Browsing by Author "Leppäniemi, Ari"
Now showing 1 - 6 of 6
Results Per Page
Sort Options
- ItemOpen Access2020 update of the WSES guidelines for the management of acute colonic diverticulitis in the emergency setting(2020-05-07) Sartelli, Massimo; Weber, Dieter G; Kluger, Yoram; Ansaloni, Luca; Coccolini, Federico; Abu-Zidan, Fikri; Augustin, Goran; Ben-Ishay, Offir; Biffl, Walter L; Bouliaris, Konstantinos; Catena, Rodolfo; Ceresoli, Marco; Chiara, Osvaldo; Chiarugi, Massimo; Coimbra, Raul; Cortese, Francesco; Cui, Yunfeng; Damaskos, Dimitris; de’ Angelis, Gian L; Delibegovic, Samir; Demetrashvili, Zaza; De Simone, Belinda; Di Marzo, Francesco; Di Saverio, Salomone; Duane, Therese M; Faro, Mario P; Fraga, Gustavo P; Gkiokas, George; Gomes, Carlos A; Hardcastle, Timothy C; Hecker, Andreas; Karamarkovic, Aleksandar; Kashuk, Jeffry; Khokha, Vladimir; Kirkpatrick, Andrew W; Kok, Kenneth Y Y; Inaba, Kenji; Isik, Arda; Labricciosa, Francesco M; Latifi, Rifat; Leppäniemi, Ari; Litvin, Andrey; Mazuski, John E; Maier, Ronald V; Marwah, Sanjay; McFarlane, Michael; Moore, Ernest E; Moore, Frederick A; Negoi, Ionut; Pagani, Leonardo; Rasa, Kemal; Rubio-Perez, Ines; Sakakushev, Boris; Sato, Norio; Sganga, Gabriele; Siquini, Walter; Tarasconi, Antonio; Tolonen, Matti; Ulrych, Jan; Zachariah, Sannop K; Catena, FaustoAbstract Acute colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in the acute setting. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of acute left-sided colonic diverticulitis (ALCD) according to the most recent available literature. The update includes recent changes introduced in the management of ALCD. The new update has been further integrated with advances in acute right-sided colonic diverticulitis (ARCD) that is more common than ALCD in select regions of the world.
- ItemOpen Access2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery(2023-09-09) de’Angelis, Nicola; Schena, Carlo A.; Marchegiani, Francesco; Reitano, Elisa; De Simone, Belinda; Wong, Geoffrey Y. M.; Martínez-Pérez, Aleix; Abu-Zidan, Fikri M.; Agnoletti, Vanni; Aisoni, Filippo; Ammendola, Michele; Ansaloni, Luca; Bala, Miklosh; Biffl, Walter; Ceccarelli, Graziano; Ceresoli, Marco; Chiara, Osvaldo; Chiarugi, Massimo; Cimbanassi, Stefania; Coccolini, Federico; Coimbra, Raul; Di Saverio, Salomone; Diana, Michele; Dioguardi Burgio, Marco; Fraga, Gustavo; Gavriilidis, Paschalis; Gurrado, Angela; Inchingolo, Riccardo; Ingels, Alexandre; Ivatury, Rao; Kashuk, Jeffry L.; Khan, Jim; Kirkpatrick, Andrew W.; Kim, Fernando J.; Kluger, Yoram; Lakkis, Zaher; Leppäniemi, Ari; Maier, Ronald V.; Memeo, Riccardo; Moore, Ernest E.; Ordoñez, Carlos A.; Peitzman, Andrew B.; Pellino, Gianluca; Picetti, Edoardo; Pikoulis, Manos; Pisano, Michele; Podda, Mauro; Romeo, Oreste; Rosa, Fausto; Tan, Edward; Ten Broek, Richard P.; Testini, Mario; Tian Wei Cheng, Brian A.; Weber, Dieter; Sacco, Emilio; Sartelli, Massimo; Tonsi, Alfredo; Dal Moro, Fabrizio; Catena, FaustoAbstract Iatrogenic urinary tract injury (IUTI) is a severe complication of emergency digestive surgery. It can lead to increased postoperative morbidity and mortality and have a long-term impact on the quality of life. The reported incidence of IUTIs varies greatly among the studies, ranging from 0.3 to 1.5%. Given the high volume of emergency digestive surgery performed worldwide, there is a need for well-defined and effective strategies to prevent and manage IUTIs. Currently, there is a lack of consensus regarding the prevention, detection, and management of IUTIs in the emergency setting. The present guidelines, promoted by the World Society of Emergency Surgery (WSES), were developed following a systematic review of the literature and an international expert panel discussion. The primary aim of these WSES guidelines is to provide evidence-based recommendations to support clinicians and surgeons in the prevention, detection, and management of IUTIs during emergency digestive surgery. The following key aspects were considered: (1) effectiveness of preventive interventions for IUTIs during emergency digestive surgery; (2) intra-operative detection of IUTIs and appropriate management strategies; (3) postoperative detection of IUTIs and appropriate management strategies and timing; and (4) effectiveness of antibiotic therapy (including type and duration) in case of IUTIs.
- ItemOpen AccessPhysiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study(2019-07-15) Sartelli, Massimo; Abu-Zidan, Fikri M; Labricciosa, Francesco M; Kluger, Yoram; Coccolini, Federico; Ansaloni, Luca; Leppäniemi, Ari; Kirkpatrick, Andrew W; Tolonen, Matti; Tranà, Cristian; Regimbeau, Jean-Marc; Hardcastle, Timothy; Koshy, Renol M; Abbas, Ashraf; Aday, Ulaş; Adesunkanmi, A. R K; Ajibade, Adesina; Akhmeteli, Lali; Akın, Emrah; Akkapulu, Nezih; Alotaibi, Alhenouf; Altintoprak, Fatih; Anyfantakis, Dimitrios; Atanasov, Boyko; Augustin, Goran; Azevedo, Constança; Bala, Miklosh; Balalis, Dimitrios; Baraket, Oussama; Baral, Suman; Barkai, Or; Beltran, Marcelo; Bini, Roberto; Bouliaris, Konstantinos; Caballero, Ana B; Calu, Valentin; Catani, Marco; Ceresoli, Marco; Charalampakis, Vasileios; Jusoh, Asri C; Chiarugi, Massimo; Cillara, Nicola; Cuesta, Raquel C; Cobuccio, Luigi; Cocorullo, Gianfranco; Colak, Elif; Conti, Luigi; Cui, Yunfeng; De Simone, Belinda; Delibegovic, Samir; Demetrashvili, Zaza; Demetriades, Demetrios; Dimova, Ana; Dogjani, Agron; Enani, Mushira; Farina, Federica; Ferrara, Francesco; Foghetti, Domitilla; Fontana, Tommaso; Fraga, Gustavo P; Gachabayov, Mahir; Gérard, Grelpois; Ghnnam, Wagih; Maurel, Teresa G; Gkiokas, Georgios; Gomes, Carlos A; Guner, Ali; Gupta, Sanjay; Hecker, Andreas; Hirano, Elcio S; Hodonou, Adrien; Hutan, Martin; Ilaschuk, Igor; Ioannidis, Orestis; Isik, Arda; Ivakhov, Georgy; Jain, Sumita; Jokubauskas, Mantas; Karamarkovic, Aleksandar; Kaushik, Robin; Kenig, Jakub; Khokha, Vladimir; Khokha, Denis; Kim, Jae I; Kong, Victor; Korkolis, Dimitris; Kruger, Vitor F; Kshirsagar, Ashok; Simões, Romeo L; Lanaia, Andrea; Lasithiotakis, Konstantinos; Leão, Pedro; Arellano, Miguel L; Listle, Holger; Litvin, Andrey; Lizarazu Pérez, Aintzane; Lopez-Tomassetti Fernandez, Eudaldo; Lostoridis, Eftychios; Luppi, Davide; Machain V, Gustavo M; Major, Piotr; Manatakis, Dimitrios; Reitz, Marianne M; Marinis, Athanasios; Marrelli, Daniele; Martínez-Pérez, Aleix; Marwah, Sanjay; McFarlane, Michael; Mesic, Mirza; Mesina, Cristian; Michalopoulos, Nickos; Misiakos, Evangelos; Moreira, Felipe G; Mouaqit, Ouadii; Muhtaroglu, Ali; Naidoo, Noel; Negoi, Ionut; Nikitina, Zane; Nikolopoulos, Ioannis; Nita, Gabriela-Elisa; Occhionorelli, Savino; Olaoye, Iyiade; Ordoñez, Carlos A; Ozkan, Zeynep; Pal, Ajay; Palini, Gian M; Papageorgiou, Kyriaki; Papagoras, Dimitris; Pata, Francesco; Pędziwiatr, Michał; Pereira, Jorge; Pereira Junior, Gerson A; Perrone, Gennaro; Pintar, Tadeja; Pisarska, Magdalena; Plehutsa, Oleksandr; Podda, Mauro; Poillucci, Gaetano; Quiodettis, Martha; Rahim, Tuba; Rios-Cruz, Daniel; Rodrigues, Gabriel; Rozov, Dmytry; Sakakushev, Boris; Sall, Ibrahima; Sazhin, Alexander; Semião, Miguel; Sharda, Taanya; Shelat, Vishal; Sinibaldi, Giovanni; Skicko, Dmitrijs; Skrovina, Matej; Stamatiou, Dimitrios; Stella, Marco; Strzałka, Marcin; Sydorchuk, Ruslan; Teixeira Gonsaga, Ricardo A; Tochie, Joel N; Tomadze, Gia; Ugoletti, Lara; Ulrych, Jan; Ümarik, Toomas; Uzunoglu, Mustafa Y; Vasilescu, Alin; Vaz, Osborne; Vereczkei, Andras; Vlad, Nutu; Walędziak, Maciej; Yahya, Ali I; Yalkin, Omer; Yilmaz, Tonguç U; Ünal, Ali E; Yuan, Kuo-Ching; Zachariah, Sanoop K; Žilinskas, Justas; Zizzo, Maurizio; Pattonieri, Vittoria; Baiocchi, Gian L; Catena, FaustoAbstract 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.
- ItemOpen AccessThe 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 abstract
- ItemOpen AccessWSES/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.
- ItemOpen AccessWSES/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.