Browsing by Author "Biffl, Walter L."
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Item Open Access 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy(2021-06-10) de’Angelis, Nicola; Catena, Fausto; Memeo, Riccardo; Coccolini, Federico; Martínez-Pérez, Aleix; Romeo, Oreste M.; De Simone, Belinda; Di Saverio, Salomone; Brustia, Raffaele; Rhaiem, Rami; Piardi, Tullio; Conticchio, Maria; Marchegiani, Francesco; Beghdadi, Nassiba; Abu-Zidan, Fikri M.; Alikhanov, Ruslan; Allard, Marc-Antoine; Allievi, Niccolò; Amaddeo, Giuliana; Ansaloni, Luca; Andersson, Roland; Andolfi, Enrico; Azfar, Mohammad; Bala, Miklosh; Benkabbou, Amine; Ben-Ishay, Offir; Bianchi, Giorgio; Biffl, Walter L.; Brunetti, Francesco; Carra, Maria C.; Casanova, Daniel; Celentano, Valerio; Ceresoli, Marco; Chiara, Osvaldo; Cimbanassi, Stefania; Bini, Roberto; Coimbra, Raul; Luigi de’Angelis, Gian; Decembrino, Francesco; De Palma, Andrea; de Reuver, Philip R.; Domingo, Carlos; Cotsoglou, Christian; Ferrero, Alessandro; Fraga, Gustavo P.; Gaiani, Federica; Gheza, Federico; Gurrado, Angela; Harrison, Ewen; Henriquez, Angel; Hofmeyr, Stefan; Iadarola, Roberta; Kashuk, Jeffry L.; Kianmanesh, Reza; Kirkpatrick, Andrew W.; Kluger, Yoram; Landi, Filippo; Langella, Serena; Lapointe, Real; Le Roy, Bertrand; Luciani, Alain; Machado, Fernando; Maggi, Umberto; Maier, Ronald V.; Mefire, Alain C.; Hiramatsu, Kazuhiro; Ordoñez, Carlos; Patrizi, Franca; Planells, Manuel; Peitzman, Andrew B.; Pekolj, Juan; Perdigao, Fabiano; Pereira, Bruno M.; Pessaux, Patrick; Pisano, Michele; Puyana, Juan C.; Rizoli, Sandro; Portigliotti, Luca; Romito, Raffaele; Sakakushev, Boris; Sanei, Behnam; Scatton, Olivier; Serradilla-Martin, Mario; Schneck, Anne-Sophie; Sissoko, Mohammed L.; Sobhani, Iradj; ten Broek, Richard P.; Testini, Mario; Valinas, Roberto; Veloudis, Giorgos; Vitali, Giulio C.; Weber, Dieter; Zorcolo, Luigi; Giuliante, Felice; Gavriilidis, Paschalis; Fuks, David; Sommacale, DanieleAbstract Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4–1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.Item Open Access A pandemic recap: lessons we have learned(2021-09-10) Coccolini, Federico; Cicuttin, Enrico; Cremonini, Camilla; Tartaglia, Dario; Viaggi, Bruno; Kuriyama, Akira; Picetti, Edoardo; Ball, Chad; Abu-Zidan, Fikri; Ceresoli, Marco; Turri, Bruno; Jain, Sumita; Palombo, Carlo; Guirao, Xavier; Rodrigues, Gabriel; Gachabayov, Mahir; Machado, Fernando; Eftychios, Lostoridis; Kanj, Souha S.; Di Carlo, Isidoro; Di Saverio, Salomone; Khokha, Vladimir; Kirkpatrick, Andrew; Massalou, Damien; Forfori, Francesco; Corradi, Francesco; Delibegovic, Samir; Machain Vega, Gustavo M.; Fantoni, Massimo; Demetriades, Demetrios; Kapoor, Garima; Kluger, Yoram; Ansari, Shamshul; Maier, Ron; Leppaniemi, Ari; Hardcastle, Timothy; Vereczkei, Andras; Karamagioli, Evika; Pikoulis, Emmanouil; Pistello, Mauro; Sakakushev, Boris E.; Navsaria, Pradeep H.; Galeiras, Rita; Yahya, Ali I.; Osipov, Aleksei V.; Dimitrov, Evgeni; Doklestić, Krstina; Pisano, Michele; Malacarne, Paolo; Carcoforo, Paolo; Sibilla, Maria G.; Kryvoruchko, Igor A.; Bonavina, Luigi; Kim, Jae I.; Shelat, Vishal G.; Czepiel, Jacek; Maseda, Emilio; Marwah, Sanjay; Chirica, Mircea; Biancofiore, Giandomenico; Podda, Mauro; Cobianchi, Lorenzo; Ansaloni, Luca; Fugazzola, Paola; Seretis, Charalampos; Gomez, Carlos A.; Tumietto, Fabio; Malbrain, Manu; Reichert, Martin; Augustin, Goran; Amato, Bruno; Puzziello, Alessandro; Hecker, Andreas; Gemignani, Angelo; Isik, Arda; Cucchetti, Alessandro; Nacoti, Mirco; Kopelman, Doron; Mesina, Cristian; Ghannam, Wagih; Ben-Ishay, Offir; Dhingra, Sameer; Coimbra, Raul; Moore, Ernest E.; Cui, Yunfeng; Quiodettis, Martha A.; Bala, Miklosh; Testini, Mario; Diaz, Jose; Girardis, Massimo; Biffl, Walter L.; Hecker, Matthias; Sall, Ibrahima; Boggi, Ugo; Materazzi, Gabriele; Ghiadoni, Lorenzo; Matsumoto, Junichi; Zuidema, Wietse P.; Ivatury, Rao; Enani, Mushira A.; Litvin, Andrey; Al-Hasan, Majdi N.; Demetrashvili, Zaza; Baraket, Oussama; Ordoñez, Carlos A.; Negoi, Ionut; Kiguba, Ronald; Memish, Ziad A.; Elmangory, Mutasim M.; Tolonen, Matti; Das, Korey; Ribeiro, Julival; O’Connor, Donal B.; Tan, Boun K.; Van Goor, Harry; Baral, Suman; De Simone, Belinda; Corbella, Davide; Brambillasca, Pietro; Scaglione, Michelangelo; Basolo, Fulvio; De’Angelis, Nicola; Bendinelli, Cino; Weber, Dieter; Pagani, Leonardo; Monti, Cinzia; Baiocchi, Gianluca; Chiarugi, Massimo; Catena, Fausto; Sartelli, MassimoAbstract On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.Item Open Access Correction: ECLAPTE: Effective Closure of LAParoTomy in Emergency—2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings(2023-11-27) Frassini, Simone; Cobianchi, Lorenzo; Fugazzola, Paola; Biffl, Walter L.; Coccolini, Federico; Damaskos, Dimitrios; Moore, Ernest E.; Kluger, Yoram; Ceresoli, Marco; Coimbra, Raul; Davies, Justin; Kirkpatrick, Andrew; Di Carlo, Isidoro; Hardcastle, Timothy C.; Isik, Arda; Chiarugi, Massimo; Gurusamy, Kurinchi; Maier, Ronald V.; Segovia Lohse, Helmut A.; Jeekel, Hans; Boermeester, Marja A.; Abu-Zidan, Fikri; Inaba, Kenji; Weber, Dieter G.; Augustin, Goran; Bonavina, Luigi; Velmahos, George; Sartelli, Massimo; Di Saverio, Salomone; Ten Broek, Richard P. G.; Granieri, Stefano; Dal Mas, Francesca; Farè, Camilla N.; Peverada, Jacopo; Zanghì, Simone; Viganò, Jacopo; Tomasoni, Matteo; Dominioni, Tommaso; Cicuttin, Enrico; Hecker, Andreas; Tebala, Giovanni D.; Galante, Joseph M.; Wani, Imtiaz; Khokha, Vladimir; Sugrue, Michael; Scalea, Thomas M.; Tan, Edward; Malangoni, Mark A.; Pararas, Nikolaos; Podda, Mauro; De Simone, Belinda; Ivatury, Rao; Cui, Yunfeng; Kashuk, Jeffry; Peitzman, Andrew; Kim, Fernando; Pikoulis, Emmanouil; Sganga, Gabriele; Chiara, Osvaldo; Kelly, Michael D.; Marzi, Ingo; Picetti, Edoardo; Agnoletti, Vanni; De’Angelis, Nicola; Campanelli, Giampiero; de Moya, Marc; Litvin, Andrey; Martínez-Pérez, Aleix; Sall, Ibrahima; Rizoli, Sandro; Tomadze, Gia; Sakakushev, Boris; Stahel, Philip F.; Civil, Ian; Shelat, Vishal; Costa, David; Chichom-Mefire, Alain; Latifi, Rifat; Chirica, Mircea; Amico, Francesco; Pardhan, Amyn; Seenarain, Vidya; Boyapati, Nikitha; Hatz, Basil; Ackermann, Travis; Abeyasundara, Sandun; Fenton, Linda; Plani, Frank; Sarvepalli, Rohit; Rouhbakhshfar, Omid; Caleo, Pamela; Ho-Ching Yau, Victor; Clement, Kristenne; Christou, Erasmia; Castillo, Ana M. G.; Gosal, Preet K. S.; Balasubramaniam, Sunder; Hsu, Jeremy; Banphawatanarak, Kamon; Pisano, Michele; Toro, Adriana; Michele, Altomare; Cioffi, Stefano P. B.; Spota, Andrea; Catena, Fausto; Ansaloni, LucaItem Open Access Early management of adult traumatic spinal cord injury in patients with polytrauma: a consensus and clinical recommendations jointly developed by the World Society of Emergency Surgery (WSES) & the European Association of Neurosurgical Societies (EANS)(2024-01-18) Picetti, Edoardo; Demetriades, Andreas K.; Catena, Fausto; Aarabi, Bizhan; Abu-Zidan, Fikri M.; Alves, Oscar L.; Ansaloni, Luca; Armonda, Rocco A.; Badenes, Rafael; Bala, Miklosh; Balogh, Zsolt J.; Barbanera, Andrea; Bertuccio, Alessandro; Biffl, Walter L.; Bouzat, Pierre; Buki, Andras; Castano-Leon, Ana M.; Cerasti, Davide; Citerio, Giuseppe; Coccolini, Federico; Coimbra, Raul; Coniglio, Carlo; Costa, Francesco; De Iure, Federico; Depreitere, Bart; Fainardi, Enrico; Fehlings, Michael J.; Gabrovsky, Nikolay; Godoy, Daniel A.; Gruen, Peter; Gupta, Deepak; Hawryluk, Gregory W. J.; Helbok, Raimund; Hossain, Iftakher; Hutchinson, Peter J.; Iaccarino, Corrado; Inaba, Kenji; Ivanov, Marcel; Kaprovoy, Stanislav; Kirkpatrick, Andrew W.; Klein, Sam; Kolias, Angelos; Konovalov, Nikolay A.; Lagares, Alfonso; Lippa, Laura; Loza-Gomez, Angelica; Luoto, Teemu M.; Maas, Andrew I. R.; Maciejczak, Andrzej; Maier, Ronald V.; Marklund, Niklas; Martin, Matthew J.; Melloni, Ilaria; Mendoza-Lattes, Sergio; Meyfroidt, Geert; Munari, Marina; Napolitano, Lena M.; Okonkwo, David O.; Otomo, Yasuhiro; Papadopoulos, Marios C.; Petr, Ondra; Peul, Wilco C.; Pudkrong, Aichholz K.; Qasim, Zaffer; Rasulo, Frank; Reizinho, Carla; Ringel, Florian; Rizoli, Sandro; Rostami, Elham; Rubiano, Andres M.; Russo, Emanuele; Sarwal, Aarti; Schwab, Jan M.; Servadei, Franco; Sharma, Deepak; Sharif, Salman; Shiban, Ehab; Shutter, Lori; Stahel, Philip F.; Taccone, Fabio S.; Terpolilli, Nicole A.; Thomé, Claudius; Toth, Peter; Tsitsopoulos, Parmenion P.; Udy, Andrew; Vaccaro, Alexander R.; Varon, Albert J.; Vavilala, Monica S.; Younsi, Alexander; Zackova, Monika; Zoerle, Tommaso; Robba, ChiaraAbstract Background The early management of polytrauma patients with traumatic spinal cord injury (tSCI) is a major challenge. Sparse data is available to provide optimal care in this scenario and worldwide variability in clinical practice has been documented in recent studies. Methods A multidisciplinary consensus panel of physicians selected for their established clinical and scientific expertise in the acute management of tSCI polytrauma patients with different specializations was established. The World Society of Emergency Surgery (WSES) and the European Association of Neurosurgical Societies (EANS) endorsed the consensus, and a modified Delphi approach was adopted. Results A total of 17 statements were proposed and discussed. A consensus was reached generating 17 recommendations (16 strong and 1 weak). Conclusions This consensus provides practical recommendations to support a clinician’s decision making in the management of tSCI polytrauma patients.Item Open Access ECLAPTE: Effective Closure of LAParoTomy in Emergency—2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings(2023-07-26) Frassini, Simone; Cobianchi, Lorenzo; Fugazzola, Paola; Biffl, Walter L.; Coccolini, Federico; Damaskos, Dimitrios; Moore, Ernest E.; Kluger, Yoram; Ceresoli, Marco; Coimbra, Raul; Davies, Justin; Kirkpatrick, Andrew; Di Carlo, Isidoro; Hardcastle, Timothy C.; Isik, Arda; Chiarugi, Massimo; Gurusamy, Kurinchi; Maier, Ronald V.; Segovia Lohse, Helmut A.; Jeekel, Hans; Boermeester, Marja A.; Abu-Zidan, Fikri; Inaba, Kenji; Weber, Dieter G.; Augustin, Goran; Bonavina, Luigi; Velmahos, George; Sartelli, Massimo; Di Saverio, Salomone; Ten Broek, Richard P. G.; Granieri, Stefano; Dal Mas, Francesca; Farè, Camilla N.; Peverada, Jacopo; Zanghì, Simone; Viganò, Jacopo; Tomasoni, Matteo; Dominioni, Tommaso; Cicuttin, Enrico; Hecker, Andreas; Tebala, Giovanni D.; Galante, Joseph M.; Wani, Imtiaz; Khokha, Vladimir; Sugrue, Michael; Scalea, Thomas M.; Tan, Edward; Malangoni, Mark A.; Pararas, Nikolaos; Podda, Mauro; De Simone, Belinda; Ivatury, Rao; Cui, Yunfeng; Kashuk, Jeffry; Peitzman, Andrew; Kim, Fernando; Pikoulis, Emmanouil; Sganga, Gabriele; Chiara, Osvaldo; Kelly, Michael D.; Marzi, Ingo; Picetti, Edoardo; Agnoletti, Vanni; De’Angelis, Nicola; Campanelli, Giampiero; de Moya, Marc; Litvin, Andrey; Martínez-Pérez, Aleix; Sall, Ibrahima; Rizoli, Sandro; Tomadze, Gia; Sakakushev, Boris; Stahel, Philip F.; Civil, Ian; Shelat, Vishal; Costa, David; Chichom-Mefire, Alain; Latifi, Rifat; Chirica, Mircea; Amico, Francesco; Pardhan, Amyn; Seenarain, Vidya; Boyapati, Nikitha; Hatz, Basil; Ackermann, Travis; Abeyasundara, Sandun; Fenton, Linda; Plani, Frank; Sarvepalli, Rohit; Rouhbakhshfar, Omid; Caleo, Pamela; Ho-Ching Yau, Victor; Clement, Kristenne; Christou, Erasmia; Castillo, Ana M. G.; Gosal, Preet K. S.; Balasubramaniam, Sunder; Hsu, Jeremy; Banphawatanarak, Kamon; Pisano, Michele; Adriana, Toro; Michele, Altomare; Cioffi, Stefano P. B.; Spota, Andrea; Catena, Fausto; Ansaloni, LucaAbstract Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy.Item Open Access Strategies to prevent blood loss and reduce transfusion in emergency general surgery, WSES-AAST consensus paper(2024-07-16) Coccolini, Federico; Shander, Aryeh; Ceresoli, Marco; Moore, Ernest; Tian, Brian; Parini, Dario; Sartelli, Massimo; Sakakushev, Boris; Doklestich, Krstina; Abu-Zidan, Fikri; Horer, Tal; Shelat, Vishal; Hardcastle, Timothy; Bignami, Elena; Kirkpatrick, Andrew; Weber, Dieter; Kryvoruchko, Igor; Leppaniemi, Ari; Tan, Edward; Kessel, Boris; Isik, Arda; Cremonini, Camilla; Forfori, Francesco; Ghiadoni, Lorenzo; Chiarugi, Massimo; Ball, Chad; Ottolino, Pablo; Hecker, Andreas; Mariani, Diego; Melai, Ettore; Malbrain, Manu; Agostini, Vanessa; Podda, Mauro; Picetti, Edoardo; Kluger, Yoram; Rizoli, Sandro; Litvin, Andrey; Maier, Ron; Beka, Solomon G.; De Simone, Belinda; Bala, Miklosh; Perez, Aleix M.; Ordonez, Carlos; Bodnaruk, Zenon; Cui, Yunfeng; Calatayud, Augusto P.; de Angelis, Nicola; Amico, Francesco; Pikoulis, Emmanouil; Damaskos, Dimitris; Coimbra, Raul; Chirica, Mircea; Biffl, Walter L.; Catena, FaustoAbstract Emergency general surgeons often provide care to severely ill patients requiring surgical interventions and intensive support. One of the primary drivers of morbidity and mortality is perioperative bleeding. In general, when addressing life threatening haemorrhage, blood transfusion can become an essential part of overall resuscitation. However, under all circumstances, indications for blood transfusion must be accurately evaluated. When patients decline blood transfusions, regardless of the reason, surgeons should aim to provide optimal care and respect and accommodate each patient’s values and target the best outcome possible given the patient’s desires and his/her clinical condition. The aim of this position paper was to perform a review of the existing literature and to provide comprehensive recommendations on organizational, surgical, anaesthetic, and haemostatic strategies that can be used to provide optimal peri-operative blood management, reduce, or avoid blood transfusions and ultimately improve patient outcomes.Item Open Access Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper(2024-10-18) Sermonesi, Giacomo; Bertelli, Riccardo; Pieracci, Fredric M.; Balogh, Zsolt J.; Coimbra, Raul; Galante, Joseph M.; Hecker, Andreas; Weber, Dieter; Bauman, Zachary M.; Kartiko, Susan; Patel, Bhavik; Whitbeck, SarahAnn S.; White, Thomas W.; Harrell, Kevin N.; Perrina, Daniele; Rampini, Alessia; Tian, Brian; Amico, Francesco; Beka, Solomon G.; Bonavina, Luigi; Ceresoli, Marco; Cobianchi, Lorenzo; Coccolini, Federico; Cui, Yunfeng; Dal Mas, Francesca; De Simone, Belinda; Di Carlo, Isidoro; Di Saverio, Salomone; Dogjani, Agron; Fette, Andreas; Fraga, Gustavo P.; Gomes, Carlos A.; Khan, Jim S.; Kirkpatrick, Andrew W.; Kruger, Vitor F.; Leppäniemi, Ari; Litvin, Andrey; Mingoli, Andrea; Navarro, David C.; Passera, Eliseo; Pisano, Michele; Podda, Mauro; Russo, Emanuele; Sakakushev, Boris; Santonastaso, Domenico; Sartelli, Massimo; Shelat, Vishal G.; Tan, Edward; Wani, Imtiaz; Abu-Zidan, Fikri M.; Biffl, Walter L.; Civil, Ian; Latifi, Rifat; Marzi, Ingo; Picetti, Edoardo; Pikoulis, Manos; Agnoletti, Vanni; Bravi, Francesca; Vallicelli, Carlo; Ansaloni, Luca; Moore, Ernest E.; Catena, FaustoAbstract Background Rib fractures are one of the most common traumatic injuries and may result in significant morbidity and mortality. Despite growing evidence, technological advances and increasing acceptance, surgical stabilization of rib fractures (SSRF) remains not uniformly considered in trauma centers. Indications, contraindications, appropriate timing, surgical approaches and utilized implants are part of an ongoing debate. The present position paper, which is endorsed by the World Society of Emergency Surgery (WSES), and supported by the Chest Wall Injury Society, aims to provide a review of the literature investigating the use of SSRF in rib fracture management to develop graded position statements, providing an updated guide and reference for SSRF. Methods This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of experts then critically revised the manuscript and discussed it in detail, to develop a consensus on the position statements. Results A total of 287 studies (systematic reviews, randomized clinical trial, prospective and retrospective comparative studies, case series, original articles) have been selected from an initial pool of 9928 studies. Thirty-nine graded position statements were put forward to address eight crucial aspects of SSRF: surgical indications, contraindications, optimal timing of surgery, preoperative imaging evaluation, rib fracture sites for surgical fixation, management of concurrent thoracic injuries, surgical approach, stabilization methods and material selection. Conclusion This consensus document addresses the key focus questions on surgical treatment of rib fractures. The expert recommendations clarify current evidences on SSRF indications, timing, operative planning, approaches and techniques, with the aim to guide clinicians in optimizing the management of rib fractures, to improve patient outcomes and direct future research.Item Open Access The 2023 WSES guidelines on the management of trauma in elderly and frail patients(2024-05-31) De Simone, Belinda; Chouillard, Elie; Podda, Mauro; Pararas, Nikolaos; de Carvalho Duarte, Gustavo; Fugazzola, Paola; Birindelli, Arianna; Coccolini, Federico; Polistena, Andrea; Sibilla, Maria G.; Kruger, Vitor; Fraga, Gustavo P.; Montori, Giulia; Russo, Emanuele; Pintar, Tadeja; Ansaloni, Luca; Avenia, Nicola; Di Saverio, Salomone; Leppäniemi, Ari; Lauretta, Andrea; Sartelli, Massimo; Puzziello, Alessandro; Carcoforo, Paolo; Agnoletti, Vanni; Bissoni, Luca; Isik, Arda; Kluger, Yoram; Moore, Ernest E.; Romeo, Oreste M.; Abu-Zidan, Fikri M.; Beka, Solomon G.; Weber, Dieter G.; Tan, Edward C. T. H.; Paolillo, Ciro; Cui, Yunfeng; Kim, Fernando; Picetti, Edoardo; Di Carlo, Isidoro; Toro, Adriana; Sganga, Gabriele; Sganga, Federica; Testini, Mario; Di Meo, Giovanna; Kirkpatrick, Andrew W.; Marzi, Ingo; déAngelis, Nicola; Kelly, Michael D.; Wani, Imtiaz; Sakakushev, Boris; Bala, Miklosh; Bonavina, Luigi; Galante, Joseph M.; Shelat, Vishal G.; Cobianchi, Lorenzo; Mas, Francesca D.; Pikoulis, Manos; Damaskos, Dimitrios; Coimbra, Raul; Dhesi, Jugdeep; Hoffman, Melissa R.; Stahel, Philip F.; Maier, Ronald V.; Litvin, Andrey; Latifi, Rifat; Biffl, Walter L.; Catena, FaustoAbstract Background The trauma mortality rate is higher in the elderly compared with younger patients. Ageing is associated with physiological changes in multiple systems and correlated with frailty. Frailty is a risk factor for mortality in elderly trauma patients. We aim to provide evidence-based guidelines for the management of geriatric trauma patients to improve it and reduce futile procedures. Methods Six working groups of expert acute care and trauma surgeons reviewed extensively the literature according to the topic and the PICO question assigned. Statements and recommendations were assessed according to the GRADE methodology and approved by a consensus of experts in the field at the 10th international congress of the WSES in 2023. Results The management of elderly trauma patients requires knowledge of ageing physiology, a focused triage, including drug history, frailty assessment, nutritional status, and early activation of trauma protocol to improve outcomes. Acute trauma pain in the elderly has to be managed in a multimodal analgesic approach, to avoid side effects of opioid use. Antibiotic prophylaxis is recommended in penetrating (abdominal, thoracic) trauma, in severely burned and in open fractures elderly patients to decrease septic complications. Antibiotics are not recommended in blunt trauma in the absence of signs of sepsis and septic shock. Venous thromboembolism prophylaxis with LMWH or UFH should be administrated as soon as possible in high and moderate-risk elderly trauma patients according to the renal function, weight of the patient and bleeding risk. A palliative care team should be involved as soon as possible to discuss the end of life in a multidisciplinary approach considering the patient’s directives, family feelings and representatives' desires, and all decisions should be shared. Conclusions The management of elderly trauma patients requires knowledge of ageing physiology, a focused triage based on assessing frailty and early activation of trauma protocol to improve outcomes. Geriatric Intensive Care Units are needed to care for elderly and frail trauma patients in a multidisciplinary approach to decrease mortality and improve outcomes. Graphical abstractItem Open Access The ChoCO-W prospective observational global study: Does COVID-19 increase gangrenous cholecystitis?(2022-12-16) De Simone, Belinda; Abu-Zidan, Fikri M.; Chouillard, Elie; Di Saverio, Salomone; Sartelli, Massimo; Podda, Mauro; Gomes, Carlos A.; Moore, Ernest E.; Moug, Susan J.; Ansaloni, Luca; Kluger, Yoram; Coccolini, Federico; Landaluce-Olavarria, Aitor; Estraviz-Mateos, Begoña; Uriguen-Etxeberria, Ana; Giordano, Alessio; Luna, Alfonso P.; Amín, Luz A. H.; Hernández, Adriana M. P.; Shabana, Amanda; Dzulkarnaen, Zakaria A.; Othman, Muhammad A.; Sani, Mohamad I.; Balla, Andrea; Scaramuzzo, Rosa; Lepiane, Pasquale; Bottari, Andrea; Staderini, Fabio; Cianchi, Fabio; Cavallaro, Andrea; Zanghì, Antonio; Cappellani, Alessandro; Campagnacci, Roberto; Maurizi, Angela; Martinotti, Mario; Ruggieri, Annamaria; Jusoh, Asri C.; Rahman, Karim A.; Zulkifli, Anis S. M.; Petronio, Barbara; Matías-García, Belén; Quiroga-Valcárcel, Ana; Mendoza-Moreno, Fernando; Atanasov, Boyko; Campanile, Fabio C.; Vecchioni, Ilaria; Cardinali, Luca; Travaglini, Grazia; Sebastiani, Elisa; Chooklin, Serge; Chuklin, Serhii; Cianci, Pasquale; Restini, Enrico; Capuzzolo, Sabino; Currò, Giuseppe; Filippo, Rosalinda; Rispoli, Michele; Aparicio-Sánchez, Daniel; Muñóz-Cruzado, Virginia D.; Barbeito, Sandra D.; Delibegovic, Samir; Kesetovic, Amar; Sasia, Diego; Borghi, Felice; Giraudo, Giorgio; Visconti, Diego; Doria, Emanuele; Santarelli, Mauro; Luppi, Davide; Bonilauri, Stefano; Grossi, Ugo; Zanus, Giacomo; Sartori, Alberto; Piatto, Giacomo; De Luca, Maurizio; Vita, Domenico; Conti, Luigi; Capelli, Patrizio; Cattaneo, Gaetano M.; Marinis, Athanasios; Vederaki, Styliani-Aikaterini; Bayrak, Mehmet; Altıntas, Yasemin; Uzunoglu, Mustafa Y.; Demirbas, Iskender E.; Altinel, Yuksel; Meric, Serhat; Aktimur, Yunus E.; Uymaz, Derya S.; Omarov, Nail; Azamat, Ibrahim; Lostoridis, Eftychios; Nagorni, Eleni-Aikaterini; Pujante, Antonio; Anania, Gabriele; Bombardini, Cristina; Bagolini, Francesco; Gonullu, Emre; Mantoglu, Baris; Capoglu, Recayi; Cappato, Stefano; Muzio, Elena; Colak, Elif; Polat, Suleyman; Koylu, Zehra A.; Altintoprak, Fatih; Bayhan, Zülfü; Akin, Emrah; Andolfi, Enrico; Rezart, Sulce; Kim, Jae I.; Jung, Sung W.; Shin, Yong C.; Enciu, Octavian; Toma, Elena A.; Medas, Fabio; Canu, Gian L.; Cappellacci, Federico; D’Acapito, Fabrizio; Ercolani, Giorgio; Solaini, Leonardo; Roscio, Francesco; Clerici, Federico; Gelmini, Roberta; Serra, Francesco; Rossi, Elena G.; Fleres, Francesco; Clarizia, Guglielmo; Spolini, Alessandro; Ferrara, Francesco; Nita, Gabriela; Sarnari, Jlenia; Gachabayov, Mahir; Abdullaev, Abakar; Poillucci, Gaetano; Palini, Gian M.; Veneroni, Simone; Garulli, Gianluca; Piccoli, Micaela; Pattacini, Gianmaria C.; Pecchini, Francesca; Argenio, Giulio; Armellino, Mariano F.; Brisinda, Giuseppe; Tedesco, Silvia; Fransvea, Pietro; Ietto, Giuseppe; Franchi, Caterina; Carcano, Giulio; Martines, Gennaro; Trigiante, Giuseppe; Negro, Giulia; Vega, Gustavo M.; González, Agustín R.; Ojeda, Leonardo; Piccolo, Gaetano; Bondurri, Andrea; Maffioli, Anna; Guerci, Claudio; Sin, Boo H.; Zuhdi, Zamri; Azman, Azlanudin; Mousa, Hussam; al Bahri, Shadi; Augustin, Goran; Romic, Ivan; Moric, Trpimir; Nikolopoulos, Ioannis; Andreuccetti, Jacopo; Pignata, Giusto; D’Alessio, Rossella; Kenig, Jakub; Skorus, Urszula; Fraga, Gustavo P.; Hirano, Elcio S.; de Lima Bertuol, Jackson V.; Isik, Arda; Kurnaz, Eray; Asghar, Mohammad S.; Afzal, Ameer; Akbar, Ali; Nikolouzakis, Taxiarchis K.; Lasithiotakis, Konstantinos; Chrysos, Emmanuel; Das, Koray; Özer, Nazmi; Seker, Ahmet; Ibrahim, Mohamed; Hamid, Hytham K. S.; Babiker, Ahmed; Bouliaris, Konstantinos; Koukoulis, George; Kolla, Chrysoula-Christina; Lucchi, Andrea; Agostinelli, Laura; Taddei, Antonio; Fortuna, Laura; Agostini, Carlotta; Licari, Leo; Viola, Simona; Callari, Cosimo; Laface, Letizia; Abate, Emmanuele; Casati, Massimiliano; Anastasi, Alessandro; Canonico, Giuseppe; Gabellini, Linda; Tosi, Lorenzo; Guariniello, Anna; Zanzi, Federico; Bains, Lovenish; Sydorchuk, Larysa; Iftoda, Oksana; Sydorchuk, Andrii; Malerba, Michele; Costanzo, Federico; Galleano, Raffaele; Monteleone, Michela; Costanzi, Andrea; Riva, Carlo; Walędziak, Maciej; Kwiatkowski, Andrzej; Czyżykowski, Łukasz; Major, Piotr; Strzałka, Marcin; Matyja, Maciej; Natkaniec, Michal; Valenti, Maria R.; Di Vita, Maria D. P.; Sotiropoulou, Maria; Kapiris, Stylianos; Massalou, Damien; Veroux, Massimiliano; Volpicelli, Alessio; Gioco, Rossella; Uccelli, Matteo; Bonaldi, Marta; Olmi, Stefano; Nardi, Matteo; Livadoti, Giada; Mesina, Cristian; Dumitrescu, Theodor V.; Ciorbagiu, Mihai C.; Ammendola, Michele; Ammerata, Giorgio; Romano, Roberto; Slavchev, Mihail; Misiakos, Evangelos P.; Pikoulis, Emmanouil; Papaconstantinou, Dimitrios; Elbahnasawy, Mohamed; Abdel-elsalam, Sherief; Felsenreich, Daniel M.; Jedamzik, Julia; Michalopoulos, Nikolaos V.; Sidiropoulos, Theodoros A.; Papadoliopoulou, Maria; Cillara, Nicola; Deserra, Antonello; Cannavera, Alessandro; Negoi, Ionuţ; Schizas, Dimitrios; Syllaios, Athanasios; Vagios, Ilias; Gourgiotis, Stavros; Dai, Nick; Gurung, Rekha; Norrey, Marcus; Pesce, Antonio; Feo, Carlo V.; Fabbri, Nicolo’; Machairas, Nikolaos; Dorovinis, Panagiotis; Keramida, Myrto D.; Mulita, Francesk; Verras, Georgios I.; Vailas, Michail; Yalkin, Omer; Iflazoglu, Nidal; Yigit, Direnc; Baraket, Oussama; Ayed, Karim; Ghalloussi, Mohamed h.; Patias, Parmenion; Ntokos, Georgios; Rahim, Razrim; Bala, Miklosh; Kedar, Asaf; Sawyer, Robert G.; Trinh, Anna; Miller, Kelsey; Sydorchuk, Ruslan; Knut, Ruslan; Plehutsa, Oleksandr; Liman, Rumeysa K.; Ozkan, Zeynep; Kader, Saleh A.; Gupta, Sanjay; Gureh, Monika; Saeidi, Sara; Aliakbarian, Mohsen; Dalili, Amin; Shoko, Tomohisa; Kojima, Mitsuaki; Nakamoto, Raira; Atici, Semra D.; Tuncer, Gizem K.; Kaya, Tayfun; Delis, Spiros G.; Rossi, Stefano; Picardi, Biagio; del Monte, Simone R.; Triantafyllou, Tania; Theodorou, Dimitrios; Pintar, Tadeja; Salobir, Jure; Manatakis, Dimitrios K.; Tasis, Nikolaos; Acheimastos, Vasileios; Ioannidis, Orestis; Loutzidou, Lydia; Symeonidis, Savvas; de Sá, Tiago C.; Rocha, Mónica; Guagni, Tommaso; Pantalone, Desiré; Maltinti, Gherardo; Khokha, Vladimir; Abdel-elsalam, Wafaa; Ghoneim, Basma; López-Ruiz, José A.; Kara, Yasin; Zainudin, Syaza; Hayati, Firdaus; Azizan, Nornazirah; Khei, Victoria T. P.; Yi, Rebecca C. X.; Sellappan, Harivinthan; Demetrashvili, Zaza; Lekiashvili, Nika; Tvaladze, Ana; Froiio, Caterina; Bernardi, Daniele; Bonavina, Luigi; Gil-Olarte, Angeles; Grassia, Sebastiano; Romero-Vargas, Estela; Bianco, Francesco; Gumbs, Andrew A.; Dogjani, Agron; Agresta, Ferdinando; Litvin, Andrey; Balogh, Zsolt J.; Gendrikson, George; Martino, Costanza; Damaskos, Dimitrios; Pararas, Nikolaos; Kirkpatrick, Andrew; Kurtenkov, Mikhail; Gomes, Felipe C.; Pisanu, Adolfo; Nardello, Oreste; Gambarini, Fabrizio; Aref, Hager; Angelis, Nicola d.; Agnoletti, Vanni; Biondi, Antonio; Vacante, Marco; Griggio, Giulia; Tutino, Roberta; Massani, Marco; Bisetto, Giovanni; Occhionorelli, Savino; Andreotti, Dario; Lacavalla, Domenico; Biffl, Walter L.; Catena, FaustoAbstract Background The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. Methods Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. Results A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p < 0.0001), diabetes (p < 0.0001), and severe chronic obstructive airway disease (p = 0.005) were significantly more frequent in the COVID-19 group. Markers of sepsis severity including ARDS (p < 0.0001), PIPAS score (p < 0.0001), WSES sepsis score (p < 0.0001), qSOFA (p < 0.0001), and Tokyo classification of severity of acute cholecystitis (p < 0.0001) were significantly higher in the COVID-19 group. The COVID-19 group had significantly higher postoperative complications (32.2% compared with 11.7%, p < 0.0001), longer mean hospital stay (13.21 compared with 6.51 days, p < 0.0001), and mortality rate (13.4% compared with 1.7%, p < 0.0001). The incidence of gangrenous cholecystitis was doubled in the COVID-19 group (40.7% compared with 22.3%). The mean wall thickness of the gallbladder was significantly higher in the COVID-19 group [6.32 (SD: 2.44) mm compared with 5.4 (SD: 3.45) mm; p < 0.0001]. Conclusions The incidence of gangrenous cholecystitis is higher in COVID patients compared with non-COVID patients admitted to the emergency department with acute cholecystitis. Gangrenous cholecystitis in COVID patients is associated with high-grade Clavien-Dindo postoperative complications, longer hospital stay and higher mortality rate. The open cholecystectomy rate is higher in COVID compared with non -COVID patients. It is recommended to delay the surgical treatment in COVID patients, when it is possible, to decrease morbidity and mortality rates. COVID-19 infection and gangrenous cholecystistis are not absolute contraindications to perform laparoscopic cholecystectomy, in a case by case evaluation, in expert hands. Graphical abstractItem Open Access The LIFE TRIAD of emergency general surgery(2022-07-25) Coccolini, Federico; Sartelli, Massimo; Kluger, Yoram; Osipov, Aleksei; Cui, Yunfeng; Beka, Solomon G.; Kirkpatrick, Andrew; Sall, Ibrahima; Moore, Ernest E.; Biffl, Walter L.; Litvin, Andrey; Pisano, Michele; Magnone, Stefano; Picetti, Edoardo; de Angelis, Nicola; Stahel, Philip; Ansaloni, Luca; Tan, Edward; Abu-Zidan, Fikri; Ceresoli, Marco; Hecker, Andreas; Chiara, Osvaldo; Sganga, Gabriele; Khokha, Vladimir; di Saverio, Salomone; Sakakushev, Boris; Campanelli, Giampiero; Fraga, Gustavo; Wani, Imtiaz; Broek, Richard t.; Cicuttin, Enrico; Cremonini, Camilla; Tartaglia, Dario; Soreide, Kjetil; Galante, Joseph; de Moya, Marc; Koike, Kaoru; De Simone, Belinda; Balogh, Zsolt; Amico, Francesco; Shelat, Vishal; Pikoulis, Emmanouil; Di Carlo, Isidoro; Bonavina, Luigi; Leppaniemi, Ari; Marzi, Ingo; Ivatury, Rao; Khan, Jim; Maier, Ronald V.; Hardcastle, Timothy C.; Isik, Arda; Podda, Mauro; Tolonen, Matti; Rasa, Kemal; Navsaria, Pradeep H.; Demetrashvili, Zaza; Tarasconi, Antonio; Carcoforo, Paolo; Sibilla, Maria G.; Baiocchi, Gian L.; Pararas, Nikolaos; Weber, Dieter; Chiarugi, Massimo; Catena, FaustoAbstract Emergency General Surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and non-traumatic acute conditions during the same admission in the hospital by general emergency surgeons and other specialists. It is the most diffused surgical discipline in the world. To live and grow strong EGS necessitates three fundamental parts: emergency and elective continuous surgical practice, evidence generation through clinical registries and data accrual, and indications and guidelines production: the LIFE TRIAD.Item Open Access The unrestricted global effort to complete the COOL trial(2023-05-11) Kirkpatrick, Andrew W.; Coccolini, Federico; Tolonen, Matti; Minor, Samuel; Catena, Fausto; Gois, Emanuel; Doig, Christopher J.; Hill, Michael D.; Ansaloni, Luca; Chiarugi, Massimo; Tartaglia, Dario; Ioannidis, Orestis; Sugrue, Michael; Colak, Elif; Hameed, S. M.; Lampela, Hanna; Agnoletti, Vanni; McKee, Jessica L.; Garraway, Naisan; Sartelli, Massimo; Ball, Chad G.; Parry, Neil G.; Voght, Kelly; Julien, Lisa; Kroeker, Jenna; Roberts, Derek J.; Faris, Peter; Tiruta, Corina; Moore, Ernest E.; Ammons, Lee A.; Anestiadou, Elissavet; Bendinelli, Cino; Bouliaris, Konstantinos; Carroll, Rosemarry; Ceresoli, Marco; Favi, Francesco; Gurrado, Angela; Rezende-Neto, Joao; Isik, Arda; Cremonini, Camilla; Strambi, Silivia; Koukoulis, Georgios; Testini, Mario; Trpcic, Sandy; Pasculli, Alessandro; Picariello, Erika; Abu-Zidan, Fikri; Adeyeye, Ademola; Augustin, Goran; Alconchel, Felipe; Altinel, Yuksel; Hernandez Amin, Luz A.; Aranda-Narváez, José M.; Baraket, Oussama; Biffl, Walter L.; Baiocchi, Gian L.; Bonavina, Luigi; Brisinda, Giuseppe; Cardinali, Luca; Celotti, Andrea; Chaouch, Mohamed; Chiarello, Maria; Costa, Gianluca; de’Angelis, Nicola; De Manzini, Nicolo; Delibegovic, Samir; Di Saverio, Salomone; De Simone, Belinda; Dubuisson, Vincent; Fransvea, Pietro; Garulli, Gianluca; Giordano, Alessio; Gomes, Carlos; Hayati, Firdaus; Huang, Jinjian; Ibrahim, Aini F.; Huei, Tan J.; Jailani, Ruhi F.; Khan, Mansoor; Luna, Alfonso P.; Malbrain, Manu L. N. G.; Marwah, Sanjay; McBeth, Paul; Mihailescu, Andrei; Morello, Alessia; Mulita, Francesk; Murzi, Valentina; Mohammad, Ahmad T.; Parmar, Simran; Pak, Ajay; Wong, Michael P.; Pantalone, Desire; Podda, Mauro; Puccioni, Caterina; Rasa, Kemal; Ren, Jianan; Roscio, Francesco; Gonzalez-Sanchez, Antonio; Sganga, Gabriele; Scheiterle, Maximilian; Slavchev, Mihail; Smirnov, Dmitry; Tosi, Lorenzo; Trivedi, Anand; Vega, Jaime A. G.; Waledziak, Maciej; Xenaki, Sofia; Winter, Desmond; Wu, Xiuwen; Zakaria, Andee D.; Zakaria, ZaidiAbstract Background Severe complicated intra-abdominal sepsis (SCIAS) has an increasing incidence with mortality rates over 80% in some settings. Mortality typically results from disruption of the gastrointestinal tract, progressive and self-perpetuating bio-mediator generation, systemic inflammation, and multiple organ failure. A further therapeutic option may be open abdomen (OA) management with negative peritoneal pressure therapy (NPPT) to remove inflammatory ascites and attenuate the systemic damage from SCIAS, although there are definite risks of leaving the abdomen open whenever it might possibly be closed. This potential therapeutic paradigm is the rationale being assessed in the Closed Or Open after Laparotomy (COOL trial) ( https://clinicaltrials.gov/ct2/show/NCT03163095 ). Initially, the COOL trial received Industry sponsorship; however, this funding mandated the use of a specific trademarked and expensive NPPT device in half of the patients allocated to the intervention (open) arm. In August 2022, the 3 M/Acelity Corporation without consultation but within the terms of the contract canceled the financial support of the trial. Although creating financial difficulty, there is now no restriction on specific NPPT devices and removing a cost-prohibitive intervention creates an opportunity to expand the COOL trial to a truly global basis. This document describes the evolution of the COOL trial, with a focus on future opportunities for global growth of the study. Methods The COOL trial is the largest prospective randomized controlled trial examining the random allocation of SCIAS patients intra-operatively to either formal closure of the fascia or the use of the OA with an application of an NPPT dressing. Patients are eligible if they have free uncontained intraperitoneal contamination and physiologic derangements exemplified by septic shock OR severely adverse predicted clinical outcomes. The primary outcome is intended to definitively inform global practice by conclusively evaluating 90-day survival. Initial recruitment has been lower than hoped but satisfactory, and the COOL steering committee and trial investigators intend with increased global support to continue enrollment until recruitment ensures a definitive answer. Discussion OA is mandated in many cases of SCIAS such as the risk of abdominal compartment syndrome associated with closure, or a planned second look as for example part of “damage control”; however, improved source control (locally and systemically) is the most uncertain indication for an OA. The COOL trial seeks to expand potential sites and proceed with the evaluation of NPPT agnostic to device, to properly examine the hypothesis that this treatment attenuates systemic damage and improves survival. This approach will not affect internal validity and should improve the external validity of any observed results of the intervention. Trial registration: National Institutes of Health ( https://clinicaltrials.gov/ct2/show/NCT03163095 ).Item Open Access WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections(2021-09-25) Sartelli, Massimo; Coccolini, Federico; Kluger, Yoram; Agastra, Ervis; Abu-Zidan, Fikri M.; Abbas, Ashraf E. S.; Ansaloni, Luca; Adesunkanmi, Abdulrashid K.; Atanasov, Boyko; Augustin, Goran; Bala, Miklosh; Baraket, Oussama; Baral, Suman; Biffl, Walter L.; Boermeester, Marja A.; Ceresoli, Marco; Cerutti, Elisabetta; Chiara, Osvaldo; Cicuttin, Enrico; Chiarugi, Massimo; Coimbra, Raul; Colak, Elif; Corsi, Daniela; Cortese, Francesco; Cui, Yunfeng; Damaskos, Dimitris; de’ Angelis, Nicola; Delibegovic, Samir; Demetrashvili, Zaza; De Simone, Belinda; de Jonge, Stijn W.; Dhingra, Sameer; Di Bella, Stefano; Di Marzo, Francesco; Di Saverio, Salomone; Dogjani, Agron; Duane, Therese M.; Enani, Mushira A.; Fugazzola, Paola; Galante, Joseph M.; Gachabayov, Mahir; Ghnnam, Wagih; Gkiokas, George; Gomes, Carlos A.; Griffiths, Ewen A.; Hardcastle, Timothy C.; Hecker, Andreas; Herzog, Torsten; Kabir, Syed M. U.; Karamarkovic, Aleksandar; Khokha, Vladimir; Kim, Peter K.; Kim, Jae I.; Kirkpatrick, Andrew W.; Kong, Victor; Koshy, Renol M.; Kryvoruchko, Igor A.; Inaba, Kenji; Isik, Arda; Iskandar, Katia; Ivatury, Rao; Labricciosa, Francesco M.; Lee, Yeong Y.; Leppäniemi, Ari; Litvin, Andrey; Luppi, Davide; Machain, Gustavo M.; Maier, Ronald V.; Marinis, Athanasios; Marmorale, Cristina; Marwah, Sanjay; Mesina, Cristian; Moore, Ernest E.; Moore, Frederick A.; Negoi, Ionut; Olaoye, Iyiade; Ordoñez, Carlos A.; Ouadii, Mouaqit; Peitzman, Andrew B.; Perrone, Gennaro; Pikoulis, Manos; Pintar, Tadeja; Pipitone, Giuseppe; Podda, Mauro; Raşa, Kemal; Ribeiro, Julival; Rodrigues, Gabriel; Rubio-Perez, Ines; Sall, Ibrahima; Sato, Norio; Sawyer, Robert G.; Segovia Lohse, Helmut; Sganga, Gabriele; Shelat, Vishal G.; Stephens, Ian; Sugrue, Michael; Tarasconi, Antonio; Tochie, Joel N.; Tolonen, Matti; Tomadze, Gia; Ulrych, Jan; Vereczkei, Andras; Viaggi, Bruno; Gurioli, Chiara; Casella, Claudio; Pagani, Leonardo; Baiocchi, Gian L.; Catena, FaustoAbstract 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.Item Open Access WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections(2022-01-15) Sartelli, Massimo; Coccolini, Federico; Kluger, Yoram; Agastra, Ervis; Abu-Zidan, Fikri M.; Abbas, Ashraf E. S.; Ansaloni, Luca; Adesunkanmi, Abdulrashid K.; Augustin, Goran; Bala, Miklosh; Baraket, Oussama; Biffl, Walter L.; Ceresoli, Marco; Cerutti, Elisabetta; Chiara, Osvaldo; Cicuttin, Enrico; Chiarugi, Massimo; Coimbra, Raul; Corsi, Daniela; Cortese, Francesco; Cui, Yunfeng; Damaskos, Dimitris; de’Angelis, Nicola; Delibegovic, Samir; Demetrashvili, Zaza; De Simone, Belinda; de Jonge, Stijn W.; Di Bella, Stefano; Di Saverio, Salomone; Duane, Therese M.; Fugazzola, Paola; Galante, Joseph M.; Ghnnam, Wagih; Gkiokas, George; Gomes, Carlos A.; Griffiths, Ewen A.; Hardcastle, Timothy C.; Hecker, Andreas; Herzog, Torsten; Karamarkovic, Aleksandar; Khokha, Vladimir; Kim, Peter K.; Kim, Jae I.; Kirkpatrick, Andrew W.; Kong, Victor; Koshy, Renol M.; Inaba, Kenji; Isik, Arda; Ivatury, Rao; Labricciosa, Francesco M.; Lee, Yeong Y.; Leppäniemi, Ari; Litvin, Andrey; Luppi, Davide; Maier, Ronald V.; Marinis, Athanasios; Marwah, Sanjay; Mesina, Cristian; Moore, Ernest E.; Moore, Frederick A.; Negoi, Ionut; Olaoye, Iyiade; Ordoñez, Carlos A.; Ouadii, Mouaqit; Peitzman, Andrew B.; Perrone, Gennaro; Pintar, Tadeja; Pipitone, Giuseppe; Podda, Mauro; Raşa, Kemal; Ribeiro, Julival; Rodrigues, Gabriel; Rubio-Perez, Ines; Sall, Ibrahima; Sato, Norio; Sawyer, Robert G.; Shelat, Vishal G.; Sugrue, Michael; Tarasconi, Antonio; Tolonen, Matti; Viaggi, Bruno; Celotti, Andrea; Casella, Claudio; Pagani, Leonardo; Dhingra, Sameer; Baiocchi, Gian L.; Catena, FaustoAbstract 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.