Browsing by Author "Maier, Ronald V."

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    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, Daniele
    Abstract 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.
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    2023 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, Fausto
    Abstract Iatrogenic urinary tract injury (IUTI) is a severe complication of emergency digestive surgery. It can lead to increased postoperative morbidity and mortality and have a long-term impact on the quality of life. The reported incidence of IUTIs varies greatly among the studies, ranging from 0.3 to 1.5%. Given the high volume of emergency digestive surgery performed worldwide, there is a need for well-defined and effective strategies to prevent and manage IUTIs. Currently, there is a lack of consensus regarding the prevention, detection, and management of IUTIs in the emergency setting. The present guidelines, promoted by the World Society of Emergency Surgery (WSES), were developed following a systematic review of the literature and an international expert panel discussion. The primary aim of these WSES guidelines is to provide evidence-based recommendations to support clinicians and surgeons in the prevention, detection, and management of IUTIs during emergency digestive surgery. The following key aspects were considered: (1) effectiveness of preventive interventions for IUTIs during emergency digestive surgery; (2) intra-operative detection of IUTIs and appropriate management strategies; (3) postoperative detection of IUTIs and appropriate management strategies and timing; and (4) effectiveness of antibiotic therapy (including type and duration) in case of IUTIs.
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    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, Luca
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    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, Chiara
    Abstract 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.
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    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, Luca
    Abstract Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy.
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    Intra-abdominal infections survival guide: a position statement by the Global Alliance For Infections In Surgery
    (2024-06-08) Sartelli, Massimo; Barie, Philip; Agnoletti, Vanni; Al-Hasan, Majdi N.; Ansaloni, Luca; Biffl, Walter; Buonomo, Luis; Blot, Stijn; Cheadle, William G.; Coimbra, Raul; De Simone, Belinda; Duane, Therese M.; Fugazzola, Paola; Giamarellou, Helen; Hardcastle, Timothy C.; Hecker, Andreas; Inaba, Kenji; Kirkpatrick, Andrew W.; Labricciosa, Francesco M.; Leone, Marc; Martin-Loeches, Ignacio; Maier, Ronald V.; Marwah, Sanjay; Maves, Ryan C.; Mingoli, Andrea; Montravers, Philippe; Ordóñez, Carlos A.; Palmieri, Miriam; Podda, Mauro; Rello, Jordi; Sawyer, Robert G.; Sganga, Gabriele; Tattevin, Pierre; Thapaliya, Dipendra; Tessier, Jeffrey; Tolonen, Matti; Ulrych, Jan; Vallicelli, Carlo; Watkins, Richard R.; Catena, Fausto; Coccolini, Federico
    Abstract Intra-abdominal infections (IAIs) are an important cause of morbidity and mortality in hospital settings worldwide. The cornerstones of IAI management include rapid, accurate diagnostics; timely, adequate source control; appropriate, short-duration antimicrobial therapy administered according to the principles of pharmacokinetics/pharmacodynamics and antimicrobial stewardship; and hemodynamic and organ functional support with intravenous fluid and adjunctive vasopressor agents for critical illness (sepsis/organ dysfunction or septic shock after correction of hypovolemia). In patients with IAIs, a personalized approach is crucial to optimize outcomes and should be based on multiple aspects that require careful clinical assessment. The anatomic extent of infection, the presumed pathogens involved and risk factors for antimicrobial resistance, the origin and extent of the infection, the patient’s clinical condition, and the host’s immune status should be assessed continuously to optimize the management of patients with complicated IAIs.
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    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, Fausto
    Abstract 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
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    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, Fausto
    Abstract Emergency General Surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and non-traumatic acute conditions during the same admission in the hospital by general emergency surgeons and other specialists. It is the most diffused surgical discipline in the world. To live and grow strong EGS necessitates three fundamental parts: emergency and elective continuous surgical practice, evidence generation through clinical registries and data accrual, and indications and guidelines production: the LIFE TRIAD.
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    Trauma quality indicators: internationally approved core factors for trauma management quality evaluation
    (2021-02-23) Coccolini, Federico; Kluger, Yoram; Moore, Ernest E.; Maier, Ronald V.; Coimbra, Raul; Ordoñez, Carlos; Ivatury, Rao; Kirkpatrick, Andrew W.; Biffl, Walter; Sartelli, Massimo; Hecker, Andreas; Ansaloni, Luca; Leppaniemi, Ari; Reva, Viktor; Civil, Ian; Vega, Felipe; Chiarugi, Massimo; Chichom-Mefire, Alain; Sakakushev, Boris; Peitzman, Andrew; Chiara, Osvaldo; Abu-Zidan, Fikri; Maegele, Marc; Miccoli, Mario; Chirica, Mircea; Khokha, Vladimir; Sugrue, Michael; Fraga, Gustavo P.; Otomo, Yasuhiro; Baiocchi, Gian L.; Catena, Fausto
    Abstract Introduction Quality in medical care must be measured in order to be improved. Trauma management is part of health care, and by definition, it must be checked constantly. The only way to measure quality and outcomes is to systematically accrue data and analyze them. Material and methods A systematic revision of the literature about quality indicators in trauma associated to an international consensus conference Results An internationally approved base core set of 82 trauma quality indicators was obtained: Indicators were divided into 6 fields: prevention, structure, process, outcome, post-traumatic management, and society integrational effects. Conclusion Present trauma quality indicator core set represents the result of an international effort aiming to provide a useful tool in quality evaluation and improvement. Further improvement may only be possible through international trauma registry development. This will allow for huge international data accrual permitting to evaluate results and compare outcomes.
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    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, Fausto
    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.
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    ItemOpen 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, Fausto
    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.