrone, Manos Pikoulis, Tadeja Pintar, Giuseppe Pipitone, Mauro Podda, Kemal Raşa, Julival Ribeiro, Gabriel Rodrigues, Ines Rubio-Perez, Ibrahima Sall, Norio Sato, Robert G. Sawyer, Helmut Segovia Lohse, Gabriele Sganga, Vishal G. Shelat, Ian Stephens, Michael Sugrue, Antonio Tarasconi, Joel Noutakdie Tochie, Matti Tolonen, Gia Tomadze, Jan Ulrych, Andras Vereczkei, Bruno Viaggi, Chiara Gurioli, Claudio Casella, Leonardo Pagani, Gian Luca Baiocchi, and Fausto Catena
Subjects: Intra-abdominal infections, Peritonitis, Sepsis, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in hospitals worldwide. The cornerstones of effective treatment of IAIs include early recognition, adequate source control, appropriate antimicrobial therapy, and prompt physiologic stabilization using a critical care environment, combined with an optimal surgical approach. Together, the World Society of Emergency Surgery (WSES), the Global Alliance for Infections in Surgery (GAIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), and the American Association for the Surgery of Trauma (AAST) have jointly completed an international multi-society document in order to facilitate clinical management of patients with IAIs worldwide building evidence-based clinical pathways for the most common IAIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting information was shared by an international task force from 46 countries with different clinical backgrounds. The aim of the document is to promote global standards of care in IAIs providing guidance to clinicians by describing reasonable approaches to the management of IAIs.
Published: 2021
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14. Clinical decision making for abdominal stab wounds in high resourced but low volume centres require structured guidelines to be effective

Author: Leon Kong, Victor Kong, Grant Christey, Damien Ah Yen, Janet Amey, Bronwyn Denize, Gina Marsden, and Damian Clarke
Subjects: Penetrating abdominal trauma stab wound, Surgery, RD1-811
Abstract: Aim: The management of abdominal stab wounds (SW) has continued to evolve. The use of CT and laparoscopy has been advocated to reduce the rate of laparotomy. This study reviews our experience with SW in a high income, low volume setting. Methods: A retrospective study was undertaken from 2006 to 2020 at Waikato Hospital, New Zealand. All adult patients age > 16 years that were admitted following trauma were included. Results: Seventy three cases of SW were included. Thirty two cases had indications for immediate laparotomy (peritonitis in 15, hemodynamic instability in 13, evisceration in 4). Twenty two underwent immediate laparotomy. Overall, 43 had a positive laparotomy. One had a negative laparotomy. Thirty seven cases had a CT. Laparoscopy was performed in 24 cases, with 23 demonstrating peritoneal breach. Subsequently 9 were converted to laparotomy whilst 15 had full laparoscopic exploration. Conclusion: The relative rarity of abdominal SW in our environment has resulted in a considerable degree of heterogeneity in our approach to this clinical dilemma. The simplified algorithm we have developed will hopefully facilitate clinical decision making in our institution.
Published: 2022
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15. Surgical registrars’ exposure to trauma laparotomy: A retrospective study from a level 1 trauma centre in New Zealand

Author: Jonathan Ko, Victor Kong, Janet Amey, Damian Clarke, Damien Ah Yen, and Grant Christey
Subjects: Wounds, Laparotomy, General Surgery, New Zealand, Residency, Education, Surgery, RD1-811
Abstract: Introduction: The objective of this study was to review the experience of surgical registrars in performing trauma laparotomies at a level 1 trauma centre in New Zealand, and to benchmark this exposure against the current literature on the topic. Methods: A cohort study was conducted retrospectively at a level 1 trauma centre, Waikato Hospital, Hamilton, New Zealand. All patients (>15 years) who underwent a laparotomy for trauma between 2012 and 2020 were included. These patients were stratified by the study conductors retrospectively, according to each case's primary operator and compared the experience of each respective operator according to the time of day and by the mechanism of injury. Results: During the 9-year study period, a total of 204 trauma laparotomies were performed at Waikato Hospital. Of these 204 laparotomies, a consultant was present in 78% (160/204). In 27% of cases, a registrar was the primary operator with a consultant present (55/204), and in 22% of cases, the registrar was the primary operator with no consultant present (44/204). In 48%, a registrar assisted a consultant (98/204), and in 3%, a consultant performed the operation without a registrar assisting (7/204). Based on there being four registrars rotating through Waikato Hospital each 6-month cycle, this would imply that each registrar would be exposed to three trauma laparotomies each cycle. Conclusions: Despite significant institutional volumes, the exposure of individual New Zealand surgical registrars to trauma laparotomy is limited. In addition, most trauma laparotomies were performed by registrars as assistants rather than as primary operators. It is hoped that the newly launched Post Fellowship Education and Training (PFET) in trauma in Australasia will provide greater exposure to surgeons who will be managing trauma in the future.
Published: 2022
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16. Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study

Author: Massimo Sartelli, Fikri M. Abu-Zidan, Francesco M. Labricciosa, Yoram Kluger, Federico Coccolini, Luca Ansaloni, Ari Leppäniemi, Andrew W. Kirkpatrick, Matti Tolonen, Cristian Tranà, Jean-Marc Regimbeau, Timothy Hardcastle, Renol M. Koshy, Ashraf Abbas, Ulaş Aday, A. R. K. Adesunkanmi, Adesina Ajibade, Lali Akhmeteli, Emrah Akın, Nezih Akkapulu, Alhenouf Alotaibi, Fatih Altintoprak, Dimitrios Anyfantakis, Boyko Atanasov, Goran Augustin, Constança Azevedo, Miklosh Bala, Dimitrios Balalis, Oussama Baraket, Suman Baral, Or Barkai, Marcelo Beltran, Roberto Bini, Konstantinos Bouliaris, Ana B. Caballero, Valentin Calu, Marco Catani, Marco Ceresoli, Vasileios Charalampakis, Asri Che Jusoh, Massimo Chiarugi, Nicola Cillara, Raquel Cobos Cuesta, Luigi Cobuccio, Gianfranco Cocorullo, Elif Colak, Luigi Conti, Yunfeng Cui, Belinda De Simone, Samir Delibegovic, Zaza Demetrashvili, Demetrios Demetriades, Ana Dimova, Agron Dogjani, Mushira Enani, Federica Farina, Francesco Ferrara, Domitilla Foghetti, Tommaso Fontana, Gustavo P. Fraga, Mahir Gachabayov, Grelpois Gérard, Wagih Ghnnam, Teresa Giménez Maurel, Georgios Gkiokas, Carlos A. Gomes, Ali Guner, Sanjay Gupta, Andreas Hecker, Elcio S. Hirano, Adrien Hodonou, Martin Hutan, Igor Ilaschuk, Orestis Ioannidis, Arda Isik, Georgy Ivakhov, Sumita Jain, Mantas Jokubauskas, Aleksandar Karamarkovic, Robin Kaushik, Jakub Kenig, Vladimir Khokha, Denis Khokha, Jae Il Kim, Victor Kong, Dimitris Korkolis, Vitor F. Kruger, Ashok Kshirsagar, Romeo Lages Simões, Andrea Lanaia, Konstantinos Lasithiotakis, Pedro Leão, Miguel León Arellano, Holger Listle, Andrey Litvin, Aintzane Lizarazu Pérez, Eudaldo Lopez-Tomassetti Fernandez, Eftychios Lostoridis, Davide Luppi, Gustavo M. Machain V, Piotr Major, Dimitrios Manatakis, Marianne Marchini Reitz, Athanasios Marinis, Daniele Marrelli, Aleix Martínez-Pérez, Sanjay Marwah, Michael McFarlane, Mirza Mesic, Cristian Mesina, Nickos Michalopoulos, Evangelos Misiakos, Felipe Gonçalves Moreira, Ouadii Mouaqit, Ali Muhtaroglu, Noel Naidoo, Ionut Negoi, Zane Nikitina, Ioannis Nikolopoulos, Gabriela-Elisa Nita, Savino Occhionorelli, Iyiade Olaoye, Carlos A. Ordoñez, Zeynep Ozkan, Ajay Pal, Gian M. Palini, Kyriaki Papageorgiou, Dimitris Papagoras, Francesco Pata, Michał Pędziwiatr, Jorge Pereira, Gerson A. Pereira Junior, Gennaro Perrone, Tadeja Pintar, Magdalena Pisarska, Oleksandr Plehutsa, Mauro Podda, Gaetano Poillucci, Martha Quiodettis, Tuba Rahim, Daniel Rios-Cruz, Gabriel Rodrigues, Dmytry Rozov, Boris Sakakushev, Ibrahima Sall, Alexander Sazhin, Miguel Semião, Taanya Sharda, Vishal Shelat, Giovanni Sinibaldi, Dmitrijs Skicko, Matej Skrovina, Dimitrios Stamatiou, Marco Stella, Marcin Strzałka, Ruslan Sydorchuk, Ricardo A. Teixeira Gonsaga, Joel Noutakdie Tochie, Gia Tomadze, Lara Ugoletti, Jan Ulrych, Toomas Ümarik, Mustafa Y. Uzunoglu, Alin Vasilescu, Osborne Vaz, Andras Vereczkei, Nutu Vlad, Maciej Walędziak, Ali I. Yahya, Omer Yalkin, Tonguç U. Yilmaz, Ali Ekrem Ünal, Kuo-Ching Yuan, Sanoop K. Zachariah, Justas Žilinskas, Maurizio Zizzo, Vittoria Pattonieri, Gian Luca Baiocchi, and Fausto Catena
Subjects: Acute peritonitis, Source control, Early warning score, Emergency surgery, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Background Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted. Methods This worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018. Results A total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47 years (interquartile range [IQR] 28–66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6 days (IQR 4–10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80 years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate ≥ 22 breaths/min, systolic blood pressure < 100 mmHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO2) < 90% in air, platelet count < 50,000 cells/mm3, and lactate > 4 mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0–1, 22.7% for those who had scores of 2–3, 46.8% for those who had scores of 4–5, and 86.7% for those who have scores of 7–8. Conclusions The simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality.
Published: 2019
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17. Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study

Author: Sèbastien Gaujoux, Nebyou Seyoum, Ville Sallinen, Ari Leppäniemi, Andrea Belli, Clare Skerritt, Naomi Wright, Savva Pronin, Azmina Verjee, Thomas Pinkney, Neil Smart, Oliver Warren, Michele Sacco, Arnav Agarwal, Simon Paterson-Brown, David Evans, Philip Choi, Ashish Gupta, Jonathan Myers, Victor Kong, Michael Wilson, Ewen M Harrison, Mircea Beuran, Ionut Negoi, Zahra Jaffry, Leonardo Solaini, Thomas M Drake, Dmitri Nepogodiev, Adesoji O Ademuyiwa, Philip Alexander, Sara W Al-Saqqa, Sule Burger, Kathryn Chu, Dhruv Ghosh, Hosni Khairy Salem, Marie Carmela Lapitan, Ismail Lawani, Maria Lorena Aguilera, Mayaba Maimbo, Alex Makupe, Rachel Moore, Vanessa Msosa, Alphonse Zeta Mutabazi, Riinu Ots, Ahmad Uzair Qureshi, Sarah Rayne, Marie Dione Parreno-Sacdalan, Richard Spence, Stephen Tabiri, Richard Lilford, Dion Morton, Aneel Bhangu, Tom Abbott, Gehad Tawfik, Sebastian King, Alexia Farrugia, Jay Park, Abhishek Sharma, Augusto Zani, Christopher Smith, Jonathan Lund, Stefano Giuliani, John Whitaker, Elaine Borg, Alexis Arnaud, Esther Ferrero, Andrea Ruzzenente, Jennifer Rickard, Yousef Abuowda, Enas Alaloul, Natalie Blencowe, Sanjay Patel, Mark Ian Hampton, Ewen Griffiths, André L Mihaljevic, Elizabeth Evans, Catherine A Shaw, Jennifer Ploski, Mengistu Worku, Ashish Minocha, Shiva Dindyal, Midhun Mohan, Dina Fouad, Christopher Owen, Priya Patel, Sunil Kumar, James Yang, Kevin C Conlon, Sandro Pasquali, Mohamed Mostafa, Yoshan Moodley, Kathryn Lee, James Glasbey, Gareth Irwin, Kjetil Søreide, Catrin Morgan, Ruth Blanco-Colino, Francesco Pata, Gianluca Pellino, Sivesh K Kamarajah, Luke Nicholson, Adesoji Ademuyiwa, Felix Alakaloko, Olumide Elebute, Omolara Faboya, Taiwo Lawal, Omolara Williams, Andrey Litvin, Elodie Haraux, James Olivier, Michael Stoddart, Rebecca White, George Ihediwa, Luigi Bonavina, Chetan Khatri, Stephen O'Neill, Roger Schmid, Stephen Knight, Ahmed Soliman, Carly Bisset, Robert Parker, Rakan Kabariti, Joshua Luck, Guo Liang Yong, Tanzeela Gala, David Bunting, Lydia Longstaff, Ye Ru Chin, J Edward Fitzgerald, Giuliano Borda-Luque, Ainhoa Costas-Chavarri, Faustin Ntirenganya, Stuart J Fergusson, JC Allen Ingabire, Lawani Ismaïl, Anyomih Theophilus Teddy Kojo, Adewale O Adisa, Tomas Poškus, Antonio Ramos-De la Medina, Sebastian Shu, Emmy Runigamugabo, Afnan Altamini, Andrew Kirby, Gustavo Recinos, Jen Cornick, Maria Marta Modolo, Sayeda Nazmum Nahar, Ade Waterman, Ismail Lawini, Mohammed Firdouse, Tyler Rouse, Qinyang Liu, Juan Camilo Correa, Peep Talving, Dushyant Iyer, Tom Arthur, MariaLorena Aguilera, Basant Kumar, Radhian Amandito, Roy Quek, Luca Ansaloni, Ahmed Altibi, Donatas Venskutonis, Justas Zilinskas, YongYong Tew, Ramos-DelaMedina Antonio, Zineb Bent, Ibrahim Al-Slaibi, Haya Tahboub, Osaid H Alser, Diego Romani, Sebestian Shu, Piotr Major, Aurel Mironescu, Matei Bratu, Amar Kourdouli, Saint Kitts, Mohammed Ubaid Alsaggaf, Ahmad Gudal, Al Faifi Jubran, Sierra Leone, Sam Seisay, Bettina Lieske, Irene Ortega, Jenifa Jeyakumar, Kithsiri Senanayake, Omar Abdulbagi, Yucel Cengiz, Dmitri Raptis, Yuksel Altinel, Chia Kong, Ella Teasdale, Sukrit Suresh, Katherine Gash, Mark Scott, Ragavan Narayanan, Besmir Grizhja, Shpetim Ymeri, Gezim Galiqi, Roberto Klappenbach, Diego Antezana, Alvaro Enrique MendozaBeleño, Cecilia Costa, Belen Sanchez, Susan Aviles, Claudio Gabriel Fermani, Rubén Balmaceda, Santiago Villalobos, Juan Manuel Carmona, Daniel Hamill, Peter Deutschmann, Simone Sandler, Daniel Cox, Ram Nataraja, Claire Sharpin, Damir Ljuhar, Demi Gray, Morgan Haines, Dush Iyer, Nithya Niranjan, Scott D'Amours, Morvarid Ashtari, Helena Franco, Ashrarur Rahman Mitul, Sabbir Karim, Nowrin F Aman, Mahnuma Mahfuz Estee, Umme Salma, Joyeta Razzaque, Tasnia Hamidkanta, Sayeedaaktar Tori, Md Shadid Alamin, Swapnil Roy, Md Shadid Al Amin, Muhtarima Haque, Amreen Faruq, Farhana Iftekhar Margaret, Greg Padmore O'Shea, Ramesh Jonnalagadda, Aliaksandr Filatau, Dzmitry Paulouski, Maryna Shubianok, Tatsiana Shachykava, Dzianis Khokha, Vladimir Khokha, Fernande Djivoh, Francis Dossou, Djifid Morel Seto, Dansou Gaspard Gbessi, Bruno Noukpozounkou, Yacoubou Imorou Souaibou, Kpèmahouton René Keke, Fred Hodonou, Ernestyemalinstephane Ahounou, Thierry Alihonou, Max Dénakpo, Germain Ahlonsou, Alemayehu Ginbo Bedada, Carlos Nsengiyumva, Sandrine Kwizera, Venerand Barendegere, Simon Stock, Luai Jamal, Georges Azzie, Sameer Kushwaha, Tzu-Ling Chen, Chingwan Yip, Irene Montes, Felipe Zapata, Sebastian Sierra, Mohamed Youssef, Hossam Elfeki, Waleed Thabet, Aly Sanad, Ahmed Zaki, Noran Abdel-Hameed, Esraa Abd Elkhalek, Yehia Zakaria, Tarek Ezzat, Ali Abo ElDahab, Mohamed Kelany, Sara Arafa, OsamaMokhtar Mohamed Hassan, Nermin Mohamed Badwi, Ahmad Saber Sleem, Hussien Ahmed, Kholoud Abdelbadeai, Mohamed Abozed Abdullah, Muhammadamsyarauni Lokman, Suraya Bahar, Anan Radyabdelazeam, Abdelrahman Adelshone, Muhammad Bin Hasnan, Athirah Zulkifli, Siti NurAlia Kamarulzamil, Abdelaziz Elhendawy, Aliang Latif, Ahmad Bin Adnan, Shahadatul Shaharuddin, Aminah HanumHaji AbdulMajid, Mahmoud Amreia, Dina Al-Marakby, Mahmoud Salma, Mohamadjeffreybin Ismail, Elissa Rifhan MohdBasir, Citra Dewi MohdAli, Aya Yehia Ata, Maha Nasr, Asmaa Rezq, Ahmed Sheta, Sherif Tariq, Abdelkhalek Sallam, Abdelrhman KZ Darwish, Sohaila Elmihy, Shady El Hadry, Ahmed Farag, Haidar Hajah, Abdelaziz Seliem, Amro Aglan, Ahmed Zohair, Mahitab Essam, Omar Moussa, Esraa El-Gizawy, Mostafa Samy, Safia Ali, Esraa Elhalawany, Ahmed Ata, Mohamed Elhalawany, Mohamed Nashat, Samar Soliman, Alaa Elazab, Mostada Samy, Mohamed A Abdelaziz, Khaled Ibrahim, Ahmed mohamed Ibrahim, Ammar Gado, Usama Hantour, Esraa Alm Eldeen, Mohamed Reda loaloa, Arwa Abouzaid, Mostafa Ahmedbahaaeldin, Eman Hashad, Fathy Sroor, Doaa Gamil, Eman Mahmoudabdulhakeem, Mahmoud Zakaria, Fawzy Mohamed, Marwan Abubakr, Elsayed Ali, Hesham Magdy, Mennatallah Ramadan, Mohamed Abdelatymohamed, Salma Mansour, Hager Abdulazizamin, Ahmed Rabiemohamed, Mahmoud Saami, Nada Ahmedredaelsayed, Adham Tarek, Sabry Mohyeldeenmahmoud, Islam MagdyEl Sayed, Amira Reda, Martina Yusufshawky, Mohammed Mousasalem, Shahinaz Alaa El-Din, Noha Abdullah Soliman, Muhammed Talaat, Shahinaz Alaael-Dein AhmedAbdelmoenelhusseiny, Noha Abdullah, Mohammed Elshaar, Aya Abdelfatahibraheem, Hager Abdulaziz, Mohammed Kamal Ismail, Mona Hamdymadkor, Mohamed Abdelaty, Sara Mahmoudabdel Kader, Osama Mohamedsalah, Mahmoud Eldafrawy, Ahmed Zakieldeeb, Mostafa Mahmoudeid, Attia Attia, Khalid Salah El-Dien, Ayman Shwky, Mohamed Adel Badenjki, Abdelrahman Soliman, Samaa Mahmoud Al Attar, Farrag Sayed, Fahd Abdelsabour, Mohammed G Azizeldine, Muhammad Shawqi, Abdullah Hashim, Ahmed Aamer, Ahmed Mahmoud Abdel Raouf, Mahmoud Abdelshakour, Amal Ibrahim, Basma Mahmoud, Mohamed Ali Mahmoud, Mostafa Qenawy, Ahmed M Rashed, Ahmed Dahy, Marwa Sayed, Ahmed W Shamsedine, Bakeer Mohamed, Ahmad Hasan, Mahmoud M Saad, Khalil Abdulbassit, Nadia Khalidabdelatif, Nada Elzahed, Ahmed Elkashash, Sarah Hafez, 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Gilani, Ida Björklund, Sandra Ahlqvist, Anders Thorell, Fredrik Wogensen, Arestis Sokratous, Michaela Breistrand, Hildur Thorarinsdottir, Johanna Sigurdadottir, Maziar Nikberg, Abbas Chabok, Maria Hjertberg, Peter Elbe, Deborah Saraste, Wiktor Rutkowski, Louise Forlin, Karoliina Niska, Malin Sund, Dennis Oswald, Georgios Peros, Rafael Bluelle, Katharina Reinisch, Daniel Frey, Adrian Palma, Dimitriaristotle Raptis, Lucius Zumbühl, Markus Zuber, Gabriela Werder, Antonio Nocito, Alexandra Gerosa, Silke Mahanty, Lukas Werner Widmer, Julia Müller, Alissa Gübeli, Grzegorz Zuk, Osman Bilgin Gulcicek, Talar Vartanoglu, Emin Kose, Servet Rustu Karahan, Mehmet Can Aydin, Nuri Alper Sahbaz, Ilkay Halicioglu, Halil Alis, Ipek Sapci, Can Adıyaman, Ahmet Murat Pektaş, Turgut Bora Cengiz, Ilkan Tansoker, Vedatcan Işler, Muazzez Cevik, Deniz Mutlu, Volkan Ozben, Berk Baris Ozmen, Sefa Bayram, Sinem Yolcu, Berna Buse Kobal, Ömer Faruk Toto, Haluk Cem Çakaloğlu, Kagan Karabulut, Vahit Mutlu, Bahar Busra Ozkan, Saban Celik, Anil Semiz, Selim Bodur, Enisburak Gül, Busra Murutoglu, Reyyan Yildirim, Bahadir Emre Baki, Ekin Arslan, Mehmet Ulusahin, Ali Guner, Nathan Walker, Nikhita Shrimanker, Simon Cole, Ryan Breslin, Ravi Srinivasan, Mohamed Elshaer, Kristina Hunter, Ahmed Al-Bahrani, Ignatius Liew, Nora Grace Mairs, Alistair Rocke, Lachlan Dick, Mobeen Qureshi, Debkumar Chowdhury, Adrienne Ho, Tharindra Dissanayake, Athula Tennakoon, Wadah Ali, Shujing Jane Lim, Charlene Tan, Catrin Jones, Dima Nassif, Aia Mehdi, Nathan Post, Eliana Kalakouti, Enkhbat Dashnyam, Frederick Stourton, Ioannis Mykoniatis, Chelise Currow, Francisca Wong, Veeranna Shatkar, Suraj Kadiwar, Alexander Smedley, Rebecca Wakefield, Philip Herrod, James Blackwell, Fraser Cohen, Ashwath Bandi, Giles Bond-Smith, Theodore Pezas, Neda Farhangmehr, Tomas Urbonas, Miklos Perenyei, Philip Ireland, Kirk Bowling, Kenneth Keogh, Hyunjin Jeon, Muhammad Rafaih Iqbal, Shivun Khosla, Anna Jeffery, James Perera, Ahmad Aboelkassem Ibrahem, Tariq Alhammali, Yahya Salama, Shaun Oram, Thomas Kidd, Fraser Cullen, Seehui Chiu, Hannah Sarafilovic, Athar Abbas, Sylvia Kamya, Norzawani Ishak, Cedar Andress, Aidan Haslegrave, Adam Boggon, Kirsten Laurie, Katie Connor, Thomas Mann, Anahita Mansuri, Rachel Davies, Aized Raza Shahbaz, Calvin Eng, Farhat Din, Ariadne L'heveder, Esther H.G. Park, Ramanish Ravishankar, Kirsten Mcintosh, Jih Dar Yau, Luke Chan, Susan Mcgarvie, Lingshan Tang, Hui Lim, Suhhuey Yap, Zhanherr Ng, Shahrukh Mirza, Yun Lin Ang, Luke Walls, Chloe Roy, Julian Camilleri-Brennan, Kenneth Mclean, Michelle D'souza, David Ewart Henshall, Eunicezuling Ter, William English, Dominic Townsend, Laura Maciejec, Shareef Mahdi, Onyinye Akpenyi, Elisabeth Hall, Hanaan Caydiid, Zakaria Rob, Hew D Torrance, Robin Johnston, Mohammedakil Gani, Gianpiero Gravante, Shivanchan Rajmohan, Kiran Majid, Madanmohan Palliyil, Neil Harvey, Katie Baillie, Sam Shillito, Suzanne Kershaw, Rebecca Bamford, Peter Orton, Elke Reunis, Robert Tyler, Waicheong Soon, Guled M. Jama, Dharminder Dhillon, Khyati Patel, Shayanthan Nanthakumaran, Rachel Heard, Kar Yan Chen, Behrad Barmayehvar, Uttaran Datta, Sobhana Iftekhartani, Eimear Monaghan, Philippa Donnelly, Michael Walker, Jehangirshaw Parakh, Sarah Blacker, Anil Kaul, Arjun Paramasivan, Sameh Farag, Ashrafun Nessa, Salwa Awadallah, Jieqi Lim, James Cheankhunng, Ravi P. Kiran, Alice Murray, Eric Etchill, Mohini Dasari, Juan Puyana, Nadeem Haddad, Martin Zielinski, Asad Choudhry, Celeste Caliman, Mieshia Beamon, Therese Duane, Mamta Swaroop, Rebecca Deal, Erik Schadde, Mark Hemmila, Lena Napolitano, Kathleen To, Joseph Musowoya, Niels Van Der Naald, Dayson Kumwenda, Alex Reece-Smith, Kars Otten, Anna Verbeek, Marloes Prins, Alibeth Andres Baquero Suarez, Chelsea Deane, Emilio Dijan, Mahmoud Elfiky, Laura Koskenvuo, Aurore Thollot, Bernard Limoges, Carmen Capito, Challine Alexandre, Henri Kotobi, Julien Leroux, Kalitha Pinnagoda, Nicolas Henric, Olivier Azzis, Olivier Rosello, Poddevin Francois, Sara Etienne, Philippe Buisson, Sophian Hmila, Joe-Nat Clegg-Lamptey, Osman Imoro, Owusu Emmanuel Abem, Dimitrios Papageorgiou, Vasiliki Soulou, Sabrina Asturias, Lenin Peña, Donal B O’Connor, Alberto Realis Luc, Alfio Alessandro Russo, Antonio Taddei, Camilla Cona, Corrado Bottini, Giovanni Pascale, Giuseppe Rotunno, Marco Maria Pascale, Margherita Notarnicola, Mario Corbellino, Paolo Ubiali, Roberto Cautiero, Tommaso Bocchetti, Elena Muzio, Vania Guglielmo, Eugenio Morandi, Patrizio Mao, Emilia De Luca, Farah Mahmoud Ali, Kestutis Strupas, Paulius Kondrotas, Robertas Baltrunas, Juozas Kutkevicius, Povilas Ignatavicius, Choy Ling Tan, Jia Yng Siaw, Sir Young Yam, Ling Wilson, Mohamed Rezal Abdul Aziz, John Bondin, Carmina Diaz Zorrilla, Anass Majbar, Danjuma Sale, Lawal Abdullahi, Olabisi Osagie, Adedeji Fatuga, Agboola Taiwo, Emeka Nwabuoku, Marte BliksØen, Zain Ali Khan, Jazmin Coronel, Cesar Miranda, Idelso Vasquez, Luis M. Helguero-Santin, Adesina Adedeji, Saleh Alqahtani, Max Rath, Michael Van Niekerk, Modise Zacharia Koto, Roel Matos-Puig, Leif Israelsson, Tobias Schuetz, Mahmut Arif Yuksek, Meric Mericliler, Bernhard Wolf, Cameron Fairfield, Katharine Whitehurst, Natalie Redgrave, Caroluce K Musyoka, Michael Cox, Muhamed M H Farhan-Alanie, Rory Callan, Chali Chibuye, Tebian Hassanein Ahmed Ali, Syrine Rekhis, Muna Rommaneh, Zi Hao Sam, Thays Brunelli Pugliesi, Gabriel Pardo, and Ruth Blanco
Subjects: Medicine (General), R5-920, Infectious and parasitic diseases, RC109-216
Abstract: Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings.Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI).Results Of 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI.Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.
Published: 2020
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18. Knowledge, awareness, and attitude towards infection prevention and management among surgeons: identifying the surgeon champion

Author: Massimo Sartelli, Yoram Kluger, Luca Ansaloni, Federico Coccolini, Gian Luca Baiocchi, Timothy C. Hardcastle, Ernest E. Moore, Addison K. May, Kamal M. F. Itani, Donald E. Fry, Marja A. Boermeester, Xavier Guirao, Lena Napolitano, Robert G. Sawyer, Kemal Rasa, Fikri M. Abu-Zidan, Abdulrashid K. Adesunkanmi, Boyko Atanasov, Goran Augustin, Miklosh Bala, Miguel A. Cainzos, Alain Chichom-Mefire, Francesco Cortese, Dimitris Damaskos, Samir Delibegovic, Zaza Demetrashvili, Belinda De Simone, Therese M. Duane, Wagih Ghnnam, George Gkiokas, Carlos A. Gomes, Andreas Hecker, Aleksandar Karamarkovic, Jakub Kenig, Vladimir Khokha, Victor Kong, Arda Isik, Ari Leppäniemi, Andrey Litvin, Eftychios Lostoridis, Gustavo M. Machain, Sanjay Marwah, Michael McFarlane, Cristian Mesina, Ionut Negoi, Iyiade Olaoye, Tadeja Pintar, Guntars Pupelis, Miran Rems, Ines Rubio-Perez, Boris Sakakushev, Helmut Segovia-Lohse, Boonying Siribumrungwong, Peep Talving, Jan Ulrych, András G. Vereczkei, Francesco M. Labricciosa, and Fausto Catena
Subjects: Surgeon, Infection, Prevention, Antibiotic therapy, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Despite evidence supporting the effectiveness of best practices of infection prevention and management, many surgeons worldwide fail to implement them. Evidence-based practices tend to be underused in routine practice. Surgeons with knowledge in surgical infections should provide feedback to prescribers and integrate best practices among surgeons and implement changes within their team. Identifying a local opinion leader to serve as a champion within the surgical department may be important. The “surgeon champion” can integrate best clinical practices of infection prevention and management, drive behavior change in their colleagues, and interact with both infection control teams in promoting antimicrobial stewardship.
Published: 2018
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19. Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

Author: Massimo Sartelli, Gian L. Baiocchi, Salomone Di Saverio, Francesco Ferrara, Francesco M. Labricciosa, Luca Ansaloni, Federico Coccolini, Deepak Vijayan, Ashraf Abbas, Hariscine K. Abongwa, John Agboola, Adamu Ahmed, Lali Akhmeteli, Nezih Akkapulu, Seckin Akkucuk, Fatih Altintoprak, Aurelia L. Andreiev, Dimitrios Anyfantakis, Boiko Atanasov, Miklosh Bala, Dimitrios Balalis, Oussama Baraket, Giovanni Bellanova, Marcelo Beltran, Renato Bessa Melo, Roberto Bini, Konstantinos Bouliaris, Daniele Brunelli, Adrian Castillo, Marco Catani, Asri Che Jusoh, Alain Chichom-Mefire, Gianfranco Cocorullo, Raul Coimbra, Elif Colak, Silvia Costa, Koray Das, Samir Delibegovic, Zaza Demetrashvili, Isidoro Di Carlo, Nadezda Kiseleva, Tamer El Zalabany, Mario Faro, Margarida Ferreira, Gustavo P. Fraga, Mahir Gachabayov, Wagih M. Ghnnam, Teresa Giménez Maurel, Georgios Gkiokas, Carlos A. Gomes, Ewen Griffiths, Ali Guner, Sanjay Gupta, Andreas Hecker, Elcio S. Hirano, Adrien Hodonou, Martin Hutan, Orestis Ioannidis, Arda Isik, Georgy Ivakhov, Sumita Jain, Mantas Jokubauskas, Aleksandar Karamarkovic, Saila Kauhanen, Robin Kaushik, Alfie Kavalakat, Jakub Kenig, Vladimir Khokha, Desmond Khor, Dennis Kim, Jae I. Kim, Victor Kong, Konstantinos Lasithiotakis, Pedro Leão, Miguel Leon, Andrey Litvin, Varut Lohsiriwat, Eudaldo López-Tomassetti Fernandez, Eftychios Lostoridis, James Maciel, Piotr Major, Ana Dimova, Dimitrios Manatakis, Athanasio Marinis, Aleix Martinez-Perez, Sanjay Marwah, Michael McFarlane, Cristian Mesina, Michał Pędziwiatr, Nickos Michalopoulos, Evangelos Misiakos, Ali Mohamedahmed, Radu Moldovanu, Giulia Montori, Raghuveer Mysore Narayana, Ionut Negoi, Ioannis Nikolopoulos, Giuseppe Novelli, Viktors Novikovs, Iyiade Olaoye, Abdelkarim Omari, Carlos A. Ordoñez, Mouaqit Ouadii, Zeynep Ozkan, Ajay Pal, Gian M. Palini, Lars I. Partecke, Francesco Pata, Gerson A. Pereira Júnior, Tadeja Pintar, Magdalena Pisarska, Cesar F. Ploneda-Valencia, Konstantinos Pouggouras, Vinod Prabhu, Padmakumar Ramakrishnapillai, Jean-Marc Regimbeau, Marianne Reitz, Daniel Rios-Cruz, Sten Saar, Boris Sakakushev, Charalampos Seretis, Alexander Sazhin, Vishal Shelat, Matej Skrovina, Dmitry Smirnov, Charalampos Spyropoulos, Marcin Strzałka, Peep Talving, Ricardo A. Teixeira Gonsaga, George Theobald, Gia Tomadze, Myftar Torba, Cristian Tranà, Jan Ulrych, Mustafa Y. Uzunoğlu, Alin Vasilescu, Savino Occhionorelli, Aurélien Venara, Andras Vereczkei, Nereo Vettoretto, Nutu Vlad, Maciej Walędziak, Tonguç U. Yilmaz, Kuo-Ching Yuan, Cui Yunfeng, Justas Zilinskas, Gérard Grelpois, and Fausto Catena
Subjects: Acute appendicitis, Diagnosis, Management, Surgery, Antibiotics, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Abstract Background Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. Methods This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016–September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. Results A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. Conclusions The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.
Published: 2018
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20. The effect of HIV status on clinical outcomes of surgical sepsis in KwaZulu-Natal Province, South Africa

Author: Samantha Green, Victor Kong, Jocinta Odendaal, Benn Sartorius, Damian L Clarke, Petra Brysiewicz, Jereme L Bruce, Grant L Laing, and Wanda Bekker
Subjects: Trauma, HIV, Sepsis, Medicine, Medicine (General), R5-920
Abstract: Background. KwaZulu-Natal Province, South Africa (SA), has long been the epicentre of the HIV epidemic, but the impact of HIV co-infection on the clinical outcomes of emergency surgical patients with sepsis remains largely unknown. Objective. To review our experience with the management of patients with HIV co-infection and to compare the disease spectrum and outcome with those without HIV infection. Methods. A retrospective study was undertaken at the Pietermaritzburg Metropolitan Surgical Service (PMSS), SA over a 5-year period from January 2010 to December 2014. Results. A total of 675 patients with a documented surgical source of sepsis were reviewed. Of these, 332 (49%) were male, and the mean age was 46 (standard deviation 19) years. HIV status was known in 237 (35%) patients, 146 (62%) were HIV-positive and the remaining 91 (38%) were HIV-negative. Other than tuberculosis of the abdomen being significantly more common in HIV-positive than HIV-negative patients (10% v. 2%, p=0.033), there were no differences in the spectrum of diseases between the two groups. There were no significant differences in overall morbidity or mortality. When adjusted for CD4 counts, the mortality in HIV-positive patients with a CD4 count 200 cells/μL it was 2% (2/101) (p
Published: 2017
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21. Damage control or definitive repair? A retrospective review of abdominal trauma at a major trauma center in South Africa

Author: Ross Weale, Victor Kong, Johan Buitendag, Abraham Ras, Joanna Blodgett, Grant Laing, John Bruce, Wanda Bekker, Vassil Manchev, and Damian Clarke
Subjects: Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Background This study set out to review a large series of trauma laparotomies from a single center and to compare those requiring damage control surgery (DCS) with those who did not, and then to interrogate a number of anatomic and physiologic scoring systems to see which best predicted the need for DCS.Methods All patients over the age of 15 years undergoing a laparotomy for trauma during the period from December 2012 to December 2017 were retrieved from the Hybrid Electronic Medical Registry (HEMR) at the Pietermaritzburg Metropolitan Trauma Service (PMTS), South Africa. They were divided into two cohorts, namely the DCS and non-DCS cohort, based on what was recorded in the operative note. These groups were then compared in terms of demographics and spectrum of injury, as well as clinical outcome. The following scores were worked out for each patient: Penetrating Abdominal Trauma Index (PATI), Injury Severity Score, Abbreviated Injury Scale-abdomen, and Abbreviated Injury Scale-chest.Results A total of 562 patients were included, and 99 of these (18%) had a DCS procedure versus 463 (82%) non-DCS. The mechanism was penetrating trauma in 81% of cases (453 of 562). A large proportion of trauma victims were male (503 of 562, 90%), with a mean age of 29.5±10.8. An overall mortality rate of 32% was recorded for DCS versus 4% for non-DCS (p
Published: 2019
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22. Pediatric trauma and emergency surgery: an international cross-sectional survey among WSES members

Author: Reichert, Martin, Sartelli, Massimo, Askevold, Ingolf H, Braun, Jaqueline, Weigand, Markus A, Hecker, Matthias, Agnoletti, Vanni, Coccolini, Federico, Catena, Fausto, Padberg, Winfried, Riedel, Jens G, Hecker, Andreas, Agron Dogjani, Akira Kuriyama, Alberto Porcu, Aleix Martínez-Pérez, Alessandro Coppola, Alessandro Spolini, Alessio Giordano, Alexandros Kyriakidis, Ali Yasen Y Mohamedahmed, Anastasia Vasilopoulou, Andee Dzulkarnaen Zakaria, Andrea Balla, Andreas Fette, Andrey Litvin, Anna Guariniello, Arda Isik, Aristotelis Kechagias, Ashrarur Rahman Mitul, Belinda De Simone, Biagio Zampogna, Bruno Sensi, Carlo Gazia, Charalampos Seretis, Cristine Brooke, Davide Luppi, Diego Coletta, Diego Sasia, Diletta Corallino, Dimitrios Chatzipetris, Dimitrios Schizas, Eftychios Lostoridis, Elmuiz A Hsabo, Emmanouil Kaouras, Emmanuel Schneck, Enrico Pinotti, Evgeni Dimitrov, Fabrizio D'Acapito, Federica Saraceno, Fikri Abu-Zidan, Francesca Maria Silvestri, Francesco Favi, Francesco Fleres, Francesk Mulita, Gabriela Nita, Gennaro Martines, Gennaro Mazzarella, Gennaro Perrone, Giorgio Giraudo, Giulia Bacchiocchi, Giulio Argenio, Giuseppe Brisinda, Giuseppe Currò, Giuseppe Palomba, Gustavo P Fraga, Hytham K S Hamid, Ioannis Katsaros, Ionut Negoi, Joel Noutakdie Tochie, Justin Davies, Kenneth Y Y Kok, Konstantinos G Apostolou, Konstantinos Lasithiotakis, Konstantinos Tsekouras, Larysa Sydorchuk, Leandro Siragusa, Leonardo Solaini, Luca Ferrario, Luis Buonomo, Maciej Walędziak, Mahir Gachabayov, Maloni Bulanauca, Manish Kumar Agrawal, Marco Ceresoli, Maria Chiara Ranucci, Maria Petridou, Mario D'Oria, Massimiliano Veroux, Maximos Frountzas, Michel Paul Johan Teuben, Miklosh Bala, Mirja Amadea Minger, Miroslava Gonçalves, Natasha Sharma, Nicolò Tamini, Noushif Medappil, Orestis Ioannidis, Pietro Bisagni, Razrim Rahim, Ricardo Alessandro Teixeira Gonsaga, Roberta Ragozzino, Roberto Bini, Roberto Cammarata, Ruslan Sydorchuk, Salomone Di Saverio, Selmy S Awad, Semra Demirli Atici, Serhat Meric, Sharfuddin Chowdhury, Sofia Xenaki, Tadeja Pintar, Teresa Perra, Timothy C Hardcastle, Valerio Voglino, Varut Lohsiriwat, Victor Kong, Voskidis Christos, Wietse Zuidema, Reichert, Martin, Sartelli, Massimo, Askevold, Ingolf H, Braun, Jaqueline, Weigand, Markus A, Hecker, Matthia, Agnoletti, Vanni, Coccolini, Federico, Catena, Fausto, Padberg, Winfried, Riedel, Jens G, Hecker, Andrea, Agron Dogjani, Akira Kuriyama, Alberto Porcu, Aleix Martínez-Pérez, Alessandro Coppola, Alessandro Spolini, Alessio Giordano, Alexandros Kyriakidis, Ali Yasen Y Mohamedahmed, Anastasia Vasilopoulou, Andee Dzulkarnaen Zakaria, Andrea Balla, Andreas Fette, Andrey Litvin, Anna Guariniello, Arda Isik, Aristotelis Kechagias, Ashrarur Rahman Mitul, Belinda De Simone, Biagio Zampogna, Bruno Sensi, Carlo Gazia, Charalampos Seretis, Cristine Brooke, Davide Luppi, Diego Coletta, Diego Sasia, Diletta Corallino, Dimitrios Chatzipetris, Dimitrios Schizas, Eftychios Lostoridis, Elmuiz A Hsabo, Emmanouil Kaouras, Emmanuel Schneck, Enrico Pinotti, Evgeni Dimitrov, Fabrizio D'Acapito, Federica Saraceno, Fikri Abu-Zidan, Francesca Maria Silvestri, Francesco Favi, Francesco Fleres, Francesk Mulita, Gabriela Nita, Gennaro Martines, Gennaro Mazzarella, Gennaro Perrone, Giorgio Giraudo, Giulia Bacchiocchi, Giulio Argenio, Giuseppe Brisinda, Giuseppe Currò, Giuseppe Palomba, Gustavo P Fraga, Hytham K S Hamid, Ioannis Katsaros, Ionut Negoi, Joel Noutakdie Tochie, Justin Davies, Kenneth Y Y Kok, Konstantinos G Apostolou, Konstantinos Lasithiotakis, Konstantinos Tsekouras, Larysa Sydorchuk, Leandro Siragusa, Leonardo Solaini, Luca Ferrario, Luis Buonomo, Maciej Walędziak, Mahir Gachabayov, Maloni Bulanauca, Manish Kumar Agrawal, Marco Ceresoli, Maria Chiara Ranucci, Maria Petridou, Mario D'Oria, Massimiliano Veroux, Maximos Frountzas, Michel Paul Johan Teuben, Miklosh Bala, Mirja Amadea Minger, Miroslava Gonçalves, Natasha Sharma, Nicolò Tamini, Noushif Medappil, Orestis Ioannidis, Pietro Bisagni, Razrim Rahim, Ricardo Alessandro Teixeira Gonsaga, Roberta Ragozzino, Roberto Bini, Roberto Cammarata, Ruslan Sydorchuk, Salomone Di Saverio, Selmy S Awad, Semra Demirli Atici, Serhat Meric, Sharfuddin Chowdhury, Sofia Xenaki, Tadeja Pintar, Teresa Perra, Timothy C Hardcastle, Valerio Voglino, Varut Lohsiriwat, Victor Kong, Voskidis Christos, Wietse Zuidema, Reichert, M, Sartelli, M, Askevold, I, Braun, J, Weigand, M, Hecker, M, Agnoletti, V, Coccolini, F, Catena, F, Padberg, W, Riedel, J, Hecker, A, Dogjani, A, Kuriyama, A, Porcu, A, Martinez-Perez, A, Coppola, A, Spolini, A, Giordano, A, Kyriakidis, A, Mohamedahmed, A, Vasilopoulou, A, Zakaria, A, Balla, A, Fette, A, Litvin, A, Guariniello, A, Isik, A, Kechagias, A, Mitul, A, De Simone, B, Zampogna, B, Sensi, B, Gazia, C, Seretis, C, Brooke, C, Luppi, D, Coletta, D, Sasia, D, Corallino, D, Chatzipetris, D, Schizas, D, Lostoridis, E, Hsabo, E, Kaouras, E, Schneck, E, Pinotti, E, Dimitrov, E, D'Acapito, F, Saraceno, F, Abu-Zidan, F, Silvestri, F, Favi, F, Fleres, F, Mulita, F, Nita, G, Martines, G, Mazzarella, G, Perrone, G, Giraudo, G, Bacchiocchi, G, Argenio, G, Brisinda, G, Curro, G, Palomba, G, Fraga, G, Hamid, H, Katsaros, I, Negoi, I, Tochie, J, Davies, J, Kok, K, Apostolou, K, Lasithiotakis, K, Tsekouras, K, Sydorchuk, L, Siragusa, L, Solaini, L, Ferrario, L, Buonomo, L, Waledziak, M, Gachabayov, M, Bulanauca, M, Agrawal, M, Ceresoli, M, Ranucci, M, Petridou, M, D'Oria, M, Veroux, M, Frountzas, M, Teuben, M, Bala, M, Minger, M, Goncalves, M, Sharma, N, Tamini, N, Medappil, N, Ioannidis, O, Bisagni, P, Rahim, R, Gonsaga, R, Ragozzino, R, Bini, R, Cammarata, R, Sydorchuk, R, Di Saverio, S, Awad, S, Atici, S, Meric, S, Chowdhury, S, Xenaki, S, Pintar, T, Perra, T, Hardcastle, T, Voglino, V, Lohsiriwat, V, Kong, V, Christos, V, Zuidema, W, Surgery, AMS - Musculoskeletal Health, APH - Quality of Care, and Other Research
Subjects: appendicitis, children, emergency, emergency surgery, injury, pediatric surgery, pediatric trauma, trauma surgery, wses, Pediatric trauma, Emergency, Emergency Medicine, Emergency surgery, Appendiciti, Surgery, Injury, WSES, Pediatric surgery, Appendicitis, Children, Trauma surgery
Abstract: Background In contrast to adults, the situation for pediatric trauma care from an international point of view and the global management of severely injured children remain rather unclear. The current study investigates structural management of pediatric trauma in centers of different trauma levels as well as experiences with pediatric trauma management around the world. Methods A web-survey had been distributed to the global mailing list of the World Society of Emergency Surgery from 10/2021–03/2022, investigating characteristics of respondents and affiliated hospitals, case-load of pediatric trauma patients, capacities and infrastructure for critical care in children, trauma team composition, clinical work-up and individual experiences with pediatric trauma management in response to patients´ age. The collaboration group was subdivided regarding sizes of affiliated hospitals to allow comparisons concerning hospital volumes. Comparable results were conducted to statistical analysis. Results A total of 133 participants from 34 countries, i.e. 5 continents responded to the survey. They were most commonly affiliated with larger hospitals (> 500 beds in 72.9%) and with level I or II trauma centers (82.0%), respectively. 74.4% of hospitals offer unrestricted pediatric medical care, but only 63.2% and 42.9% of the participants had sufficient experiences with trauma care in children ≤ 10 and ≤ 5 years of age (p = 0.0014). This situation is aggravated in participants from smaller hospitals (p 500 in-hospital beds), larger hospitals were more likely affiliated with advanced trauma centers, more elaborated pediatric intensive care infrastructure (p p = 0.0938) and have higher case-loads of severely injured children p = 0.0009). Therefore, the majority of larger hospitals reserve either pediatric surgery departments or board-certified pediatric surgeons (p Conclusions Multi-professional management of pediatric trauma and individual experiences with severely injured children depend on volumes, level of trauma centers and infrastructure of the hospital. However, respondents from hospitals at all levels of trauma care complain about an alarming lack of knowledge on pediatric trauma management.
Published: 2023

23. Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Author: Reichert, Martin, Sartelli, Massimo, Weigand, Markus A, Hecker, Matthias, Oppelt, Philip U, Noll, Julia, Askevold, Ingolf H, Liese, Juliane, Padberg, Winfried, Coccolini, Federico, Catena, Fausto, Hecker, Andreas, Adam Peckham-Cooper, Adrian Camacho-Ortiz, Aikaterini T. Mastoraki, Aitor Landaluce-Olavarria, Ajay Kumar Pal, Akira Kuriyama, Alain Chichom-Mefire, Alberto Porcu, Aleix Martínez-Pérez, Aleksandar R. Karamarkovic, Aleksei V. Osipov, Alessandro Coppola, Alessandro Cucchetti, Alessandro Spolini, Alessio Giordano, Alexander Reinisch-Liese, Alfie J. Kavalakat, Alin Vasilescu, Amin Alamin, Amit Gupta, Ana Maria Dascalu, Ana-Maria Musina, Anargyros Bakopoulos, Andee Dzulkarnaen Zakaria, Andras Vereczkei, Andrea Balla, Andrea Bottari, Andreas Baumann, Andreas Fette, Andrey Litvin, Aniella Katharina Reichert, Anna Guariniello, Anna Paspala, Anne-Sophie Schneck, Antonio Brillantino, Antonio Pesce, Arda Isik, Ari Kalevi Leppäniemi, Aristeidis Papadopoulos, Aristotelis Kechagias, Ashraf Yehya Abdalla Mohamed, Ashrarur Rahman Mitul, Athanasios Marinis, Athanasios Syllaios, Baris Mantoglu, Belinda De Simone, Benjamin Stefan Weiss, Bernd Pösentrup, Biagio Picardi, Biagio Zampogna, Boris Eugeniev Sakakushev, Boyko Chavdarov Atanasov, Bruno Nardo, Bulent Calik, Camilla Cremonini, Carlos A. Ordoñez, Charalampos Seretis, Chiara Cascone, Christos Chouliaras, Cino Bendinelli, Claudia Lopes, Claudio Guerci, Clemens Weber, Constantinos Nastos, Cristian Mesina, Damiano Caputo, Damien Massalou, Davide Cavaliere, Deborah A. McNamara, Demetrios Demetriades, Desirè Pantalone, Diego Coletta, Diego Sasia, Diego Visconti, Dieter G. Weber, Diletta Corallino, Dimitrios Chatzipetris, Dimitrios K. Manatakis, Dimitrios Ntourakis, Dimitrios Papaconstantinou, Dimitrios Schizas, Dimosthenis Chrysikos, Dmitry Mikhailovich Adamovich, Doaa Elkafrawy, Dragos Seban, Edgar Fernando Hernandez García, Edoardo Baldini, Edoardo Picetti, Edward C. T. H. Tan, Efstratia Baili, Eftychios Lostoridis, Elena Adelina Toma, Elif Colak, Elisabetta Cerutti, Elmin Steyn, Elmuiz A. Hsabo, Emmanouil Ioannis Kapetanakis, Emmanouil Kaouras, Emmanuel Schneck, Emrah Akin, Emre Gonullu, Enes çelik, Enrico Cicuttin, Enrico Pinotti, Erik Johnsson, Ernest E. Moore, Ervis Agastra, Evgeni Nikolaev Dimitrov, Ewen A. Griffiths, Fabrizio D’Acapito, Federica Saraceno, Felipe Alconchel, Felix Alexander Zeppernick, Fernando Machado Rodríguez, Fikri Abu-Zidan, Francesca Pecchini, Francesco Favi, Francesco Ferrara, Francesco Fleres, Francesco Pata, Francesco Pietro Maria Roscio, Francesk Mulita, Frank J. M. F. Dor, Fredrik Linder, Gabriel Dimofte, Gabriel Rodrigues, Gabriela Nita, Gabriele Sganga, Gennaro Martines, Gennaro Mazzarella, Gennaro Perrone, George Velmahos, Georgios D. Lianos, Gia Tomadze, Gian Luca Baiocchi, Giancarlo D’Ambrosio, Gianluca Pellino, Gianmaria Casoni Pattacini, Giorgio Giraudo, Giorgio Lisi, Giovanni Domenico Tebala, Giovanni Pirozzolo, Giulia Montori, Giulio Argenio, Giuseppe Brisinda, Giuseppe Currò, Giuseppe Giuliani, Giuseppe Palomba, Giuseppe Roscitano, Gökhan Avşar, Goran Augustin, Guglielmo Clarizia, Gustavo M. Machain Vega, Gustavo P. Fraga, Harsheet Sethi, Hazim Abdulnassir Eltyeb, Helmut A. Segovia Lohse, Herald René Segovia Lohse, Hüseyin Bayhan, Hytham K. S. Hamid, Igor A. Kryvoruchko, Immacolata Iannone, Imtiaz Wani, Ioannis I. Lazaridis, Ioannis Katsaros, Ioannis Nikolopoulos, Ionut Negoi, Isabella Reccia, Isidoro Di Carlo, Iyiade Olatunde Olaoye, Jacek Czepiel, Jae Il Kim, Jeremy Meyer, Jesus Manuel Saenz Terrazas, Joel Noutakdie Tochie, Joseph M. Galante, Justin Davies, Kapil Sugand, Kebebe Bekele Gonfa, Kemal Rasa, Kenneth Y. Y. Kok, Konstantinos G. Apostolou, Konstantinos Lasithiotakis, Konstantinos Tsekouras, Kumar Angamuthu, Lali Akhmeteli, Larysa Sydorchuk, Laura Fortuna, Leandro Siragusa, Leonardo Pagani, Leonardo Solaini, Lisa A. Miller, Lovenish Bains, Luca Ansaloni, Luca Ferrario, Luigi Bonavina, Luigi Conti, Luis Antonio Buonomo, Luis Tallon-Aguilar, Lukas Tomczyk, Lukas Werner Widmer, Maciej Walędziak, Mahir Gachabayov, Maloni M. Bulanauca, Manu L. N. G. Malbrain, Marc Maegele, Marco Catarci, Marco Ceresoli, Maria Chiara Ranucci, Maria Ioanna Antonopoulou, Maria Papadoliopoulou, Maria Rosaria Valenti, Maria Sotiropoulou, Mario D’Oria, Mario Serradilla Martín, Markus Hirschburger, Massimiliano Veroux, Massimo Fantoni, Matteo Nardi, Matti Tolonen, Mauro Montuori, Mauro Podda, Maximilian Scheiterle, Maximos Frountzas, Mehmet Sarıkaya, Mehmet Yildirim, Michael Bender, Michail Vailas, Michel Teuben, Michela Campanelli, Michele Ammendola, Michele Malerba, Michele Pisano, Mihaela Pertea, Mihail Slavchev, Mika Ukkonen, Miklosh Bala, Mircea Chirica, Mirko Barone, Mohamed Maher Shaat, Mohammed Jibreel Suliman Mohammed, Mona Awad Akasha Abuelgasim, Monika Gureh, Mouaqit Ouadii, Mujdat Balkan, Mumin Mohamed, Musluh Hakseven, Natalia Velenciuc, Nicola Cillara, Nicola de’Angelis, Nicolò Tamini, Nikolaos J. Zavras, Nikolaos Machairas, Nikolaos Michalopoulos, Nikolaos N. Koliakos, Nikolaos Pararas, Noel E. Donlon, Noushif Medappil, Offir Ben-Ishay, Olmi Stefano, Omar Islam, Ömer Tammo, Orestis Ioannidis, Oscar Aparicio, Oussama Baraket, Pankaj Kumar, Pasquale Cianci, Per Örtenwall, Petar Angelov Uchikov, Philip de Reuver, Philip F. Stahel, Philip S. Barie, Micaela Piccoli, Piotr Major, Pradeep H. Navsaria, Prakash Kumar Sasmal, Raul Coimbra, Razrim Rahim, Recayi Çapoğlu, Renol M. Koshy, Ricardo Alessandro Teixeira Gonsaga, Riccardo Pertile, Rifat Ramadan Mussa Mohamed, Rıza Deryol, Robert G. Sawyer, Roberta Angelico, Roberta Ragozzino, Roberto Bini, Roberto Cammarata, Rosa Scaramuzzo, Rossella Gioco, Ruslan Sydorchuk, Salma Ahmed, Salomone Di Saverio, Sameh Hany Emile, Samir Delibegovic, Sanjay Marwah, Savvas Symeonidis, Scott G. Thomas, Sebahattin Demir, Selmy S. Awad, Semra Demirli Atici, Serge Chooklin, Serhat Meric, Sevcan Sarıkaya, Sharfuddin Chowdhury, Shaza Faycal Mirghani, Sherry M. Wren, Simone Gargarella, Simone Rossi Del Monte, Sofia Esposito, Sofia Xenaki, Soliman Fayez Ghedan Mohamed, Solomon Gurmu Beka, Sorinel Lunca, Spiros G. Delis, Spyridon Dritsas, Stefan Morarasu, Stefano Magnone, Stefano Rossi, Stefanos Bitsianis, Stylianos Kykalos, Suman Baral, Sumita A. Jain, Syed Muhammad Ali, Tadeja Pintar, Tania Triantafyllou, Tarik Delko, Teresa Perra, Theodoros A. Sidiropoulos, Thomas M. Scalea, Tim Oliver Vilz, Timothy Craig Hardcastle, Tongporn Wannatoop, Torsten Herzog, Tushar Subhadarshan Mishra, Ugo Boggi, Valentin Calu, Valentina Tomajer, Vanni Agnoletti, Varut Lohsiriwat, Victor Kong, Virginia Durán Muñoz-Cruzado, Vishal G. Shelat, Vladimir Khokha, Wagih Mommtaz Ghannam, Walter L. Biffl, Wietse Zuidema, Yasin Kara, Yoshiro Kobe, Zaza Demetrashvili, Ziad A. Memish, Zoilo Madrazo, Zsolt J. Balogh, Zulfu Bayhan, Surgery, AMS - Musculoskeletal Health, Other Research, APH - Quality of Care, Reichert, Martin, Sartelli, Massimo, Weigand, Markus A, Hecker, Matthia, Oppelt, Philip U, Noll, Julia, Askevold, Ingolf H, Liese, Juliane, Padberg, Winfried, Coccolini, Federico, Catena, Fausto, Hecker, Andrea, Adam Peckham-Cooper, Adrian Camacho-Ortiz, Aikaterini T. Mastoraki, Aitor Landaluce-Olavarria, Ajay Kumar Pal, Akira Kuriyama, Alain Chichom-Mefire, Alberto Porcu, Aleix Martínez-Pérez, Aleksandar R. Karamarkovic, Aleksei V. Osipov, Alessandro Coppola, Alessandro Cucchetti, Alessandro Spolini, Alessio Giordano, Alexander Reinisch-Liese, Alfie J. Kavalakat, Alin Vasilescu, Amin Alamin, Amit Gupta, Ana Maria Dascalu, Ana-Maria Musina, Anargyros Bakopoulos, Andee Dzulkarnaen Zakaria, Andras Vereczkei, Andrea Balla, Andrea Bottari, Andreas Baumann, Andreas Fette, Andrey Litvin, Aniella Katharina Reichert, Anna Guariniello, Anna Paspala, Anne-Sophie Schneck, Antonio Brillantino, Antonio Pesce, Arda Isik, Ari Kalevi Leppäniemi, Aristeidis Papadopoulos, Aristotelis Kechagias, Ashraf Yehya Abdalla Mohamed, Ashrarur Rahman Mitul, Athanasios Marinis, Athanasios Syllaios, Baris Mantoglu, Belinda De Simone, Benjamin Stefan Weiss, Bernd Pösentrup, Biagio Picardi, Biagio Zampogna, Boris Eugeniev Sakakushev, Boyko Chavdarov Atanasov, Bruno Nardo, Bulent Calik, Camilla Cremonini, Carlos A. Ordoñez, Charalampos Seretis, Chiara Cascone, Christos Chouliaras, Cino Bendinelli, Claudia Lopes, Claudio Guerci, Clemens Weber, Constantinos Nastos, Cristian Mesina, Damiano Caputo, Damien Massalou, Davide Cavaliere, Deborah A. McNamara, Demetrios Demetriades, Desirè Pantalone, Diego Coletta, Diego Sasia, Diego Visconti, Dieter G. Weber, Diletta Corallino, Dimitrios Chatzipetris, Dimitrios K. Manatakis, Dimitrios Ntourakis, Dimitrios Papaconstantinou, Dimitrios Schizas, Dimosthenis Chrysikos, Dmitry Mikhailovich Adamovich, Doaa Elkafrawy, Dragos Seban, Edgar Fernando Hernandez García, Edoardo Baldini, Edoardo Picetti, Edward C. T. H. Tan, Efstratia Baili, Eftychios Lostoridis, Elena Adelina Toma, Elif Colak, Elisabetta Cerutti, Elmin Steyn, Elmuiz A. Hsabo, Emmanouil Ioannis Kapetanakis, Emmanouil Kaouras, Emmanuel Schneck, Emrah Akin, Emre Gonullu, Enes çelik, Enrico Cicuttin, Enrico Pinotti, Erik Johnsson, Ernest E. Moore, Ervis Agastra, Evgeni Nikolaev Dimitrov, Ewen A. Griffiths, Fabrizio D’Acapito, Federica Saraceno, Felipe Alconchel, Felix Alexander Zeppernick, Fernando Machado Rodríguez, Fikri Abu-Zidan, Francesca Pecchini, Francesco Favi, Francesco Ferrara, Francesco Fleres, Francesco Pata, Francesco Pietro Maria Roscio, Francesk Mulita, Frank J. M. F. Dor, Fredrik Linder, Gabriel Dimofte, Gabriel Rodrigues, Gabriela Nita, Gabriele Sganga, Gennaro Martines, Gennaro Mazzarella, Gennaro Perrone, George Velmahos, Georgios D. Lianos, Gia Tomadze, Gian Luca Baiocchi, Giancarlo D’Ambrosio, Gianluca Pellino, Gianmaria Casoni Pattacini, Giorgio Giraudo, Giorgio Lisi, Giovanni Domenico Tebala, Giovanni Pirozzolo, Giulia Montori, Giulio Argenio, Giuseppe Brisinda, Giuseppe Currò, Giuseppe Giuliani, Giuseppe Palomba, Giuseppe Roscitano, Gökhan Avşar, Goran Augustin, Guglielmo Clarizia, Gustavo M. Machain Vega, Gustavo P. Fraga, Harsheet Sethi, Hazim Abdulnassir Eltyeb, Helmut A. Segovia Lohse, Herald René Segovia Lohse, Hüseyin Bayhan, Hytham K. S. Hamid, Igor A. Kryvoruchko, Immacolata Iannone, Imtiaz Wani, Ioannis I. Lazaridis, Ioannis Katsaros, Ioannis Nikolopoulos, Ionut Negoi, Isabella Reccia, Isidoro Di Carlo, Iyiade Olatunde Olaoye, Jacek Czepiel, Jae Il Kim, Jeremy Meyer, Jesus Manuel Saenz Terrazas, Joel Noutakdie Tochie, Joseph M. Galante, Justin Davies, Kapil Sugand, Kebebe Bekele Gonfa, Kemal Rasa, Kenneth Y. Y. Kok, Konstantinos G. Apostolou, Konstantinos Lasithiotakis, Konstantinos Tsekouras, Kumar Angamuthu, Lali Akhmeteli, Larysa Sydorchuk, Laura Fortuna, Leandro Siragusa, Leonardo Pagani, Leonardo Solaini, Lisa A. Miller, Lovenish Bains, Luca Ansaloni, Luca Ferrario, Luigi Bonavina, Luigi Conti, Luis Antonio Buonomo, Luis Tallon-Aguilar, Lukas Tomczyk, Lukas Werner Widmer, Maciej Walędziak, Mahir Gachabayov, Maloni M. Bulanauca, Manu L. N. G. Malbrain, Marc Maegele, Marco Catarci, Marco Ceresoli, Maria Chiara Ranucci, Maria Ioanna Antonopoulou, Maria Papadoliopoulou, Maria Rosaria Valenti, Maria Sotiropoulou, Mario D’Oria, Mario Serradilla Martín, Markus Hirschburger, Massimiliano Veroux, Massimo Fantoni, Matteo Nardi, Matti Tolonen, Mauro Montuori, Mauro Podda, Maximilian Scheiterle, Maximos Frountzas, Mehmet Sarıkaya, Mehmet Yildirim, Michael Bender, Michail Vailas, Michel Teuben, Michela Campanelli, Michele Ammendola, Michele Malerba, Michele Pisano, Mihaela Pertea, Mihail Slavchev, Mika Ukkonen, Miklosh Bala, Mircea Chirica, Mirko Barone, Mohamed Maher Shaat, Mohammed Jibreel Suliman Mohammed, Mona Awad Akasha Abuelgasim, Monika Gureh, Mouaqit Ouadii, Mujdat Balkan, Mumin Mohamed, Musluh Hakseven, Natalia Velenciuc, Nicola Cillara, Nicola de’Angelis, Nicolò Tamini, Nikolaos J. Zavras, Nikolaos Machairas, Nikolaos Michalopoulos, Nikolaos N. Koliakos, Nikolaos Pararas, Noel E. Donlon, Noushif Medappil, Offir Ben-Ishay, Olmi Stefano, Omar Islam, Ömer Tammo, Orestis Ioannidis, Oscar Aparicio, Oussama Baraket, Pankaj Kumar, Pasquale Cianci, Per Örtenwall, Petar Angelov Uchikov, Philip de Reuver, Philip F. Stahel, Philip S. Barie, Micaela Piccoli, Piotr Major, Pradeep H. Navsaria, Prakash Kumar Sasmal, Raul Coimbra, Razrim Rahim, Recayi Çapoğlu, Renol M. Koshy, Ricardo Alessandro Teixeira Gonsaga, Riccardo Pertile, Rifat Ramadan Mussa Mohamed, Rıza Deryol, Robert G. Sawyer, Roberta Angelico, Roberta Ragozzino, Roberto Bini, Roberto Cammarata, Rosa Scaramuzzo, Rossella Gioco, Ruslan Sydorchuk, Salma Ahmed, Salomone Di Saverio, Sameh Hany Emile, Samir Delibegovic, Sanjay Marwah, Savvas Symeonidis, Scott G. Thomas, Sebahattin Demir, Selmy S. Awad, Semra Demirli Atici, Serge Chooklin, Serhat Meric, Sevcan Sarıkaya, Sharfuddin Chowdhury, Shaza Faycal Mirghani, Sherry M. Wren, Simone Gargarella, Simone Rossi Del Monte, Sofia Esposito, Sofia Xenaki, Soliman Fayez Ghedan Mohamed, Solomon Gurmu Beka, Sorinel Lunca, Spiros G. Delis, Spyridon Dritsas, Stefan Morarasu, Stefano Magnone, Stefano Rossi, Stefanos Bitsianis, Stylianos Kykalos, Suman Baral, Sumita A. Jain, Syed Muhammad Ali, Tadeja Pintar, Tania Triantafyllou, Tarik Delko, Teresa Perra, Theodoros A. Sidiropoulos, Thomas M. Scalea, Tim Oliver Vilz, Timothy Craig Hardcastle, Tongporn Wannatoop, Torsten Herzog, Tushar Subhadarshan Mishra, Ugo Boggi, Valentin Calu, Valentina Tomajer, Vanni Agnoletti, Varut Lohsiriwat, Victor Kong, Virginia Durán Muñoz-Cruzado, Vishal G. Shelat, Vladimir Khokha, Wagih Mommtaz Ghannam, Walter L. Biffl, Wietse Zuidema, Yasin Kara, Yoshiro Kobe, Zaza Demetrashvili, Ziad A. Memish, Zoilo Madrazo, Zsolt J. Balogh, Zulfu Bayhan, Reichert, M, Sartelli, M, Weigand, M, Hecker, M, Oppelt, P, Noll, J, Askevold, I, Liese, J, Padberg, W, Coccolini, F, Catena, F, Hecker, A, Peckham-Cooper, A, Camacho-Ortiz, A, Mastoraki, A, Landaluce-Olavarria, A, Pal, A, Kuriyama, A, Chichom-Mefire, A, Porcu, A, Martinez-Perez, A, Karamarkovic, A, Osipov, A, Coppola, A, Cucchetti, A, Spolini, A, Giordano, A, Reinisch-Liese, A, Kavalakat, A, Vasilescu, A, Alamin, A, Gupta, A, Dascalu, A, Musina, A, Bakopoulos, A, Zakaria, A, Vereczkei, A, Balla, A, Bottari, A, Baumann, A, Fette, A, Litvin, A, Reichert, A, Guariniello, A, Paspala, A, Schneck, A, Brillantino, A, Pesce, A, Isik, A, Leppaniemi, A, Papadopoulos, A, Kechagias, A, Mohamed, A, Mitul, A, Marinis, A, Syllaios, A, Mantoglu, B, De Simone, B, Weiss, B, Posentrup, B, Picardi, B, Zampogna, B, Sakakushev, B, Atanasov, B, Nardo, B, Calik, B, Cremonini, C, Ordonez, C, Seretis, C, Cascone, C, Chouliaras, C, Bendinelli, C, Lopes, C, Guerci, C, Weber, C, Nastos, C, Mesina, C, Caputo, D, Massalou, D, Cavaliere, D, Mcnamara, D, Demetriades, D, Pantalone, D, Coletta, D, Sasia, D, Visconti, D, Weber, D, Corallino, D, Chatzipetris, D, Manatakis, D, Ntourakis, D, Papaconstantinou, D, Schizas, D, Chrysikos, D, Adamovich, D, Elkafrawy, D, Seban, D, Garcia, E, Baldini, E, Picetti, E, Tan, E, Baili, E, Lostoridis, E, Toma, E, Colak, E, Cerutti, E, Steyn, E, Hsabo, E, Kapetanakis, E, Kaouras, E, Schneck, E, Akin, E, Gonullu, E, Celik, E, Cicuttin, E, Pinotti, E, Johnsson, E, Moore, E, Agastra, E, Dimitrov, E, Griffiths, E, D'Acapito, F, Saraceno, F, Alconchel, F, Zeppernick, F, Rodriguez, F, Abu-Zidan, F, Pecchini, F, Favi, F, Ferrara, F, Fleres, F, Pata, F, Roscio, F, Mulita, F, Dor, F, Linder, F, Dimofte, G, Rodrigues, G, Nita, G, Sganga, G, Martines, G, Mazzarella, G, Perrone, G, Velmahos, G, Lianos, G, Tomadze, G, Baiocchi, G, D'Ambrosio, G, Pellino, G, Pattacini, G, Giraudo, G, Lisi, G, Tebala, G, Pirozzolo, G, Montori, G, Argenio, G, Brisinda, G, Curro, G, Giuliani, G, Palomba, G, Roscitano, G, Avsar, G, Augustin, G, Clarizia, G, Vega, G, Fraga, G, Sethi, H, Eltyeb, H, Lohse, H, Bayhan, H, Hamid, H, Kryvoruchko, I, Iannone, I, Wani, I, Lazaridis, I, Katsaros, I, Nikolopoulos, I, Negoi, I, Reccia, I, Di Carlo, I, Olaoye, I, Czepiel, J, Kim, J, Meyer, J, Terrazas, J, Tochie, J, Galante, J, Davies, J, Sugand, K, Gonfa, K, Rasa, K, Kok, K, Apostolou, K, Lasithiotakis, K, Tsekouras, K, Angamuthu, K, Akhmeteli, L, Sydorchuk, L, Fortuna, L, Siragusa, L, Pagani, L, Solaini, L, Miller, L, Bains, L, Ansaloni, L, Ferrario, L, Bonavina, L, Conti, L, Buonomo, L, Tallon-Aguilar, L, Tomczyk, L, Widmer, L, Waledziak, M, Gachabayov, M, Bulanauca, M, Malbrain, M, Maegele, M, Catarci, M, Ceresoli, M, Ranucci, M, Antonopoulou, M, Papadoliopoulou, M, Valenti, M, Sotiropoulou, M, D'Oria, M, Martin, M, Hirschburger, M, Veroux, M, Fantoni, M, Nardi, M, Tolonen, M, Montuori, M, Podda, M, Scheiterle, M, Frountzas, M, Sarikaya, M, Yildirim, M, Bender, M, Vailas, M, Teuben, M, Campanelli, M, Ammendola, M, Malerba, M, Pisano, M, Pertea, M, Slavchev, M, Ukkonen, M, Bala, M, Chirica, M, Barone, M, Shaat, M, Mohammed, M, Abuelgasim, M, Gureh, M, Ouadii, M, Balkan, M, Mohamed, M, Hakseven, M, Velenciuc, N, Cillara, N, De'Angelis, N, Tamini, N, Zavras, N, Machairas, N, Michalopoulos, N, Koliakos, N, Pararas, N, Donlon, N, Medappil, N, Ben-Ishay, O, Stefano, O, Islam, O, Tammo, O, Ioannidis, O, Aparicio, O, Baraket, O, Kumar, P, Cianci, P, Ortenwall, P, Uchikov, P, de Reuver, P, Stahel, P, Barie, P, Piccoli, M, Major, P, Navsaria, P, Sasmal, P, Coimbra, R, Rahim, R, Capoglu, R, Koshy, R, Gonsaga, R, Pertile, R, Mohamed, R, Deryol, R, Sawyer, R, Angelico, R, Ragozzino, R, Bini, R, Cammarata, R, Scaramuzzo, R, Gioco, R, Sydorchuk, R, Ahmed, S, Di Saverio, S, Emile, S, Delibegovic, S, Marwah, S, Symeonidis, S, Thomas, S, Demir, S, Awad, S, Atici, S, Chooklin, S, Meric, S, Sarikaya, S, Chowdhury, S, Mirghani, S, Wren, S, Gargarella, S, Del Monte, S, Esposito, S, Xenaki, S, Mohamed, S, Beka, S, Lunca, S, Delis, S, Dritsas, S, Morarasu, S, Magnone, S, Rossi, S, Bitsianis, S, Kykalos, S, Baral, S, Jain, S, Ali, S, Pintar, T, Triantafyllou, T, Delko, T, Perra, T, Sidiropoulos, T, Scalea, T, Vilz, T, Hardcastle, T, Wannatoop, T, Herzog, T, Mishra, T, Boggi, U, Calu, V, Tomajer, V, Agnoletti, V, Lohsiriwat, V, Kong, V, Munoz-Cruzado, V, Shelat, V, Khokha, V, Ghannam, W, Biffl, W, Zuidema, W, Kara, Y, Kobe, Y, Demetrashvili, Z, Memish, Z, Madrazo, Z, Balogh, Z, and Bayhan, Z
Subjects: Cross-Sectional Studie, ddc:610, Capacity, Pandemic, SARS-CoV-2, COVID-19, WSES, Time to intervention, Appendicitis, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Cross-Sectional Studies, Emergency, Quarantine, Emergency Medicine, Emergency surgery, Humans, Surgery, Appendiciti, COVID-19, SARS-CoV-2, Pandemic, Emergency surgery, Emergency, Appendicitis, WSES, Time to intervention, Capacity, Quarantine, Pandemics, Diverticulitis, Human
Abstract: Background The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years.
Published: 2022

24. Penetrating trauma in children and adolescents in Pietermaritzburg

Author: Victor Kong, S. E. Moffatt, Damian L. Clarke, W. Bekker, John L. Bruce, M T D Smith, V Manchev, L. Khumalo-Mugabi, and Grant L. Laing
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Incidence (epidemiology), General surgery, Poison control, vulnerable group, medicine.disease, penetrating trauma, Occupational safety and health, Icu admission, children, prevention, Laparotomy, Cohort, Injury prevention, Medicine, endemic, Surgery, business, Penetrating trauma
Abstract: Background: This project aims to review the spectrum and outcome of penetrating trauma in children and adolescents with the objective of defining the extent of the problem and of developing strategies to reduce the incidence and severity of this form of trauma. Methods: All patients less than eighteen years of age who were admitted to the Pietermaritzburg Metropolitan Trauma Service (PMTS) following penetrating trauma between December 2012 and December 2018 were identified from the Hybrid Electronic Medical Registry (HEMR). Results: During the five-year period under review, a total of 164 patients less than eighteen years of age sustained penetrating trauma and were admitted to the PMTS. There were 138 males and 26 females. The mean age was 13.29 years and the median age 15 years. There were 70 stab wounds (SW) and 73 gunshot wounds (GSW). There were 21 non-intentional impalement injuries. The mean ISS was 9.04 and the median was 9. A total of 155 plain X-rays were performed, 50 CT scans and 51 CT angiograms in this cohort of patients. Only two ultrasound examinations were performed. A total of 76 patients required an operation, which included 50 laparotomies. Of the patients who underwent a laparotomy, 18 required a repeat laparotomy. There were 46 other procedures undertaken in this cohort of patients, which included two thoracotomies, three laparoscopies and two thoracotomies. The median hospital stay was 2 days and 17 (10%) patients required ICU admission and 7 (4%) died. Conclusion: Penetrating trauma in children and adolescents is associated with significant mortality and morbidity. There are similarities with the management of these injuries in adults, but further work is required to ensure that paediatric management algorithms are evidence based.&nbsp
Published: 2023

25. Laparotomy for penetrating gastric trauma - A South African experience

Author: Natalie Allen, Victor Kong, Cynthia Cheung, Nigel Rajaretnam, John Bruce, Grant Laing, Vasil Manchev, William Xu, and Damian Clarke
Subjects: Adult, Male, Laparotomy, Thoracic Injuries, Wounds, Penetrating, Abdominal Injuries, Wounds, Stab, South Africa, Trauma Centers, Sepsis, Humans, General Earth and Planetary Sciences, Female, Wounds, Gunshot, Retrospective Studies, General Environmental Science
Abstract: Penetrating gastric injury (PGI) is common and although primary repair is sufficient for most injuries, several areas surrounding the peri-operative management remain contentious. This study reviews our experience in the management of PGI and review the clinical outcome at a major trauma centre in South Africa.A retrospective study was conducted from January 2012 to April 2020 at a major trauma centre in South Africa.210 cases were included (184 male, median age: 30 years). Mechanism of injury was 59% stab wounds (SWs) and 41% gunshot wounds (GSWs). The AAST grade was predominantly (92%) grade 2 for all cases. 20% (41/210) were isolated gastric injuries. All cases underwent primary repair and there were no cases of suture line failure. Eleven cases (5%) had one or more injuries not identified at the index laparotomy: 7 were unidentified gastric injuries and the remaining 4 were unidentified non gastric injuries. There was no association between unidentified injuries and mechanism of injury or outcome. Fifty-seven (27%) cases experienced one or more complications. Eighty-two cases (39%) required intensive care unit admission. The overall median length of hospital stay was 7 (IQR 4-11) days. The overall mortality was 14%. GSW injuries were more likely to have additional organ injury, higher ISS and PATI scores, longer length of hospitalization, higher likelihood of ICU stay, greater morbidity and mortality than SW injuries. There was a slight increase in the wound sepsis rate as number of associated extra gastric injuries increased but this was not statistically significant. There was no difference in wound overall sepsis rate between SW and GSW injuries (2% vs 8%, p=0.121).Primary repair alone is sufficient for most PGI, but laparotomy is associated with high incidence of unidentified injury and surgeons must to be cognisant of the likelihood of these occult injuries.
Published: 2022

26. Trends in the Management of Abdominal Gunshot Wounds Over the Last Decade: A South African Experience

Author: Hong Lee, Victor Kong, Cynthia Cheung, Varun Thirayan, Nigel Rajaretnam, Abdallah Elsabagh, John Bruce, Grant Laing, Vasil Manchev, and Damian Clarke
Subjects: Adult, Male, Laparotomy, South Africa, Injury Severity Score, Humans, Female, Wounds, Gunshot, Surgery, Abdominal Injuries, Retrospective Studies
Abstract: This study aimed to review our decade-long experience with the management of abdominal gunshot wounds (GSWs), to document trends in our approach and to develop an evidence base for our contemporary management algorithms in a major trauma in South Africa.This was a retrospective study that included all adult patients with abdominal GSWs between January 2013 and October 2020 managed at a major trauma centre in South Africa.Five hundred and ninety-six cases were included (87% male, mean age: 32 years). The median Injury Severity Score (ISS) was 12. 52% (309/596) of cases had indications of immediate laparotomy and proceeded directly to the operating room without any CT imaging. Of this cohort, the laparotomy was positive in 292 and in the remainder (5%) was negative. Of the remaining 287 cases, 209 underwent a CT scan (35%). 78 were managed without any CT imaging. Of the 78 who did not undergo CT scan, all were managed without any operation and discharged home well. Of the 209 who underwent CT scan, 99 were observed and only one case in this group subsequently required a laparotomy. The remaining 110 cases underwent a laparotomy, which was negative in 7. There were correlations with increasing use of CT, as well as a decrease in those proceeding directly to laparotomy. The overall morbidity rate was 8% (47/596). 32% (190/596) require intensive care unit (ICU) admission. The overall mortality rate was 8% (67/596).The management of abdominal GSWs has continued to evolve. There is now a well-defined role for selective non-operative management in this group of patients and relies on accurate CT assessment. CT scan is now an important component in the management of abdominal GSW even in our resource-constrained environment.
Published: 2022

27. Trends in Adoption of Laparoscopic Appendicectomy in a Developing Country: Closing the Gap

Author: Maheshwar Naidoo, Varun Thirayan, Victor Kong, Vishendran Govindasamy, Ash Dasrath, Bob Mills, John Bruce, Grant Laing, and Damian Clarke
Subjects: South Africa, Appendectomy, Humans, Laparoscopy, Surgery, Length of Stay, Appendicitis, Developing Countries, Retrospective Studies
Abstract: This study reviews our use of laparoscopic versus open appendicectomy over the last decade to track the trends in their usage in a middle-income country.A retrospective study was conducted on patients with intraoperative confirmed acute appendicitis from January 2013 to December 2019 at Grey's Hospital, Pietermaritzburg, South Africa.Eight hundred fifty-one cases of AA were included. 724 (85%) patients underwent open surgery; 435 (60%) via a midline incision and 194 (27%) via a local incision. 127 (15%) patients underwent laparoscopic appendicectomy. A significant rend was noted for an increasing proportion of surgery performed by laparoscopy compared to open surgery (p = 0.02). Patients who underwent open surgery compared to laparoscopy presented with greater peritonism (48.5% vs. 28%, p 0.001), delay from symptom onset (3 vs. 2 days, p 0.001), more frequently from rural areas (94% vs. 86%, p = 0.002) and with higher AAST scores (46.7% AAST ≥ 4, vs. 14.9%, p 0.001). This former group had significantly greater morbidity (42% vs. 35%, p 0.001) with higher Clavien-Dindo scores, were more likely to require ICU admission (8.3% vs. 2.3%, p 0.001) and have longer hospital stay (4 days vs. 2 days, p 0.001); no statistically significant difference in mortality was observed (1.1% vs. 0.8%, p = 0.75).There has been a steady increase in the uptake of laparoscopic appendicectomy and decrease in open approaches in our centre. There is still a high rate of patients with advanced disease, and it is unlikely that this cohort will be suitable for laparoscopic surgery. If we hope to increase the uptake of laparoscopic surgery for acute appendicitis even further, we must focus on identifying patients with early and low-grade disease.
Published: 2022

28. An overview of penetrating traumatic brain injuries at a major civilian trauma centre in South Africa

Author: Abraham Ras, J J P Buitendag, Grant L. Laing, Damian L. Clarke, Victor Kong, Petra Brysiewicz, and John L. Bruce
Subjects: medicine.medical_specialty, business.industry, General surgery, Medicine, Trauma centre, Surgery, business
Abstract: Background: This study reviews our experience with penetrating Traumatic Brain Injury (TBI) in order to define and describe the injury pattern and the outcome. A secondary aim of this study was to review the use of the Motor Score (M Score) and the Simplified Motor Score (SMS) to assess and triage patients with penetrating TBI.Methods: All patients with a TBI secondary to a penetrating mechanism were identified from the Hybrid Electronic Medical Registry at Pietermaritzburg Metropolitan Trauma Service (PMTS) from January 2012 to December 2014. Standard demographic data, need for neuro-surgical intervention, location of external wounds, CT findings and mortality where analysed. The Glasgow Coma Scale (GCS) M score and SMS score were specifically evaluated to determine the relationship between the individual motor component and patient outcome.Results: Over the two-year period January 2012–December 2014, a total of 384 patients were admitted following a penetrating TBI. There were 350 males and 34 females and of this total 7 (1.82%) died. The mechanism of injury was axe (30), bottle (34), gunshot wound (GSW) (22) and stab wound (298). The average age for axe injuries was 27 and bottle injuries was 30. The average age for firearms and knives was 29 and 30 respectively. Surgery was not required for 76.67% of patients. The need for surgery varied according to mechanism of injury. Axe injuries were treated non-operatively in 47.83%, bottle injuries in 87.50%, firearms 70% and knife injuries were treated nonoperatively in 86.84% of cases. The overall survival rate for a penetrating head injury in this population is 98.16%. There were a total of 368 patients with a motor score of 6 of which one died. The survival rate was 99.7% and the mortality rate 0.3%. There were only 6 patients with a motor score of 5 and only 2 with a motor score of 4. The survival rate for both these groups was 100%. There was a total of 6 patients with a motor score of 1. There was a 100% mortality rate is this group.Conclusion: Penetrating TBI has a good prognosis. The vast majority of cases do not require neuro-surgical intervention. Poor motor score is associated with a poor outcome.
Published: 2023

29. Surgeons' perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey

Author: Cobianchi, Lorenzo, Piccolo, Daniele, Dal Mas, Francesca, Agnoletti, Vanni, Ansaloni, Luca, Balch, Jeremy, Biffl, Walter, Butturini, Giovanni, Catena, Fausto, Coccolini, Federico, Denicolai, Stefano, De Simone, Belinda, Frigerio, Isabella, Fugazzola, Paola, Marseglia, Gianluigi, Marseglia, Giuseppe Roberto, Martellucci, Jacopo, Modenese, Mirko, Previtali, Pietro, Ruta, Federico, Venturi, Alessandro, Kaafarani, Haytham M, Loftus, Tyler J, Kenneth Lyle Abbott, Abubaker Abdelmalik, Nebyou Seyoum Abebe, Fikri Abu-Zidan, Yousif Abdallah Yousif Adam, Harissou Adamou, Dmitry Mikhailovich Adamovich, Ferdinando Agresta, Antonino Agrusa, Emrah Akin, Mario Alessiani, Henrique Alexandrino, Syed Muhammad Ali, Vasilescu Alin Mihai, Pedro Miguel Almeida, Mohammed Mohammed Al-Shehari, Michele Altomare, Francesco Amico, Michele Ammendola, Jacopo Andreuccetti, Elissavet Anestiadou, Peter Angelos, Alfredo Annicchiarico, Amedeo Antonelli, Daniel Aparicio-Sanchez, Antonella Ardito, Giulio Argenio, Catherine Claude Arvieux, Ingolf Harald Askevold, Boyko Tchavdarov Atanasov, Goran Augustin, Selmy Sabry Awad, Giulia Bacchiocchi, Carlo Bagnoli, Hany Bahouth, Efstratia Baili, Lovenish Bains, Gian Luca Baiocchi, Miklosh Bala, Carmen Balagué, Dimitrios Balalis, Edoardo Baldini, Oussama Baraket, Suman Baral, Mirko Barone, Alberto Gonzãlez Barranquero, Jorge Arturo Barreras, Gary Alan Bass, Zulfu Bayhan, Giovanni Bellanova, Offir Ben-Ishay, Fabrizio Bert, Valentina Bianchi, Helena Biancuzzi, Chiara Bidoli, Raluca Bievel Radulescu, Mark Brian Bignell, Alan Biloslavo, Daniele Bissacco, Roberto Bini, Paolo Boati, Guillaume Boddaert, Branko Bogdanic, Cristina Bombardini, Luigi Bonavina, Luca Bonomo, Andrea Bottari, Konstantinos Bouliaris, Gioia Brachini, Antonio Brillantino, Giuseppe Brisinda, Maloni Mamada Bulanauca, Luis Antonio Buonomo, Jakob Burcharth, Salvatore Buscemi, Francesca Calabretto, Giacomo Calini, Valentin Calu, Fabio Cesare Campanile, Riccardo Campo Dall Orto, Andrea Campos-Serra, Stefano Campostrini, Recayi Capoglu, Joao Miguel Carvas, Marco Cascella, Gianmaria Casoni Pattacini, Valerio Celentano, Danilo Corrado Centonze, Marco Ceresoli, Dimitrios Chatzipetris, Antonella Chessa, Maria Michela Chiarello, Mircea Chirica, Serge Chooklin, Christos Chouliaras, Sharfuddin Chowdhury, Pasquale Cianci, Nicola Cillara, Stefania Cimbanassi, Stefano Piero Bernardo Cioffi, Elif Colak, Enrique Colás Ruiz, Luigi Conti, Alessandro Coppola, Tiago Correia De Sa, Silvia Dantas Costa, Valerio Cozza, Giuseppe Curro', Kirsten Felicia Ann-Sophie Aimee Dabekaussen, Fabrizio D'Acapito, Dimitrios Damaskos, Giancarlo D'Ambrosio, Koray Das, Richard Justin Davies, Andrew Charles De Beaux, Sara Patricia De Lebrusant Fernandez, Alessandro De Luca, Francesca De Stefano, Luca Degrate, Zaza Demetrashvili, Andreas Kyriacou Demetriades, Dzemail Smail Detanac, Agnese Dezi, Giuseppe Di Buono, Isidoro Di Carlo, Pierpaolo Di Lascio, Marcello Di Martino, Salomone Di Saverio, Bogdan Diaconescu, Jose J Diaz, Rigers Dibra, Evgeni Nikolaev Dimitrov, Vincenza Paola Dinuzzi, Sandra Dios-Barbeito, Jehangir Farman Ali Diyani, Agron Dogjani, Maurizio Domanin, Mario D'Oria, Virginia Duran Munoz-Cruzado, Barbora East, Mikael Ekelund, Gerald Takem Ekwen, Adel Hamed Elbaih, Muhammed Elhadi, Natalie Enninghorst, Mairam Ernisova, Juan Pablo Escalera-Antezana, Sofia Esposito, Giuseppe Esposito, Mercedes Estaire, Camilla Nikita Farè, Roser Farre, Francesco Favi, Luca Ferrario, Antonjacopo Ferrario di Tor Vajana, Claudia Filisetti, Francesco Fleres, Vinicius Cordeiro Fonseca, Alexander Forero-Torres, Francesco Forfori, Laura Fortuna, Evangelos Fradelos, Gustavo P Fraga, Pietro Fransvea, Simone Frassini, Giuseppe Frazzetta, Erica Pizzocaro, Maximos Frountzas, Mahir Gachabayov, Rita Galeiras, Alain A Garcia Vazquez, Simone Gargarella, Ibrahim Umar Garzali, Wagih Mommtaz Ghannam, Faiz Najmuddin Ghazi, Lawrence Marshall Gillman, Rossella Gioco, Alessio Giordano, Luca Giordano, Carlo Giove, Giorgio Giraudo, Mario Giuffrida, Michela Giulii Capponi, Emanuel Gois Jr, Carlos Augusto Gomes, Felipe Couto Gomes, Ricardo Alessandro Teixeira Gonsaga, Emre Gonullu, Jacques Goosen, Tatjana Goranovic, Raquel Gracia-Roman, Giorgio Maria Paolo Graziano, Ewen Alexander Griffiths, Tommaso Guagni, Dimitar Bozhidarov Hadzhiev, Muad Gamil Haidar, Hytham K S Hamid, Timothy Craig Hardcastle, Firdaus Hayati, Andrew James Healey, Andreas Hecker, Matthias Hecker, Edgar Fernando Hernandez Garcia, Adrien Montcho Hodonou, Eduardo Cancio Huaman, Martin Huerta, Aini Fahriza Ibrahim, Basil Mohamed Salabeldin Ibrahim, Giuseppe Ietto, Marco Inama, Orestis Ioannidis, Arda Isik, Nizar Ismail, Azzain Mahadi Hamid Ismail, Ruhi Fadzlyana Jailani, Ji Young Jang, Christos Kalfountzos, Sujala Niatarika Rajsain Kalipershad, Emmanouil Kaouras, Lewis Jay Kaplan, Yasin Kara, Evika Karamagioli, Aleksandar Karamarkovia, Ioannis Katsaros, Alfie J Kavalakat, Aristotelis Kechagias, Jakub Kenig, Boris Juli Kessel, Jim S Khan, Vladimir Khokha, Jae Il Kim, Andrew Wallace Kirkpatrick, Roberto Klappenbach, Yoram Kluger, Yoshiro Kobe, Efstratios Kofopoulos Lymperis, Kenneth Yuh Yen Kok, Victor Kong, Dimitris P Korkolis, Georgios Koukoulis, Bojan Kovacevic, Vitor Favali Kruger, Igor A Kryvoruchko, Hayato Kurihara, Akira Kuriyama, Aitor Landaluce-Olavarria, Pierfrancesco Lapolla, Ari Leppäniemi, Leo Licari, Giorgio Lisi, Andrey Litvin, Aintzane Lizarazu, Heura Llaquet Bayo, Varut Lohsiriwat, Claudia Cristina Lopes Moreira, Eftychios Lostoridis, Agustãn Tovar Luna, Davide Luppi, Gustavo Miguel Machain V, Marc Maegele, Daniele Maggiore, Stefano Magnone, Ronald V Maier, Piotr Major, Mallikarjuna Manangi, Andrea Manetti, Baris Mantoglu, Chiara Marafante, Federico Mariani, Athanasios Marinis, Evandro Antonio Sbalcheiro Mariot, Gennaro Martines, Aleix Martinez Perez, Costanza Martino, Pietro Mascagni, Damien Massalou, Maurizio Massaro, Belen Matías-García, Gennaro Mazzarella, Giorgio Mazzarolo, Renato Bessa Melo, Fernando Mendoza-Moreno, Serhat Meric, Jeremy Meyer, Luca Miceli, Nikolaos V Michalopoulos, Flavio Milana, Andrea Mingoli, Tushar S Mishra, Muyed Mohamed, Musab Isam Eldin Abbas Mohamed, Ali Yasen Mohamedahmed, Mohammed Jibreel Suliman Mohammed, Rajashekar Mohan, Ernest E Moore, Dieter Morales-Garcia, Mã Ns Muhrbeck, Francesk Mulita, Sami Mohamed Siddig Mustafa, Edoardo Maria Muttillo, Mukhammad David Naimzada, Pradeep H Navsaria, Ionut Negoi, Luca Nespoli, Christine Nguyen, Melkamu Kibret Nidaw, Giuseppe Nigri, Ioannis Nikolopoulos, Donal Brendan O'Connor, Habeeb Damilola Ogundipe, Cristina Oliveri, Stefano Olmi, Ernest Cun Wang Ong, Luca Orecchia, Aleksei V Osipov, Muhammad Faeid Othman, Marco Pace, Mario Pacilli, Leonardo Pagani, Giuseppe Palomba, Desire' Pantalone, Arpad Panyko, Ciro Paolillo, Mario Virgilio Papa, Dimitrios Papaconstantinou, Maria Papadoliopoulou, Aristeidis Papadopoulos, Davide Papis, Nikolaos Pararas, Jose Gustavo Parreira, Neil Geordie Parry, Francesco Pata, Tapan Patel, Simon Paterson-Brown, Giovanna Pavone, Francesca Pecchini, Veronica Pegoraro, Gianluca Pellino, Maria Pelloni, Andrea Peloso, Eduardo Perea Del Pozo, Rita Goncalves Pereira, Bruno Monteiro Pereira, Aintzane Lizarazu Perez, Silvia Pérez, Teresa Perra, Gennaro Perrone, Antonio Pesce, Lorenzo Petagna, Giovanni Petracca, Vorapong Phupong, Biagio Picardi, Arcangelo Picciariello, Micaela Piccoli, Edoardo Picetti, Emmanouil Pikoulis Pikoulis, Tadeja Pintar, Giovanni Pirozzolo, Francesco Piscioneri, Mauro Podda, Alberto Porcu, Francesca Privitera, Clelia Punzo, Silvia Quaresima, Martha Alexa Quiodettis, Niels Qvist, Razrim Rahim, Filipe Ramalho de Almeida, Rosnelifaizur Bin Ramely, Huseyin Kemal Rasa, Martin Reichert, Alexander Reinisch-Liese, Angela Renne, Camilla Riccetti, Maria Rita Rodriguez-Luna, Daniel Roizblatt, Andrea Romanzi, Luigi Romeo, Francesco Pietro Maria Roscio, Ramely Bin Rosnelifaizur, Stefano Rossi, Andres M Rubiano, Elena Ruiz-Ucar, Boris Evgeniev Sakakushev, Juan Carlos Salamea, Ibrahima Sall, Lasitha Bhagya Samarakoon, Fabrizio Sammartano, Alejandro Sanchez Arteaga, Sergi Sanchez-Cordero, Domenico Pietro Maria Santoanastaso, Massimo Sartelli, Diego Sasia, Norio Sato, Artem Savchuk, Robert Grant Sawyer, Giacomo Scaioli, Dimitrios Schizas, Simone Sebastiani, Barbara Seeliger, Helmut Alfredo Segovia Lohse, Charalampos Seretis, Giacomo Sermonesi, Mario Serradilla-Martin, Vishal G Shelat, Sergei Shlyapnikov, Theodoros Sidiropoulos, Romeo Lages Simoes, Leandro Siragusa, Boonying Siribumrungwong, Mihail Slavchev, Leonardo Solaini, Gabriele Soldini, Andrey Sopuev, Kjetil Soreide, Apostolos Sovatzidis, Philip Frank Stahel, Matt Strickland, Mohamed Arif Hameed Sultan, Ruslan Sydorchuk, Larysa Sydorchuk, Syed Muhammad Ali Muhammad Syed, Luis Tallon-Aguilar, Andrea Marco Tamburini, Nicolò Tamini, Edward C T H Tan, Jih Huei Tan, Antonio Tarasconi, Nicola Tartaglia, Giuseppe Tartaglia, Dario Tartaglia, John Vincent Taylor, Giovanni Domenico Tebala, Michel Teuben, Alexis Theodorou, Matti Tolonen, Giovanni Tomasicchio, Adriana Toro, Beatrice Torre, Tania Triantafyllou, Giuseppe Trigiante Trigiante, Marzia Tripepi, Julio Trostchansky, Konstantinos Tsekouras, Victor Turrado-Rodriguez, Roberta Tutino, Matteo Uccelli, Petar Angelov Uchikov, Bakarne Ugarte-Sierra, Mika Tapani Ukkonen, Michail Vailas, Panteleimon G Vassiliu, Alain Garcia Vazquez, Rita Galeiras Vazquez, George Velmahos, Juan Ezequiel Verde, Juan Manuel Verde, Massimiliano Veroux, Jacopo Viganò, Ramon Vilallonga, Diego Visconti, Alessandro Vittori, Maciej Waledziak, Tongporn Wannatoop, Lukas Werner Widmer, Michael Samuel James Wilson, Sarah Woltz, Ting Hway Wong, Sofia Xenaki, Byungchul Yu, Steven Yule, Sanoop Koshy Zachariah, Georgios Zacharis, Claudia Zaghi, Andee Dzulkarnaen Zakaria, Diego A Zambrano, Nikolaos Zampitis, Biagio Zampogna, Simone Zanghì, Maristella Zantedeschi, Konstantinos Zapsalis, Fabio Zattoni, Monica Zese, Lorenzo, Cobianchi, Daniele, Piccolo, Francesca, Dal Ma, Vanni, Agnoletti, Luca, Ansaloni, Jeremy, Balch, Walter, Biffl, Giovanni, Butturini, Fausto, Catena, Federico, Coccolini, Stefano, Denicolai, Belinda, De Simone, Isabella, Frigerio, Paola, Fugazzola, Gianluigi, Marseglia, Giuseppe Roberto, Marseglia, Jacopo, Martellucci, Mirko, Modenese, Pietro, Previtali, Federico, Ruta, Alessandro, Venturi, Haytham M, Kaafarani, Tyler J, Loftu, Lyle Abbott, Kenneth, Abdelmalik, Abubaker, Seyoum Abebe, Nebyou, Abu-Zidan, Fikri, Abdallah Yousif Adam, Yousif, Adamou, Harissou, Mikhailovich Adamovich, Dmitry, Agresta, Ferdinando, Agrusa, Antonino, Akin, Emrah, Alessiani, Mario, Alexandrino, Henrique, Muhammad Ali, Syed, Alin Mihai, Vasilescu, Miguel Almeida, Pedro, Mohammed Al-Shehari, Mohammed, Altomare, Michele, Amico, Francesco, Ammendola, Michele, Andreuccetti, Jacopo, Anestiadou, Elissavet, Angelos, Peter, Annicchiarico, Alfredo, Antonelli, Amedeo, Aparicio-Sanchez, Daniel, Ardito, Antonella, Argenio, Giulio, Claude Arvieux, Catherine, Harald Askevold, Ingolf, Tchavdarov Atanasov, Boyko, Augustin, Goran, Sabry Awad, Selmy, Bacchiocchi, Giulia, Bagnoli, Carlo, Bahouth, Hany, Baili, Efstratia, Bains, Lovenish, Luca Baiocchi, Gian, Bala, Miklosh, Balagué, Carmen, Balalis, Dimitrio, Baldini, Edoardo, Baraket, Oussama, Baral, Suman, Barone, Mirko, Gonzãlez Barranquero, Alberto, Arturo Barreras, Jorge, Alan Bass, Gary, Bayhan, Zulfu, Bellanova, Giovanni, Ben-Ishay, Offir, Bert, Fabrizio, Bianchi, Valentina, Biancuzzi, Helena, Bidoli, Chiara, Bievel Radulescu, Raluca, Brian Bignell, Mark, Biloslavo, Alan, Bissacco, Daniele, Bini, Roberto, Boati, Paolo, Boddaert, Guillaume, Bogdanic, Branko, Bombardini, Cristina, Bonavina, Luigi, Bonomo, Luca, Bottari, Andrea, Bouliaris, Konstantino, Brachini, Gioia, Brillantino, Antonio, Brisinda, Giuseppe, Mamada Bulanauca, Maloni, Antonio Buonomo, Lui, Burcharth, Jakob, Buscemi, Salvatore, Calabretto, Francesca, Calini, Giacomo, Calu, Valentin, Cesare Campanile, Fabio, Campo Dall Orto, Riccardo, Campos-Serra, Andrea, Campostrini, Stefano, Capoglu, Recayi, Miguel Carvas, Joao, Cascella, Marco, Casoni Pattacini, Gianmaria, Celentano, Valerio, Corrado Centonze, Danilo, Ceresoli, Marco, Chatzipetris, Dimitrio, Chessa, Antonella, Michela Chiarello, Maria, Chirica, Mircea, Chooklin, Serge, Chouliaras, Christo, Chowdhury, Sharfuddin, Cianci, Pasquale, Cillara, Nicola, Cimbanassi, Stefania, Piero Bernardo Cioffi, Stefano, Colak, Elif, Colás Ruiz, Enrique, Conti, Luigi, Coppola, Alessandro, Correia De Sa, Tiago, Dantas Costa, Silvia, Cozza, Valerio, Curro', Giuseppe, Felicia Ann-Sophie Aimee Dabekaussen, Kirsten, D'Acapito, Fabrizio, Damaskos, Dimitrio, D'Ambrosio, Giancarlo, Das, Koray, Justin Davies, Richard, Charles De Beaux, Andrew, Patricia De Lebrusant Fernandez, Sara, De Luca, Alessandro, De Stefano, Francesca, Degrate, Luca, Demetrashvili, Zaza, Kyriacou Demetriades, Andrea, Smail Detanac, Dzemail, Dezi, Agnese, Di Buono, Giuseppe, Di Carlo, Isidoro, Di Lascio, Pierpaolo, Di Martino, Marcello, Di Saverio, Salomone, Diaconescu, Bogdan, J Diaz, Jose, Dibra, Riger, Nikolaev Dimitrov, Evgeni, Paola Dinuzzi, Vincenza, Dios-Barbeito, Sandra, Farman Ali Diyani, Jehangir, Dogjani, Agron, Domanin, Maurizio, D'Oria, Mario, Duran Munoz-Cruzado, Virginia, East, Barbora, Ekelund, Mikael, Takem Ekwen, Gerald, Hamed Elbaih, Adel, Elhadi, Muhammed, Enninghorst, Natalie, Ernisova, Mairam, Pablo Escalera-Antezana, Juan, Esposito, Sofia, Esposito, Giuseppe, Estaire, Mercede, Nikita Farè, Camilla, Farre, Roser, Favi, Francesco, Ferrario, Luca, Ferrario di Tor Vajana, Antonjacopo, Filisetti, Claudia, Fleres, Francesco, Cordeiro Fonseca, Viniciu, Forero-Torres, Alexander, Forfori, Francesco, Fortuna, Laura, Fradelos, Evangelo, P Fraga, Gustavo, Fransvea, Pietro, Frassini, Simone, Frazzetta, Giuseppe, Pizzocaro, Erica, Frountzas, Maximo, Gachabayov, Mahir, Galeiras, Rita, A Garcia Vazquez, Alain, Gargarella, Simone, Umar Garzali, Ibrahim, Mommtaz Ghannam, Wagih, Najmuddin Ghazi, Faiz, Marshall Gillman, Lawrence, Gioco, Rossella, Giordano, Alessio, Giordano, Luca, Giove, Carlo, Giraudo, Giorgio, Giuffrida, Mario, Giulii Capponi, Michela, Gois Jr, Emanuel, Augusto Gomes, Carlo, Couto Gomes, Felipe, Alessandro Teixeira Gonsaga, Ricardo, Gonullu, Emre, Goosen, Jacque, Goranovic, Tatjana, Gracia-Roman, Raquel, Maria Paolo Graziano, Giorgio, Alexander Griffiths, Ewen, Guagni, Tommaso, Bozhidarov Hadzhiev, Dimitar, Gamil Haidar, Muad, S Hamid, Hytham K, Craig Hardcastle, Timothy, Hayati, Firdau, James Healey, Andrew, Hecker, Andrea, Hecker, Matthia, Fernando Hernandez Garcia, Edgar, Montcho Hodonou, Adrien, Cancio Huaman, Eduardo, Huerta, Martin, Fahriza Ibrahim, Aini, Mohamed Salabeldin Ibrahim, Basil, Ietto, Giuseppe, Inama, Marco, Ioannidis, Oresti, Isik, Arda, Ismail, Nizar, Mahadi Hamid Ismail, Azzain, Fadzlyana Jailani, Ruhi, Young Jang, Ji, Kalfountzos, Christo, Niatarika Rajsain Kalipershad, Sujala, Kaouras, Emmanouil, Jay Kaplan, Lewi, Kara, Yasin, Karamagioli, Evika, Karamarkovia, Aleksandar, Katsaros, Ioanni, J Kavalakat, Alfie, Kechagias, Aristoteli, Kenig, Jakub, Juli Kessel, Bori, S Khan, Jim, Khokha, Vladimir, Il Kim, Jae, Wallace Kirkpatrick, Andrew, Klappenbach, Roberto, Kluger, Yoram, Kobe, Yoshiro, Kofopoulos Lymperis, Efstratio, Yuh Yen Kok, Kenneth, Kong, Victor, P Korkolis, Dimitri, Koukoulis, Georgio, Kovacevic, Bojan, Favali Kruger, Vitor, A Kryvoruchko, Igor, Kurihara, Hayato, Kuriyama, Akira, Landaluce-Olavarria, Aitor, Lapolla, Pierfrancesco, Leppäniemi, Ari, Licari, Leo, Lisi, Giorgio, Litvin, Andrey, Lizarazu, Aintzane, Llaquet Bayo, Heura, Lohsiriwat, Varut, Cristina Lopes Moreira, Claudia, Lostoridis, Eftychio, Tovar Luna, Agustãn, Luppi, Davide, V, Gustavo Miguel Machain, Maegele, Marc, Maggiore, Daniele, Magnone, Stefano, V Maier, Ronald, Major, Piotr, Manangi, Mallikarjuna, Manetti, Andrea, Mantoglu, Bari, Marafante, Chiara, Mariani, Federico, Marinis, Athanasio, Antonio Sbalcheiro Mariot, Evandro, Martines, Gennaro, Martinez Perez, Aleix, Martino, Costanza, Mascagni, Pietro, Massalou, Damien, Massaro, Maurizio, Matías-García, Belen, Mazzarella, Gennaro, Mazzarolo, Giorgio, Bessa Melo, Renato, Mendoza-Moreno, Fernando, Meric, Serhat, Meyer, Jeremy, Miceli, Luca, V Michalopoulos, Nikolao, Milana, Flavio, Mingoli, Andrea, S Mishra, Tushar, Mohamed, Muyed, Isam Eldin Abbas Mohamed, Musab, Yasen Mohamedahmed, Ali, Jibreel Suliman Mohammed, Mohammed, Mohan, Rajashekar, E Moore, Ernest, Morales-Garcia, Dieter, Ns Muhrbeck, Mã, Mulita, Francesk, Mohamed Siddig Mustafa, Sami, Maria Muttillo, Edoardo, David Naimzada, Mukhammad, H Navsaria, Pradeep, Negoi, Ionut, Nespoli, Luca, Nguyen, Christine, Kibret Nidaw, Melkamu, Nigri, Giuseppe, Nikolopoulos, Ioanni, Brendan O'Connor, Donal, Damilola Ogundipe, Habeeb, Oliveri, Cristina, Olmi, Stefano, Cun Wang Ong, Ernest, Orecchia, Luca, V Osipov, Aleksei, Faeid Othman, Muhammad, Pace, Marco, Pacilli, Mario, Pagani, Leonardo, 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Kemal Rasa, Huseyin, Reichert, Martin, Reinisch-Liese, Alexander, Renne, Angela, Riccetti, Camilla, Rita Rodriguez-Luna, Maria, Roizblatt, Daniel, Romanzi, Andrea, Romeo, Luigi, Pietro Maria Roscio, Francesco, Bin Rosnelifaizur, Ramely, Rossi, Stefano, M Rubiano, Andre, Ruiz-Ucar, Elena, Evgeniev Sakakushev, Bori, Carlos Salamea, Juan, Sall, Ibrahima, Bhagya Samarakoon, Lasitha, Sammartano, Fabrizio, Sanchez Arteaga, Alejandro, Sanchez-Cordero, Sergi, Pietro Maria Santoanastaso, Domenico, Sartelli, Massimo, Sasia, Diego, Sato, Norio, Savchuk, Artem, Grant Sawyer, Robert, Scaioli, Giacomo, Schizas, Dimitrio, Sebastiani, Simone, Seeliger, Barbara, Alfredo Segovia Lohse, Helmut, Seretis, Charalampo, Sermonesi, Giacomo, Serradilla-Martin, Mario, G Shelat, Vishal, Shlyapnikov, Sergei, Sidiropoulos, Theodoro, Lages Simoes, Romeo, Siragusa, Leandro, Siribumrungwong, Boonying, Slavchev, Mihail, Solaini, Leonardo, Soldini, Gabriele, Sopuev, Andrey, Soreide, Kjetil, Sovatzidis, Apostolo, Frank Stahel, Philip, Strickland, Matt, Arif Hameed Sultan, Mohamed, Sydorchuk, Ruslan, Sydorchuk, Larysa, Muhammad Ali Muhammad Syed, Syed, Tallon-Aguilar, Lui, Marco Tamburini, Andrea, Tamini, Nicolò, H Tan, Edward C T, Huei Tan, Jih, Tarasconi, Antonio, Tartaglia, Nicola, Tartaglia, Giuseppe, Tartaglia, Dario, Vincent Taylor, John, Domenico Tebala, Giovanni, Teuben, Michel, Theodorou, Alexi, Tolonen, Matti, Tomasicchio, Giovanni, Toro, Adriana, Torre, Beatrice, Triantafyllou, Tania, Trigiante Trigiante, Giuseppe, Tripepi, Marzia, Trostchansky, Julio, Tsekouras, Konstantino, Turrado-Rodriguez, Victor, Tutino, Roberta, Uccelli, Matteo, Angelov Uchikov, Petar, Ugarte-Sierra, Bakarne, Tapani Ukkonen, Mika, Vailas, Michail, G Vassiliu, Panteleimon, Garcia Vazquez, Alain, Galeiras Vazquez, Rita, Velmahos, George, Ezequiel Verde, Juan, Manuel Verde, Juan, Veroux, Massimiliano, Viganò, Jacopo, Vilallonga, Ramon, Visconti, Diego, Vittori, Alessandro, Waledziak, Maciej, Wannatoop, Tongporn, Werner Widmer, Luka, Samuel James Wilson, Michael, Woltz, Sarah, Hway Wong, Ting, Xenaki, Sofia, Yu, Byungchul, Yule, Steven, Koshy Zachariah, Sanoop, Zacharis, Georgio, Zaghi, Claudia, Dzulkarnaen Zakaria, Andee, A Zambrano, Diego, Zampitis, Nikolao, Zampogna, Biagio, Zanghì, Simone, Zantedeschi, Maristella, Zapsalis, Konstantino, Zattoni, Fabio, Zese, Monica, Cobianchi L., Piccolo D., Mas F.D., Agnoletti V., Ansaloni L., Balch J., Biffl W., Butturini G., Catena F., Coccolini F., Denicolai S., De Simone B., Frigerio I., Fugazzola P., Marseglia G., Marseglia G.R., Martellucci J., Modenese M., Previtali P., Ruta F., Venturi A., Kaafarani H.M., Loftus T.J., Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Team Dynamics Study Group, Cobianchi, L, Piccolo, D, Dal Mas, F, Agnoletti, V, Ansaloni, L, Balch, J, Biffl, W, Butturini, G, Catena, F, Coccolini, F, Denicolai, S, De Simone, B, Frigerio, I, Fugazzola, P, Marseglia, G, Martellucci, J, Modenese, M, Previtali, P, Ruta, F, Venturi, A, Kaafarani, H, Loftus, T, Abbott, K, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Adamovich, D, Agresta, F, Agrusa, A, Akin, E, Alessiani, M, Alexandrino, H, Ali, S, Mihai, V, Almeida, P, Al-Shehari, M, Altomare, M, Amico, F, Ammendola, M, Andreuccetti, J, Anestiadou, E, Angelos, P, Annicchiarico, A, Antonelli, A, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Arvieux, C, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bacchiocchi, G, Bagnoli, C, Bahouth, H, Baili, E, Bains, L, Baiocchi, G, Bala, M, Balague, C, Balalis, D, Baldini, E, Baraket, O, Baral, S, Barone, M, Barranquero, A, Barreras, J, Bass, G, 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Martino, M, Di Saverio, S, Diaconescu, B, Diaz, J, Dibra, R, Dimitrov, E, Dinuzzi, V, Dios-Barbeito, S, Diyani, J, Dogjani, A, Domanin, M, D'Oria, M, Munoz-Cruzado, V, East, B, Ekelund, M, Ekwen, G, Elbaih, A, Elhadi, M, Enninghorst, N, Ernisova, M, Escalera-Antezana, J, Esposito, S, Esposito, G, Estaire, M, Fare, C, Farre, R, Favi, F, Ferrario, L, Vajana, A, Filisetti, C, Fleres, F, Fonseca, V, Forero-Torres, A, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Frassini, S, Frazzetta, G, Pizzocaro, E, Frountzas, M, Gachabayov, M, Galeiras, R, Vazquez, A, Gargarella, S, Garzali, I, Ghannam, W, Ghazi, F, Gillman, L, Gioco, R, Giordano, A, Giordano, L, Giove, C, Giraudo, G, Giuffrida, M, Capponi, M, Gois, E, Gomes, C, Gomes, F, Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Gracia-Roman, R, Graziano, G, Griffiths, E, Guagni, T, Hadzhiev, D, Haidar, M, Hamid, H, Hardcastle, T, Hayati, F, Healey, A, Hecker, A, Hecker, M, Garcia, E, Hodonou, A, Huaman, E, Huerta, M, Ibrahim, A, Ibrahim, B, Ietto, G, Inama, M, Ioannidis, O, Isik, A, Ismail, N, Ismail, A, Jailani, R, Jang, J, Kalfountzos, C, Kalipershad, S, Kaouras, E, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Katsaros, I, Kavalakat, A, Kechagias, A, Kenig, J, Kessel, B, Khan, J, Khokha, V, Kim, J, Kirkpatrick, A, Klappenbach, R, Kluger, Y, Kobe, Y, Lymperis, E, Kok, K, Kong, V, Korkolis, D, Koukoulis, G, Kovacevic, B, Kruger, V, Kryvoruchko, I, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Lapolla, P, Leppaniemi, A, Licari, L, Lisi, G, Litvin, A, Lizarazu, A, Bayo, H, Lohsiriwat, V, Moreira, C, Lostoridis, E, Luna, A, Luppi, D, Machain, V, Maegele, M, Maggiore, D, Magnone, S, Maier, R, Major, P, Manangi, M, Manetti, A, Mantoglu, B, Marafante, C, Mariani, F, Marinis, A, Mariot, E, Martines, G, Perez, A, Martino, C, Mascagni, P, Massalou, D, Massaro, M, Matias-Garcia, B, Mazzarella, G, Mazzarolo, G, Melo, R, Mendoza-Moreno, F, Meric, S, Meyer, J, Miceli, L, Michalopoulos, N, Milana, F, Mingoli, A, 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Subjects: Settore SECS-P/10 - Organizzazione Aziendale, Settore MED/18 - Chirurgia Generale, Artificial intelligence, Settore SECS-P/07 - Economia Aziendale, Decision aid, Emergency Medicine, Decision aids, Surgery, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Trauma and emergency surgery, Clinical decision-making, Survey
Abstract: Background Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons’ knowledge and perception of using AI-based tools in clinical decision-making processes. Methods An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society’s website and Twitter profile. Results 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI.
Published: 2023

30. Use of Telemedicine for Post-discharge Assessment of the Surgical Wound. International Cohort Study, and Systematic Review with Meta-analysis

Author: James, Glasbey, Issi, Trout, Victoria, Adeyeye, Adesoji, Ademuyiwa, Adewale, Adisa, Alisha, Bhatt, Bruce, Biccard, Peter, Brocklehurst, Jean De La Croix Allen Ingabire, Francis Moïse Dossou, Irani, Durán, Rohini, Dutta, Dhruva, Ghosh, Frank, Gyamfi, Pollyanna, Hardy, Gabriella, Hyman, Ritu, Jain, Bryar, Kadir, Stephen, Knight, Oluwaseun, Ladipo-Ajayi, Ismail, Lawani, Souliath, Lawani, Rachel, Lillywhite, Rhiannon, Macefield, Laura, Magill, Janet, Martin, Jonathan, Mathers, Kenneth, Mclean, Punam, Mistry, Rohin, Mittal, Rachel, Moore, Dion, Morton, Faustin, Ntirenganya, Emmanuel, Ofori, Rupert, Pearse, Alberto, Peón, Thomas, Pinkney, Antonio Ramos de la Medina, Tubasiime, Ronald, David, Roman, Joana, Simoes, Anita, Slade, Stephen, Tabiri, Donna, Smith, Ewen, Harrison, Aneel, Bhangu, Azmina, Verjee, Emmy, Runigamugabo, Adesoji, O Ademuyiwa, Adewale, O Adisa, Maria Lorena Aguilera, Afnan, Altamini, Philip, Alexander, Sara, W Al-Saqqa, Giuliano, Borda-Luque, Jen, Cornick, Ainhoa, Costas-Chavarri, Thomas, M Drake, Stuart, J Fergusson, J Edward Fitzgerald, C Allen Ingabire, J, Lawani, Ismaïl, Zahra, Jaffry, Hosni Khairy Salem, Chetan, Khatri, Andrew, Kirby, Anyomih Theophilus Teddy Kojo, Marie Carmela Lapitan, Richard, Lilford, Andre, L Mihaljevic, Midhun, Mohan, Alphonse Zeta Mutabazi, Dmitri, Nepogodiev, Riinu, Ots, Pata, Francesco, Tomas, Poškus, Ahmad Uzair Qureshi, Antonio Ramos-De la Medina, Sarah, Rayne, Gustavo, Recinos, Kjetil, Søreide, Catherine, A Shaw, Sebastian, Shu, Richard, Spence, Neil, Smart, Ewen, M Harrison, Maria Marta Modolo, Dushyant, Iyer, Sebastian, King, Tom, Arthur, Sayeda Nazmum Nahar, Ade, Waterman, Michael, Walsh, Arnav, Agarwal, Zani, Augusto, Mohammed, Firdouse, Tyler, Rouse, Qinyang, Liu, Juan Camilo Correa, Peep, Talving, Mengistu, Worku, Alexis, Arnaud, Vassilis, Kalles, Basant, Kumar, Sunil, Kumar, Radhian, Amandito, Roy, Quek, Luca, Ansaloni, Ahmed, Altibi, Donatas, Venskutonis, Justas, Zilinskas, Tomas, Poskus, John, Whitaker, Vanessa, Msosa, Yong Yong Tew, Alexia, Farrugia, Elaine, Borg, Zineb, Bentounsi, Tanzeela, Gala, Ibrahim, Al-Slaibi, Haya, Tahboub, Osaid, H Alser, Diego, Romani, Sebestian, Shu, Piotr, Major, Aurel, Mironescu, Matei, Bratu, Amar, Kourdouli, Aliyu, Ndajiwo, Abdulaziz, Altwijri, Mohammed Ubaid Alsaggaf, Ahmad, Gudal, Al Faifi Jubran, Sam, Seisay, Bettina, Lieske, Irene, Ortega, Jenifa, Jeyakumar, Kithsiri, J Senanayake, Omar, Abdulbagi, Yucel Cengiz Dmitri Raptis, Yuksel, Altinel, Chia, Kong, Ella, Teasdale, Gareth, Irwin, Michael, Stoddart, Rakan, Kabariti, Sukrit, Suresh, Katherine, Gash, Ragavan, Narayanan, Mayaba, Maimbo, Besmir, Grizhja, Shpetim, Ymeri, Gezim, Galiqi, Roberto, Klappenbach, Diego, Antezana, Alvaro Enrique Mendoza Beleño, Cecilia, Costa, Belen, Sanchez, Susan, Aviles, Claudio Gabriel Fermani, Rubén, Balmaceda, Santiago, Villalobos, Juan Manuel Carmona, Daniel, Hamill, Peter, Deutschmann, Simone, Sandler, Daniel, Cox, Ram, Nataraja, Claire, Sharpin, Damir, Ljuhar, 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Corro-Diaz, Samantha, Manriquez-Reyes, Marisol, Abdelhamid, Amina, Hrora, Abdelmalek, Benammi, Sarah, Bachri, Houda, Abbouch, Meryem, Boukhal, Khaoula, Mammar Bennai, Redouane, Belkouchi, Abdelkader, Sobhi Jabal, Mohamed, Benyaiche, Chaymae, Vermaas, Maarten, Duinhouwer, Lucia, Pastora, Javier, Wood, Greta, Soledad Merlo, Maria, Ajao, Akinlabi, Ayandipo, Omobolaji, Lawal, Taiwo, Abdurrazzaaq, Abdussemiu, Alada, Muslimat, Nasir, Abdulrasheed, Adeniran, Jame, Habeeb, Olufemi, Popoola, Ademola, Adeyeye, Ademola, Adebanjo, Ademola, Adesanya, Opeoluwa, Adeniyi, Adewale, Mendel, Henry, Bello, Bashir, Muktar, Umar, Osinowo, Adedapo, Olagboyega Olajide, Thoma, Oshati, Oyindamola, Ihediwa, George, Adenekan, Babajide, Nwinee, Victor, Alakaloko, Felix, Elebute, Olumide, Lawal, Abdulrazzaq, Bode, Chri, Olugbemi, Mojolaoluwa, Adesina, Alaba, Faturoti, Olubukola, Odutola, Oluwatomi, Adebola, Oluwaseyi, Onuoha, Clement, Taiwo, Ogechukwu, Williams, Omolara, Balogun, Fatai, Ajai, Olalekan, Oludara, Mobolaji, Njokanma, Iloba, Osuoji, Roland, Kache, Stephen, Ajah, Jonathan, Makama, Jerry, Adamu, Ahmed, Baba, Suleiman, Aliyu, Mohammad, Aliyu, Shamsudeen, Ukwenya, Yahaya, Aliyu, Halima, Sholadoye, Tunde, Daniyan, Muhammad, Ogunsua, Oluseyi, Anyanwu, Lofty-John, Sheshe, Abdurrahaman, Mohammad Samson Olori, Aminu, Mshelbwala, Philip, Odeyemi, Babatunde, Samson, Garba, Kehinde Timothy, Oyediran, Ali Samuel, Sani, Ajiboye, Anthony, Amole, Isaac, Abiola, Olajide, Olaolorun, Akin, Veen, Torhild, Kanani, Arezo, Styles, Kristian, Herikstad, Ragnar, Wiik Larsen, Johanne, Arne Søreide, Jon, Jensen, Elisabeth, Gran, Mad, Kjus Aahlin, Eirik, Gaarder, Tina, Wiel Monrad-Hansen, Peter, Aksel Næss, Pål, Lauzikas, Giedriu, Wiborg, Joachim, Holte, Silje, Magne Augestad, Knut, Singh Banipal, Gurpreet, Monteleone, Michela, Tetens Moe, Thoma, Kurt Schultz, Johanne, Taher, Al-Taher, Hamdan, Ayah, Salman, Ayman, Saadeh, Rana, Musleh, Aseel, Jaradat, Dana, Abushamleh, Soha, Hanoun, Sakhaa, Abu Qumbos, Amjad, Hamarshi, Aseel, And Taher, Ayman, Qawasmi, Israa, Qurie, Khalid, Altarayra, Marwa, Ghannam, Mohammad, Shaheen, Alaa, Herebat, Azher, Abdelhaq, Aram, Shalabi, Ahmad, Abu-Toyour, Maram, Asi, Fatema, Shamasneh, Ala, Atiyeh, Anwar, Mustafa, Mousa, Zaa'Treh, Rula, Dabboor, Majd, Alaloul, Ena, Baraka, Heba, Meqbil, Jehad, Al-Buhaisi, Alaa, Elshami, Mohamedraed, Afana, Samah, Jaber, Sahar, Alyacoubi, Said, Abuowda Tasneem Idress, Yousef, Abuqwaider, Eman, Al-Saqqa, Sara, Bowabsak, Alaa, El Jamassi, Alaa, Hasanain, Doaa, Al-Farram, Hadeel, Salah, Maram, Firwana, Aya, Hamdan, Marwa, Awad, Israa, Ashour, Ahmad, Elian Al Barrawi, Fayez, Al-Khatib, Ahmed, Al-Faqawi, Maha, Fares, Mohamed, Elmashala, Amjad, Adawi, Mohammad, Adawi, Ihdaa, Khreishi, Reem, Khreishi, Rose, Ghaben, Ahed, Nadeem, Najwa, Saqlain, Muhammad, Abbasy, Jibran, Rehman Alvi, Abdul, Shahzad, Noman, Faisal Bhopal, Kamran, Iftikhar, Zainab, Talha Butt, Muhammad, Asaat Ul Razi, Syed, Ahmed, Asdaq, Khan Niazi, Ali, Raza, Ibrahim, Baluch, Fatima, Raza, Ahmed, Bani-Sadar, Ahmad, Adil, Muhammad, Raza, Awai, Javaid, Mahnoor, Waqar, Muhammad, Ali Khan, Maryam, Mohsin Arshad, Mohammad, Amjad, Mohammadasim, Miguel Machain Vega, Gustavo, Torres Cardozo, Jorge, O Higgins Roche, Marcelo, Rodolfo Pertersen Servin, Gustavo, Alfredo Segovia Lohse, Helmut, Ines Páez Lopez, Larissa, Augusto Melo Cardozo, Ramón, Espinoza, Fernando, David Pérez Rojas, Angel, Sanchez, Diana, Sanchez Samaniego, Camila, Guevara Torres, Shalon, Canta Calua, Alexander, Razuri, Cesar, Ortiz, Nadia, Rodriguez, Xianelle, Carrasco, Nahilia, Saravia, Fridiz, Shibao Miyasato, Hector, Valcarcel-Saldaña, María, Esthefany Alejos Bermúdez, Ysabel, Carpio, Juan, Ruiz Panez, Walter, Angel Toribio Orbegozo, Pedro, Guzmán Dueñas, Carolina, Turpo Espinoza, Kevin, Maria Sandoval Barrantes, Ana, Armando Chungui Bravo, Jorge, Fuentes-Rivera, Lorena, Fernández, Carmen, Málaga, Bárbara, Ye, Joselyn, Velasquez, Ricardo, Salcedo, Jannin, Lucia Contreras-Vergara, Ana, Genoveva Vergara Mejia, Angelica, Soledad Gonzales Montejo, Maria, Del Carmen Escalante Salas, Marilia, Alcca Ticona, Willy, Vargas, Marvin, Christian Manrique Sila, George, Mas, Robinson, Del Pilar Paucar, Arazzelly, José Román Velásquez, Armando, Robledo-Rabanal, Alina, Alexander Zeta Solis, Ludwing, Turpo Espinoza, Kenny, Luis Hamasaki Hamaguchi, José, Samuel Florez Farfan, Erick, Alvi Madrid Barrientos, Linda, Jaime Herrera Matta, Juan, V Mora, John Jemuel, P Redota, Menold Archee, Francisco Roxas, Manuel, B Maño, Maria Jesusa, Dione Parreno-Sacdalan, Marie, Leanne Almanon, Christel, Walędziak, Maciej, Roszkowski, Rafa, Janik, Micha, Lasek, Anna, Radkowiak, Dorota, Rubinkiewicz, Mateusz, Fernandes, Cristina, Costa-Maia, Jose, Melo, Renato, Muntean, Liviu, Sandu Mironescu, Aurel, Corneliu Vida, Lucian, Popa, Mariuca, Mircea, Hogea, Vartic, Mihaela, Diaconescu, Bogdan, Razvan Bratu, Matei, Negoi, Ionut, Beuran, Mircea, Ciubotaru, Cezar, Uzabumwana, Norbert, Duhoranenayo, Dieudonne, Jovine, Elio, Zanini, Nicola, Landolfo, Giovanni, Aljiffry, Murad, Idris, Faisal, A Alghamdi, Mohammed Saleh, Maghrabi, Ashraf, Altaf, Abdulmalik, Alkaaki, Aroub, Khoja, Ahmad, Nawawi, Abrar, Turkustani, Sondo, Khalifah, Eyad, Albiety, Adel, Sahel, Sarah, Alshareef, Reham, Najjar, Mohammed, Alzahrani, Ahmed, Alghamdi, Ahmed, Alhazmi, Wedyan, Al Saied, Ghiath, Alamoudi, Mohammed, Masood Ria, Muhammed, Hassanain, Mazen, Alhassan, Basmah, Altamimi, Abdullah, Alyahya, Reem, Al Subaie, Norah, Al Bastawis, Fatema, Altamimi, Afnan, Nouh, Thamer, Khan, Roaa, Radojkovic, Milan, Jeremic, Ljiljana, Nestorovic, Milica, Hao Law, Jia, Say Kwang Tan, Keith, Choon Kiat Tan, Ryan, Kin Tan, Joel, Wen Liang Joel, Lau, Wei Chan, Xue, Qi Hui Leong, Faith, Seng Chong, Choon, Koh, Sharon, Yin Lee, Kai, Chung Lee, Kuok, Pluke, Kent, Dedekind, Britta, Nashidengo, Puyearashid, Ian Hampton, Mark, Joosten, Johanna, Sobnach, Sanju, Roodt, Liana, Sander, Anthony, Pape, Jame, Maistry, Niveshni, Ndwambi, Phumudzo, Kinandu, Kamau, Tun, Myint, Du Toit, Frederick, Ellison, Quinn, Burger, Sule, C Grobler, D, Bongani Khulu, Lawrence, Jennings, Vicky, Leusink, Astrid, Kariem, Nazmie, Gouws, Juan, Chu, Kathryn, Bougard, Heather, Noor, Fazlin, Dell, Angela, Van Straten, Stephanie, Khamajeet, Arvin, Kapenda Tshisola, Serge, Kabongo, Kalangu, Kong, Victor, Moodley, Yoshan, Anderson, Frank, Madiba, Thandinkosi, du Plooy, Flip, Hartford, Leila, Chilton, Gareth, Karjiker, Parveen, Ernest Mabitsela, Matlou, Ruth Ndlovu, Sibongile, Badicel, Maria, Jaich, Robert, Ruiz-Tovar, Jaime, Garcia-Florez, Lui, L Otero-Díez, Jorge, Ramos Pérez, Virginia, Aguado Suárez, Nuria, Minguez García, Javier, Corral Moreno, Sara, Vicenta Collado, Maria, Jiménez Carneros, Virginia, García Septiem, Javier, Gonzalez, Mariana, Picardo, Antonio, Esteban, Enrique, Ferrero, Esther, Espin-Basany, Eloy, Blanco-Colino, Ruth, Andriola, Valeria, Solar García, Lorena, Contreras, Elisa, García Bernardo, Carmen, Pagnozzi, Janet, Sanz, Sandra, Miyar de León, Alberto, Dorismé, Asnel, Rodicio, Joselui, Suarez, Aida, Stuva, Jessica, Diaz Vico, Tamara, Fernandez-Vega, Laura, Soldevila-Verdeguer, Carla, Sena-Ruiz, Fatima, Pujol-Cano, Natalia, Diaz-Jover, Paula, Maria Garcia-Perez, José, Jose Segura-Sampedro, Juan, Pineño-Flores, Cristina, Ambrona-Zafra, David, Craus-Miguel, Andrea, Jimenez-Morillas, Patricia, Mazzella, Angela, B Jayathilake, A, B Thalgaspitiya, S P, S Wijayarathna, L, N Wimalge, P M S, Ayomi Sanni, Hakeem, Okenabirhie, Ogheneochuko, Homeida, Anmar, Younis, Abobaker, Abdelbagi Omer, Omer, Abdulaziz, Mustafa, Mussad, Ali, Adam, Ali, Cengiz, Yucel, Björklund, Ida, Ahlqvist, Sandra, Thorell, Ander, Wogensen, Fredrik, Sokratous, Aresti, Breistrand, Michaela, Thorarinsdottir, Hildur, Sigurdadottir, Johanna, Nikberg, Maziar, Chabok, Abba, Hjertberg, Maria, Elbe, Peter, Saraste, Deborah, Rutkowski, Wiktor, Forlin, Louise, Niska, Karoliina, Sund, Malin, Oswald, Denni, Peros, Georgio, Bluelle, Rafael, Reinisch, Katharina, Frey, Daniel, Palma, Adrian, Aristotle Raptis, Dimitri, Zumbühl, Luciu, Zuber, Marku, Schmid, Roger, Werder, Gabriela, Nocito, Antonio, Gerosa, Alexandra, Mahanty, Silke, Werner Widmer, Luka, Müller, Julia, Gübeli, Alissa, Zuk, Grzegorz, Bilgin Gulcicek, Osman, Vartanoglu, Talar, Kose, Emin, Rustu Karahan, Servet, Can Aydin, Mehmet, Alper Sahbaz, Nuri, Halicioglu, Ilkay, Alis, Halil, Sapci, Ipek, Adıyaman, Can, Murat Pektaş, Ahmet, Bora Cengiz, Turgut, Tansoker, Ilkan, Işler, Vedatcan, Cevik, Muazzez, Mutlu, Deniz, Ozben, Volkan, Baris Ozmen, Berk, Bayram, Sefa, Yolcu, Sinem, Buse Kobal, Berna, Faruk Toto, Ömer, Cem Çakaloğlu, Haluk, Karabulut, Kagan, Mutlu, Vahit, Busra Ozkan, Bahar, Celik, Saban, Semiz, Anil, Bodur, Selim, Gül, Enisburak, Murutoglu, Busra, Yildirim, Reyyan, Emre Baki, Bahadir, Arslan, Ekin, Ulusahin, Mehmet, Guner, Ali, Walker, Nathan, Shrimanker, Nikhita, Cole, Simon, Breslin, Ryan, Srinivasan, Ravi, Elshaer, Mohamed, Hunter, Kristina, Al-Bahrani, Ahmed, Liew, Ignatiu, Grace Mairs, Nora, Rocke, Alistair, Dick, Lachlan, Qureshi, Mobeen, Chowdhury, Debkumar, Wright, Naomi, Skerritt, Clare, Kufeji, Dorothy, Ho, Adrienne, Dissanayake, Tharindra, Tennakoon, Athula, Ali, Wadah, Jane Lim, Shujing, Tan, Charlene, O'Neill, Stephen, Jones, Catrin, Nassif, Dima, Sharma, Abhishek, Warren, Oliver, White, Rebecca, Mehdi, Aia, Post, Nathan, Kalakouti, Eliana, Dashnyam, Enkhbat, Stourton, Frederick, Mykoniatis, Ioanni, Currow, Chelise, Wong, Francisca, Gupta, Ashish, Shatkar, Veeranna, Luck, Joshua, Kadiwar, Suraj, Smedley, Alexander, Wakefield, Rebecca, Herrod, Philip, Blackwell, Jame, Lund, Jonathan, Cohen, Fraser, Bandi, Ashwath, Giuliani, Stefano, Bond-Smith, Gile, Pezas, Theodore, Farhangmehr, Neda, Urbonas, Toma, Perenyei, Miklo, Ireland, Philip, Blencowe, Natalie, Bowling, Kirk, Bunting, David, Longstaff, Lydia, Keogh, Kenneth, Jeon, Hyunjin, Rafaih Iqbal, Muhammad, Khosla, Shivun, Jeffery, Anna, Perera, Jame, Aboelkassem Ibrahem, Ahmad, Alhammali, Tariq, Salama, Yahya, Oram, Shaun, Kidd, Thoma, Cullen, Fraser, Owen, Christopher, Wilson, Michael, Chiu, Seehui, Sarafilovi, Hannah, Ploski, Jennifer, Evans, Elizabeth, Abbas, Athar, Kamya, Sylvia, Ishak, Norzawani, Bisset, Carly, Andress, Cedar, Ru Chin, Ye, Patel, Priya, Evans, David, Haslegrave, Aidan, Boggon, Adam, Laurie, Kirsten, Connor, Katie, Mann, Thoma, Mansuri, Anahita, Davies, Rachel, Griffiths, Ewen, Raza Shahbaz, Aized, Eng, Calvin, Din, Farhat, L'Heveder, Ariadne, G Park, Esther H, Ravishankar, Ramanish, Mcintosh, Kirsten, Dar Yau, Jih, Chan, Luke, Mcgarvie, Susan, Tang, Lingshan, Lim, Hui, Yap, Suhhuey, Park, Jay, Herr Ng, Zhan, Mirza, Shahrukh, Lin Ang, Yun, Walls, Luke, Roy, Chloe, Paterson-Brown, Simon, Camilleri-Brennan, Julian, S D'Souza, Michelle, Pronin, Savva, Ewart Henshall, David, Zuling Ter, Eunice, Fouad, Dina, Minocha, Ashish, English, William, Morgan, Catrin, Townsend, Dominic, Maciejec, Laura, Mahdi, Shareef, Akpenyi, Onyinye, Hall, Elisabeth, Caydiid, Hanaan, Rob, Zakaria, Abbott, Tom, D Torrance, Hew, Johnston, Robin, Akil Gani, Mohammed, Gravante, Gianpiero, Rajmohan, Shivanchan, Majid, Kiran, Dindyal, Shiva, Smith, Christopher, Palliyil, Madanmohan, Patel, Sanjay, Nicholson, Luke, Harvey, Neil, Baillie, Katie, Shillito, Sam, Kershaw, Suzanne, Bamford, Rebecca, Orton, Peter, Reunis, Elke, Tyler, Robert, Cheong Soon, Wai, M Jama, Guled, Dhillon, Dharminder, Pate, Khyati, Nanthakumaran, Shayanthan, Heard, Rachel, Yan Chen, Kar, Barmayehvar, Behrad, Datta, Uttaran, K Kamarajah, Sivesh, Karandikar, Sharad, Iftekhar Tani, Sobhana, Monaghan, Eimear, Donnelly, Philippa, Walker, Michael, Parakh, Jehangirshaw, Blacker, Sarah, Kaul, Anil, Paramasivan, Arjun, Farag, Sameh, Nessa, Ashrafun, Awadallah, Salwa, Lim, Jieqi, Chean Khun Ng, Jame, P Kiran, Ravi, Murray, Alice, Etchill, Eric, Dasari, Mohini, Puyana, Juan, Haddad, Nadeem, Zielinski, Martin, Choudhry, Asad, Caliman, Celeste, Beamon, Mieshia, Duane, Therese, Swaroop, Mamta, Myers, Jonathan, Deal, Rebecca, Schadde, Erik, Hemmila, Mark, Napolitano, Lena, To, Kathleen, Makupe, Alex, Musowoya, Joseph, Van Der Naald, Niel, Kumwenda, Dayson, Reece-Smith, Alex, Otten, Kar, Verbeek, Anna, Prins, Marloe, Andres Baquero Suarez, Alibeth, Balmaceda, Ruben, Deane, Chelsea, Dijan, Emilio, Elfiky, Mahmoud, Koskenvuo, Laura, Thollot, Aurore, Limoges, Bernard, Capito, Carmen, Alexandre, Challine, Kotobi, Henri, Leroux, Julien, Pinnagoda, Kalitha, Henric, Nicola, Azzis, Olivier, Rosello, Olivier, Francois, Poddevin, Etienne, Sara, Buisson, Philippe, Hmila, Sophian, Clegg-Lamptey, Joe-Nat, Imoro, Osman, Emmanuel Abem, Owusu, Papageorgiou, Dimitrio, Soulou, Vasiliki, Asturias, Sabrina, Peña, Lenin, B O'Connor, Donal, Realis Luc, Alberto, Alessandro Russo, Alfio, Ruzzenente, Andrea, Taddei, Antonio, Cona, Camilla, Bottini, Corrado, Pascale, Giovanni, Rotunno, Giuseppe, Solaini, Leonardo, Maria Pascale, Marco, Notarnicola, Margherita, Corbellino, Mario, Sacco, Michele, Ubiali, Paolo, Cautiero, Roberto, Bocchetti, Tommaso, Muzio, Elena, Guglielmo, Vania, Morandi, Eugenio, Mao, Patrizio, De Luca, Emilia, Mahmoud Ali, Farah, Žilinskas, Justa, Strupas, Kestuti, Kondrotas, Pauliu, Baltrunas, Roberta, Kutkevicius, Juoza, Ignatavicius, Povila, Ling Tan, Choy, Yng Siaw, Jia, Young Yam, Sir, Wilson, Ling, Rezal Abdul Aziz, Mohamed, Bondin, John, Diaz Zorrilla, Carmina, Majbar, Ana, Sale, Danjuma, Abdullahi, Lawal, Osagie, Olabisi, Faboya, Omolara, Fatuga, Adedeji, Taiwo, Agboola, Nwabuoku, Emeka, Bliksøen, Marte, Ali Khan, Zain, Coronel, Jazmin, Miranda, Cesar, Vasquez, Idelso, M Helguero-Santin, Lui, Rickard, Jennifer, Adedeji, Adesina, Alqahtani, Saleh, Rath, Max, Van Niekerk, Michael, Zacharia Koto, Modise, Matos-Puig, Roel, Israelsson, Leif, Schuetz, Tobia, Arif Yuksek, Mahmut, Mericliler, Meric, Uluşahi, Mehmet, Wolf, Bernhard, Fairfield, Cameron, Liang Yong, Guo, Whitehurst, Katharine, Redgrave, Natalie, K Musyoka, Caroluce, Olivier, Jame, Lee, Kathryn, Cox, Michael, H Farhan-Alanie, Muhamed M, Callan, Rory, Chibuye, Chali, Hassanein Ahmed Ali, Tebian, Rekhis, Syrine, Rommaneh, Muna, Hao Sam, Zi, Hong Chieh Chen, Jacky, Roi, Dylan, Brunelli Pugliesi, Thay, Pardo, Gabriel, Blanco, Ruth, and Grasset Escobar, Eugenio
Subjects: surgical site infection , surgical complications , global surgery , global health , research methodology , outcome assessment, surgical wound, Surgery, telemedicine, postdischarge
Abstract: Objective: This study aimed to determine whether remote wound reviews using telemedicine can be safely upscaled, and if standardised assessment tools are needed. Summary background data: Surgical site infection is the most common complication of surgery worldwide, and frequently occurs after hospital discharge. Evidence to support implementation of telemedicine during postoperative recovery will be an essential component of pandemic recovery. Methods: The primary outcome of this study was surgical site infection reported up to 30-days after surgery (SSI), comparing rates reported using telemedicine (telephone and/or video assessment) to those with in-person review. The first part of this study analysed primary data from an international cohort study of adult patients undergoing abdominal surgery who were discharged from hospital before 30-days after surgery. The second part combined this data with the results of a systematic review to perform a meta-analysis of all available data conducted in accordance with PRIMSA guidelines (PROSPERO:192596). Results: The cohort study included 15,358 patients from 66 countries (8069 high, 4448 middle, 1744 low income). Of these, 6907 (45.0%) were followed up using telemedicine. The SSI rate reported using telemedicine was slightly lower than with in-person follow-up (13.4% vs. 11.1%, P
Published: 2023

31. The Management of Penetrating Neck Injury With Retained Knife: 15-Year Experience From a Major Trauma Center in South Africa

Author: Victor Kong, Cynthia Cheung, Jonathan Ko, William Xu, John Bruce, Grant Liang, Vasil Manchev, and Damian Clarke
Subjects: Adult, Male, Neck Injuries, South Africa, Trauma Centers, Humans, Wounds, Penetrating, Wounds, Stab, General Medicine, Retrospective Studies
Abstract: Background This study reviews our cumulative experience with the management of patients presenting with a retained knife following a penetrating neck injury (PNI). Methods A retrospective cohort study was conducted at a major trauma center in South Africa over a 15-year period from July 2006 to December 2020. All patients who presented with a retained knife in the neck following a stab wound (SW) were included. Results Twenty-two cases were included: 20 males (91%), mean age: 29 years. 77% (17/22) were retained knives and 23% (5/22) were retained blades. Eighteen (82%) were in the anterior neck, and the remaining 4 cases were in the posterior neck. Plain radiography was performed in 95% (21/22) of cases, and computed tomography (CT) was performed in 91% (20/22). Ninety-five percent (21/22) had the knife or blade extracted in the operating room (OR). Formal neck exploration (FNE) was undertaken in 45% (10/22) of cases, and the remaining 55% (12/22) underwent simple extraction (SE) only. Formal neck exploration was more commonly performed for anterior neck retained knives than the posterior neck, although not statistically significant [56% (10/18) vs 0% (0/18), P = .096]. There were no significant differences in the need for intensive care admission, length of hospital stay, morbidities, or mortalities between anterior and posterior neck retained knives. Discussion Uncontrolled extraction of a retained knife in the neck outside of the operating room may be dangerous. Retained knives in the anterior neck commonly required formal neck exploration but not for posterior neck retained knives.
Published: 2021

32. Penetrating Colon Trauma—the Effect of Injury Location on Outcomes

Author: J J P Buitendag, Sharon Čačala, Victor Kong, Saffiya Variawa, D. Couch, Damian L. Clarke, George Oosthuizen, and N. Allen
Subjects: medicine.medical_specialty, business.industry, Anastomosis, Vascular surgery, digestive system diseases, Cardiac surgery, Surgery, Stoma (medicine), Cardiothoracic surgery, Damage control surgery, medicine, Complication, business, Abdominal surgery
Abstract: There is limited evidence to suggest that the more distal a penetrating colonic injury, the poorer its expected outcome, prompting consideration of diversion rather than anastomosis when faced with left colonic injury. The clinical outcomes of penetrating colonic trauma in relation to their anatomical location within the colon were reviewed. A review was performed over eight years (2012—2020) of all patients over 18 years who had sustained penetrating colon injury and presented to our trauma centre in South Africa. Direct comparison was made between right colon vs left colon injuries. A total of 450 patients were included; right colon: 260, left colon: 190. Gunshots predominated in the right colon, and the PATI was higher in this group. There were minimal differences in admission physiology and blood gas parameters between groups, but higher damage control surgery and ICU admission rates for the right colon group. There were similar rates of primary repair, anastomosis, and stoma between groups. Leak rates were no different between the two groups, and although overall complication rates were higher for the right colon, there was no difference with regard to gastro-intestinal and other complications, nor for mortality. While regression analysis did identify PATI to be a risk factor for overall complications and mortality, it failed to do so for anastomotic leak. Our study did not demonstrate any difference in anastomotic leak rates or mortality between right vs left colonic injury. We recommend that all colonic injuries should be treated on their own merit, balanced against the patient’s condition, regardless of anatomical location within the colon.
Published: 2021

33. The 'weekend effect' does not impact on outcome of trauma laparotomy – Experience from a level 1 trauma centre in New Zealand

Author: Jonathan Ko, Victor Kong, Janet Amey, Damien Ah Yen, Damian Clarke, and Grant Christey
Subjects: Orthopedics and Sports Medicine, Surgery, Original Article
Abstract: PURPOSE: Trauma centres have been proven to provide better outcomes in developed countries for overall trauma, but there is limited literature on the systematic factors that describe any discrepancies in outcomes for trauma laparotomies in these centres. This study was conducted to examine and interrogate the effect of systematic factors on patients undergoing a trauma laparotomy in a developed country, intending to identify potential discrepancies in the outcome. METHODS: This was a retrospective study of all laparotomies performed for trauma at a level 1 trauma centre in New Zealand. All adult patients who had undergone an index laparotomy for trauma between February 2012 and November 2020 were identified and laparotomies for both blunt and penetrating trauma were included. Repeat laparotomies and trauma laparotomies in children were excluded. The primary clinical outcomes reviewed included morbidity, length of hospital stay, and mortality. All statistical analysis was performed using R v.4.0.3. RESULTS: During the 9-year study period, 204 trauma laparotomies were performed at Waikato hospital. The majority (83.3%) were performed during office hours (170/204), and the remaining 16.7% were performed after hours (34/204). And 61.3% were performed on a weekday (125/204), whilst 38.7% were performed on the weekend/public holiday (79/204). Most of the parameters in office hours and after hours groups had no statistically significant difference, except lactate (p = 0.026). Most of the variables in weekday and weekend groups had no statistically significant difference, except pH, lactate, length of stay, and gastrointestinal complications (p = 0.012, p
Published: 2022

34. Contemporary management of isolated free fluid on computed tomography scan in blunt abdominal trauma-experience from a Level 1 trauma centre in New Zealand

Author: Priscilla, Leow, Victor, Kong, Nigel, Rajaretnam, Damien, Ah Yen, Janet, Amey, Bronwyn, Denize, Gina, Masden, Damian, Clarke, and Grant, Christey
Subjects: Adult, Male, Laparotomy, Trauma Centers, Humans, Female, Abdominal Injuries, Tomography, X-Ray Computed, Wounds, Nonpenetrating, Aged, New Zealand, Retrospective Studies
Abstract: The management of patients with blunt abdominal trauma (BAT) who have isolated free fluid (IFF) with no solid organ injury (SOI) on computed tomography (CT) remains controversial. This study aims to determine if the volume of free fluid (FF) is a predictor of the need for operative management of traumatic intra-abdominal injuries, by reviewing the local cumulative experience with IFF at a major trauma centre in New Zealand.A retrospective study was undertaken over nine years at a Level 1 trauma centre in New Zealand. Patients aged over 15 years who sustained BAT and had IFF with no SOI demonstrated on CT were included. All CT scans and patient notes were reviewed. The volume of free fluid was classified by the local interpreting radiologist on the CT report.Eighty-two out of 1,177 BAT patients (7%) had IFF with no SOI on CT. Thirty-eight percent were males, with a median age of 31 years. Nineteen (23%) underwent immediate operative management (OM) at the time of presentation. The remaining 63 patients had a trial of non-operative management (NOM), 10 (16%) of which were unsuccessful and required an operation. Overall, 29 patients (35%) required operative management. Eighty-nine percent of the OM group and 90% who failed NOM had positive operative findings, giving an overall true positive of 32%.The presence of IFF in itself is not an absolute indication for operative exploration and many patients with trace IFF can be managed non-operatively. Small amounts of IFF should be regarded with suspicion, and moderate or large amounts of fluid are likely to require operative exploration. Further work must make use of clinical scoring systems and laparoscopy or laparotomy to assess patients at high risk of surgically remediable intra-abdominal injury post BAT.
Published: 2022

35. Penetrating colonic trauma and damage control surgery: Anastomosis or stoma?

Author: George Oosthuizen, Victor Kong, Johan Buitendag, Damian L. Clarke, William Xu, Sharon Čačala, and Saffiya Variawa
Subjects: Adult, Male, medicine.medical_specialty, Colon, medicine.medical_treatment, Wounds, Penetrating, 030230 surgery, Anastomosis, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Laparotomy, medicine, Humans, Retrospective Studies, business.industry, Anastomosis, Surgical, Retrospective cohort study, General Medicine, Intensive care unit, Colorectal surgery, Surgery, Treatment Outcome, Damage control surgery, 030220 oncology & carcinogenesis, Injury Severity Score, business, Trauma surgery
Abstract: BACKGROUND The management of colon injuries in damage control surgery (DCS) remains controversial. METHODS A retrospective study investigating outcomes of penetrating colonic trauma in patients who survived beyond the initial repeat laparotomy (IRL) after DCS was performed. Patients over 18 years with penetrating colon injury and who underwent DCS from 2012 to 2020 were included from our electronic trauma registry. Demographic data, admission physiology and Injury Severity Score (ISS) were reviewed. Patients were classified into three groups: primary repair of non-destructive injuries at DCL, delayed anastomosis of destructive injuries at IRL and diversion of destructive injuries at IRL. Outcomes observed included leak rates, length of intensive care unit stay, length of hospital stay, morbidities, mortality and colon-related mortality. RESULTS Out of 584 patients with penetrating colonic trauma, 89 (15%) underwent DCS. After exclusions, 74 patients were analysed. Mean age was 32.8 years (SD 12.5); 67 (91%) were male. Mechanism of injury was gunshot in 63 (85%) and stab 11 (15%) patients. Seventeen patients underwent primary repair at DCS, of which one leaked. Twenty patients underwent delayed anastomosis at IRL. Of these, five (25%) developed leaks. Mortality was significantly higher for those with an anastomotic leak compared to those without (p
Published: 2021

36. Retrospective cohort study of paediatric splenic injuries at a major adult trauma centre in South Africa identifies areas of success and improvement

Author: Victor Kong, W Bekker, Grant L. Laing, Abdallah Elsabagh, Chris Varghese, Bernike Conradie, Cynthia Cheung, Damian L. Clarke, John L. Bruce, and Nigel Rajaretnam
Subjects: Adult, medicine.medical_specialty, Splenic trauma, medicine.medical_treatment, Splenectomy, Abdominal Injuries, Wounds, Nonpenetrating, South Africa, 03 medical and health sciences, Injury Severity Score, 0302 clinical medicine, Trauma Centers, Laparotomy, medicine, Humans, Trauma centre, Child, Retrospective Studies, Paediatric patients, business.industry, Major trauma, General surgery, Retrospective cohort study, General Medicine, medicine.disease, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Surgery, business
Abstract: This study reviews our experience with paediatric splenic trauma in a major trauma centre in South Africa. We reviewed the management and outcomes of 66 paediatric patients and concluded that selective non-operative management of paediatric splenic trauma can be undertaken successfully in a middle-income country such as South Africa. The grade of splenic injury itself is rarely the sole determinant of operative or non-operative treatment and clinical outcome.Over the last 50 years, the gold standard for paediatric trauma management has grown to be non-operative management. This study reviews a South African experience with paediatric splenic trauma in order to benchmark this against the international standard and to identify discrepancies in access to care and in surgical outcomes.This was a retrospective study conducted at a major trauma centre in South Africa. All children less than 18 years of age who were admitted to our trauma centre following trauma between December 2012 and October 2020 were identified and all those who sustained splenic trauma were reviewed.Of the 66 patients reviewed, 48 (72%) were male, and the median age was 12 years (0-18 years). Thirty-three (51%) were of rural origin and 61 (93%) sustained blunt trauma. Only eight (12%) had an isolated splenic injury, while the remaining 58 (88%) had other associated injuries. Forty-five patients (68%) were managed non-operatively whilst the remainder were subjected to laparotomy. Five (7%) required a splenectomy and one required angio-embolisation. Twenty-six patients (39%) required intensive care unit (ICU) admission: 15 (37%) in the non-operative cohort required ICU admission and eight (40%) in the laparotomy group required ICU admission. Twenty-eight (42%) patients required ventilatory support. Median length of stay was 5.5 days. Four (6%) patients died.Although non-operative management of paediatric splenic trauma can be undertaken successfully by adult trauma surgeons in a middle-income country such as South Africa, there remains room for improvement. To achieve splenic salvage rates comparable to those in dedicated paediatric trauma centres in high-income countries will require systematic quality improvement programmes.
Published: 2021

37. Recurrent pneumothorax following chest tube removal in thoracic stab wounds: a comparative study between end inspiratory versus end expiratory removal techniques at a major trauma centre in South Africa

Author: Cynthia Cheung, Rohit Sarvepalli, Nigel Rajaretnam, Ross Weale, William Xu, Damian L. Clarke, Chris Varghese, and Victor Kong
Subjects: medicine.medical_specialty, Thoracic Injuries, medicine.medical_treatment, Wounds, Stab, South Africa, 03 medical and health sciences, 0302 clinical medicine, Trauma Centers, Performed Procedure, Humans, Medicine, Prospective Studies, Expiration, Prospective cohort study, Retrospective Studies, business.industry, Major trauma, Pneumothorax, General Medicine, medicine.disease, Thoracostomy, Surgery, Chest tube, Chest Tubes, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, business, Penetrating trauma
Abstract: Background Tube thoracostomy (TT) insertion is a commonly performed procedure in trauma that is standardised, but the optimal removal technique based on the timing in relation to the respiratory cycle remains controversial. Methods A prospective study was undertaken at a major trauma centre in South Africa over a 4-year period from January 2010 to December 2013, and included all patients with pneumothorax secondary to thoracic stab wounds. TTs were removed by either end of inspiration technique (EIT) or end of expiration (EET) technique and the rate of recurrent pneumothorax (RPTX) following removal was compared. We hypothesized that there is no difference in the rate of RPTX between the end inspiratory (EI) and end expiratory (EE) removal technique. Results A total 347 patients were included. Of the 184 TTs removed by EIT, there were 17 (9%) RPTXs. Of the 163 with EET, there were 11 RPTXs (7%), (9% versus 7%, chi-squared, P = 0.395). Of the total 28 (9%) patients with RPTXs following removal of chest tubes, two (7%) required reinsertion of chest tube (0.5% (1/184) in EIT and 0.6% (1/163) in EET, P = 0.747). Conclusions Timing of TT removal in relation to the respiratory cycle does not appear to influence the incidence of RPTX in patients with thoracic stab wounds. Technique of removal may well be a more important consideration and more attention must be focused on refining the optimal technique.
Published: 2021

38. Obscuring complexity and performing progress: Unpacking SDG indicator 6.5.1 and the implementation of IWRM

Author: Anna Mdee, Alesia D. Ofori, Joshua Cohen, Marianne Kjellén, Elliot Rooney, Shivani Singhal, Jaime Amezaga, Ankush, Alejandro Figueroa-Benítez, Shambavi Gupta, Alemseged Tamiru Haile, Amare Haileslassie, Victor Kongo, Ashok Kumar, Samy Andrés Mafla Noguera, Mohsen Nagheeby, Zainura Zainon Noor, Xanthe Polaine, Nitin Singh, Ruth Sylvester, Wan Asiah Nurjannah Wan Ahmad Tajuddin, Zulkifli Bin Yusop, and Julián Zúñiga-Barragán
Subjects: iwrm, indicators, politics of data, sdg 6.5.1, colombia, ethiopia, india, malaysia, uk, Hydraulic engineering, TC1-978
Abstract: At a rhetorical level, the SDGs provide a unified global agenda, and their targets and indicators are believed to drive action for social and environmental transformation. However, what if the SDGs (and their specific goals and indicators) are more of a problem than a solution? What if they create the illusion of action through a depoliticised and technical approach that fails to address fundamental dilemmas of politics and power? What if this illusion continues to reproduce poverty, inequality, and environmental degradation? This paper addresses these questions through a focus on SDG 6.5.1 – the implementation of integrated water resources management (IWRM), measured on a 0-100 scale through a composite indicator. The paper presents an empirical analysis of SDG 6.5.1 reporting in Colombia, Ethiopia, India, Malaysia, and the UK, drawing on research from the Water Security and Sustainable Development Hub.1 An evidence review and series of expert interviews are used to interrogate the local politics of IWRM measurement, specifically three dilemmas of global composite indicator construction: (1) reductive quantification of normative and contested processes; (2) weak analysis of actually existing institutional capability, politics, and power; and (3) distracting performativity dynamics in reporting. The paper concludes that SDG 6.5.1 is an example of a 'fantasy artefact', and that in all countries in this study, IWRM institutions are failing to address fundamental and 'wicked' problems in water resources management. We find little evidence that these numbers, or the survey that gives rise to them, drive meaningful reflection on the aims or outcomes of IWRM. Instead, they tend to hide the actually-existing political and institutional dynamics that sit behind the complexity of the global water crisis.
Published: 2024

39. Counting the cost of preventable diabetes-related lower limb amputations at a single district hospital in KwaZulu-Natal: what does this mean, what can be done?

Author: Damian L. Clarke, Victor Kong, Colleen Aldous, Anette Telmo Thompson, and John L. Bruce
Subjects: medicine.medical_specialty, business.industry, Endocrinology, Diabetes and Metabolism, Public health, Podiatry, 030230 surgery, medicine.disease, Lower limb, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Healthcare policy, District hospital, Diabetes mellitus, Family medicine, Internal Medicine, medicine, 030212 general & internal medicine, business, health care economics and organizations, Kwazulu natal
Abstract: Background: Healthcare policy decisions are driven by many factors, including cost, hence the need to show costs of diabetes mellitus-related lower limb amputations (DMLLA) to inform amendments to ...
Published: 2020

40. Contemporary management of rectal trauma - A South African experience

Author: Victor Kong, Abdallah Elsabagh, Grant L. Laing, Hayaki Uchino, John L. Bruce, V Manchev, and Damian L. Clarke
Subjects: Adult, Male, medicine.medical_specialty, Rectum, Wounds, Penetrating, Abdominal Injuries, Sepsis, South Africa, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Blunt, Intensive care, Colostomy, medicine, Humans, In patient, Mortality, Sigmoidoscopy, Retrospective Studies, General Environmental Science, 030222 orthopedics, Trauma Severity Indices, medicine.diagnostic_test, business.industry, Mortality rate, 030208 emergency & critical care medicine, medicine.disease, Surgery, medicine.anatomical_structure, Mechanism of injury, Drainage, General Earth and Planetary Sciences, Female, business
Abstract: Introduction The management of rectal trauma remains controversial. There are three modalities which have been used to manage these injuries; proximal diversion (PD), washout of the distal rectum (DRW) and presacral drainage (PSD). The EAST group tentatively advocate mandatory proximal diversion for extraperitoneal rectal injuries and omitting DRW or PSD. Other authors have suggested that diversion can be eschewed in patients with an intraperitoneal injury which can be primarily repaired. In light of all these controversies, this project set out to review our experience with rectal injuries over the last seven years with the objective of reviewing our use of PD, PSD and DRW. Methods Patients aged greater than or equal to 15 years with rectal injuries during December 2012 to July 2019 were included. Patient demographics, mechanism of injury, management strategy (operative or non-operative), complications, patient residential status (urban or rural), hospital and intensive care duration of stay, and 30-day mortality rates were assessed. Results During the study period, a total of 51 patients with a rectal injury were treated. There were 45 (88%) males and the median age was 29 (22-39) years. There were 7 (14%) blunt mechanisms, 41 (80%) penetrating mechanisms and 3 (6%) combined blunt and penetrating mechanisms. The median ISS was 13 (9-18). Of the 50 rectal injuries ultimately treated at our institution, there were 31 extraperitoneal and 14 intraperitoneal injuries. There were five combined intra and extraperitoneal injuries. A total of 21 rigid sigmoidoscopies and a single flexible sigmoidoscopy were performed. A total of 24 patients underwent a CT scan. There were 13 primary repairs and 45 PD. A single patient required a PSD. Of the 34 documented complications, 15 (44%) were related to sepsis and can be attributed to the rectal injury. The overall mortality rate was 11.8%. Conclusions Rectal injuries are associated with significant septic related morbidity and mortality. Although we have begun to avoid diversion in a small subset of patients with an intraperitoneal injury, we continue to perform PD for the vast majority of patients with a rectal injury. We do not perform DRW and PSD is used in highly selective cases.
Published: 2020

41. Predicting the Outcome of Non-operative Management of Splenic Trauma in South Africa

Author: Michael D. Traynor, Grant L. Laing, John L. Bruce, Martin D. Zielinski, Victor Kong, Ariel W. Knight, W Bekker, Matthew C. Hernandez, and Damian L. Clarke
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Clinical Decision-Making, Abdominal Injuries, 030230 surgery, Conservative Treatment, law.invention, South Africa, Young Adult, 03 medical and health sciences, 0302 clinical medicine, law, Clinical Decision Rules, Internal medicine, medicine, Humans, Young adult, Aged, Retrospective Studies, Aged, 80 and over, Univariate analysis, business.industry, Retrospective cohort study, Odds ratio, Middle Aged, Vascular surgery, medicine.disease, Intensive care unit, Logistic Models, Treatment Outcome, 030220 oncology & carcinogenesis, Splenectomy, Female, Surgery, business, Spleen, Penetrating trauma, Abdominal surgery
Abstract: We aimed to expand on the global surgical discussion around splenic trauma in order to understand locally and clinically relevant factors for operative (OP) and non-operative management (NOM) of splenic trauma in a South African setting. A retrospective cohort study was performed using 2013–2017 data from the Pietermaritzburg Metropolitan Trauma Service. All adult patients (≥15 years) were included. Those managed with OP or NOM for splenic trauma were identified and analyzed descriptively. Multiple logistic regression analysis identified patients and clinical factors associated with management type. There were 127 patients with splenic injury. Median age was 29 [19–35] years with 42 (33%) women and 85 (67%) men. Blunt injuries occurred in the majority (81, 64%). Organ Injury Scale (OIS) grades included I (25, 20%), II (43, 34%), III (36, 28%), IV (15, 11%), and V (8, 6%). Nine patients expired. On univariate analysis, increasing OIS was associated with OP management, need for intensive care unit (ICU) admission, and hospital and ICU duration of stay, but not mortality. In patients with a delayed compared to early presentation, ICU utilization (62% vs. 36%, p = 0.008) and mortality (14% vs. 4%, p = 0.03) were increased. After adjusting for age, sex, presence of shock, and splenic OIS, penetrating trauma (adjusted odds ratio, 5.7; 95%CI, 1.7–9.8) and admission lactate concentration (adjusted odds ratio, 1.4; 95%CI 1.1–1.9) were significantly associated with OP compared to NOM (p = 0.002; area under the curve 0.81). We have identified injury mechanism and admission lactate as factors predictive of OP in South African patients with splenic trauma. Timely presentation to definitive care affects both ICU duration of stay and mortality outcomes. Future global surgical efforts may focus on expanding non-operative management protocols and improving pre-hospital care in patients with splenic trauma.
Published: 2020

42. Foley Catheter Balloon Tamponade for Actively Bleeding Wounds Following Penetrating Neck Injury is an Effective Technique for Controlling Non-Compressible Junctional External Haemorrhage

Author: Victor Kong, Jonathan Ko, Cynthia Cheung, Bogo Lee, Priscilla Leow, Varun Thirayan, John Bruce, Grant Laing, Manar Khashram, and Damian Clarke
Subjects: Neck Injuries, Catheters, Humans, Surgery, Hemorrhage, Wounds, Gunshot, Wounds, Penetrating, Wounds, Stab, Balloon Occlusion, Retrospective Studies
Abstract: The foley catheter balloon tamponade (FCBT) has been widely employed in the management of trauma. This study reviews our cumulative experience with the use of FCBT in the management of patients presenting with a penetrating neck injury (PNI).A retrospective study was conducted at a major trauma centre in South Africa over a 9-year period from January 2012 to December 2020. All patients who presented with a PNI who had FCBT were included.A total of 1581 patients with a PNI were managed by our trauma centre, and 44 (3%) patients had an FCBT. Of the 44 cases of FCBT, stab wounds accounted for 93% (41/44) and the remaining 7% were for gunshot wounds. Seventy-five per cent of all FCBT (33/44) were inserted at a rural hospital prior to transfer to our trauma centre; the remaining 25% (11/44) were inserted in our resuscitation room. The success rate of FCBT was 80% (35/44), allowing further CT with angiography (CTA) to be performed. CTA findings were: 10/35 (29%) positive, 18/35 (51%) negative, and 7/35 (20%) equivocal. Fifteen patients required additional intervention (open surgery or endovascular intervention). The overall morbidity was 14% (6/44). Eighteen per cent required intensive care unit admission. The median length of stay was 1 day. The overall mortality rate was 11% (5/44).FCBT is a simple and effective technique as an adjunct in the management of major haemorrhage from a PNI. In highly selective patients, it may also be used as definitive management.
Published: 2022

43. Global economic burden of unmet surgical need for appendicitis

Author: Reuter, Anna, Rogge, Lisa, Monahan, Mark, Kachapila, Mwayi, Morton, Dion G, Davies, Justine, Vollmer, Sebastian, A A Essam, Abd Elkhalek Sallam, Abd Elrahman Elshafay, Abd El-Rahman Hegazy Khedr, Abdalla Gamal Saad, Abdalla Gharib, Abdalla Kenibar, Abdallah Salah Elsherbiny, Abdalrahman Adel, Abdelaziz Abdelaal, Abdelaziz Osman Abdelaziz Elhendawy, Abdelfatah Hussein, Abdelkader Belkouchi, Abdelmalek Hrora, Abdelrahman Adelshone, Abdelrahman Alkammash, Abdelrahman Assal, Abdelrahman Geuoshy, Abdelrahman Haroun, Abdelrahman Mohammed, Abdelrahman Sayed, Abdelrahman Soliman, Abdelrhman Essam Elnemr, Abdelrhman Kz Darwish, Abdelrhman Osama Elsebaaye, Abdul Khalique, Abdul Rehman Alvi, Abdul Wahid Anwar, Abdulaziz Altwijri, Abdullah Al-Mallah, Abdullah Almoflihi, Abdullah Altamimi, Abdullah Daqeeq, Abdullah Dwydar, Abdullah Gouda, Abdullah Hashim, Abdulmalik Altaf, Abdulmalik Huwait, Abdulrahman Abdel-Aty, Abdulrahman M Altwigry, Abdulrahman Sheshe, Abdulrasheed A Nasir, AbdulRazzaq Oluwagbemiga Lawal, Abdulshafi Khaled Abdrabou, Abdurrahaman Sheshe, Abdussemiu Abdurrazzaaq, Abebe Bekele Zerihun, Abeer Al-Shammari, Abeer El Gendy, Abeer Esam, Abeer Marey, Abhishek Mittal, Abiboye Yifieyeh, Abid Bin Mahamood, Abidemi Adesuyi, Abouelatta Khairy Aly, Abrar Nawawi, Adam Gyedu, Ade Waterman, Adedapo Osinowo, Adedeji Fatuga, Adel Albiety, Adel B Hassanein, Adel Denewar, Adeleke Adekoya, Ademola Adebanjo, Ademola Adeyeye, Ademola Popoola, Adesina Adedeji, Adesoji O Ademuyiwa, Adesoji Tade, Adewale Adeniyi, Adewale O Adisa, Adham Tarek, Adomas Ladukas, Adrian F Palma, Afifatun Hasanah, Afizah Salleh, Afnan Abdelfatah, Afnan Altamimi, Afnan Altamini, Agazi Fitsum, Agboola Taiwo, Ahamed Hassan, Ahed Ghaben, Ahmad Abdel Fattah, Ahmad Abdel Razaq Al Rafati, Ahmad Aboelkassem Ibrahem, Ahmad Aldalaq, Ahmad Ali, Ahmad Almallah, Ahmad Alrifaie, Ahmad Ashour, Ahmad Bakr, Ahmad Bani-Sadar, Ahmad Bin Adnan, Ahmad Elbatahgy, Ahmad Faraz, Ahmad Gudal, Ahmad Hasan, Ahmad Khaled Sabe, Ahmad Khoja, Ahmad Nashaat, Ahmad Qaissieh, Ahmad Sabe, Ahmad Saber Sleem, Ahmad Sakr, Ahmad Shalabi, Ahmad Uzair Qureshi, Ahmed Aamer, Ahmed Abd El Galeel, Ahmed Abd Elmoen Elhusseiny, Ahmed Abd Elsameea, Ahmed Abdelkareem, Ahmed Abdelmotaleb Ghazy, Ahmed Abo El Magd, Ahmed Abo Elazayem, Ahmed Adamu, Ahmed Adel, Ahmed Afandy, Ahmed Ahmed, Ahmed Alghamdi, Ahmed Ali, Ahmed Al-Khatib, Ahmed Altibi, Ahmed Alzahrani, Ahmed Ata, Ahmed Badr, Ahmed Dahy, Ahmed Diab, Ahmed El Kashash, Ahmed El Kholy, Ahmed Elgaili Khalid Musa, Ahmed Elgebaly, Ahmed Elkelany, Ahmed Elkholy, Ahmed El-Sehily, Ahmed Essam, Ahmed Fahiem, Ahmed Farag, Ahmed Fawzy, Ahmed Fouad, Ahmed Gad, Ahmed Ghanem, Ahmed Gheith, Ahmed Gomaa, Ahmed Hafez El-Badri Kotb, Ahmed Hammad, Ahmed Hassan, Ahmed Hossam Eldin Fouad Rida, Ahmed Ismail, Ahmed Karim, Ahmed Khyrallh, Ahmed Lasheen, Ahmed M Rashed, Ahmed Magdy, Ahmed Mahmoud Abdelraouf, Ahmed Menshawy, Ahmed Meshref, Ahmed Mohamed Afifi, Ahmed Mohamed Ibrahim, Ahmed Mohameden, Ahmed Mohammed, Ahmed Mokhtar, Ahmed Mosad, Ahmed Moustafa, Ahmed Moustafa Saeed, Ahmed Negida, Ahmed Rabeih Mohammed, Ahmed Rabie Mohamed, Ahmed Ragab Nayel, Ahmed Ragab Soliman, Ahmed Raslan, Ahmed Raza, Ahmed Refaat, Ahmed Rslan, Ahmed Sabry, Ahmed Sabry El-Hamouly, Ahmed Safwan Marey, Ahmed Saidbadr, Ahmed Sakr, Ahmed Samir, Ahmed Shahine, Ahmed Sheta, Ahmed Soliman, Ahmed Tammam, Ahmed Tarek Abdelbaset Hassan, Ahmed W Shamsedine, Ahmed Zaki, Ahmed Zaki Eldeeb, Ahmed Zohair, Ahmedali M Kandil, Ahmedglal Elnagar, Ahsan Zil-E-Ali, Aijaz Jabbar, Ailsa Claire Snaith, Ainhoa Costas-Chavarri, Aiste Austraite, Ajayesh Mistry, Akin Olaolorun, Akinlabi E Ajao, Al Faifi Jubran, Ala Shamasneh, Alaa Abouelnasr, Alaa Al-Buhaisi, Alaa Bowabsak, Alaa El Jamassi, Alaa Elazab, Alaa Elhadad, Alaa Fergany, Alaa Habeebullah, Alaa Hassan, Alaa Shabkah, Alaa Shaheen, Alaba Adesina, Alan Baird, Alan Grant, Alasdair Ball, Alban Cacurri, Albert Mohale Mphatsoe, Alberto Realis Luc, Alejandro Matheu, Alejandro Munera, Alemayehu Ginbo Bedada, Alessandro Favero, Alessio Maniscalco, Alexander Canta Calua, Alexander J Fowler, Alexandra Gerosa, Alexandre Horobjowsky, Alexandre Venancio De Sousa, Alexia Farrugia, Alexis Pierre Arnaud, Alfio Alessandro Russo, Alfredo Gulielmi, Ali Ababneh, Ali Abo El Dahab, Ali Amin Ahmed Ata, Ali Khan Niazi, Ali Kiasat, Ali Mohamed Hammad, Ali Zardab, Ali Zeynel Abidin Balkan, Aliaa Gamal Toeema, Aliaa Sadek, Aliaksandr Filatau, Aliang Latif, Alibeth Andres Baquero Suarez, Alice Faure, Alice Niragire, Alina Robledo-Rabanal, Aline Broch, Alireza Hasheminia, Alisdair Macdonald, Aliyu Ndajiwo, Allan Novak, Alphonse Zeta Mutabazi, Alvaro Enrique Mendoza Beleño, Alvin Ee Zhiun Cheah, Aly Abd Elrazek, Aly Nasr, Aly Sanad, Alyaa Halim Elgendy, Alyne Daltri Lazzarini Cury, Amal Ibrahim, Amandine Martin, Amani Althwainy, Amany Abouzahra, Amany Eldosouky Mohammed, Amar Kourdouli, Amel Hashish, Amerdip Birring, Amgad Al Meligy, Amina Abdelhamid, Aminah Hanum Haji Abdul Majid, Aminu Mohammad, Amir Ait Kaci, Amira Atef Omar, Amira Elsawy, Amira Hassan Bekhet, Amira Reda, Amjad Abu Qumbos, Amjad Elmashala, Ammar Gado, Amna Mamdouh Mohamed, Amna Mohamed, Amoudtha Rasendran, Amr Ahmed Saleh, Amr Fadel, Amr Hasan, Amr Hassaan, Amr Hossameldin, Amr Muhammad Elkorashy, Amr Tarek Hafez, Amreen Faruq, Amro Aglan, Ana Cecilia Manchego Bautista, Ana Lucia Contreras-Vergara, Ana Maria Sandoval Barrantes, Ana Vega Carreiro De Freitas, Ana Vega Freitas, Anam Rashid, Anan Rady Abdelazeam, Anand Kirishnan, Anass Majbar, Anastasia Bamicha, Anastasios Stefanopoulos, Anders Thorell, Andre Das, Andre Dubois, Andre L Mihaljevic, Andre Navarro, Andrea Allegri, Andrea Armellini, Andrea Belli, Andrea Bondurri, Andrea Echevarria Rosas Moran, Andrea Natili, Andrea Ruzzenente, Andrea Simioni, Andreass Haloho, Andrei Tanase, Andrej Kolosov, Andrejus Subocius, Andrew G N Robertson, Andrew Kirby, Andrew Mcguigan, Andrew Spina, Andrey Litvin, Andrius Burmistrovas, Andrius Strazdas, Andy Arenas, Aneel Bhangu, Anele Rudzenskaite, Angel David Pérez Rojas, Angela Dell, Angelica Genoveva Vergara Mejia, Angeline Charles, Angelo Antoniozzi, Angelo Benevento, Angelos Tselos, Angham Solaiman El-Ma'doul, Anjana Sreedharan, Ankur Bhatnagar, Ann Kjellin, Anna Lasek, Anna Maffioli, Anna Powell, Anna Rinaldi, Anna Watts, Annalisa Lo Conte, Annamaria Bigaran, Annelisse Ashton, Annisa Dewi Fitriana Mukin, Antanas Gulbinas, Antanas Zadoroznas, Anthonius Santoso Rulie, Anthony Ajiboye, Anthony Avoka, Anthony Chuk-Him Lai, Anthony Davor, Anthony Sander, Antje Oosterkamp, Antoinette Bediako-Bowan, Antonella La Brocca, Antônio Leal, Antonio Nocito, Antonio Ramos-De La Medina, Antonio Taddei, Anwar Atiyeh, Anyomih Theophilus Teddy Kojo, Aoife Driscoll, Apar Shah, Apostolos Vlachogiorgos, April Camilla Roslani, Aram Abdelhaq, Arazzelly Del Pilar Paucar, Arcangelo Picciariello, Areej Tarek, Arezo Kanani, Ari Leppäniemi, Arianna Birindelli, Arij Ibrahim, Arjun Nesaratnam, Arlindawati Suyadi, Armando José Román Velásquez, Arnaud Bonnard, Arnav Agarwal, Aroub Alkaaki, Arturas Vaicius, Arvin Khamajeet, Arvo Reinsoo, Arwa Abouzaid, Arwa Elfarargy, Arwa Ibrahim, Arwa Mohamed, Asaf Kedar, Asdaq Ahmed, Ased Ali, Aseel Alnusairat, Aseel Hamarshi, Aseel Musleh, Ash Prabhudesai, Ashraf A Maghrabi, Ashraf Morsi, Ashrarur Rahman Mitul, Asmaa Abdelgelil, Asmaa Abdel-Rahman Al-Aarag, Asmaa Rezq, Asmaa Salah, Aspasia Papailia, Assmaa Badwy, Astrid Leusink, Ata Khan, Ataa Ahmed, Athanasia Bamicha, Athar Eysa, Athirah Zulkifli, Atif Mahdi, Attia Attia, Attia Mohamed Attia, Audrey Clarissa, Audrius Dulskas, Audrius Parseliunas, Augusto Zani, Aung Kyaw Tun, Aurel Mironescu, Aurel Sandu Mironescu, Aurelien Scalabre, Aurora Mariani, Aurore Haffreingue, Aurore Thollot, Ausrine Usaityte, Austė Skardžiukaitė, Awais Raza, Aya Abdel Fatah Ibraheem, Aya Aboarab, Aya Adel Elsharkawy, Aya El-Sawy, Aya Elwaey, Aya Firwana, Aya Hagar, Aya Hammad, Aya Mohamed Fathy, Aya Reda, Aya Yehia Ata, Ayah Hamdan, Ayat Hassaan, Ayman And Taher, Ayman Elwan, Ayman Nabawi, Ayman Salman, Ayman Shwky, Ayokunle Ogunyemi, Azher Herebat, Azmina Verjee, Babajide Adenekan, Babatunde Odeyemi, Badr Eldin Adel, Badreldin Adel Tawfik, Bahar Busra Ozkan, Bakeer Mohamed, Bakhtiar Nighat, Bandar Albeladi, Bárbara Málaga, Barbara Mijuskovic, Barbara Pereira Silvestre, Basant Kumar, Basem Sieda, Bashir Bello, Basim Alghamdi, Basma Magdy, Basma Mahmoud, Basmah Alhassan, Bassant Mowafy, Beatrice Brunoni, Beatrix Weber, Belen Sanchez, Ben Thompson, Benoît Parmentier, Bernard Limoges, Bernard Van Duren, Bernhard Wolf, Bertrand Dousset, Besmir Grizhja, Bettina Lieske, Betty Maillot, Billal Mansour, Bjorn Frisk, Bogdan Diaconescu, Bogdan-Valeriu Martian, Boris Marinkovic, Brendan Skelly, Brian Cameron, Britta Dedekind, Bruno Noukpozounkou, Bryon Frankie Hon Khi Chong, Bylapudi Seshu Kumar, Caio Vinícius Barroso de Lima, Calogero Iacono, Cameron Fairfield, Camila Sanchez Samaniego, Camilla Cona, Camilo Lopez-Arevalo, Caoimhe Normile, Caranj Venugopal, Carla Cecilia Ramã Rez Cabrera, Carla Pierina García Torres, Carlo Corbellini, Carlos Alejandro Arroyo Basto, Carlos Iván Pérez Velásquez, Carlos Morales, Carlos Nsengiyumva, Carlos Paz Galvez, Carmen Capito, Carmen Fernández, Carmina Diaz-Zorrilla, Carolina Guzmán Dueñas, Carolina Oliveira Felipe, Caroline Clifford, Caroluce K Musyoka, Catherine A Shaw, Cathy Magee, Cecile Muller, Cecilia Costa, Cecilia Tolg, Cecilia Wredberg, Celeste Del Basso, Céline Grosos, Cesar Augusto Azmitia Mendizabal, Cesar Miranda, Cesar Razuri, Cezar Ciubotaru, Chali Chibuye, Challine Alexandre, Charing Cheuk Ling Szeto, Charles Dally, Charlotte Jane Mcintyre, Chaymae Benyaiche, Chean Leung Chong, Chee Siong Wong, Cheewei Gan, Chelise Currow, Chelsea Deane, Cheng Chun Goh, Cherry Koh, Cheryl Ou Yong, Chetan Khatri, Chi Chung Foo, Chi Ying Jacquelyn Fok, Chia Kong, Chiara Ceriani, Chimwemwe Kwatiwani, Chingwan Yip, Chintya Tedjaatmadja, Choon Seng Chong, Chouikh Taieb, Choy Ling Tan, Chris Bode, Chris Lee, Christel Leanne Almanon, Christian Hinojosa, Christian Lari Coompson, Christin Schoewe, Christina Neophytou, Christina P Major, Christina Panteli, Christine Mizzi, Christoforos Ferousis, Christopher Bode, Christos Agalianos, Christos Anthoulakis, Christos Barkolias, Christos Dervenis, Chu-Ann Chai, Chui Yee Wong, Ciara Fahy, Cicilia Viany Evajelista, Cirugia De Emergencia, Ciskje Zarb, Citra Dewi Mohd Ali, Claire Sharpin, Clara Milagros Herrera Puma, Clare M Rees, Clare Morgan, Claudia Reali, Claudio Arcudi, Claudio Fermani, Claudio Gabriel Fermani, Clemens Nawara, Clement Onuoha, Clodagh Mangan, Colleen Sampson, Collins Nwokoro, Colombani Jean-Francois, Constantinos Marinos, Cornelius Mukuzunga, Corrado Bottini, Craig Gouldthorpe, Crislee Elizabeth Lopez, Cristina Fernandes, Crystal Yern Nee Chow, Cutting Edge Manipal, Dale Vimalachandran, Dalia Alkhabbaz, Dalia Hemeda, Damien Brown, Damir Ljuhar, Dan L Deckelbaum, Dana Jaradat, Danelo Du Plessis, Daniel Ardian Soeselo, Daniel Cox, Daniel Dabessa, Daniel Estuardo Marroquín Rodríguez, Daniel Hamill, Daniel Nel, Daniel Youssef, Daniela Magri, Daniele Angelieri, Daniele Gui, Danilo Herrera Cruz, Danjuma Sale, Dansou Gaspard Gbessi, Dario Andreotti, Darius Kazanavicius, Darragh McCullagh, David Mcnish, David Merlini, David Monterroso Cohen, Davide De Boni, Davide Rossi, Dayang Nita Abdul Aziz, D C Grobler, Debora Schivo, Deborah Chiesa, Deimante Mikuckyte, Deividas Dragatas, Demi Gray, Diaa Eldin Abdelazeem Amin Elsorogy, Diaa Moustafa Elbendary Elsawahly, Diaaaldin Zahran, Diana Duarte Cadogan, Diana Sanchez, Dickson Bandoh, Diego Alonso Romani Pozo, Diego Antezana, Diego Coletta, Diego Romani, Diego Sasia, Dietmar Öfner, Dieudonne Duhoranenayo, Dimitri Aristotle Raptis, Dimitrios Balalis, Dimitrios K Manatakis, Dimitrios Karousos, Dimitrios Korkolis, Dimitrios Kyziridis, Dimitrios Lytras, Dimitrios Papageorgiou, Dimitrios Sfougaris, Dimitris-Christos Zachariades, Dina Al-Marakby, Dina Faizatur Rahmah, Dina Gamal, Dina Tarek, Dineshwary Periasammy, Diogo Vinicius Dos Santos, Dion Morton, Diya Mirghani, Djifid Morel Seto, D M Cocker, Dmitri A Raptis, Dmitri Nepogodiev, Dmitri Raptis, Doaa Emadeldin, Doaa Gamil, Doaa Hasan, Doaa Hasanain, Doaa Maher Abdelrouf, Domenica Pata, Domingos Mapasse, Dominic Charles Marshall, Donal B O'Connor, Donatas Danys, Donatas Venskutonis, Dorota Radkowiak, Doug Bowley, Dovilè Majauskyté, Dulan Irusha Samaraweera, Durvesh Lacthman Jethwani, Dush Iyer, Dushyant Iyer, Dzianis Khokha, Dzmitry Paulouski, Ebenezer Takyi Atkins, Echaieb Anis, Edgar Domini, Edilberto Temoche, Eduardo Huaman, Edvard Grisin, Edvinas Dainius, Efeson Thomas, Egle Preckailaite, Ehab Alnawam, Ehab Mamdouh, Eirik Kjus Aahlin, Eirini Kefalidi, Ekow Mensah, Elaine Borg, Eldaa Prisca Refianti Sutanto, Eleanor Marks, Elena Goldin, Elena Muzio, Elena Vendramin, Elena Zdanyte Sruogiene, Eleonora Ciccioli, Elio Jovine, Elisa Francone, Elisabeth Jensen, Elissa Rifhan Mohd Basir, Elizabeth Snyder, Ella Teasdale, Elliot Akoto, Elodie Gaignard, Elodie Haraux, Elsa Robert, Elsayed Ali, Elsayed Gamaly, Emad Abdallah, Emad Al-Dakka, Emad Ali Ahmed, Emad Aljohani, Emad Mohamed Saeed Taha, Eman Abd Al Raouf, Eman Abdelmageed, Eman Abuqwaider, Eman Adel Sayma, Eman Elwy, Eman Emara, Eman Hashad, Eman Ibrahim, Eman Magdy, Eman Magdy Hegazy, Eman Mahmoud Abdulhakeem, Eman Mohamed Ibrahim, Eman Mohamed Morshedy, Eman Nofal, Eman Rashad, Eman Yahya Mansor, Emanuel Barrios, Emanuele Rausa, Emeka Nwabuoku, Emilia De Luca, Emilie Eyssartier, Emilio Dijan, Emma Blower, Emma Jurdell, Emma Upchurch, Emmanuel Acquah, Emmanuel Akatibo, Emmanuel Barrios, Emmy Runigamugabo, Enas Alaloul, Enas Alqahtani, Enoch Dagoe, Enoch Tackie, Eriberto Farinella, Eric Ackom, Eric Kofi Appiah, Erick Samuel Florez Farfan, Erik Hervieux, Erik Schadde, Erika Vicario, Erikas Laugzemys, Ernest Yemalin Stephane Ahounou, Eslam Elbanby, Eslam Ezzat, Esraa Abd 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Ferdy Iskandar, Fernanda Altoe, Fernanda Frade, Fernande Djivoh, Fernando Espinoza, Fernando Fernandez-Bueno, Fernando Tale, Ferry Fitriya Ayu Andika, Fidelis Jacklyn Adella, Filippo Di Franco, Finaritra Casimir Fleur Prudence Rahantasoa, Fitjerald Henry, Fitriana Nur Rahmawati, Florence Dedey, Florian Primavesi, Florin-Mihail Iordache, Fong Yee Lam, Foteini Koumpa, Francesca Steccanella, Francesco Pata, Francesco Riente, Francesco Ruben Giardino, Francesco Selvaggi, Francis Abantanga, Francis Dossou, Francisco Fujii, Francisco Regalado, Francois-Coridon Helene, Françoise Schmitt, Frank Enoch Gyamfi, Frank Owusu, Fred Alexander Naranjo Aristizã Bal, Fred Hodonou, Frederick Du Toit, Frederique Sauvat, Fredrik Wogensen, Frehun Ayele Asele, Fridiz Saravia, Gabriel Pardo, Gabriela Elisa Nita, Gaetano Gallo, Gaetano Luglio, Gaetano Tessera, Galaleldin Abdelazim, Gamal Shimy, Gandau Naa Barnabas, Garba Samson, Gareth Irwin, Gehad El Ashal, Gehad Samir El Sayed, Gehad Tawfik, Gemma Humm, Genoveffa Balducci, George Christian Manrique Sila, George Ihediwa, George Manrique Sila, Georges Azzie, Georgette Marie Camilleri, Georgios Gemenetzis, Georgios Gkiokas, Georgios Karabelias, Georgios Kyrou, Georgios Tzikos, Gerardo Perrotta, Gerfried Teufelberger, Germain Ahlonsou, German Minguez, Geta Maharaj, Gezim Galiqi, Ghada Elhoseny, Ghada Saied Nagy, Ghiath Al Saied, Ghina Shamim Shamsi, Giacomo Nastri, Giacomo Pata, Gianfranco Cocorullo, Gianluca Curletti, Gianluca Pagano, Gianluca Pellino, Gianmaria Confalonieri, Gianpiero Gravante, Giedrius Lauzikas, Giles Dawnay, Gintaras Simutis, Giorgio Vasquez, Giovanni Landolfo, Giovanni Lazzari, Giovanni Luca Lamanna, Giovanni Pascale, Giovanni Pesenti, Giovanni Sgroi, Giridhar H Devadasar, Gisele Moreira, Giuliano Borda-Luque, Giuseppe Clerico, Giuseppe Rotunno, Giuseppe Salamone, Giuseppe Sammarco, Gokhan Lap, Greg Padmore, Gregorio Tugnoli, Gregory Kouraklis, Greta Mclachlan, Greta Wood, Greta Žiubrytė, Guillaume Podevin, Guillermo Sanchez Rosenberg, Guo Liang Yong, Gurdeep Singh Mannu, Gurpreet Singh Banipal, Gustavo Miguel Machain Vega, Gustavo Peixoto Soares Miguel, Gustavo Pereira Fraga, Gustavo Recinos, Gustavo Rodolfo Pertersen Servin, Haaris A Shiwani, Hadeel Al-Farram, Hafiz Hakim, Hagar Zidan, Hager Abdul Aziz Amin, Hager Abdulaziz, Hager Ahmed El-Badawy, Hager Elwakil, Hager Tolba, Hagir Zain Elabdin, Haidar Hajeh, Hala Ahmed, Hala Saad, Halima Aliyu, Hamdi Ebdewi, Hamza Asumah, Hamza Waleed, Hanan Adel Saad, Haney Youssef, Hani Natalie, Hanna Royson, Hannah Anderson-Knight, Hannah Burns, Hannah S Thomas, Hans-Ivar Pahlsson, Harish Neelamraju Lakshmi, Harriet Jordan, Hasan Ismael Ibraheem, Hasan Ismael Ibraheem Al-Hameedi, Hasbi Maulana Arsyad, Hasnain Abbas Dharamshi, Hassan Ali Mostafa, Hatem El-Sheemy, Haya Tahboub, Hayam Ahmed, Hayden Kretzmann, Hayssam Rashwan, Haytham Abudeeb, Hazem Khaled, Hazmi Dwinanda Nurqistan, Heather Bougard, Heba Baraka, Heba Gamal, Heba Shaker, Hector Shibao Miyasato, Helen Mohan, Helen Woodward, Helena Franco, Helene Francois-Coridon, Helmut Alfredo Segovia Lohse, Hend Adel Gawad Shakshouk, Hend Kandil, Hend Mahmoud, Henri Kotobi, Henry Mendel, Henry Nnaj, Herlin Karismaningtyas, Herman Cruz, Hesham Magdy, Hesham Mohammed Bakry, Hian Ee Heng, Hildur Thorarinsdottir, Hisham Safa, Hisham Samih, Hogea Mircea, Hong Kong Sar, Hong Yee Wong, Hoong-Yin Chong, Hope Edem Kofi Kordorwu, Hope Glover-Addy, Horacio Paredes Decoud, Hosni Khairy Salem, Hossam Dawoud, Hossam Elfeki, Hossam Emadeldin, Houda Bachri, Hunain Shiwani, Hussein Ali, Hussein El-Kashef, Hussein Mohammed, Hussien Ahmed, Iason-Antonios Papaskarlatos, Ibrahem Abdelmotaleb, Ibrahim AbdelFattah, Ibrahim Alhabli, Ibrahim Al-Slaibi, Ibrahim AlYoussef, Ibrahim Elzayat, Ibrahim Elzayyat, Ibrahim N Alomar, Ibrahim Rakha, Ibrahim Raza, Ida Björklund, Idelso Vasquez, Ignas Rakita, Ihab Hassan, Ihdaa Adawi, Iloba Njokanma, Iman Elkadsh, Immacolata Iannone, Ingemar Havemann, Ioannis Kyriazanos, Ioannis Patoulias, Ioannis Valioulis, Ionasc Dan, Ionut Negoi, Ionut-Bogdan Diaconescu, Irene Montes, Irene Ortega-Vazquez, Isaac Amole, Isaac Bertuello, Isaac Hanley, Isam Bsisu, Islam Magdy El Sayed, Ismael Isaac Zelada Alvarez, Ismail Lawani, Israa Abdullah Aziz Al-Azraqi, Israa Adel, Israa Awad, Israa Qawasmi, Ivan Mendoza Restrepo, J Edward Fitzgerald, Jack Almy, Jacqueline Sheehan, Jaime Andres Montoya Botero, Jaime Herrera-Matta, Jakeline Restrepo, Jakov Mihanovic, James Adeniran, James Brown, James Davies, James Giles, James Glasbey, James Olivier, James Pape, James Richards, James Wheeler, James Yang, Jamie Shah, Janet Pagnozzi, Jannin Salcedo, Jasim Amin, Jason Brown, Javier Pastora, Javier Rosales, Jazmin Coronel, Jean Bréaud, Jean De La Croix Allen Ingabire, Jean-Baptiste Marret, Jean-Francois Colombani, Jean-François Lecompte, Jeffrey Dalli, Jehad Hassan Youssif, Jehad Meqbil, Jemina Onimowo, Jen Cornick, Jenifa Jeyakumar, Jennifer Nowers, Jennifer Rickard, Jennifer Skehan, Jerry Makama, Jesse Ron Swire Ting, Jessica Juliana Tan, Jessica Patricia Gonzales Stuva, Jessica Roth, Jessica Souza Luiz, Jia Hao Law, Jia Yng Siaw, Jian Er Saw, Jibran Abbasy, Jiheon Song, Jimy Harold Jara Quezada, Joachim Amoako, Joachim Wiborg, Joanna Swann, Jo-Anne Carreira, Joanne Edwards, Joe Vincent, Joel Kin Tan, Joe-Nat Clegg-Lamptey, Johanna Joosten, Johanna Nyberg, Johannes Kurt Schultz, Johannes Wiik Larsen, John Bondin, John F Camilleri-Brennan, John Jemuel V Mora, John Lee Y Allen, John Whitaker, Jolanta Gribauskaite, Jon Arne Søreide, Jon Kristian Narvestad, Jonathan Ajah, Jonathan Dakubo, Jonathan Heath, Jonathan R L Wild, Jonny Setiawan, Jorge Armando Chungui Bravo, Jorge Torres Cardozo, Jose Aguilar-Jimenez, Jose Andres Garcia-Marin, Jose Antonio Cabala Chiong, Jose Costa-Maia, José Hamasaki, José Luis Hamasaki Hamaguchi, Jose Luis Rodicio, Jose María Vergara Celis, José René Arévalo Azmitia, Joselyn Ye, Joseph Awuku-Asabre, Josephine Psaila, Joshua Luck, Joshua Michael Clements, Joyeta Razzaque, Juan Camilo Correa, Juan Carpio, Juan Gouws, Juan Jaime Herrera Matta, Juan Manuel Carmona, Juan Marcelo Delgado, Juana Kabba, Jubran J Al-Faifi, Julia Guasti Pinto Vianna, Julian Camilleri-Brennan, Juliana Menegussi, Julien Leroux, Julien Rod, Juliette Hascoet, Julio Jimenez, Junyeong Oh, Juozas Kutkevicius, Justas Kuliavas, Justas Žilinskas, Justin Chak Yiu Lam, Justus Lando, Ka Hin Gabriel Li, Ka Wai Leung, Kai Yin Lee, Kalangu Kabongo, Kalitha Pinnagoda, Kalon Hewage, Kamau Kinandu, Kamran Faisal Bhopal, Kandasami Palayan, Kareem Dabbour, Kareem Elshaer, Karen Bailey, Karim Hilal, Karl Bonavia, Karolis Lagunavicius, Karolis Varkalys, Kate Cross, Kate Yu-Ching Chang, Katharina Beate Reinisch, Katharine Whitehurst, Katherine Gash, Kathryn Chu, Kathryn Lee, Katie Connor, Katrin Gudlaugsdottir, Kaustuv Das, Kazeem Atobatele, K C Janardha, Kean Leong Koay, Keat-Seong Poh, Keiran David Clement, Keith Sammut, Keith Say Kwang Tan, Kenneth Aaniana, Kenneth Johnson, Kenneth Mealy, Kenneth Thorsen, Kenny Turpo Espinoza, Kent Pluke, Kestutis Strupas, Kevin C Conlon, Kevin Turpo Espinoza, Khaled Abozeid, Khaled Alhady, Khaled Aljboor, Khaled Dawood, Khaled Hesham Elbisomy, Khaled Ibrahim, Khaled Khattab, Khaled Naser El Deen, Khalid Mahmud, Khalid Qurie, Khalid Salah El-Dien, Khalil Abdul Bassit, Khaoula Boukhal, Khlood Ashour, Kholod Tarek Lasheen, Kholoud Abdelbadeai, Khurram Khan, Khuzaimah Zahid Syibrah, Kieran Atkinson, Kieran Ka Kei Li, Kirsten Lafferty, Kjetil Søreide, Knut Magne Augestad, Kolonia Konstantina, Konstantinos Farmakis, Konstantinos Gasteratos, Kornelija Maceviciute, Kpèmahouton René Keke, Kresimir Zamarin, Kristian Styles, Kristijonas Jasaitis, Kristijonas Jokubonis, Kristina Cassar, Kuet Jun Chung, Kuhaendran Gunaseelan, Kuok Chung Lee, Kurt Carabott, Kwabena Agbedinu, Kwaku Boakye-Yiadom, Kwame Maison, Kwasi Asare-Bediako, Kwasi Kusi, Kyaw Phyo Aung, Kylie Joan-Yi Szeto, Kyriakos Psarianos, Laimonas Uščinas, Lalith Asanka Jayasooriya Jayasooriya Arachchige, Lana Abusalem, Larissa Ines Páez Lopez, Lau Wen Liang Joel, Laura Gavagna, Laura Koskenvuo, Laura Lorenzon, Laura Luque, Laurent Fourcade, Lawal Abdullahi, Lawani Ismaïl, Lawrence Bongani Khulu, Layza-Alejandra Mercado Rodriguez, Lee Shi Yeo, Leif Israelsson, Lemuel Davies Bray, Lenin Peña, Leo Licari, Leonardo Solaini, Li Jing Yeang, Liam Henderson, Liam Richardson, Liana Roodt, Lillian Reza, Linas Urbanavicius, Linas Venclauskas, Linda Alvi Madrid Barrientos, Linda Andersson, Ling Wilson, Linn Nymo, Linnea Mauro, Liviu Iuliu Muntean, Liviu Muntean, Ljiljana Jeremic, Lofty-John Anyanwu, Lopna Ahmed Mohamed Ahmed, Lorena Fuentes-Rivera, Lorena Rodriguez, Lorena Solar García, Lorraine Sproule, Lotfy Eldamaty, Luai Jamal, Luana Ayres Da Silva, Lubna Sabeeh, Luc Hervé Samison, Luca Ansaloni, Luca Bortolasi, Luca Turati, Lucia Duinhouwer, Lucian Corneliu Vida, Lucile Fievet, Lucio Selvaggi, Ludwing Alexander Zeta Solis, Luen Shaun Chew, Luigi 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Mahmoud Warda, Mahmoud Zakaria, Mahmut Arif Yuksek, Mahnoor Javaid, Mahnuma Mahfuz Estee, Mai Ebidy, Mai Mohamed Ebidy, Mai Salama, Maíra Cassa Careta, Maja Marcus, Majd Dabboor, Majed Aboelella, Makafui Dayie, Makki Elsayed, Malcolm Falzon, Maleeha Hassan, Malin Sund, Man Fung Leung, Man Hon Andrew Yeung, Manar Abd-Elmawla, Manar Saeed, Mantas Drungilas, Mantas Jokubauskas, Mantas Vilčinskas, Manuel Francisco Roxas, Manuel Hache-Marliere, Manuel Lopez, Manuel Rodriguez Castro, Manuela Mendez, Manzoor Dar, Maram Abu-Toyour, Maram Salah, Marcelo O Higgins Roche, Marco Catani, Marco Maria Pascale, Marco Migliore, Mardelangel Zapata Ponze De Leon, Margaret O'Shea, Margarita Montrimaite, Margherita Notarnicola, Margub Hussain, Maria Clara Mendoza Arango, Maria Giovanna Grella, Maria Hjertberg, Maria Isabel Villegas Lanau, Maria Jesusa B Maño, Maria Lorena Aguilera, Maria Marta Modolo, Maria Mayasari, Maria Novella Ringressi, Maria Soledad Gonzales Montejo, Maria Soledad Merlo, Maria Utter, María Valcarcel-Saldaña, Maria-Lorena Aguilera-Arevalo, Mariam Darweesh, Mariam O Gad, Mariam Saad Aboul-Naga, Mariano Cesare Giglio, Mariastella Malavenda, Marie Carmela Lapitan, Marie Dione Parreno-Sacdalan, Marie Paul, Mariette Renaux-Petel, Marija Agius, Marilia Del Carmen Escalante Salas, Marilla Dickfos, Marina Luiza Pimenta, Mario Contreras Urquizu, Mario Corbellino, Mário Jacobe, Mario Lopez, Mario Pasini, Mario Trompetto, Marisa Leal, Marisol Manriquez-Reyes, Mariuca Popa, Mark Ian Hampton, Mark Sykes, Mark Wagener, Markus Zuber, Marte Bliksøen, Martha Glynn, Martin Jarmin, Martin Kyereh, Martina Perino, Martina Yusuf Shawky, Martinique Vella-Baldacchino, Marvin Vargas, Marwa Altarayra, Marwa Elashmawy, Marwa Elshobary, Marwa Hamdan, Marwa Sayed, Marwan Abubakr, Marwan Fahim, Marwan Shawki, Maryam Ali Khan, Maryna Shubianok, Mashael Al-Mousa, Masood Alghamdi, Masood Jawaid, Massiell Machaca, Massimiliano Dal Canto, Massimo Coletti, Matas Pažuskis, Matei Bratu, Matei Razvan Bratu, Mateusz Rubinkiewicz, Matteo Papandrea, Matteo Ripa, Mattew Ekow, Matthew Baldacchino, Matthew Billy, Matthew Young-Han Kim, Matthieu Peycelon, Matti Tolonen, Maureen Bezzina, Maurizio Foco, Mawaddah Alrajraji, Max Dénakpo, Max Rath, Mayaba Maimbo, Mazed Mohamed, Mazen Hassanain, Megan Turner, Mehmet Ali Yavuz, Mehmet Gumar, Mehmet Uluşahin, Melanie Castro Mollo, Melanie Zapata Ponze De Leon, Menatalla Salem, Mengistu Worku, Menna Tallah Ramadan, Mennaallah Hafez, Mennat-Allah Mustafa, Menold Archee P Redota, Meran Allam, Meric Mericliler, Merna Mostafa, Meryem Abbouch, Metwally Aboraya, Michael Amoah, Michael Cox, Michael Edye, Michael Gillespie, Michael Hanrahan, Michael Livingston, Michael Puttick, Michael Stoddart, Michael Van Niekerk, Michael Walsh, Michael Wilson, Michail Kontos, Michail Margaritis, Michał Janik, Micheal Ohene-Yeboah, Michela Monteleone, Michele Carlucci, Michele Sacco, Michelle Mccarthy, Midhun Mohan, Miguel Angel Paludi, Miguel Siguantay, Mihael Radic, Mihaela Vartic, Miklosh Bala, Milaksh Kumar Nirumal, Milan Radojkovic, Milica Nestorovic, Millika Ghetia, Mindaugas Kiudelis, Mircea Beuran, Mircea Hogea, Mirko Mangiapane, Mitchelle Solange De Fã Tima Linares Delgado, Moayad Othman, Mobolaji Oludara, Modise Zacharia Koto, Mohamad Baheeg, Mohamad Bakhaidar, Mohamad Jeffrey Bin Ismail, Mohamed A Abdelaziz, Mohamed A Amer, Mohamed A Baky Fahmy, Mohamed Abbas, Mohamed Abd El Slam, Mohamed Abdelaty, Mohamed Abdelaty Mohamed, Mohamed Abdelkhalek, Mohamed Abdelraheim, Mohamed Abozaid, Mohamed Abozed Abdullah, Mohamed Abuseif, Mohamed Adel Badenjki, Mohamed Ali Ghonaim, Mohamed Ali Mahmoud, Mohamed Ameen, Mohamed Ammar, Mohamed Asal, Mohamed Awad Elkarim Hamad Mohamed, Mohamed Dablouk, Mohamed El Halawany, Mohamed Elazoul, Mohamed Elbermawy, Mohamed Elfil, Mohamed Elsehimy, Mohamed Elzayat, Mohamed Etman, Mohamed F Zalabia, Mohamed Fares, Mohamed Fawzy Mahrous Badr, Mohamed Fouad Hamed, Mohamed Gadelkarim, Mohamed Ghoneem, Mohamed Gulamhussein, Mohamed Hafez, Mohamed Hashish, Mohamed Hassab Alnaby, Mohamed Husseini, Mohamed Ibrahim, Mohamed Ismail, Mohamed Karkeet, Mohamed Kelany, Mohamed Mabrouk, Mohamed Magdy, Mohamed Mahmoud, Mohamed Moamen Mohamed, Mohamed Moaty, Mohamed Mostafa, Mohamed Mustafa, Mohamed Nashat, Mohamed Nazir, Mohamed Reda Loaloa, Mohamed Rezal Abdul Aziz, Mohamed Sabry Ammar, Mohamed Salah, Mohamed Salah Elhelbawy, Mohamed Seisa, Mohamed Shaalan, Mohamed Sleem, Mohamed Sobhi Jabal, Mohamed Youssef, Mohamed Zidan, Mohamedraed Elshami, Mohammad Abdulkhalek Habeeb, Mohammad Aboraya, Mohammad Adawi, Mohammad Alherz, Mohammad Aliyu, Mohammad Elsayed Omar, Mohammad Ghannam, Mohammad Ghassan Alwafai, Mohammad Mohsin Arshad, Mohammad Rashid, Mohammadasim Amjad, Mohammed Alamoudi, Mohammed Alhendy, Mohammed AlRowais, Mohammed Alsaggaf, Mohammed Alzahrani, Mohammed Bukari, Mohammed Deputy, Mohammed Elgheriany, Mohammed Elsayed, Mohammed Elshaar, Mohammed Elsiddig, Mohammed Firdouse, Mohammed G Azizeldine, Mohammed Hanafy, Mohammed Ismail, Mohammed Kamal Ismail, Mohammed Mousa, Mohammed Mousa Salem, Mohammed Mustafa Hassan Mohammed, Mohammed Mustafa Mohammed, Mohammed Najjar, Mohammed Nasr, Mohammed Osman, Mohammed Osman Dablouk, Mohammed Saeed, Mohammed Saleh A Alghamdi, Mohammed Ubaid Alsaggaf, Mohammed Yahia Mohamed Aly, Mohannad Aledrisy, Mojolaoluwa Olugbemi, Mona Hamdy Madkor, Mona Hosh, Mona Rashad, Monica Bassem, Monique Moron Munhoz, Monty Khajanchi, Morgan Haines, Morvarid Ashtari, Mostada Samy, Mostafa Abdelkader, Mostafa Ahmed Bahaa Eldin, Mostafa Allam, Mostafa Gemeah, Mostafa Mahmoud Eid, Mostafa Qenawy, Mostafa Samy, Mostafa Seif, Mostafa Shalaby, Mousa Mustafa, Moustafa Ibrahim Mahmoud, Moustafa R Aboelsoud, Msafiri Kimaro, Muayad Ahmed Alfarsi, Muhamed M H Farhan-Alanie, Muhammad Adil, Muhammad Alkelani, Muhammad Amsyar Auni Lokman, Muhammad Bin Hasnan, Muhammad Daniyan, Muhammad El-Saied Ahmad Muhammad Gohar, Muhammad Fathi Waleed Omar, Muhammad Habib Ibrahim, Muhammad Mohsin Furqan, Muhammad Rashid Minhas Qadir, Muhammad Saqlain, Muhammad Shawqi, Muhammad Talha Butt, Muhammad Taqiyuddin Yahaya, Muhammad Waqar, Muhammed Masood Riaz, Muhammed Talaat, Muhtarima Haque, Muna Rommaneh, Murad Aljiffry, Murat Karakahya, Musah Yakubu, Muslimat Alada, Mustafa Farhad, Mustafa Mohammed Taher, Muthukumaran Rangarajan, Muwaffaq Mezeil Telfah, Myint Tun, Myranda Attard, Nada Ahmed Reda Elsayed, Nada El-Sagheer, Nada Elzahed, Nada Mohamed Bekhet, Nader Abd El Hamid, Nadia Khalid Abd El-Latif, Nadia Ortiz, Nadin Elsayed, Nadya Johanna, Nahilia Carrasco, Najwa Nadeem, Naomi J Wright, Napoleon Mendez, Narimantas E Samalavicius, Nashat Ghandora, Nasir Bustangi, Natale Di Martino, Natalie Blencowe, Natalie Redgrave, Nathalie Botto, Nathania Sutandi, Nawal Sadig, Nazmie Kariem, Nebil Behar, Nebiyou Seyoum Abebe, Nebyou Seyoum, Nebyou Seyoum Abebe, Neel Gobin, Neel Limaye, Neerav Aruldas, Nehal Yosri Elsayed Abdel-Wahab, Neil Smart, Nelson Manuel Urbina Rojas, Nelson Msiska, Nerijus Kaselis, Nermeen Soubhy El-Shahat, Nermin M Badwi, Nermin Mohamed Badwi, Nesma Elfouly, Nicholas Phillips, Nichole Starr, Nicola Chetta, Nicola Zanini, Nicolas Henric, Nicole D'aguzan, Nicole Grech, Nicoleta Panait, Nicoletta Leone, Nicolò Falco, Nidhi Gyanchandani, Nigel J Hall, Nihaal Shaikh, Niiarmah Adu-Aryee, Nik Azim Nik Abdullah, Nik Ritza Kosai, Nikica Pezelj, Nikki Green, Nikolaos Gouvas, Nikolaos Ivros, Nikolaos Mitroudis, Nikolaos Nikoloudis, Nikolaos Zampitis, Nithya Niranjan, Niveshni Maistry, Noha Abdullah, Noha Abdullah Soliman, Noha Maraie, Noha Wael, Nohad Osman, Noman Shahzad, Nora Abdul Aziz, Norah Al Subaie, Noran Abdel-Hameed, Noran Halim El Gendy, Norbert Uzabumwana, Norberto Herrera, Norma Depalma, Nosisa Sishuba, Nouf Akeel, Noura A Attallah, Nourhan Adam, Nourhan Anwar, Nourhan Elsabbagh, Nourhan Medhat Elhadary, Nourhan Mesbah, Nourhan Semeda, Nourhan Soliman, Novia Adhitama, Nowrin F Aman, Nuno Muralha, Nur Zulaika Riswan, 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Pandi Eduard, Panu Mentula, Paola Salusso, Paola Violi, Paolino De Marco, Paolo Aonzo, Paolo Silvani, Paolo Ubiali, Patrizio Mao, Paul Kielty, Paul Sutton, Paul Ugalde, Paul Witherspoon, Paul Wondoh, Pauline Gastaldi, Paulius Karumnas, Paulius Kondrotas, Paulo Alves Bezerra Morais, Pedro Angel Toribio Orbegozo, Peep Talving, Pei Ying Koh, Per Weber, Per-Olof Lundgren, Peter Deutschmann, Peter Labib, Peter Wiel Monrad-Hansen, Petras Višinskas, Phebe Anggita Gultom, Philip Alexander, Philip Choi, Philip Mshelbwala, Philip Taah Amoako, Philippe Buisson, Phoebe De Bono, Phumudzo Ndwambi, Pier Paolo Grandinetti, Piergiorgio Danelli, Pierpaolo Sileri, Pietra Ligure, Pietro Mingrone, Pigeneswaren Yoganathan, Piotr Major, Poddevin Francois, Povilas Ignatavicius, Povilas Mazrimas, Prasad Pitigala Arachchi, Pratik Jain, Prince Kwakyeafriyie, Prisca A L Har, Pui Xin Chin, Puneet Malik, Puyearashid Nashidengo, Qinyang Liu, Quentin Alimi, Quentin Ballouhey, Quinn Ellison, R Goh Ern Tze, Rachel 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Abdelrouf, Doaa, Pata, Domenica, Mapasse, Domingo, Charles Marshall, Dominic, B O'Connor, Donal, Danys, Donata, Venskutonis, Donata, Radkowiak, Dorota, Bowley, Doug, Majauskyté, Dovilè, Irusha Samaraweera, Dulan, Lacthman Jethwani, Durvesh, Iyer, Dush, Iyer, Dushyant, Khokha, Dziani, Paulouski, Dzmitry, Takyi Atkins, Ebenezer, Anis, Echaieb, Domini, Edgar, Temoche, Edilberto, Huaman, Eduardo, Grisin, Edvard, Dainius, Edvina, Thomas, Efeson, Preckailaite, Egle, Alnawam, Ehab, Mamdouh, Ehab, Kjus Aahlin, Eirik, Kefalidi, Eirini, Mensah, Ekow, Borg, Elaine, Prisca Refianti Sutanto, Eldaa, Marks, Eleanor, Goldin, Elena, Muzio, Elena, Vendramin, Elena, Zdanyte Sruogiene, Elena, Ciccioli, Eleonora, Jovine, Elio, Francone, Elisa, Jensen, Elisabeth, Rifhan Mohd Basir, Elissa, Snyder, Elizabeth, Teasdale, Ella, Akoto, Elliot, Gaignard, Elodie, Haraux, Elodie, Robert, Elsa, Ali, Elsayed, Gamaly, Elsayed, Abdallah, Emad, Al-Dakka, Emad, Ali Ahmed, Emad, Aljohani, Emad, Mohamed Saeed Taha, Emad, 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Tuan, Sholadoye, Tunde, Mak, Twc, Rouse, Tyler, Chen, Tzu-Ling, Muddebihal, Uday, Karabacak, Ufuk, Gunnarsson, Ulf, Gustafsson, Ulf, Muktar, Umar, Tedeschi, Umberto, Salma, Umme, Hantour, Usama, Alamoudi, Uthman, Jotautas, Valdemara, Parent, Valentine, Dina Palomino Castillo, Vanessa, Msosa, Vanessa, Guglielmo, Vania, Silvestri, Vania, Despotidis, Vasileio, Kalles, Vasileio, Soulou, Vasiliki, Kalles, Vassili, Shatkar, Veereanna, Barendegere, Venerand, Grassi, Veronica, Lazzari, Veronica, Jennings, Vicky, Dassah, Victor, Etwire, Victor, Kong, Victor, Manuel Quintero Riaza, Victor, Nwinee, Victor, K Proctor, Victoria, Upadhyaya, Vijaid, Gadhvi, Vijay, Ambrozeviciute, Viktorija, Nevieraite, Viktorija, Sallinen, Ville, Thanusan, Vimalakanthan, Jonas Banaitis, Vinca, Beisa, Virgiliju, Sollazzo, Viviana, Graffieille, Vivien, Jean Paul Nsengimana, Vizir, Khokha, Vladimir, Thanh Hien Le, Vu, Gaižauskas, Vytauta, Lipnickas, Vytauta, Anwer, Wahid, Cheong Soon, Wai, Him Lam, Wai, Ndegwa, Wairimu, 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Esthefany Alejos Bermúdez, Ysabel, Cengiz, Yücel, Hong Eric Cheung, Yuk, Altinel, Yuksel, Kok Ng, Yung, Macchitella, Yuri, Aigrain, Yve, Mikwar, Zaher, Jaffry, Zahra, Ali Khan, Zain, Iftikhar, Zainab, M Elsayed, Zaynab, Zhang, Zhongtao, Hao Sam, Zi, Urniežius, Zigmanta, Dambrauskas, Zilvina, Bentounsi, Zineb, Tverskis, Zygimantas, Reuter A., Rogge L., Monahan M., Kachapila M., Morton D.G., Davies J., Vollmer S., Essam A.A., Sallam A.E., Elshafay A.E., Khedr A.E.-R.H., Saad A.G., Gharib A., Kenibar A., Elsherbiny A.S., Adel A., Abdelaal A., Elhendawy A.O.A., Hussein A., Belkouchi A., Hrora A., Adelshone A., Alkammash A., Assal A., Geuoshy A., Haroun A., Mohammed A., Sayed A., Soliman A., Elnemr A.E., Darwish A.K.Z., Elsebaaye A.O., Khalique A., Alvi A.R., Anwar A.W., Altwijri A., Al-Mallah A., Almoflihi A., Altamimi A., Daqeeq A., Dwydar A., Gouda A., Hashim A., Altaf A., Huwait A., Abdel-Aty A., Altwigry A.M., Sheshe A., Nasir A.A., Lawal A.O., Abdrabou A.K., Abdurrazzaaq A., Zerihun A.B., Al-Shammari A., Gendy A.E., Esam A., Marey A., Mittal A., Yifieyeh A., Bin Mahamood A., Adesuyi A., Aly A.K., Nawawi A., Gyedu A., Waterman A., Osinowo A., Fatuga A., Albiety A., Hassanein A.B., Denewar A., Adekoya A., Adebanjo A., Adeyeye A., Popoola A., Adedeji A., Ademuyiwa A.O., Tade A., Adeniyi A., Adisa A.O., Tarek A., Ladukas A., Palma A.F., Hasanah A., Salleh A., Abdelfatah A., Altamini A., Fitsum A., Taiwo A., Hassan A., Ghaben A., Fattah A.A., Al Rafati A.A.R., Ibrahem A.A., Aldalaq A., Ali A., Almallah A., Alrifaie A., Ashour A., Bakr A., Bani-Sadar A., Bin Adnan A., Elbatahgy A., Faraz A., Gudal A., Hasan A., Sabe A.K., Khoja A., Nashaat A., Qaissieh A., Sabe A., Sleem A.S., Sakr A., Shalabi A., Qureshi A.U., Aamer A., El Galeel A.A., Elhusseiny A.A.E., Elsameea A.A., Abdelkareem A., Ghazy A.A., El Magd A.A., Elazayem A.A., Adamu A., Afandy A., Ahmed A., Alghamdi A., Al-Khatib A., Altibi A., Alzahrani A., Ata A., Badr A., Dahy A., Diab A., Kashash A.E., Kholy A.E., Musa A.E.K., Elgebaly A., Elkelany A., Elkholy A., El-Sehily A., Essam A., Fahiem A., Farag A., Fawzy A., Fouad A., Gad A., Ghanem A., Gheith A., Gomaa A., El-Badri Kotb A.H., Hammad A., Rida A.H.E.F., Ismail A., Karim A., Khyrallh A., Lasheen A., Rashed A.M., Magdy A., Abdelraouf A.M., Menshawy A., Meshref A., Afifi A.M., Ibrahim A.M., Mohameden A., Mokhtar A., Mosad A., Moustafa A., Saeed A.M., Negida A., Mohammed A.R., Mohamed A.R., Nayel A.R., Soliman A.R., Raslan A., Raza A., Refaat A., Rslan A., Sabry A., El-Hamouly A.S., Marey A.S., Saidbadr A., Samir A., Shahine A., Sheta A., Tammam A., Hassan A.T.A., Shamsedine A.W., Zaki A., Eldeeb A.Z., Zohair A., Kandil A.M., Elnagar A., Zil-E-Ali A., Jabbar A., Snaith A.C., Costas-Chavarri A., Austraite A., Mistry A., Olaolorun A., Ajao A.E., Jubran A.F., Shamasneh A., Abouelnasr A., Al-Buhaisi A., Bowabsak A., Jamassi A.E., Elazab A., Elhadad A., Fergany A., Habeebullah A., Shabkah A., Shaheen A., Adesina A., Baird A., Grant A., Ball A., Cacurri A., Mphatsoe A.M., Luc A.R., Matheu A., Munera A., Bedada A.G., Favero A., Maniscalco A., Calua A.C., Fowler A.J., Gerosa A., Horobjowsky A., De Sousa A.V., Farrugia A., Arnaud A.P., Russo A.A., Gulielmi A., Ababneh A., El Dahab A.A., Ata A.A.A., Niazi A.K., Kiasat A., Hammad A.M., Zardab A., Balkan A.Z.A., Toeema A.G., Sadek A., Filatau A., Latif A., Suarez A.A.B., Faure A., Niragire A., Robledo-Rabanal A., Broch A., Hasheminia A., Macdonald A., Ndajiwo A., Novak A., Mutabazi A.Z., Beleno A.E.M., Cheah A.E.Z., Elrazek A.A., Nasr A., Sanad A., Elgendy A.H., Cury A.D.L., Ibrahim A., Martin A., Althwainy A., Abouzahra A., Mohammed A.E., Kourdouli A., Hashish A., Birring A., Al Meligy A., Abdelhamid A., Majid A.H.H.A., Mohammad A., Kaci A.A., Omar A.A., Elsawy A., Bekhet A.H., Reda A., Qumbos A.A., Elmashala A., Gado A., Mohamed A.M., Mohamed A., Rasendran A., Saleh A.A., Fadel A., Hassaan A., Hossameldin A., Elkorashy A.M., Hafez A.T., Faruq A., Aglan A., Bautista A.C.M., Contreras-Vergara A.L., Barrantes A.M.S., De Freitas A.V.C., Freitas A.V., Rashid A., Abdelazeam A.R., Kirishnan A., Majbar A., Bamicha A., Stefanopoulos A., Thorell A., Das A., Dubois A., Mihaljevic A.L., Navarro A., Allegri A., Armellini A., Belli A., Bondurri A., Moran A.E.R., Natili A., Ruzzenente A., Simioni A., Haloho A., Tanase A., Kolosov A., Subocius A., Robertson A.G.N., Kirby A., McGuigan A., Spina A., Litvin A., Burmistrovas A., Strazdas A., Arenas A., Bhangu A., Rudzenskaite A., Rojas A.D.P., Dell A., Mejia A.G.V., Charles A., Antoniozzi A., Benevento A., Tselos A., El-Ma'doul A.S., Sreedharan A., Bhatnagar A., Kjellin A., Lasek A., Maffioli A., Powell A., Rinaldi A., Watts A., lo Conte A., Bigaran A., Ashton A., Mukin A.D.F., Gulbinas A., Zadoroznas A., Rulie A.S., Ajiboye A., Avoka A., Lai A.C.-H., Davor A., Sander A., Oosterkamp A., Bediako-Bowan A., Brocca A.L., Leal A., Nocito A., La Medina A.R.-D., Taddei A., Atiyeh A., Kojo A.T.T., Driscoll A., Shah A., Vlachogiorgos A., Roslani A.C., Abdelhaq A., del Pilar Paucar A., Picciariello A., Kanani A., Leppaniemi A., Birindelli A., Nesaratnam A., Suyadi A., Velasquez A.J.R., Bonnard A., Agarwal A., Alkaaki A., Vaicius A., Khamajeet A., Reinsoo A., Abouzaid A., Elfarargy A., Kedar A., Alnusairat A., Hamarshi A., Musleh A., Prabhudesai A., Maghrabi A.A., Morsi A., Mitul A.R., Abdelgelil A., Al-Aarag A.A.-R., Rezq A., Salah A., Papailia A., Badwy A., Leusink A., Khan A., Eysa A., Zulkifli A., Mahdi A., Attia A., Attia A.M., Clarissa A., Dulskas A., Parseliunas A., Zani A., Tun A.K., Mironescu A., Mironescu A.S., Scalabre A., Mariani A., Haffreingue A., Thollot A., Usaityte A., Skardziukaite A., Ibraheem A.A.F., Aboarab A., Elsharkawy A.A., El-Sawy A., Elwaey A., Firwana A., Hagar A., Fathy A.M., Ata A.Y., Hamdan A., Taher A.A., Elwan A., Nabawi A., Salman A., Shwky A., Ogunyemi A., Herebat A., Verjee A., Adenekan B., Odeyemi B., Adel B.E., Tawfik B.A., Ozkan B.B., Mohamed B., Nighat B., Albeladi B., Malaga B., Mijuskovic B., Silvestre B.P., Kumar B., Sieda B., Bello B., Alghamdi B., Magdy B., Mahmoud B., Alhassan B., Mowafy B., Brunoni B., Weber B., Sanchez B., Thompson B., Parmentier B., Limoges B., Van Duren B., Wolf B., Dousset B., Grizhja B., Lieske B., Maillot B., Mansour B., Frisk B., Diaconescu B., Martian B.-V., Marinkovic B., Skelly B., Cameron B., Dedekind B., Noukpozounkou B., Chong B.F.H.K., Kumar B.S., de Lima C.V.B., Iacono C., Fairfield C., Samaniego C.S., Cona C., Lopez-Arevalo C., Normile C., Venugopal C., Cabrera C.C.R., Torres C.P.G., Corbellini C., Basto C.A.A., Velasquez C.I.P., Morales C., Nsengiyumva C., Galvez C.P., Capito C., Fernandez C., Diaz-Zorrilla C., Duenas C.G., Felipe C.O., Clifford C., Musyoka C.K., Shaw C.A., Magee C., Muller C., Costa C., Tolg C., Wredberg C., Del Basso C., Grosos C., Mendizabal C.A.A., Miranda C., Razuri C., Ciubotaru C., Chibuye C., Alexandre C., Szeto C.C.L., Dally C., McIntyre C.J., Benyaiche C., Chong C.L., Wong C.S., Gan C., Currow C., Deane C., Goh C.C., Koh C., Yong C.O., Khatri C., Foo C.C., Fok C.Y.J., Kong C., Ceriani C., Kwatiwani C., Yip C., Tedjaatmadja C., Chong C.S., Taieb C., Tan C.L., Bode C., Lee C., Almanon C.L., Hinojosa C., Coompson C.L., Schoewe C., Neophytou C., Major C.P., Panteli C., Mizzi C., Ferousis C., Agalianos C., Anthoulakis C., Barkolias C., Dervenis C., Chai C.-A., Wong C.Y., Fahy C., Evajelista C.V., De Emergencia C., Zarb C., Ali C.D.M., Sharpin C., Puma C.M.H., Rees C.M., Morgan C., Reali C., Arcudi C., Fermani C., Fermani C.G., Nawara C., Onuoha C., Mangan C., Sampson C., Nwokoro C., Jean-Francois C., Marinos C., Mukuzunga C., Bottini C., Gouldthorpe C., Lopez C.E., Fernandes C., Chow C.Y.N., Manipal C.E., Vimalachandran D., Alkhabbaz D., Hemeda D., Brown D., Ljuhar D., Deckelbaum D.L., Jaradat D., Du Plessis D., Soeselo D.A., Cox D., Dabessa D., Rodriguez D.E.M., Hamill D., Nel D., Youssef D., Magri D., Angelieri D., Gui D., Cruz D.H., Sale D., Gbessi D.G., Andreotti D., Kazanavicius D., McCullagh D., McNish D., Merlini D., Cohen D.M., De Boni D., Rossi D., Aziz D.N.A., Grobler D.C., Schivo D., Chiesa D., Mikuckyte D., Dragatas D., Gray D., Elsorogy D.E.A.A., Elsawahly D.M.E., Zahran D., Cadogan D.D., Sanchez D., Bandoh D., Pozo D.A.R., Antezana D., Coletta D., Romani D., Sasia D., Ofner D., Duhoranenayo D., Raptis D.A., Balalis D., Manatakis D.K., Karousos D., Korkolis D., Kyziridis D., Lytras D., Papageorgiou D., Sfougaris D., Zachariades D.-C., Al-Marakby D., Rahmah D.F., Gamal D., Tarek D., Periasammy D., dos Santos D.V., Morton D., Mirghani D., Seto D.M., Cocker D.M., Nepogodiev D., Raptis D., Emadeldin D., Gamil D., Hasan D., Hasanain D., Abdelrouf D.M., Pata D., Mapasse D., Marshall D.C., O'Connor D.B., Danys D., Venskutonis D., Radkowiak D., Bowley D., Majauskyte D., Samaraweera D.I., Jethwani D.L., Iyer D., Khokha D., Paulouski D., Atkins E.T., Anis E., Domini E., Temoche E., Huaman E., Grisin E., Dainius E., Thomas E., Preckailaite E., Alnawam E., Mamdouh E., Aahlin E.K., Kefalidi E., Mensah E., Borg E., Sutanto E.P.R., Marks E., Goldin E., Muzio E., Vendramin E., Sruogiene E.Z., Ciccioli E., Jovine E., Francone E., Jensen E., Basir E.R.M., Snyder E., Teasdale E., Akoto E., Gaignard E., Haraux E., Robert E., Ali E., Gamaly E., Abdallah E., Al-Dakka E., Ahmed E.A., Aljohani E., Taha E.M.S., Al Raouf E.A., Abdelmageed E., Abuqwaider E., Sayma E.A., Elwy E., Emara E., Hashad E., Ibrahim E., Magdy E., Hegazy E.M., Abdulhakeem E.M., Ibrahim E.M., Morshedy E.M., Nofal E., Rashad E., Mansor E.Y., Barrios E., Rausa E., Nwabuoku E., De Luca E., Eyssartier E., Dijan E., Blower E., Jurdell E., Upchurch E., Acquah E., Akatibo E., Runigamugabo E., Alaloul E., Alqahtani E., Dagoe E., Tackie E., Farinella E., Ackom E., Appiah E.K., Farfan E.S.F., Hervieux E., Schadde E., Vicario E., Laugzemys E., Ahounou E.Y.S., Elbanby E., Ezzat E., Elkhalek E.A., Kasem E.A., Eldeen E.A., El-Gizawy E., Elhalawany E., El-Taher E., Gamal E., Ghanem E., Kasem E., Elbanby E.S., Zakaria E., Hany E., Courboin E., Lee E.X., Macdonald E., Niyirera E., Grasset E., Morandi E., Panieri E., Borin E., Voulgaris E., Slapelyte E., Woin E., Macdermid E., Harrison E.M., Khalifah E., Veronese E., Deichsel F., Aquilino F., Sabour F.A., Idris F., Leong F.Q.H., Rasoaherinomenjanahary F., Ali F.M., Iftekhar F., Sayed F., Balogun F., Al Bastawis F., Asi F., Nada F., Elzowawi F., El-Salam F.A., Sroor F., Baluch F., Elgendy F.I., Elkady F., Ntirenganya F., Elsherif F.A., Mohamed F., Al Barrawi F.E., Noor F., Bianco F., Falaschi F., Coccolini F., Zheng F., Zapata F., Alakaloko F., Lee F., Chai F.Y., Iskandar F., Altoe F., Frade F., Djivoh F., Espinoza F., Fernandez-Bueno F., Tale F., Andika F.F.A., Adella F.J., Di Franco F., Rahantasoa F.C.F.P., Henry F., Rahmawati F.N., Dedey F., Primavesi F., Iordache F.-M., Lam F.Y., Koumpa F., Steccanella F., Pata F., Riente F., Giardino F.R., Selvaggi F., Abantanga F., Dossou F., Fujii F., Regalado F., Helene F.-C., Schmitt F., Gyamfi F.E., Owusu F., Aristizabal F.A.N., Hodonou F., Du Toit F., Sauvat F., Wogensen F., Asele F.A., Saravia F., Pardo G., Nita G.E., Gallo G., Luglio G., Tessera G., Abdelazim G., Shimy G., Barnabas G.N., Samson G., Irwin G., El Ashal G., El Sayed G.S., Tawfik G., Humm G., Balducci G., Sila G.C.M., Ihediwa G., Sila G.M., Azzie G., Camilleri G.M., Gemenetzis G., Gkiokas G., Karabelias G., Kyrou G., Tzikos G., Perrotta G., Teufelberger G., Ahlonsou G., Minguez G., Maharaj G., Galiqi G., Elhoseny G., Nagy G.S., Al Saied G., Shamsi G.S., Nastri G., Pata G., Cocorullo G., Curletti G., Pagano G., Pellino G., Confalonieri G., Gravante G., Lauzikas G., Dawnay G., Simutis G., Vasquez G., Landolfo G., Lazzari G., Lamanna G.L., Pascale G., Pesenti G., Sgroi G., Devadasar G.H., Moreira G., Borda-Luque G., Clerico G., Rotunno G., Salamone G., Sammarco G., Lap G., Padmore G., Tugnoli G., Kouraklis G., McLachlan G., Wood G., Ziubryte G., Podevin G., Rosenberg G.S., Yong G.L., Mannu G.S., Banipal G.S., Vega G.M.M., Miguel G.P.S., Fraga G.P., Recinos G., Servin G.R.P., Shiwani H.A., Al-Farram H., Hakim H., Zidan H., Amin H.A.A., Abdulaziz H., El-Badawy H.A., Elwakil H., Tolba H., Elabdin H.Z., Hajeh H., Ahmed H., Saad H., Aliyu H., Ebdewi H., Asumah H., Waleed H., Saad H.A., Youssef H., Natalie H., Royson H., Anderson-Knight H., Burns H., Thomas H.S., Pahlsson H.-I., Lakshmi H.N., Jordan H., Ibraheem H.I., Al-Hameedi H.I.I., Arsyad H.M., Dharamshi H.A., Mostafa H.A., El-Sheemy H., Tahboub H., Kretzmann H., Rashwan H., Abudeeb H., Khaled H., Nurqistan H.D., Bougard H., Baraka H., Gamal H., Shaker H., Miyasato H.S., Mohan H., Woodward H., Franco H., Francois-Coridon H., Lohse H.A.S., Shakshouk H.A.G., Kandil H., Mahmoud H., Kotobi H., Mendel H., Nnaj H., Karismaningtyas H., Cruz H., Magdy H., Bakry H.M., Heng H.E., Thorarinsdottir H., Safa H., Samih H., Mircea H., Sar H.K., Wong H.Y., Chong H.-Y., Kordorwu H.E.K., Glover-Addy H., Decoud H.P., Salem 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J., Oh J., Kutkevicius J., Kuliavas J., Zilinskas J., Lam J.C.Y., Lando J., Li K.H.G., Leung K.W., Lee K.Y., Kabongo K., Pinnagoda K., Hewage K., Kinandu K., Bhopal K.F., Palayan K., Dabbour K., Elshaer K., Bailey K., Hilal K., Bonavia K., Lagunavicius K., Varkalys K., Cross K., Chang K.Y.-C., Reinisch K.B., Whitehurst K., Gash K., Chu K., Lee K., Connor K., Gudlaugsdottir K., Das K., Atobatele K., Janardha K.C., Koay K.L., Poh K.-S., Clement K.D., Sammut K., Tan K.S.K., Aaniana K., Johnson K., Mealy K., Thorsen K., Espinoza K.T., Pluke K., Strupas K., Conlon K.C., Abozeid K., Alhady K., Aljboor K., Dawood K., Elbisomy K.H., Ibrahim K., Khattab K., El Deen K.N., Mahmud K., Qurie K., El-Dien K.S., Bassit K.A., Boukhal K., Ashour K., Lasheen K.T., Abdelbadeai K., Khan K., Syibrah K.Z., Atkinson K., Li K.K.K., Lafferty K., Soreide K., Augestad K.M., Konstantina K., Farmakis K., Gasteratos K., Maceviciute K., Keke K.R., Zamarin K., Styles K., Jasaitis K., Jokubonis K., Cassar K., Chung K.J., Gunaseelan K., Lee K.C., Carabott K., Agbedinu K., Boakye-Yiadom K., Maison K., Asare-Bediako K., Kusi K., Aung K.P., Szeto K.J.-Y., Psarianos K., Uscinas L., Arachchige L.A.J.J., Abusalem L., Lopez L.I.P., Joel L.W.L., Gavagna L., Koskenvuo L., Lorenzon L., Luque L., Fourcade L., Abdullahi L., Ismail L., Khulu L.B., Rodriguez L.-A.M., Yeo L.S., Israelsson L., Bray L.D., Pena L., Licari L., Solaini L., Yeang L.J., Henderson L., Richardson L., Roodt L., Reza L., Urbanavicius L., Venclauskas L., Barrientos L.A.M., Andersson L., Wilson L., Nymo L., Mauro L., Muntean L.I., Muntean L., Jeremic L., Anyanwu L.-J., Ahmed L.A.M., Fuentes-Rivera L., Rodriguez L., Garcia L.S., Sproule L., Eldamaty L., Jamal L., Da Silva L.A., Sabeeh L., Samison L.H., Ansaloni L., Bortolasi L., Turati L., Duinhouwer L., Vida L.C., Fievet L., Selvaggi L., Solis L.A.Z., Chew L.S., Bonavina L., Bucci L., Cloro L.M., Laufer L.A.V., Barneo L., Florez L.J.G., Helguero-Santin L.M., Barreda L.M.A., Tale L., Giavarini L., De Castro Segundo L.C.B., Tatagiba L.S., Eisner L., Mata L.P.S., Vermaas M., Amoako-Boateng M., Dziak M.W., Jha M., Gimzewska M., Gran M., O'neill M., Mitroudi M., Boijsen M., Al-Faqawi M., Elmasry M., Hamad M.G.M., Nasr M., Tata M.D., Essam M., Farahat M.M., Elnajjar M.A., Abdelshafy M., Abdelshakour M., Abdulgawad M., Abozyed M.A.F., Alrahawy M., Amreia M., Badawy M., Eldafrawy M., Elfiky M., Maher M.E., Elkhadrawi M., Moghazy M.E., Gomah M., Saad M.M., Metwally M.M., Morsi M., Saad M., Saami M., Salama M., Salma M., Shalaby M., Warda M., Zakaria M., Yuksek M.A., Javaid M., Estee M.M., Ebidy M., Ebidy M.M., Careta M.C., Marcus M., Dabboor M., Aboelella M., Dayie M., Elsayed M., Falzon M., Hassan M., Sund M., Leung M.F., Yeung M.H.A., Abd-Elmawla M., Saeed M., Drungilas M., Jokubauskas M., Vilcinskas M., Roxas M.F., Hache-Marliere M., Lopez M., Castro M.R., Mendez M., Dar M., Abu-Toyour M., Salah M., Higgins Roche M.O., Catani M., Pascale M.M., Migliore M., De Leon M.Z.P., O'Shea M., Montrimaite M., Notarnicola M., Hussain M., Arango M.C.M., Grella M.G., Hjertberg M., Lanau M.I.V., Mano M.J.B., Aguilera M.L., Modolo M.M., Mayasari M., Ringressi M.N., Montejo M.S.G., Merlo M.S., Utter M., Valcarcel-Saldana M., Aguilera-Arevalo M.-L., Darweesh M., Gad M.O., Aboul-Naga M.S., Giglio M.C., Malavenda M., Lapitan M.C., Parreno-Sacdalan M.D., Paul M., Renaux-Petel M., Agius M., Del Carmen Escalante Salas M., Dickfos M., Pimenta M.L., Urquizu M.C., Corbellino M., Jacobe M., Pasini M., Trompetto M., Leal M., Manriquez-Reyes M., Popa M., Hampton M.I., Sykes M., Wagener M., Zuber M., Bliksoen M., Glynn M., Jarmin M., Kyereh M., Perino M., Shawky M.Y., Vella-Baldacchino M., Vargas M., Altarayra M., Elashmawy M., Elshobary M., Hamdan M., Sayed M., Abubakr M., Fahim M., Shawki M., Khan M.A., Shubianok M., Al-Mousa M., Alghamdi M., Jawaid M., Machaca M., Dal Canto M., Coletti M., Pazuskis M., Bratu M., Bratu M.R., Rubinkiewicz M., Papandrea M., Ripa M., Ekow M., Baldacchino M., Billy M., Kim M.Y.-H., Peycelon M., Tolonen M., Bezzina M., Foco M., Alrajraji M., Denakpo M., Rath M., Maimbo M., Mohamed M., Hassanain M., Turner M., Yavuz M.A., Gumar M., Ulusahin M., Mollo M.C., Salem M., Worku M., Ramadan M.T., Hafez M., Mustafa M.-A., Redota M.A.P., Allam M., Mericliler M., Mostafa M., Abbouch M., Aboraya M., Amoah M., Cox M., Edye M., Gillespie M., Hanrahan M., Livingston M., Puttick M., Stoddart M., Van Niekerk M., Walsh M., Wilson M., Kontos M., Margaritis M., Janik M., Ohene-Yeboah M., Monteleone M., Carlucci M., Sacco M., McCarthy M., Mohan M., Paludi M.A., Siguantay M., Radic M., Vartic M., Bala M., Nirumal M.K., Radojkovic M., Nestorovic M., Ghetia M., Kiudelis M., Beuran M., Hogea M., Mangiapane M., De Fa Tima Linares Delgado M.S., Othman M., Oludara M., Koto M.Z., Baheeg M., Bakhaidar M., Bin Ismail M.J., Abdelaziz M.A., Amer M.A., Baky Fahmy M.A., Abbas M., El Slam M.A., Abdelaty M., Mohamed M.A., Abdelkhalek M., Abdelraheim M., Abozaid M., Abdullah M.A., Abuseif M., Badenjki M.A., Ghonaim M.A., Mahmoud M.A., Ameen M., Ammar M., Asal M., Mohamed M.A.E.H., Dablouk M., El Halawany M., Elazoul M., Elbermawy M., Elfil M., Elsehimy M., Elzayat M., Etman M., Zalabia M.F., Fares M., Badr M.F.M., Hamed M.F., Gadelkarim M., Ghoneem M., Gulamhussein M., Hashish M., Alnaby M.H., Husseini M., Ibrahim M., Ismail M., Karkeet M., Kelany M., Mabrouk M., Magdy M., Mahmoud M., Mohamed M.M., Moaty M., Mustafa M., Nashat M., Nazir M., Loaloa M.R., Aziz M.R.A., Ammar M.S., Elhelbawy M.S., Seisa M., Shaalan M., Sleem M., Jabal M.S., Youssef M., Zidan M., Elshami M., Habeeb M.A., Adawi M., Alherz M., Aliyu M., Omar M.E., Ghannam M., Alwafai M.G., Arshad M.M., Rashid M., Amjad M., Alamoudi M., Alhendy M., AlRowais M., Alsaggaf M., Alzahrani M., Bukari M., Deputy M., Elgheriany M., Elshaar M., Elsiddig M., Firdouse M., Azizeldine M.G., Hanafy M., Ismail M.K., Mousa M., Salem M.M., Mohammed M.M.H., Mohammed M.M., Najjar M., Osman M., Dablouk 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P., Mingrone P., Yoganathan P., Major P., Francois P., Ignatavicius P., Mazrimas P., Arachchi P.P., Jain P., Kwakyeafriyie P., Har P.A.L., Chin P.X., Malik P., Nashidengo P., Liu Q., Alimi Q., Ballouhey Q., Ellison Q., Tze R.G.E., King R., Moore R., Amandito R., Dorani R.M.N.R., Araujo R., Soley R., Roszkowski R., Galleano R., Narayanan R., Herikstad R., Kamil R., Satoskar R., Kabariti R., Staerkle R.F., Nataraja R., Oumer R., Shaker R., Jonnalagadda R., Jaramillo R.A., Cardozo R.A.M., Mamdouh R., Saadeh R., Rodriguez-Uria R., Claire R., Abdelhamed R., Bratu R.-M., Zilinskiene R., Bennai R.M., Alyahya R., Fakher R., Husseiny R., Khreishi R., Balila R.M.H., Elashry R., El-Din R.A., Alshareef R., Saad R., Melo R., D'cruz R., Rajan R., Karim R., Velasquez R., Gilbert R., Lilford R., Opoku-Agyeman R., Spence R., Gilbert R.W., Hagan R., Alyami R., Ots R., Rakauskas R., Khan R., George R., Karlo R., Kerley R., McIntyre R., Morton R., Parker R., Tyler R., Bugeja R., Tutino R., Villa R., 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Elhadry S., Hussein S., Mahmoud S., Talukder S., Shaharuddin S., El-Din S.A., Aql S., Torres S.G., Aliyu S., Karandikar S., Koh S., Mohamed S.R., Elsheikh S., Shehata S., Tariq S., Gamal S., Elkholy S.S., Gaafar S., Tewari S., Dindyal S., Tharmalingam S., El Mesery S., Ymeri S., Nadkarni S., Ayyar S., Kong S.N., Teo S.Y., Gokani S., Lim S.Y., Holte S., Basilico S., Boni S., De Franciscis S., Gosling S.G., Gosling S., Ng S., Stock S., Juciute S., Kasputyte S., Conci S., Sandler S., Targa S., Yam S.Y., Asilah S.M.D., Kamarulzamil S.N.A., Sivaganesh S., Suleiman S.I., Chung S., Elsobky S., Mouttalib S., Abushamleh S., Elmihy S., Ahmed S.M., Turkustani S., Hmila S., Africa S., Pai S., Bhat S., Prasad S.S., Paul S., Parasyris S., Botes S., Breitenstein S., Zammit S., Berti S., Cucumazzo S., Basso S.M.M., Roncali S., Kim S.B., Saar S., Kwok S.H.-W., Van Straten S., Dias S., Chapman S.J., Kache S., McAleer S., Knight S.R., Tabiri S., Petrikenas S., Fergusson S.J., Parpoudi S., Germanos S., Roy S., Suresh S., Burger S., Baba S., Almuallem S., Kim S.-H., Das S., Bahar S., Aviles S., Limache S., Mathew S.W., Durand S.Y.A., Brincat S.D., Kruspi S., Ali S.A.W.E.W., Naqvi S.A., ul Razi S.A., Lemaire S.B., Mochet S., Rekhis S., Widiastini T.A., Ngwa T.E., Yusufali T., Al-Taher T., Yaseen T.M., Yaseen T., Naqvi T., Lawal T.A., Lawal T., Arulampalam T., Gala T., Kumar T., Grima T., Ezzat T., Razek T., Idress T., Kanta T.H., Shachykava T., Khan T., Ali T.H.A., Fautz T., Worku T., Nouh T., Pugliesi T.B., Dimech T., Tembo T., Xerri T., Pezas T., Theodosopoulos T., Giuriato T.F., Alihonou T., Feidantsis T., Fozard T., Weiser T.G., Drake T.M., Olajide T.O., Pinkney T., Prudhomme T., Sherman T., Moe T.T., Alzayat T., Hettiarachchi T.S., Lee T.S.B., White T., Gaarder T., Schuetz T., Tolotra T.E.C., Cecilia T., Malik T.A.M., Arthur T., Hall T.F., Abaliksta T., Jankus T., Poskus T., Bocchetti T., Campagnaro T., Fontana T., Mak T., Khafagy T., Veen T., Wold T.B., Chan T.-Y.K., Mat T.N.T., Sholadoye T., Mak T.W.C., Rouse T., Chen T.-L., Muddebihal U., Karabacak U., Gunnarsson U., Gustafsson U., Muktar U., Tedeschi U., Salma U., Hantour U., Alamoudi U., Jotautas V., Parent V., Castillo V.D.P., Msosa V., Guglielmo V., Silvestri V., Despotidis V., Kalles V., Soulou V., Shatkar V., Barendegere V., Grassi V., Lazzari V., Jennings V., Dassah V., Etwire V., Kong V., Riaza V.M.Q., Nwinee V., Proctor V.K., Upadhyaya V., Gadhvi V., Ambrozeviciute V., Nevieraite V., Sallinen V., Thanusan V., Banaitis V.J., Beisa V., Sollazzo V., Graffieille V., Nsengimana V.J.P., Khokha V., Le V.T.H., Gaizauskas V., Lipnickas V., Anwer W., Soon W.C., Lam W.H., Ndegwa W., Thabet W., Adham W., Forno W., Panez W.R., Nasir W.N.A.W.M., Senanayake W.S.M.K.J., Hamsho W., Dar W., Alhazmi W., Guo W., Ho W., Dao W., Aguilar W.L.M., Goh W., Jeo W.S., Pino W., Appeadu-Mensah W., Beasley W., Bonney W., Hutch W., Lossius W.J., Milligan W., Ticona W.A., Li W.S., Chachulski W., Delforge X., Rodriguez X., Low X., Chan X.W., Neo Y.T., Souaibou Y.I., Ukwenya Y., Salama Y., Rajjoub Y., Ibrahim Y., Abd-Elrasoul Y., Elfouly Y., Hegazy Y., Soliman Y., El Salam Y.A., Tan Y.W., Zakaria Y., Reddy Y., Tan Y.K., Mok Y.T., Cheong Y.J., Gan Y.Y., Der Y., Mogan Y.P., Allam Y., Asar Y.H., Tew Y.Y., Abuowda Y., Shoura Y.E., Bermudez Y.E.A., Cengiz Y., Cheung Y.H.E., Altinel Y., Ng Y.K., Macchitella Y., Aigrain Y., Mikwar Z., Jaffry Z., Khan Z.A., Iftikhar Z., Elsayed Z.M., Zhang Z., Sam Z.H., Urniezius Z., Dambrauskas Z., Bentounsi Z., and Tverskis Z.
Subjects: surgical unmetneed, no keywords listed, appendicitis, global surgery, Financial Stress, Health Care Costs, Appendicitis, Financial Stre, Health Care Cost, Cost of Illness, Humans, appendicitis,economic burden, surgery, Surgery, Appendiciti, Human
Abstract: Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and $73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and $75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially.
Published: 2022

44. Utilization of age-adjusted shock index in a resource-strained setting

Author: Grant L. Laing, Damian L. Clarke, Victor Kong, Stephanie F. Polites, Michael B. Ishitani, Matthew C. Hernandez, Michael D. Traynor, Elizabeth B. Habermann, Martin D. Zielinski, John L. Bruce, and Christopher R. Moir
Subjects: medicine.medical_specialty, Adolescent, Age adjustment, Blood Pressure, Severity of Illness Index, Cohort Studies, South Africa, 03 medical and health sciences, 0302 clinical medicine, Trauma Centers, Heart Rate, 030225 pediatrics, Internal medicine, Heart rate, medicine, Humans, Child, Univariate analysis, Receiver operating characteristic, business.industry, Infant, Shock, General Medicine, medicine.disease, Shock index, Triage, United States, Hospitalization, ROC Curve, Child, Preschool, 030220 oncology & carcinogenesis, Pediatrics, Perinatology and Child Health, Cohort, Surgery, business, Pediatric trauma
Abstract: Background Identification of injury severity and appropriate triage are critical to effective surgical care, especially where medical and surgical resources are strained. We hypothesized that pediatric age-adjusted shock index (SIPA) would outperform traditional shock index (SI) in a middle-income country (MIC) setting. Methods Injured children hospitalized in two trauma centers (South Africa and the United States) from 2012 to 2017 were reviewed. Maximum heart rate and minimum systolic blood pressure defined SI. SI > 0.9 defined elevation. SIPA elevation was based on SI stratified by age: 1–6 years (SI > 1.22), 7–12 years (SI > 1.0), and 13–17 years (SI > 0.9). SI and SIPA were compared using univariate analyses and area under the receiver operating characteristic curves (AUROC). Results 1648 patients (741 MIC and 907 high-income country (HIC)) were evaluated with a median [IQR] age of 11 [6–15] years. SI was elevated in 377 (51%) MIC children, whereas SIPA was elevated in 248 (34%). In both the HIC and MIC, elevated SIPA was more associated with ISS ≥ 25, ICU admission, and mortality. In MIC patients specifically, elevated SIPA improved discrimination for in-hospital mortality (AUROC 0.66 vs AUROC 0.57, p Conclusion In a multinational cohort including MIC patients, SIPA facilitated identification of injured children with altered physiology, reflecting greater injury severity and poorer outcomes. Use of SIPA has the potential for more effective resource utilization in MICs. Level of evidence Level III.
Published: 2019

45. Penetrating buttock trauma is morbid but rarely fatal - A South African experience

Author: Victor Kong, Jonathan Ko, Varun Thirayan, Priscilla Leow, Jia Lim, John Bruce, Grant Laing, and Damian Clarke
Subjects: General Medicine
Abstract: Background Penetrating injuries to the buttock are relatively rare but are associated with significant morbidity. This study aimed to review our experience in managing penetrating trauma to the buttocks to contextualize the injury, document the most common associated injuries, and generate an algorithm to assist with the management of these patients. Methods A retrospective study was conducted at a major trauma center in South Africa over 8 years (January 2012 to January 2020). All patients presenting with a penetrating buttock injury were included. Results Our study included 40 patients. Gunshot wounds accounted for 93% (37/40), stab wounds accounted for 5% (2/40), and 1 case was gored by a cow. The majority (98%) underwent further investigation in the form of imaging or endoscopy. Forty percent (16/40) required surgical intervention. Of these 16 cases, 14 required a laparotomy, and 2 required gluteal exploration. Fifty-six percent (9/16) required a stoma. Five percent (2/40) experienced one or more complications, both of whom had stomas. The median length of stay for all patients was 3 days, whereas for the patients with stomas was 7 days. There were no ICU admissions or mortality in this study. Only 3 of the 9 stomas were reversed, and the median time to reversal was 16 months. Conclusion Penetrating trauma to the buttock may result in injuries to surrounding vital structures, which must be actively excluded. Rectal injury was the most common injury, and most required a defunctioning colostomy as part of the management resulting in significant morbidity.
Published: 2022

46. Trauma to the gallbladder is associated with concurrent injuries to the extra hepatic biliary system: A South African experience

Author: Jhanvi Dholakia, Abdalla Elsabagh, John L. Bruce, Nigel Rajaretnam, Grant L. Laing, V Manchev, Victor Kong, Cynthia Cheung, William Xu, and Damian L. Clarke
Subjects: Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Perforation (oil well), Gallbladder Injury, Abdominal Injuries, Wounds, Nonpenetrating, Gallbladder perforation, medicine, Humans, Biliary Tract, General Environmental Science, Retrospective Studies, business.industry, Major trauma, Gallbladder, medicine.disease, Surgery, medicine.anatomical_structure, Blunt trauma, General Earth and Planetary Sciences, Cholecystectomy, Female, Wounds, Gunshot, business, Penetrating trauma
Abstract: Introduction Gallbladder trauma is a rare injury. This study aimed to describe the significance of these injuries and the appropriate management strategies. Methods A retrospective study was undertaken at a major trauma centre in South Africa and included all patients diagnosed with a gallbladder injury between January 2012 and October 2020. Results A total of 51 cases were included (88% male, mean age: 38 years), with 44 (86%) penetrating trauma cases [28 stab wounds (SW), 16 sustained gunshot wounds (GSW)]. Of the 7 (13%) blunt trauma cases, five were involved in a motor vehicle crash, and two were injured via assault. All patients underwent laparotomy. Full-thickness gallbladder laceration or perforation was the most common type of injury (84%) and all patients with a gallbladder perforation or laceration had a cholecystectomy at index operation. Two out of 5 patients with a gallbladder contusion were managed conservatively without a cholecystectomy and the remaining three had evidence of gallbladder necrosis which were managed with cholecystectomy. Associated extrahepatic bile duct injuries occurred in 4% of cases, and 18 cases (35%) required intensive care unit (ICU) admission. The overall mortality was 8%. Conclusion Gallbladder injury is rare but when encountered implies a significant degree of trauma. Although cholecystectomy is usually definitive, there is an association with other occult extra-hepatic biliary tract injuries. The severity of the associated injuries usually determines patient outcomes.
Published: 2021

47. Isolated free fluid on computed tomography for blunt abdominal trauma

Author: Mtd Smith, John L. Bruce, Victor Kong, W Bekker, Grant L. Laing, Damian L. Clarke, and V Manchev
Subjects: Adult, Male, Radiography, Abdominal, medicine.medical_specialty, Clinical Decision-Making, Hemorrhage, Computed tomography, Abdominal Injuries, Wounds, Nonpenetrating, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Blunt, Predictive Value of Tests, Multidetector Computed Tomography, Humans, Medicine, In patient, Clinical significance, Emergency Surgery, Medical Audit, medicine.diagnostic_test, business.industry, Ascites, General Medicine, medicine.disease, Body Fluids, Abdominal trauma, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Surgery, Radiology, Abdominal computed tomography, business, Algorithms, Free fluid
Abstract: Introduction The clinical significance of isolated free fluid on abdominal computed tomography (CT) in patients with blunt abdominal trauma is unclear. This audit reviews our unit’s experience with isolated free fluid and attempts to refine our clinical algorithms for the assessment of patients with blunt abdominal trauma. Materials and methods All patients who sustained blunt abdominal trauma between December 2012 and December 2017 who were subjected to multidetector CT of the abdomen as part of their initial investigation were included in this study. Results During the five-year period under review, a total of 1066 patients underwent abdominal CT following blunt poly trauma. A total of 84 (7.9%) patients died. There were 148 (14%) patients with CT finding of isolated free fluid. Of these, 128 (67%) were selected for non-operative management, which included a period of serial abdominal examinations. In this non-operative group, five patients failed their abdominal observations and underwent laparotomy. Findings in these five cases were negative (1), non-therapeutic (1), splenic injury (1), Pancreatic and splenic injury (1) and bladder injury (1). Thirteen patients (10%) died, none of whom had surgery. The causes of death were exsanguination from a major traumatic lower limb injury (1), multiple organ failure (1), traumatic brain injury (10) and spinal cord injury (1). The remaining 20 patients underwent laparotomy. The indications were failed non-operative management (5), abdominal distension (1) and suspicion of a missed hollow viscus injury (14). In this group there were 11 therapeutic and 6 non-therapeutic surgeries and three negative laparotomies. For the 15 patients selected for operative management, the findings were as follows: hollow viscus injury (3), mesenteric bleeds (2), splenic and pancreatic injury (1), liver and bladder injury (1), splenic and bladder injury (1), non-therapeutic (4), negative (3). The finding of isolated free fluid on CT is 98% sensitive and 96% specific for true isolated free fluid (chi square 331.598; P = 0.000). This finding predicts successful non-operative management with a positive predictive value of 93% and a negative predictive value of 96%. Discussion In patients with blunt abdominal trauma, the finding of isolated free fluid on abdominal CT alone is no longer an indication for laparotomy. Other clinical factors must be taken into account when deciding on the need for laparotomy, such as haemodynamic status, clinical abdominal findings and the ability to reliably assess the abdomen. In the absence of a clinical indication for urgent laparotomy, patients with isolated free fluid may be observed.
Published: 2019

48. The spectrum of injuries resulting from abdominal stab wounds with isolated omental evisceration: A South African experience

Author: Victor Kong, John L. Bruce, Ross Weale, J J P Buitendag, George Oosthuizen, Joanna M Blodgett, Damian L. Clarke, and Grant L. Laing
Subjects: Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Abdominal Injuries, Wounds, Stab, South Africa, 03 medical and health sciences, 0302 clinical medicine, Laparotomy, medicine, Humans, Evisceration (ophthalmology), Retrospective Studies, business.industry, Major trauma, 030208 emergency & critical care medicine, Mean age, 030229 sport sciences, General Medicine, medicine.disease, Stab, Surgery, Viscera, Female, business, Omentum
Abstract: The spectrum of injury associated with anterior abdominal stab wounds (SWs) is well established. The literature in the specific setting of isolated omental evisceration is limited.We reviewed our experience of 244 consecutive patients with established indications for laparotomy over an eight year period at a major trauma centre in South Africa.Of the 244 patients (93% male, mean age: 27 years), 224 (92) underwent immediate laparotomy (IL). Twenty were initially observed and eventually required a laparotomy (delayed laparotomy, DL). The mean time from injury to decision for laparotomy was3 h in 92% (224/244),6 h in 6% (14/244),12 h 2% (4/244) and18 h in 1% (2/244). Ninety-eight per cent (238/244) of laparotomies were positive and 96% of the positive laparotomies (229/238) were considered therapeutic. The mostly commonly injured organ encountered on laparotomy were small bowel, stomach and colon.The most commonly injures encountered are intestinal and gastric. Clinicians must remain vigilant as injuries may be subtle.
Published: 2019

49. Penetrating Pharyngoesophageal Injuries

Author: Damian L. Clarke, Victor Kong, A S Madsen, Emil Loots, and Vimal Nair
Subjects: medicine.medical_specialty, medicine.diagnostic_test, business.industry, Rehabilitation, Pharynx, 030208 emergency & critical care medicine, Physical examination, Nonoperative treatment, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Flexible endoscopy, Angiography, otorhinolaryngologic diseases, medicine, Orthopedics and Sports Medicine, Surgery, 030212 general & internal medicine, Radiology, Cervical esophagus, Esophagus, Nonoperative management, business
Abstract: Penetrating pharyngoesophageal injuries (PPEI) are relatively rare yet are associated with significant morbidity and even mortality. Even if diagnosed appropriately, their management is controversial. This monograph attempts to contextualize these injuries and provide evidence-based guidelines to assist with their recognition, diagnosis, and management. The pharynx and esophagus may be divided into a number of regions: the pharynx, the cervical esophagus, the intrathoracic esophagus, and the intra-abdominal esophagus. Management approaches differ depending on the site of the injury. Clinical examination is important but unreliable and the clinical signs of a PPEI are nonspecific. Imaging is essential to exclude or confirm the presence of a PPEI. CT angiography can accurately assess the vasculature in the neck and can exclude a PPEI. If there is still a suspicion of a PPEI, then a contrast study or a flexible endoscopy will accurately delineate the injury. There is no need to combine these two modalities routinely. If an injury to the oro/hypopharynx is identified, then nonoperative treatment is safe and effective. Injuries to the cervical esophagus are traditionally managed operatively, but in a select subset of patients, nonoperative management may well be both safe and effective. Injuries to the intrathoracic and intra-abdominal esophagus are rare and are treated operatively. PPEI must be actively excluded by good clinical examination in conjunction with appropriate imaging. Injuries to the proximal part of the tract can be safely managed nonoperatively. More distal injuries traditionally are managed operatively but in a small subset of cases may be safely managed nonoperatively.
Published: 2019

50. Trauma registry data as a tool for comparison of practice patterns and outcomes between low- and middle-income and high-income healthcare settings

Author: Damian L. Clarke, Denise B. Klinkner, Michael D. Traynor, Stephanie F. Polites, J J P Buitendag, Martin D. Zielinski, Victor Kong, W Bekker, Grant L. Laing, Omair A. Shariq, Christopher R. Moir, Amy E. Glasgow, Elizabeth B. Habermann, Matthew C. Hernandez, and John L. Bruce
Subjects: Male, Patient Transfer, medicine.medical_specialty, Quality management, Adolescent, Minnesota, Trauma registry, South Africa, 03 medical and health sciences, Injury Severity Score, 0302 clinical medicine, 030225 pediatrics, Pediatric surgery, Injury prevention, medicine, Humans, Hospital Mortality, Registries, Child, Referral and Consultation, Practice patterns, business.industry, Shock, General Medicine, medicine.disease, Child, Preschool, Pediatrics, Perinatology and Child Health, Healthcare settings, Emergency medicine, Wounds and Injuries, Female, 030211 gastroenterology & hepatology, Surgery, Low and middle income, business, Pediatric trauma
Abstract: There is a lack of data-driven, risk-adjusted mortality estimates for injured children outside of high-income countries (HIC). To inform injury prevention and quality improvement efforts, an upper middle-income country (UMIC) pediatric trauma registry was compared to that of a HIC.Clinical data, injury details, and mortality of injured children ( 18 years) hospitalized in two centers (USA and South African (SA)) from 2013 to 2017 were abstracted. Univariate and multivariable analyses evaluated risk of mortality and were expressed as odds ratios (OR) with 95% confidence intervals (CI).Of 2089 patients, SA patients had prolonged transfer times (21.1 vs 3.4 h) and were more likely referred (78.2% vs 53.9%; both p 0.001). Penetrating injuries were more frequent in SA (23.2% vs 7.4%, p 0.001); injury severity (9 vs 4) and shock index (0.90 vs 0.80) were greater (both p 0.001). SA utilized cross-sectional imaging more frequently (66.4% vs 37.3%, p 0.001). In-hospital mortality was similar (1.9% SA, 1.3% USA, p = 0.31). Upon multivariable analysis, ISS 25 [210.50 (66.0-671.0)] and penetrating injury [5.5 (1.3-23.3)] were associated with mortality, while institution [1.7 (0.7-4.2)] was not.Despite transfer time, the centers demonstrated comparable survival rates. Comparison of registry data can alert clinicians to problematic practice patterns, assisting initiatives to improve trauma systems.
Published: 2019

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