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1. Assessing and managing frailty in emergency laparotomy: a WSES position paper

Author

Tian, B, Stahel, P, Picetti, E, Campanelli, G, Di Saverio, S, Moore, E, Bensard, D, Sakakushev, B, Galante, J, Fraga, G, Koike, K, Di Carlo, I, Tebala, G, Leppaniemi, A, Tan, E, Damaskos, D, De'Angelis, N, Hecker, A, Pisano, M, Yunfengcui, Maier, R, De Simone, B, Amico, F, Ceresoli, M, Pikoulis, M, Weber, D, Biffl, W, Beka, S, Abu-Zidan, F, Valentino, M, Coccolini, F, Kluger, Y, Sartelli, M, Agnoletti, V, Chirica, M, Bravi, F, Sall, I, Catena, F, Tian B. W. C. A., Stahel P. F., Picetti E., Campanelli G., Di Saverio S., Moore E., Bensard D., Sakakushev B., Galante J., Fraga G. P., Koike K., Di Carlo I., Tebala G. D., Leppaniemi A., Tan E., Damaskos D., De'Angelis N., Hecker A., Pisano M., YunfengCui, Maier R. V., De Simone B., Amico F., Ceresoli M., Pikoulis M., Weber D. G., Biffl W., Beka S. G., Abu-Zidan F. M., Valentino M., Coccolini F., Kluger Y., Sartelli M., Agnoletti V., Chirica M., Bravi F., Sall I., Catena F., Tian, B, Stahel, P, Picetti, E, Campanelli, G, Di Saverio, S, Moore, E, Bensard, D, Sakakushev, B, Galante, J, Fraga, G, Koike, K, Di Carlo, I, Tebala, G, Leppaniemi, A, Tan, E, Damaskos, D, De'Angelis, N, Hecker, A, Pisano, M, Yunfengcui, Maier, R, De Simone, B, Amico, F, Ceresoli, M, Pikoulis, M, Weber, D, Biffl, W, Beka, S, Abu-Zidan, F, Valentino, M, Coccolini, F, Kluger, Y, Sartelli, M, Agnoletti, V, Chirica, M, Bravi, F, Sall, I, Catena, F, Tian B. W. C. A., Stahel P. F., Picetti E., Campanelli G., Di Saverio S., Moore E., Bensard D., Sakakushev B., Galante J., Fraga G. P., Koike K., Di Carlo I., Tebala G. D., Leppaniemi A., Tan E., Damaskos D., De'Angelis N., Hecker A., Pisano M., YunfengCui, Maier R. V., De Simone B., Amico F., Ceresoli M., Pikoulis M., Weber D. G., Biffl W., Beka S. G., Abu-Zidan F. M., Valentino M., Coccolini F., Kluger Y., Sartelli M., Agnoletti V., Chirica M., Bravi F., Sall I., and Catena F.

Abstract

Many countries are facing an aging population. As people live longer, surgeons face the prospect of operating on increasingly older patients. Traditional teaching is that with older age, these patients face an increased risk of mortality and morbidity, even to a level deemed too prohibitive for surgery. However, this is not always true. An active 90-year-old patient can be much fitter than an overweight, sedentary 65-year-old patient with comorbidities. Recent literature shows that frailty—an age-related cumulative decline in multiple physiological systems, is therefore a better predictor of mortality and morbidity than chronological age alone. Despite recognition of frailty as an important tool in identifying vulnerable surgical patients, many surgeons still shun objective tools. The aim of this position paper was to perform a review of the existing literature and to provide recommendations on emergency laparotomy and in frail patients. This position paper was reviewed by an international expert panel composed of 37 experts who were asked to critically revise the manuscript and position statements. The position paper was conducted according to the WSES methodology. We shall present the derived statements upon which a consensus was reached, specifying the quality of the supporting evidence and suggesting future research directions.

Published
2023

2. WSES consensus guidelines on sigmoid volvulus management

Author

Tian, B, Vigutto, G, Tan, E, van Goor, H, Bendinelli, C, Abu-Zidan, F, Ivatury, R, Sakakushev, B, Di Carlo, I, Sganga, G, Maier, R, Coimbra, R, Leppaniemi, A, Litvin, A, Damaskos, D, Broek, R, Biffl, W, Di Saverio, S, De Simone, B, Ceresoli, M, Picetti, E, Galante, J, Tebala, G, Beka, S, Bonavina, L, Cui, Y, Khan, J, Cicuttin, E, Amico, F, Kenji, I, Hecker, A, Ansaloni, L, Sartelli, M, Moore, E, Kluger, Y, Testini, M, Weber, D, Agnoletti, V, Angelis, N, Coccolini, F, Sall, I, Catena, F, Tian B. W. C. A., Vigutto G., Tan E., van Goor H., Bendinelli C., Abu-Zidan F., Ivatury R., Sakakushev B., Di Carlo I., Sganga G., Maier R. V., Coimbra R., Leppaniemi A., Litvin A., Damaskos D., Broek R. T., Biffl W., Di Saverio S., De Simone B., Ceresoli M., Picetti E., Galante J., Tebala G. D., Beka S. G., Bonavina L., Cui Y., Khan J., Cicuttin E., Amico F., Kenji I., Hecker A., Ansaloni L., Sartelli M., Moore E. E., Kluger Y., Testini M., Weber D., Agnoletti V., Angelis N. D., Coccolini F., Sall I., Catena F., Tian, B, Vigutto, G, Tan, E, van Goor, H, Bendinelli, C, Abu-Zidan, F, Ivatury, R, Sakakushev, B, Di Carlo, I, Sganga, G, Maier, R, Coimbra, R, Leppaniemi, A, Litvin, A, Damaskos, D, Broek, R, Biffl, W, Di Saverio, S, De Simone, B, Ceresoli, M, Picetti, E, Galante, J, Tebala, G, Beka, S, Bonavina, L, Cui, Y, Khan, J, Cicuttin, E, Amico, F, Kenji, I, Hecker, A, Ansaloni, L, Sartelli, M, Moore, E, Kluger, Y, Testini, M, Weber, D, Agnoletti, V, Angelis, N, Coccolini, F, Sall, I, Catena, F, Tian B. W. C. A., Vigutto G., Tan E., van Goor H., Bendinelli C., Abu-Zidan F., Ivatury R., Sakakushev B., Di Carlo I., Sganga G., Maier R. V., Coimbra R., Leppaniemi A., Litvin A., Damaskos D., Broek R. T., Biffl W., Di Saverio S., De Simone B., Ceresoli M., Picetti E., Galante J., Tebala G. D., Beka S. G., Bonavina L., Cui Y., Khan J., Cicuttin E., Amico F., Kenji I., Hecker A., Ansaloni L., Sartelli M., Moore E. E., Kluger Y., Testini M., Weber D., Agnoletti V., Angelis N. D., Coccolini F., Sall I., and Catena F.

Abstract

Sigmoid volvulus is a common surgical emergency, especially in elderly patients. Patients can present with a wide range of clinical states: from asymptomatic, to frank peritonitis secondary to colonic perforation. These patients generally need urgent treatment, be it endoscopic decompression of the colon or an upfront colectomy. The World Society of Emergency Surgery united a worldwide group of international experts to review the current evidence and propose a consensus guidelines on the management of sigmoid volvulus.

Published
2023

3. Training curriculum in minimally invasive emergency digestive surgery: 2022 WSES position paper

Author

De'Angelis, N, Marchegiani, F, Schena, C, Khan, J, Agnoletti, V, Ansaloni, L, Barria Rodriguez, A, Bianchi, P, Biffl, W, Bravi, F, Ceccarelli, G, Ceresoli, M, Chiara, O, Chirica, M, Cobianchi, L, Coccolini, F, Coimbra, R, Cotsoglou, C, D'Hondt, M, Damaskos, D, De Simone, B, Di Saverio, S, Diana, M, Espin-Basany, E, Fichtner-Feigl, S, Fugazzola, P, Gavriilidis, P, Gronnier, C, Kashuk, J, Kirkpatrick, A, Ammendola, M, Kouwenhoven, E, Laurent, A, Leppaniemi, A, Lesurtel, M, Memeo, R, Milone, M, Moore, E, Pararas, N, Peitzmann, A, Pessaux, P, Picetti, E, Pikoulis, M, Pisano, M, Ris, F, Robison, T, Sartelli, M, Shelat, V, Spinoglio, G, Sugrue, M, Tan, E, Van Eetvelde, E, Kluger, Y, Weber, D, Catena, F, de'Angelis N., Marchegiani F., Schena C. A., Khan J., Agnoletti V., Ansaloni L., Barria Rodriguez A. G., Bianchi P. P., Biffl W., Bravi F., Ceccarelli G., Ceresoli M., Chiara O., Chirica M., Cobianchi L., Coccolini F., Coimbra R., Cotsoglou C., D'Hondt M., Damaskos D., De Simone B., Di Saverio S., Diana M., Espin-Basany E., Fichtner-Feigl S., Fugazzola P., Gavriilidis P., Gronnier C., Kashuk J., Kirkpatrick A. W., Ammendola M., Kouwenhoven E. A., Laurent A., Leppaniemi A., Lesurtel M., Memeo R., Milone M., Moore E., Pararas N., Peitzmann A., Pessaux P., Picetti E., Pikoulis M., Pisano M., Ris F., Robison T., Sartelli M., Shelat V. G., Spinoglio G., Sugrue M., Tan E., Van Eetvelde E., Kluger Y., Weber D., Catena F., De'Angelis, N, Marchegiani, F, Schena, C, Khan, J, Agnoletti, V, Ansaloni, L, Barria Rodriguez, A, Bianchi, P, Biffl, W, Bravi, F, Ceccarelli, G, Ceresoli, M, Chiara, O, Chirica, M, Cobianchi, L, Coccolini, F, Coimbra, R, Cotsoglou, C, D'Hondt, M, Damaskos, D, De Simone, B, Di Saverio, S, Diana, M, Espin-Basany, E, Fichtner-Feigl, S, Fugazzola, P, Gavriilidis, P, Gronnier, C, Kashuk, J, Kirkpatrick, A, Ammendola, M, Kouwenhoven, E, Laurent, A, Leppaniemi, A, Lesurtel, M, Memeo, R, Milone, M, Moore, E, Pararas, N, Peitzmann, A, Pessaux, P, Picetti, E, Pikoulis, M, Pisano, M, Ris, F, Robison, T, Sartelli, M, Shelat, V, Spinoglio, G, Sugrue, M, Tan, E, Van Eetvelde, E, Kluger, Y, Weber, D, Catena, F, de'Angelis N., Marchegiani F., Schena C. A., Khan J., Agnoletti V., Ansaloni L., Barria Rodriguez A. G., Bianchi P. P., Biffl W., Bravi F., Ceccarelli G., Ceresoli M., Chiara O., Chirica M., Cobianchi L., Coccolini F., Coimbra R., Cotsoglou C., D'Hondt M., Damaskos D., De Simone B., Di Saverio S., Diana M., Espin-Basany E., Fichtner-Feigl S., Fugazzola P., Gavriilidis P., Gronnier C., Kashuk J., Kirkpatrick A. W., Ammendola M., Kouwenhoven E. A., Laurent A., Leppaniemi A., Lesurtel M., Memeo R., Milone M., Moore E., Pararas N., Peitzmann A., Pessaux P., Picetti E., Pikoulis M., Pisano M., Ris F., Robison T., Sartelli M., Shelat V. G., Spinoglio G., Sugrue M., Tan E., Van Eetvelde E., Kluger Y., Weber D., and Catena F.

Abstract

Background: Minimally invasive surgery (MIS), including laparoscopic and robotic approaches, is widely adopted in elective digestive surgery, but selectively used for surgical emergencies. The present position paper summarizes the available evidence concerning the learning curve to achieve proficiency in emergency MIS and provides five expert opinion statements, which may form the basis for developing standardized curricula and training programs in emergency MIS. Methods: This position paper was conducted according to the World Society of Emergency Surgery methodology. A steering committee and an international expert panel were involved in the critical appraisal of the literature and the development of the consensus statements. Results: Thirteen studies regarding the learning curve in emergency MIS were selected. All but one study considered laparoscopic appendectomy. Only one study reported on emergency robotic surgery. In most of the studies, proficiency was achieved after an average of 30 procedures (range: 20–107) depending on the initial surgeon’s experience. High heterogeneity was noted in the way the learning curve was assessed. The experts claim that further studies investigating learning curve processes in emergency MIS are needed. The emergency surgeon curriculum should include a progressive and adequate training based on simulation, supervised clinical practice (proctoring), and surgical fellowships. The results should be evaluated by adopting a credentialing system to ensure quality standards. Surgical proficiency should be maintained with a minimum caseload and constantly evaluated. Moreover, the training process should involve the entire surgical team to facilitate the surgeon’s proficiency. Conclusions: Limited evidence exists concerning the learning process in laparoscopic and robotic emergency surgery. The proposed statements should be seen as a preliminary guide for the surgical community while stressing the need for further research.

Published
2023

4. Perceptions and practices surrounding the perioperative management of frail emergency surgery patients: a WSES-endorsed cross-sectional qualitative survey

Author

Viswanath, M, Clinch, D, Ceresoli, M, Dhesi, J, D'Oria, M, De Simone, B, Podda, M, Di Saverio, S, Coccolini, F, Sartelli, M, Catena, F, Moore, E, Rangar, D, Biffl, W, Damaskos, D, Viswanath M., Clinch D., Ceresoli M., Dhesi J., D'Oria M., De Simone B., Podda M., Di Saverio S., Coccolini F., Sartelli M., Catena F., Moore E., Rangar D., Biffl W. L., Damaskos D., Viswanath, M, Clinch, D, Ceresoli, M, Dhesi, J, D'Oria, M, De Simone, B, Podda, M, Di Saverio, S, Coccolini, F, Sartelli, M, Catena, F, Moore, E, Rangar, D, Biffl, W, Damaskos, D, Viswanath M., Clinch D., Ceresoli M., Dhesi J., D'Oria M., De Simone B., Podda M., Di Saverio S., Coccolini F., Sartelli M., Catena F., Moore E., Rangar D., Biffl W. L., and Damaskos D.

Abstract

Background: Frailty is associated with poor post-operative outcomes in emergency surgical patients. Shared multidisciplinary models have been developed to provide a holistic, reactive model of care to improve outcomes for older people living with frailty. We aimed to describe current perioperative practices, and surgeons’ awareness and perception of perioperative frailty management, and barriers to its implementation. Methods: A qualitative cross-sectional survey was sent via the World Society of Emergency Surgery e-letter to their members. Responses were analysed using descriptive statistics and reported by themes: risk scoring systems, frailty awareness and assessment and barriers to implementation. Result: Of 168/1000 respondents, 38% were aware of the terms “Perioperative medicine for older people undergoing surgery” (POPS) and Comprehensive Geriatric Assessment (CGA). 66.6% of respondents assessed perioperative risk, with 45.2% using the American Society of Anaesthesiologists Physical Status Classification System (ASA-PS). 77.8% of respondents mostly agreed or agreed with the statement that they routinely conducted medical comorbidity management, and pain and falls risk assessment during emergency surgical admissions. Although 98.2% of respondents agreed that frailty was important, only 2.4% performed CGA and 1.2% used a specific frailty screening tool. Clinical frailty score was the most commonly used tool by those who did. Screening was usually conducted by surgical trainees. Key barriers included a lack of knowledge about frailty assessment, a lack of clarity on who should be responsible for frailty screening, and a lack of trained staff. Conclusions: Our study highlights the ubiquitous lack of awareness regarding frailty assessment and the POPS model of care. More training and clear guidelines on frailty scoring, alongside support by multidisciplinary teams, may reduce the burden on surgical trainees, potentially improving rates of appropriate frailty asses

Published
2023

5. Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey

Author

Cobianchi, L, Dal Mas, F, Agnoletti, V, Ansaloni, L, Biffl, W, Butturini, G, Campostrini, S, Catena, F, Denicolai, S, Fugazzola, P, Martellucci, J, Massaro, M, Previtali, P, Ruta, F, Venturi, A, Woltz, S, Kaafarani, H, Loftus, T, Aapoaylu, R, Abbott, K, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Adamovich, D, Agresta, F, Agrusa, A, Akin, E, Alessiani, M, Alexandrino, H, Bidoli, C, Ali, S, Mihai, V, Almeida, P, Al-Shehari, M, Altomare, M, Amico, F, Ammendola, M, Andreuccetti, J, Anestiadou, E, Annicchiarico, A, Antonelli, A, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Arvieux, C, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bacchiocchi, G, Bagnoli, C, Bahouth, H, Baili, E, Bains, L, Baiocchi, G, Bala, M, Balaguacopyright, C, Balalis, D, Baldini, E, Baraket, O, Baral, S, Barone, M, Gonzalez Barranquero, A, Barreras, J, Bass, G, Bayhan, Z, Bellanova, G, Ben-Ishay, O, Bert, F, Bianchi, V, Biancuzzi, H, Radulescu, R, Bignell, M, Biloslavo, A, Bini, R, Bissacco, D, Boati, P, Boddaert, G, Bogdanic, B, Bombardini, C, Bonavina, L, Bonomo, L, Bottari, A, Bouliaris, K, Brachini, G, Brillantino, A, Brisinda, G, Bulanauca, M, Buonomo, L, Burcharth, J, Buscemi, S, Calabretto, F, Calini, G, Calu, V, Campanile, F, Campo Dall'Orto, R, Campos-Serra, A, Carvas, J, Cascella, M, Pattacini, G, Celentano, V, Centonze, D, Ceresoli, M, Chatzipetris, D, Chessa, A, Chiarello, M, Chirica, M, Chooklin, S, Chouliaras, C, Chowdhury, S, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colais-Ruiz, E, Colak, E, Conti, L, Coppola, A, de Sa, T, Costa, S, Cozza, V, Curro', G, Dabekaussen, K, D'Acapito, F, Damaskos, D, D'Ambrosio, G, Das, K, Davies, R, de Beaux, A, De Lebrusant Fernandez, S, De Luca, A, De Simone, B, De Stefano, F, Degrate, L, Demetrashvili, Z, Demetriades, A, Detanac, D, Dezi, A, Di Buono, G, Carlo, I, Di Lascio, P, Di Martino, M, Di Saverio, S, Diaconescu, B, Diaz, J, Dibra, R, Dimitrov, E, Dinuzzi, V, Dios-Barbeito, S, Diyani, J, Dogjani, A, Domanin, M, D'Oria, M, Munoz-Cruzado, V, East, B, Ekelund, M, Ekwen, G, Elbaih, A, Elhadi, M, Enninghorst, N, Ernisova, M, Escalera-Antezana, J, Esposito, S, Esposito, G, Estaire-Gamez, M, Fara, C, Farre, R, Favi, F, Ferrario, L, Ferrario di Tor Vajana, A, Filisetti, C, Fleres, F, Fonseca, V, Forero-Torres, A, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Frassini, S, Frazzetta, G, Frigerio, I, Frountzas, M, Gachabayov, M, Galeiras, R, Garcaa, B, Garcia Vazquez, A, Gargarella, S, Garzali, I, Ghannam, W, Ghazi, F, Gillman, L, Gioco, R, Giordano, A, Giordano, L, Giove, C, Giraudo, G, Giuffrida, M, Capponi, M, Gois, E, Gomes, C, Gomes, F, Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Gracia-Roman, R, Graziano, G, Griffiths, E, Guagni, T, Hadzhiev, D, Haidar, M, Hamid, H, Hardcastle, T, Hayati, F, Healey, A, Hecker, A, Hecker, M, Garcia, E, Hodonou, A, Huaman, E, Huerta, M, Ibrahim, A, Ibrahim, B, Ietto, G, Inama, M, Ioannidis, O, Isik, A, Ismail, N, Ismail, A, Jailani, R, Jang, J, Kalfountzos, C, Kalipershad, S, Kaouras, E, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Katsaros, I, Kavalakat, A, Kechagias, A, Kenig, J, Kessel, B, Khan, J, Khokha, V, Kim, J, Kirkpatrick, A, Klappenbach, R, Kobe, Y, Lymperis, E, Kok, K, Kong, V, Korkolis, D, Koukoulis, G, Kovacevic, B, Kruger, V, Kryvoruchko, I, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Lapolla, P, Licari, L, Lisi, G, Litvin, A, Lizarazu, A, Bayo, H, Lohsiriwat, V, Moreira, C, Lostoridis, E, Luna, A, Luppi, D, V, G, Maegele, M, Maggiore, D, Magnone, S, Maier, R, Major, P, Manangi, M, Manetti, A, Mantoglu, B, Marafante, C, Mariani, F, Marinis, A, Mariot, E, Marseglia, G, Martanez-Parez, A, Martines, G, Perez, A, Martino, C, Mascagni, P, Massalou, D, Mataas-Garcaa, B, Mazzarella, G, Mazzarolo, G, Melo, R, Mendoza-Moreno, F, Meric, S, Meyer, J, Miceli, L, Michalopoulos, N, Milana, F, Mingoli, A, Mishra, T, Mohamed, M, Mohamedahmed, A, Mohammed, M, Mohan, R, Moore, E, Morales-Garcia, D, Muhrbeck, M, Mulita, F, Mustafa, S, Muttillo, E, Naimzada, M, Navsaria, P, Negoi, I, Nespoli, L, Nguyen, C, Nidaw, M, Nigri, G, Nikolopoulos, I, O'Connor, D, Ogundipe, H, Oliveri, C, Olmi, S, Ong, E, Orecchia, L, Osipov, A, Othman, M, Pace, M, Pacilli, M, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papa, M, Papaconstantinou, D, Papadoliopoulou, M, Papadopoulos, A, Papis, D, Pararas, N, Parreira, J, Parry, N, Pata, F, Patel, T, Paterson-Brown, S, Pavone, G, Pecchini, F, Pellino, G, Pelloni, M, Peloso, A, del Pozo, E, Pereira, R, Pereira, B, Perra, T, Perrone, G, Pesce, A, Petagna, L, Petracca, G, Phupong, V, Picardi, B, Picciariello, A, Piccoli, M, Piccolo, D, Picetti, E, Pikoulis Pikoulis, E, Pintar, T, Pirozzolo, G, Piscioneri, F, Podda, M, Porcu, A, Privitera, F, Punzo, C, Quaresima, S, Quiodettis, M, Qvist, N, Rahim, R, de Almeida, F, Ramely, R, Rasa, H, Reichert, M, Reinisch-Liese, A, Renne, A, Riccetti, C, Rodriguez-Luna, M, Roizblatt, D, Romanzi, A, Romeo, L, Roscio, F, Rosnelifaizur, R, Rossi, S, Rubiano, A, Ruiz-Ascar, E, Sakakushev, B, Salamea, J, Sall, I, Samarakoon, L, Sammartano, F, Arteaga, A, Sanchez-Cordero, S, Santoanastaso, D, Sasia, D, Sato, N, Savchuk, A, Sawyer, R, Scaioli, G, Schizas, D, Sebastiani, S, Seeliger, B, Lohse, H, Seretis, C, Sermonesi, G, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Sidiropoulos, T, Simoes, R, Siragusa, L, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Sopuev, A, Soreide, K, Sovatzidis, A, Stahel, P, Strickland, M, Sultan, M, Sydorchuk, R, Sydorchuk, L, Syed, S, Syed, A, Tallon-Aguilar, L, Tamburini, A, Tamini, N, Tan, E, Tan, J, Tarasconi, A, Tartaglia, N, Tartaglia, G, Tartaglia, D, Taylor, J, Tebala, G, Teuben, M, Theodorou, A, Tolonen, M, Tomasicchio, G, Toro, A, Torre, B, Triantafyllou, T, Trigiante Trigiante, G, Tripepi, M, Trostchansky, J, Tsekouras, K, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Uchikov, P, Ugarte-Sierra, B, Ukkonen, M, Vailas, M, Vassiliu, P, Vazquez, A, Vazquez, R, Verde, J, Veroux, M, Vigano, J, Vilallonga, R, Visconti, D, Vittori, A, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Wong, T, Xenaki, S, Yu, B, Yule, S, Zachariah, S, Zacharis, G, Zaghi, C, Zakaria, A, Zambrano, D, Zampitis, N, Zampogna, B, Zangha, S, Zapsalis, K, Zattoni, F, Zese, M, Farre, S, Pegoraro, V, Zantedeschi, M, Reitano, E, Pizzocaro, E, Cobianchi L., Dal Mas F., Agnoletti V., Ansaloni L., Biffl W., Butturini G., Campostrini S., Catena F., Denicolai S., Fugazzola P., Martellucci J., Massaro M., Previtali P., Ruta F., Venturi A., Woltz S., Kaafarani H. M., Loftus T. J., Aapoaylu R., Abbott K. L., Abdelmalik A., Abebe N. S., Abu-Zidan F., Adam Y. A. Y., Adamou H., Adamovich D. M., Agresta F., Agrusa A., Akin E., Alessiani M., Alexandrino H., Bidoli C., Ali S. M., Mihai V. A., Almeida P. M., Al-Shehari M. M., Altomare M., Amico F., Ammendola M., Andreuccetti J., Anestiadou E., Annicchiarico A., Antonelli A., Aparicio-Sanchez D., Ardito A., Argenio G., Arvieux C. C., Arvieux C., Askevold I. H., Atanasov B. T., Augustin G., Awad S. S., Bacchiocchi G., Bagnoli C., Bahouth H., Baili E., Bains L., Baiocchi G. L., Bala M., BalaguaCopyright C., Balalis D., Baldini E., Baraket O., Baral S., Barone M., Gonzalez Barranquero A., Barreras J. A., Bass G. A., Bayhan Z., Bellanova G., Ben-Ishay O., Bert F., Bianchi V., Biancuzzi H., Radulescu R. B., Bignell M. B., Biloslavo A., Bini R., Bissacco D., Boati P., Boddaert G., Bogdanic B., Bombardini C., Bonavina L., Bonomo L., Bottari A., Bouliaris K., Brachini G., Brillantino A., Brisinda G., Bulanauca M. M., Buonomo L. A., Burcharth J., Buscemi S., Calabretto F., Calini G., Calu V., Campanile F. C., Campo Dall'Orto R., Campos-Serra A., Carvas J. M., Cascella M., Pattacini G. C., Celentano V., Centonze D. C., Ceresoli M., Chatzipetris D., Chessa A., Chiarello M. M., Chirica M., Chooklin S., Chouliaras C., Chowdhury S., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colais-Ruiz E., Colak E., Conti L., Coppola A., de Sa T. C., Costa S. D., Cozza V., Curro' G., Dabekaussen K. F. A. -S. A., D'acapito F., Damaskos D., D'Ambrosio G., Das K., Davies R. J., de Beaux A. C., De Lebrusant Fernandez S. P., De Luca A., De Simone B., De Stefano F., Degrate L., Demetrashvili Z., Demetriades A. K., Detanac D. S., Dezi A., Di Buono G., Carlo I. -D. I., Di Lascio P., Di Martino M., Di Saverio S., Diaconescu B., Diaz J. J., Dibra R., Dimitrov E. N., Dinuzzi V. P., Dios-Barbeito S., Diyani J. F. A., Dogjani A., Domanin M., D'Oria M., Munoz-Cruzado V. D., East B., Ekelund M., Ekwen G. T., Elbaih A. H., Elhadi M., Enninghorst N., Ernisova M., Escalera-Antezana J. P., Esposito S., Esposito G., Estaire-Gamez M., Fara C. N., Farre R., Favi F., Ferrario L., Ferrario di Tor Vajana A., Filisetti C., Fleres F., Fonseca V. C., Forero-Torres A., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Frassini S., Frazzetta G., Frigerio I., Frountzas M., Gachabayov M., Galeiras R., Garcaa B. M., Garcia Vazquez A., Gargarella S., Garzali I. U., Ghannam W. M., Ghazi F. N., Gillman L. M., Gioco R., Giordano A., Giordano L., Giove C., Giraudo G., Giuffrida M., Capponi M. G., Gois E., Gomes C. A., Gomes F. C., Gonsaga R. A. T., Gonullu E., Goosen J., Goranovic T., Gracia-Roman R., Graziano G. M. P., Griffiths E. A., Guagni T., Hadzhiev D. B., Haidar M. G., Hamid H. K. S., Hardcastle T. C., Hayati F., Healey A. J., Hecker A., Hecker M., Garcia E. F. H., hodonou A. M., huaman E., Huerta M., Ibrahim A. F., Ibrahim B. M. S., Ietto G., Inama M., Ioannidis O., Isik A., Ismail N., Ismail A. M. H., Jailani R. F., Jang J. Y., Kalfountzos C., Kalipershad S. N. R., Kaouras E., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Katsaros I., Kavalakat A. J., Kechagias A., Kenig J., Kessel B. J., Khan J. S., Khokha V., Kim J. I., Kirkpatrick A. W., Klappenbach R., Kobe Y., Lymperis E. K., Kok K. Y. Y., Kong V., Korkolis D. P., Koukoulis G., Kovacevic B., Kruger V. F., Kryvoruchko I. A., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Lapolla P., Licari L., Lisi G., Litvin A., Lizarazu A., Bayo H. L., Lohsiriwat V., Moreira C. C. L., Lostoridis E., Luna A. T., Luppi D., V G. M. M., Maegele M., Maggiore D., Magnone S., Maier R. V., Major P., Manangi M., manetti A., Mantoglu B., Marafante C., Mariani F., Marinis A., Mariot E. A. S., Marseglia G. R., Martanez-Parez A., Martines G., Perez A. M., Martino C., Mascagni P., Massalou D., Mataas-Garcaa B., Mazzarella G., Mazzarolo G., Melo R. B., Mendoza-Moreno F., Meric S., Meyer J., Miceli L., Michalopoulos N. V., Milana F., Mingoli A., Mishra T. S., Mohamed M., Mohamed M. I. E. A., Mohamedahmed A. Y., Mohammed M. J. S., Mohan R., Moore E. E., Morales-Garcia D., Muhrbeck M., Mulita F., Mustafa S. M. S., Muttillo E. M., Naimzada M. D., Navsaria P. H., Negoi I., Nespoli L., Nguyen C., Nidaw M. K., Nigri G., Nikolopoulos I., O'Connor D. B., Ogundipe H. D., Oliveri C., Olmi S., Ong E. C. W., Orecchia L., Osipov A. V., Othman M. F., Pace M., Pacilli M., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papa M. V., Papaconstantinou D., Papadoliopoulou M., Papadopoulos A., Papis D., Pararas N., Parreira J. G., Parry N. G., Pata F., Patel T., Paterson-Brown S., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., del Pozo E. P., Pereira R. G., Pereira B. M., perez A. L., Perra T., Perrone G., Pesce A., Petagna L., Petracca G., Phupong V., Picardi B., Picciariello A., Piccoli M., Piccolo D., Picetti E., Pikoulis Pikoulis E., Pintar T., Pirozzolo G., Piscioneri F., Podda M., Porcu A., Privitera F., Punzo C., Quaresima S., Quiodettis M. A., Qvist N., Rahim R., de Almeida F. R., Ramely R. B., Rasa H. K., Reichert M., Reinisch-Liese A., Renne A., Riccetti C., Rodriguez-Luna M. R., Roizblatt D., Romanzi A., Romeo L., Roscio F. P. M., Rosnelifaizur R. B., Rossi S., Rubiano A. M., Ruiz-Ascar E., Sakakushev B. E., Salamea J. C., Sall I., Samarakoon L. B., Sammartano F., Arteaga A. S., Sanchez-Cordero S., Santoanastaso D. P. M., Sasia D., Sato N., Savchuk A., Sawyer R. G., Scaioli G., Schizas D., Sebastiani S., Seeliger B., Lohse H. A. S., Seretis C., Sermonesi G., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Sidiropoulos T., Simoes R. L., Siragusa L., Siribumrungwong B., Slavchev M., Solaini L., soldini G., Sopuev A., Soreide K., Sovatzidis A., Stahel P. F., Strickland M., Sultan M. A. H., Sydorchuk R., Sydorchuk L., Syed S. M. A. M., Syed A. M., Tallon-Aguilar L., Tamburini A. M., Tamini N., Tan E. C. T. H., Tan J. H., Tarasconi A., Tartaglia N., Tartaglia G., Tartaglia D., Taylor J. V., Tebala G. D., Teuben M., Theodorou A., Tolonen M., Tomasicchio G., Toro A., Torre B., Triantafyllou T., Trigiante Trigiante G., Tripepi M., Trostchansky J., Tsekouras K., Turrado-Rodriguez V., Tutino R., Uccelli M., Uchikov P. A., Ugarte-Sierra B., Ukkonen M. T., Vailas M., Vassiliu P. G., Vazquez A. G., Vazquez R. G., Verde J. E., Verde J. M., Veroux M., Vigano J., Vilallonga R., Visconti D., Vittori A., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Wong T. H., Xenaki S., Yu B., Yule S., Zachariah S. K., Zacharis G., Zaghi C., Zakaria A. D., Zambrano D. A., Zampitis N., Zampogna B., Zangha S., Zapsalis K., Zattoni F., Zese M., Farre S. P., Pegoraro V., Zantedeschi M., Reitano E., Pizzocaro E., Cobianchi, L, Dal Mas, F, Agnoletti, V, Ansaloni, L, Biffl, W, Butturini, G, Campostrini, S, Catena, F, Denicolai, S, Fugazzola, P, Martellucci, J, Massaro, M, Previtali, P, Ruta, F, Venturi, A, Woltz, S, Kaafarani, H, Loftus, T, Aapoaylu, R, Abbott, K, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Adamovich, D, Agresta, F, Agrusa, A, Akin, E, Alessiani, M, Alexandrino, H, Bidoli, C, Ali, S, Mihai, V, Almeida, P, Al-Shehari, M, Altomare, M, Amico, F, Ammendola, M, Andreuccetti, J, Anestiadou, E, Annicchiarico, A, Antonelli, A, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Arvieux, C, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bacchiocchi, G, Bagnoli, C, Bahouth, H, Baili, E, Bains, L, Baiocchi, G, Bala, M, Balaguacopyright, C, Balalis, D, Baldini, E, Baraket, O, Baral, S, Barone, M, Gonzalez Barranquero, A, Barreras, J, Bass, G, Bayhan, Z, Bellanova, G, Ben-Ishay, O, Bert, F, Bianchi, V, Biancuzzi, H, Radulescu, R, Bignell, M, Biloslavo, A, Bini, R, Bissacco, D, Boati, P, Boddaert, G, Bogdanic, B, Bombardini, C, Bonavina, L, Bonomo, L, Bottari, A, Bouliaris, K, Brachini, G, Brillantino, A, Brisinda, G, Bulanauca, M, Buonomo, L, Burcharth, J, Buscemi, S, Calabretto, F, Calini, G, Calu, V, Campanile, F, Campo Dall'Orto, R, Campos-Serra, A, Carvas, J, Cascella, M, Pattacini, G, Celentano, V, Centonze, D, Ceresoli, M, Chatzipetris, D, Chessa, A, Chiarello, M, Chirica, M, Chooklin, S, Chouliaras, C, Chowdhury, S, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colais-Ruiz, E, Colak, E, Conti, L, Coppola, A, de Sa, T, Costa, S, Cozza, V, Curro', G, Dabekaussen, K, D'Acapito, F, Damaskos, D, D'Ambrosio, G, Das, K, Davies, R, de Beaux, A, De Lebrusant Fernandez, S, De Luca, A, De Simone, B, De Stefano, F, Degrate, L, Demetrashvili, Z, Demetriades, A, Detanac, D, Dezi, A, Di Buono, G, Carlo, I, Di Lascio, P, Di Martino, M, Di Saverio, S, Diaconescu, B, Diaz, J, Dibra, R, Dimitrov, E, Dinuzzi, V, Dios-Barbeito, S, Diyani, J, Dogjani, A, Domanin, M, D'Oria, M, Munoz-Cruzado, V, East, B, Ekelund, M, Ekwen, G, Elbaih, A, Elhadi, M, Enninghorst, N, Ernisova, M, Escalera-Antezana, J, Esposito, S, Esposito, G, Estaire-Gamez, M, Fara, C, Farre, R, Favi, F, Ferrario, L, Ferrario di Tor Vajana, A, Filisetti, C, Fleres, F, Fonseca, V, Forero-Torres, A, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Frassini, S, Frazzetta, G, Frigerio, I, Frountzas, M, Gachabayov, M, Galeiras, R, Garcaa, B, Garcia Vazquez, A, Gargarella, S, Garzali, I, Ghannam, W, Ghazi, F, Gillman, L, Gioco, R, Giordano, A, Giordano, L, Giove, C, Giraudo, G, Giuffrida, M, Capponi, M, Gois, E, Gomes, C, Gomes, F, Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Gracia-Roman, R, Graziano, G, Griffiths, E, Guagni, T, Hadzhiev, D, Haidar, M, Hamid, H, Hardcastle, T, Hayati, F, Healey, A, Hecker, A, Hecker, M, Garcia, E, Hodonou, A, Huaman, E, Huerta, M, Ibrahim, A, Ibrahim, B, Ietto, G, Inama, M, Ioannidis, O, Isik, A, Ismail, N, Ismail, A, Jailani, R, Jang, J, Kalfountzos, C, Kalipershad, S, Kaouras, E, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Katsaros, I, Kavalakat, A, Kechagias, A, Kenig, J, Kessel, B, Khan, J, Khokha, V, Kim, J, Kirkpatrick, A, Klappenbach, R, Kobe, Y, Lymperis, E, Kok, K, Kong, V, Korkolis, D, Koukoulis, G, Kovacevic, B, Kruger, V, Kryvoruchko, I, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Lapolla, P, Licari, L, Lisi, G, Litvin, A, Lizarazu, A, Bayo, H, Lohsiriwat, V, Moreira, C, Lostoridis, E, Luna, A, Luppi, D, V, G, Maegele, M, Maggiore, D, Magnone, S, Maier, R, Major, P, Manangi, M, Manetti, A, Mantoglu, B, Marafante, C, Mariani, F, Marinis, A, Mariot, E, Marseglia, G, Martanez-Parez, A, Martines, G, Perez, A, Martino, C, Mascagni, P, Massalou, D, Mataas-Garcaa, B, Mazzarella, G, Mazzarolo, G, Melo, R, Mendoza-Moreno, F, Meric, S, Meyer, J, Miceli, L, Michalopoulos, N, Milana, F, Mingoli, A, Mishra, T, Mohamed, M, Mohamedahmed, A, Mohammed, M, Mohan, R, Moore, E, Morales-Garcia, D, Muhrbeck, M, Mulita, F, Mustafa, S, Muttillo, E, Naimzada, M, Navsaria, P, Negoi, I, Nespoli, L, Nguyen, C, Nidaw, M, Nigri, G, Nikolopoulos, I, O'Connor, D, Ogundipe, H, Oliveri, C, Olmi, S, Ong, E, Orecchia, L, Osipov, A, Othman, M, Pace, M, Pacilli, M, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papa, M, Papaconstantinou, D, Papadoliopoulou, M, Papadopoulos, A, Papis, D, Pararas, N, Parreira, J, Parry, N, Pata, F, Patel, T, Paterson-Brown, S, Pavone, G, Pecchini, F, Pellino, G, Pelloni, M, Peloso, A, del Pozo, E, Pereira, R, Pereira, B, Perra, T, Perrone, G, Pesce, A, Petagna, L, Petracca, G, Phupong, V, Picardi, B, Picciariello, A, Piccoli, M, Piccolo, D, Picetti, E, Pikoulis Pikoulis, E, Pintar, T, Pirozzolo, G, Piscioneri, F, Podda, M, Porcu, A, Privitera, F, Punzo, C, Quaresima, S, Quiodettis, M, Qvist, N, Rahim, R, de Almeida, F, Ramely, R, Rasa, H, Reichert, M, Reinisch-Liese, A, Renne, A, Riccetti, C, Rodriguez-Luna, M, Roizblatt, D, Romanzi, A, Romeo, L, Roscio, F, Rosnelifaizur, R, Rossi, S, Rubiano, A, Ruiz-Ascar, E, Sakakushev, B, Salamea, J, Sall, I, Samarakoon, L, Sammartano, F, Arteaga, A, Sanchez-Cordero, S, Santoanastaso, D, Sasia, D, Sato, N, Savchuk, A, Sawyer, R, Scaioli, G, Schizas, D, Sebastiani, S, Seeliger, B, Lohse, H, Seretis, C, Sermonesi, G, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Sidiropoulos, T, Simoes, R, Siragusa, L, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Sopuev, A, Soreide, K, Sovatzidis, A, Stahel, P, Strickland, M, Sultan, M, Sydorchuk, R, Sydorchuk, L, Syed, S, Syed, A, Tallon-Aguilar, L, Tamburini, A, Tamini, N, Tan, E, Tan, J, Tarasconi, A, Tartaglia, N, Tartaglia, G, Tartaglia, D, Taylor, J, Tebala, G, Teuben, M, Theodorou, A, Tolonen, M, Tomasicchio, G, Toro, A, Torre, B, Triantafyllou, T, Trigiante Trigiante, G, Tripepi, M, Trostchansky, J, Tsekouras, K, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Uchikov, P, Ugarte-Sierra, B, Ukkonen, M, Vailas, M, Vassiliu, P, Vazquez, A, Vazquez, R, Verde, J, Veroux, M, Vigano, J, Vilallonga, R, Visconti, D, Vittori, A, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Wong, T, Xenaki, S, Yu, B, Yule, S, Zachariah, S, Zacharis, G, Zaghi, C, Zakaria, A, Zambrano, D, Zampitis, N, Zampogna, B, Zangha, S, Zapsalis, K, Zattoni, F, Zese, M, Farre, S, Pegoraro, V, Zantedeschi, M, Reitano, E, Pizzocaro, E, Cobianchi L., Dal Mas F., Agnoletti V., Ansaloni L., Biffl W., Butturini G., Campostrini S., Catena F., Denicolai S., Fugazzola P., Martellucci J., Massaro M., Previtali P., Ruta F., Venturi A., Woltz S., Kaafarani H. M., Loftus T. J., Aapoaylu R., Abbott K. L., Abdelmalik A., Abebe N. S., Abu-Zidan F., Adam Y. A. Y., Adamou H., Adamovich D. M., Agresta F., Agrusa A., Akin E., Alessiani M., Alexandrino H., Bidoli C., Ali S. M., Mihai V. A., Almeida P. M., Al-Shehari M. M., Altomare M., Amico F., Ammendola M., Andreuccetti J., Anestiadou E., Annicchiarico A., Antonelli A., Aparicio-Sanchez D., Ardito A., Argenio G., Arvieux C. C., Arvieux C., Askevold I. H., Atanasov B. T., Augustin G., Awad S. S., Bacchiocchi G., Bagnoli C., Bahouth H., Baili E., Bains L., Baiocchi G. L., Bala M., BalaguaCopyright C., Balalis D., Baldini E., Baraket O., Baral S., Barone M., Gonzalez Barranquero A., Barreras J. A., Bass G. A., Bayhan Z., Bellanova G., Ben-Ishay O., Bert F., Bianchi V., Biancuzzi H., Radulescu R. B., Bignell M. B., Biloslavo A., Bini R., Bissacco D., Boati P., Boddaert G., Bogdanic B., Bombardini C., Bonavina L., Bonomo L., Bottari A., Bouliaris K., Brachini G., Brillantino A., Brisinda G., Bulanauca M. M., Buonomo L. A., Burcharth J., Buscemi S., Calabretto F., Calini G., Calu V., Campanile F. C., Campo Dall'Orto R., Campos-Serra A., Carvas J. M., Cascella M., Pattacini G. C., Celentano V., Centonze D. C., Ceresoli M., Chatzipetris D., Chessa A., Chiarello M. M., Chirica M., Chooklin S., Chouliaras C., Chowdhury S., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colais-Ruiz E., Colak E., Conti L., Coppola A., de Sa T. C., Costa S. D., Cozza V., Curro' G., Dabekaussen K. F. A. -S. A., D'acapito F., Damaskos D., D'Ambrosio G., Das K., Davies R. J., de Beaux A. C., De Lebrusant Fernandez S. P., De Luca A., De Simone B., De Stefano F., Degrate L., Demetrashvili Z., Demetriades A. K., Detanac D. S., Dezi A., Di Buono G., Carlo I. -D. I., Di Lascio P., Di Martino M., Di Saverio S., Diaconescu B., Diaz J. J., Dibra R., Dimitrov E. N., Dinuzzi V. P., Dios-Barbeito S., Diyani J. F. A., Dogjani A., Domanin M., D'Oria M., Munoz-Cruzado V. D., East B., Ekelund M., Ekwen G. T., Elbaih A. H., Elhadi M., Enninghorst N., Ernisova M., Escalera-Antezana J. P., Esposito S., Esposito G., Estaire-Gamez M., Fara C. N., Farre R., Favi F., Ferrario L., Ferrario di Tor Vajana A., Filisetti C., Fleres F., Fonseca V. C., Forero-Torres A., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Frassini S., Frazzetta G., Frigerio I., Frountzas M., Gachabayov M., Galeiras R., Garcaa B. M., Garcia Vazquez A., Gargarella S., Garzali I. U., Ghannam W. M., Ghazi F. N., Gillman L. M., Gioco R., Giordano A., Giordano L., Giove C., Giraudo G., Giuffrida M., Capponi M. G., Gois E., Gomes C. A., Gomes F. C., Gonsaga R. A. T., Gonullu E., Goosen J., Goranovic T., Gracia-Roman R., Graziano G. M. P., Griffiths E. A., Guagni T., Hadzhiev D. B., Haidar M. G., Hamid H. K. S., Hardcastle T. C., Hayati F., Healey A. J., Hecker A., Hecker M., Garcia E. F. H., hodonou A. M., huaman E., Huerta M., Ibrahim A. F., Ibrahim B. M. S., Ietto G., Inama M., Ioannidis O., Isik A., Ismail N., Ismail A. M. H., Jailani R. F., Jang J. Y., Kalfountzos C., Kalipershad S. N. R., Kaouras E., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Katsaros I., Kavalakat A. J., Kechagias A., Kenig J., Kessel B. J., Khan J. S., Khokha V., Kim J. I., Kirkpatrick A. W., Klappenbach R., Kobe Y., Lymperis E. K., Kok K. Y. Y., Kong V., Korkolis D. P., Koukoulis G., Kovacevic B., Kruger V. F., Kryvoruchko I. A., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Lapolla P., Licari L., Lisi G., Litvin A., Lizarazu A., Bayo H. L., Lohsiriwat V., Moreira C. C. L., Lostoridis E., Luna A. T., Luppi D., V G. M. M., Maegele M., Maggiore D., Magnone S., Maier R. V., Major P., Manangi M., manetti A., Mantoglu B., Marafante C., Mariani F., Marinis A., Mariot E. A. S., Marseglia G. R., Martanez-Parez A., Martines G., Perez A. M., Martino C., Mascagni P., Massalou D., Mataas-Garcaa B., Mazzarella G., Mazzarolo G., Melo R. B., Mendoza-Moreno F., Meric S., Meyer J., Miceli L., Michalopoulos N. V., Milana F., Mingoli A., Mishra T. S., Mohamed M., Mohamed M. I. E. A., Mohamedahmed A. Y., Mohammed M. J. S., Mohan R., Moore E. E., Morales-Garcia D., Muhrbeck M., Mulita F., Mustafa S. M. S., Muttillo E. M., Naimzada M. D., Navsaria P. H., Negoi I., Nespoli L., Nguyen C., Nidaw M. K., Nigri G., Nikolopoulos I., O'Connor D. B., Ogundipe H. D., Oliveri C., Olmi S., Ong E. C. W., Orecchia L., Osipov A. V., Othman M. F., Pace M., Pacilli M., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papa M. V., Papaconstantinou D., Papadoliopoulou M., Papadopoulos A., Papis D., Pararas N., Parreira J. G., Parry N. G., Pata F., Patel T., Paterson-Brown S., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., del Pozo E. P., Pereira R. G., Pereira B. M., perez A. L., Perra T., Perrone G., Pesce A., Petagna L., Petracca G., Phupong V., Picardi B., Picciariello A., Piccoli M., Piccolo D., Picetti E., Pikoulis Pikoulis E., Pintar T., Pirozzolo G., Piscioneri F., Podda M., Porcu A., Privitera F., Punzo C., Quaresima S., Quiodettis M. A., Qvist N., Rahim R., de Almeida F. R., Ramely R. B., Rasa H. K., Reichert M., Reinisch-Liese A., Renne A., Riccetti C., Rodriguez-Luna M. R., Roizblatt D., Romanzi A., Romeo L., Roscio F. P. M., Rosnelifaizur R. B., Rossi S., Rubiano A. M., Ruiz-Ascar E., Sakakushev B. E., Salamea J. C., Sall I., Samarakoon L. B., Sammartano F., Arteaga A. S., Sanchez-Cordero S., Santoanastaso D. P. M., Sasia D., Sato N., Savchuk A., Sawyer R. G., Scaioli G., Schizas D., Sebastiani S., Seeliger B., Lohse H. A. S., Seretis C., Sermonesi G., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Sidiropoulos T., Simoes R. L., Siragusa L., Siribumrungwong B., Slavchev M., Solaini L., soldini G., Sopuev A., Soreide K., Sovatzidis A., Stahel P. F., Strickland M., Sultan M. A. H., Sydorchuk R., Sydorchuk L., Syed S. M. A. M., Syed A. M., Tallon-Aguilar L., Tamburini A. M., Tamini N., Tan E. C. T. H., Tan J. H., Tarasconi A., Tartaglia N., Tartaglia G., Tartaglia D., Taylor J. V., Tebala G. D., Teuben M., Theodorou A., Tolonen M., Tomasicchio G., Toro A., Torre B., Triantafyllou T., Trigiante Trigiante G., Tripepi M., Trostchansky J., Tsekouras K., Turrado-Rodriguez V., Tutino R., Uccelli M., Uchikov P. A., Ugarte-Sierra B., Ukkonen M. T., Vailas M., Vassiliu P. G., Vazquez A. G., Vazquez R. G., Verde J. E., Verde J. M., Veroux M., Vigano J., Vilallonga R., Visconti D., Vittori A., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Wong T. H., Xenaki S., Yu B., Yule S., Zachariah S. K., Zacharis G., Zaghi C., Zakaria A. D., Zambrano D. A., Zampitis N., Zampogna B., Zangha S., Zapsalis K., Zattoni F., Zese M., Farre S. P., Pegoraro V., Zantedeschi M., Reitano E., and Pizzocaro E.

Abstract

Background: Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons. Methods: Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society’s website, and shared on the society’s Twitter profile. Results: A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involving the patient. Several barriers to effectively partnering with the patient in the decision-making process were identified, such as the lack of time and the need to concentrate on making medical teams work smoothly. Discussion: Our investigation underlines how only a minority of trauma and emergency surgeons understand SDM, and perhaps, the value of SDM is not fully accepted in trauma and emergency situations. The inclusion of SDM practices in clinical guidelines may represent the most feasible and advocated solutions.

Published
2023

6. Assessing and managing frailty in emergency laparotomy: a WSES position paper

Author

Tian B. W. C. A., Stahel P. F., Picetti E., Campanelli G., Di Saverio S., Moore E., Bensard D., Sakakushev B., Galante J., Fraga G. P., Koike K., Di Carlo I., Tebala G. D., Leppaniemi A., Tan E., Damaskos D., De'Angelis N., Hecker A., Pisano M., YunfengCui, Maier R. V., De Simone B., Amico F., Ceresoli M., Pikoulis M., Weber D. G., Biffl W., Beka S. G., Abu-Zidan F. M., Valentino M., Coccolini F., Kluger Y., Sartelli M., Agnoletti V., Chirica M., Bravi F., Sall I., Catena F., Tian, B, Stahel, P, Picetti, E, Campanelli, G, Di Saverio, S, Moore, E, Bensard, D, Sakakushev, B, Galante, J, Fraga, G, Koike, K, Di Carlo, I, Tebala, G, Leppaniemi, A, Tan, E, Damaskos, D, De'Angelis, N, Hecker, A, Pisano, M, Yunfengcui, Maier, R, De Simone, B, Amico, F, Ceresoli, M, Pikoulis, M, Weber, D, Biffl, W, Beka, S, Abu-Zidan, F, Valentino, M, Coccolini, F, Kluger, Y, Sartelli, M, Agnoletti, V, Chirica, M, Bravi, F, Sall, I, and Catena, F

Subjects
Laparotomy, Elderly, Frail, Frailty, Emergency surgery
Abstract

Many countries are facing an aging population. As people live longer, surgeons face the prospect of operating on increasingly older patients. Traditional teaching is that with older age, these patients face an increased risk of mortality and morbidity, even to a level deemed too prohibitive for surgery. However, this is not always true. An active 90-year-old patient can be much fitter than an overweight, sedentary 65-year-old patient with comorbidities. Recent literature shows that frailty—an age-related cumulative decline in multiple physiological systems, is therefore a better predictor of mortality and morbidity than chronological age alone. Despite recognition of frailty as an important tool in identifying vulnerable surgical patients, many surgeons still shun objective tools. The aim of this position paper was to perform a review of the existing literature and to provide recommendations on emergency laparotomy and in frail patients. This position paper was reviewed by an international expert panel composed of 37 experts who were asked to critically revise the manuscript and position statements. The position paper was conducted according to the WSES methodology. We shall present the derived statements upon which a consensus was reached, specifying the quality of the supporting evidence and suggesting future research directions.

Published
2023

7. Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines

Author

Coccolini, F, Corradi, F, Sartelli, M, Coimbra, R, Kryvoruchko, I, Leppaniemi, A, Doklestic, K, Bignami, E, Biancofiore, G, Bala, M, Ceresoli, M, Damaskos, D, Biffl, W, Fugazzola, P, Santonastaso, D, Agnoletti, V, Sbarbaro, C, Nacoti, M, Hardcastle, T, Mariani, D, De Simone, B, Tolonen, M, Ball, C, Podda, M, Di Carlo, I, Di Saverio, S, Navsaria, P, Bonavina, L, Abu-Zidan, F, Soreide, K, Fraga, G, Carvalho, V, Batista, S, Hecker, A, Cucchetti, A, Ercolani, G, Tartaglia, D, Galante, J, Wani, I, Kurihara, H, Tan, E, Litvin, A, Melotti, R, Sganga, G, Zoro, T, Isirdi, A, De'Angelis, N, Weber, D, Hodonou, A, Tenbroek, R, Parini, D, Khan, J, Sbrana, G, Coniglio, C, Giarratano, A, Gratarola, A, Zaghi, C, Romeo, O, Kelly, M, Forfori, F, Chiarugi, M, Moore, E, Catena, F, Malbrain, M, Coccolini F., Corradi F., Sartelli M., Coimbra R., Kryvoruchko I. A., Leppaniemi A., Doklestic K., Bignami E., Biancofiore G., Bala M., Ceresoli M., Damaskos D., Biffl W. L., Fugazzola P., Santonastaso D., Agnoletti V., Sbarbaro C., Nacoti M., Hardcastle T. C., Mariani D., De Simone B., Tolonen M., Ball C., Podda M., Di Carlo I., Di Saverio S., Navsaria P., Bonavina L., Abu-Zidan F., Soreide K., Fraga G. P., Carvalho V. H., Batista S. F., Hecker A., Cucchetti A., Ercolani G., Tartaglia D., Galante J. M., Wani I., Kurihara H., Tan E., Litvin A., Melotti R. M., Sganga G., Zoro T., Isirdi A., De'Angelis N., Weber D. G., Hodonou A. M., tenBroek R., Parini D., Khan J., Sbrana G., Coniglio C., Giarratano A., Gratarola A., Zaghi C., Romeo O., Kelly M., Forfori F., Chiarugi M., Moore E. E., Catena F., Malbrain M. L. N. G., Coccolini, F, Corradi, F, Sartelli, M, Coimbra, R, Kryvoruchko, I, Leppaniemi, A, Doklestic, K, Bignami, E, Biancofiore, G, Bala, M, Ceresoli, M, Damaskos, D, Biffl, W, Fugazzola, P, Santonastaso, D, Agnoletti, V, Sbarbaro, C, Nacoti, M, Hardcastle, T, Mariani, D, De Simone, B, Tolonen, M, Ball, C, Podda, M, Di Carlo, I, Di Saverio, S, Navsaria, P, Bonavina, L, Abu-Zidan, F, Soreide, K, Fraga, G, Carvalho, V, Batista, S, Hecker, A, Cucchetti, A, Ercolani, G, Tartaglia, D, Galante, J, Wani, I, Kurihara, H, Tan, E, Litvin, A, Melotti, R, Sganga, G, Zoro, T, Isirdi, A, De'Angelis, N, Weber, D, Hodonou, A, Tenbroek, R, Parini, D, Khan, J, Sbrana, G, Coniglio, C, Giarratano, A, Gratarola, A, Zaghi, C, Romeo, O, Kelly, M, Forfori, F, Chiarugi, M, Moore, E, Catena, F, Malbrain, M, Coccolini F., Corradi F., Sartelli M., Coimbra R., Kryvoruchko I. A., Leppaniemi A., Doklestic K., Bignami E., Biancofiore G., Bala M., Ceresoli M., Damaskos D., Biffl W. L., Fugazzola P., Santonastaso D., Agnoletti V., Sbarbaro C., Nacoti M., Hardcastle T. C., Mariani D., De Simone B., Tolonen M., Ball C., Podda M., Di Carlo I., Di Saverio S., Navsaria P., Bonavina L., Abu-Zidan F., Soreide K., Fraga G. P., Carvalho V. H., Batista S. F., Hecker A., Cucchetti A., Ercolani G., Tartaglia D., Galante J. M., Wani I., Kurihara H., Tan E., Litvin A., Melotti R. M., Sganga G., Zoro T., Isirdi A., De'Angelis N., Weber D. G., Hodonou A. M., tenBroek R., Parini D., Khan J., Sbrana G., Coniglio C., Giarratano A., Gratarola A., Zaghi C., Romeo O., Kelly M., Forfori F., Chiarugi M., Moore E. E., Catena F., and Malbrain M. L. N. G.

Abstract

Background: Non-traumatic emergency general surgery involves a heterogeneous population that may present with several underlying diseases. Timeous emergency surgical treatment should be supplemented with high-quality perioperative care, ideally performed by multidisciplinary teams trained to identify and handle complex postoperative courses. Uncontrolled or poorly controlled acute postoperative pain may result in significant complications. While pain management after elective surgery has been standardized in perioperative pathways, the traditional perioperative treatment of patients undergoing emergency surgery is often a haphazard practice. The present recommended pain management guidelines are for pain management after non-traumatic emergency surgical intervention. It is meant to provide clinicians a list of indications to prescribe the optimal analgesics even in the absence of a multidisciplinary pain team. Material and methods: An international expert panel discussed the different issues in subsequent rounds. Four international recognized scientific societies: World Society of Emergency Surgery (WSES), Global Alliance for Infection in Surgery (GAIS), Italian Society of Anesthesia, Analgesia Intensive Care (SIAARTI), and American Association for the Surgery of Trauma (AAST), endorsed the project and approved the final manuscript. Conclusion: Dealing with acute postoperative pain in the emergency abdominal surgery setting is complex, requires special attention, and should be multidisciplinary. Several tools are available, and their combination is mandatory whenever is possible. Analgesic approach to the various situations and conditions should be patient based and tailored according to procedure, pathology, age, response, and available expertise. A better understanding of the patho-mechanisms of postoperative pain for short- and long-term outcomes is necessary to improve prophylactic and treatment strategies.

Published
2022

8. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery

Author

Bala, M, Catena, F, Kashuk, J, De Simone, B, Gomes, C, Weber, D, Sartelli, M, Coccolini, F, Kluger, Y, Abu-Zidan, F, Picetti, E, Ansaloni, L, Augustin, G, Biffl, W, Ceresoli, M, Chiara, O, Chiarugi, M, Coimbra, R, Cui, Y, Damaskos, D, Di Saverio, S, Galante, J, Khokha, V, Kirkpatrick, A, Inaba, K, Leppaniemi, A, Litvin, A, Peitzman, A, Shelat, V, Sugrue, M, Tolonen, M, Rizoli, S, Sall, I, Beka, S, Di Carlo, I, Ten Broek, R, Mircea, C, Tebala, G, Pisano, M, van Goor, H, Maier, R, Jeekel, H, Civil, I, Hecker, A, Tan, E, Soreide, K, Lee, M, Wani, I, Bonavina, L, Malangoni, M, Koike, K, Velmahos, G, Fraga, G, Fette, A, De'Angelis, N, Balogh, Z, Scalea, T, Sganga, G, Kelly, M, Khan, J, Stahel, P, Moore, E, Bala M., Catena F., Kashuk J., De Simone B., Gomes C. A., Weber D., Sartelli M., Coccolini F., Kluger Y., Abu-Zidan F. M., Picetti E., Ansaloni L., Augustin G., Biffl W. L., Ceresoli M., Chiara O., Chiarugi M., Coimbra R., Cui Y., Damaskos D., Di Saverio S., Galante J. M., Khokha V., Kirkpatrick A. W., Inaba K., Leppaniemi A., Litvin A., Peitzman A. B., Shelat V. G., Sugrue M., Tolonen M., Rizoli S., Sall I., Beka S. G., Di Carlo I., Ten Broek R., Mircea C., Tebala G., Pisano M., van Goor H., Maier R. V., Jeekel H., Civil I., Hecker A., Tan E., Soreide K., Lee M. J., Wani I., Bonavina L., Malangoni M. A., Koike K., Velmahos G. C., Fraga G. P., Fette A., de'Angelis N., Balogh Z. J., Scalea T. M., Sganga G., Kelly M. D., Khan J., Stahel P. F., Moore E. E., Bala, M, Catena, F, Kashuk, J, De Simone, B, Gomes, C, Weber, D, Sartelli, M, Coccolini, F, Kluger, Y, Abu-Zidan, F, Picetti, E, Ansaloni, L, Augustin, G, Biffl, W, Ceresoli, M, Chiara, O, Chiarugi, M, Coimbra, R, Cui, Y, Damaskos, D, Di Saverio, S, Galante, J, Khokha, V, Kirkpatrick, A, Inaba, K, Leppaniemi, A, Litvin, A, Peitzman, A, Shelat, V, Sugrue, M, Tolonen, M, Rizoli, S, Sall, I, Beka, S, Di Carlo, I, Ten Broek, R, Mircea, C, Tebala, G, Pisano, M, van Goor, H, Maier, R, Jeekel, H, Civil, I, Hecker, A, Tan, E, Soreide, K, Lee, M, Wani, I, Bonavina, L, Malangoni, M, Koike, K, Velmahos, G, Fraga, G, Fette, A, De'Angelis, N, Balogh, Z, Scalea, T, Sganga, G, Kelly, M, Khan, J, Stahel, P, Moore, E, Bala M., Catena F., Kashuk J., De Simone B., Gomes C. A., Weber D., Sartelli M., Coccolini F., Kluger Y., Abu-Zidan F. M., Picetti E., Ansaloni L., Augustin G., Biffl W. L., Ceresoli M., Chiara O., Chiarugi M., Coimbra R., Cui Y., Damaskos D., Di Saverio S., Galante J. M., Khokha V., Kirkpatrick A. W., Inaba K., Leppaniemi A., Litvin A., Peitzman A. B., Shelat V. G., Sugrue M., Tolonen M., Rizoli S., Sall I., Beka S. G., Di Carlo I., Ten Broek R., Mircea C., Tebala G., Pisano M., van Goor H., Maier R. V., Jeekel H., Civil I., Hecker A., Tan E., Soreide K., Lee M. J., Wani I., Bonavina L., Malangoni M. A., Koike K., Velmahos G. C., Fraga G. P., Fette A., de'Angelis N., Balogh Z. J., Scalea T. M., Sganga G., Kelly M. D., Khan J., Stahel P. F., and Moore E. E.

Abstract

Acute mesenteric ischemia (AMI) is a group of diseases characterized by an interruption of the blood supply to varying portions of the intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process may progress to life-threatening intestinal necrosis. The incidence is low, estimated at 0.09–0.2% of all acute surgical admissions, but increases with age. Although the entity is an uncommon cause of abdominal pain, diligence is required because if untreated, mortality remains in the range of 50%. Early diagnosis and timely surgical intervention are the cornerstones of modern treatment to reduce the high mortality associated with this entity. The advent of endovascular approaches in parallel with modern imaging techniques is evolving and provides new treatment options. Lastly, a focused multidisciplinary approach based on early diagnosis and individualized treatment is essential. Thus, we believe that updated guidelines from World Society of Emergency Surgery are warranted, in order to provide the most recent and practical recommendations for diagnosis and treatment of AMI.

Published
2022

9. Follow-up strategies for patients with splenic trauma managed non-operatively: the 2022 World Society of Emergency Surgery consensus document

Author

Podda, M, De Simone, B, Ceresoli, M, Virdis, F, Favi, F, Wiik Larsen, J, Coccolini, F, Sartelli, M, Pararas, N, Beka, S, Bonavina, L, Bova, R, Pisanu, A, Abu-Zidan, F, Balogh, Z, Chiara, O, Wani, I, Stahel, P, Di Saverio, S, Scalea, T, Soreide, K, Sakakushev, B, Amico, F, Martino, C, Hecker, A, De'Angelis, N, Chirica, M, Galante, J, Kirkpatrick, A, Pikoulis, E, Kluger, Y, Bensard, D, Ansaloni, L, Fraga, G, Civil, I, Tebala, G, Di Carlo, I, Cui, Y, Coimbra, R, Agnoletti, V, Sall, I, Tan, E, Picetti, E, Litvin, A, Damaskos, D, Inaba, K, Leung, J, Maier, R, Biffl, W, Leppaniemi, A, Moore, E, Gurusamy, K, Catena, F, Podda M., De Simone B., Ceresoli M., Virdis F., Favi F., Wiik Larsen J., Coccolini F., Sartelli M., Pararas N., Beka S. G., Bonavina L., Bova R., Pisanu A., Abu-Zidan F., Balogh Z., Chiara O., Wani I., Stahel P., Di Saverio S., Scalea T., Soreide K., Sakakushev B., Amico F., Martino C., Hecker A., de'Angelis N., Chirica M., Galante J., Kirkpatrick A., Pikoulis E., Kluger Y., Bensard D., Ansaloni L., Fraga G., Civil I., Tebala G. D., Di Carlo I., Cui Y., Coimbra R., Agnoletti V., Sall I., Tan E., Picetti E., Litvin A., Damaskos D., Inaba K., Leung J., Maier R., Biffl W., Leppaniemi A., Moore E., Gurusamy K., Catena F., Podda, M, De Simone, B, Ceresoli, M, Virdis, F, Favi, F, Wiik Larsen, J, Coccolini, F, Sartelli, M, Pararas, N, Beka, S, Bonavina, L, Bova, R, Pisanu, A, Abu-Zidan, F, Balogh, Z, Chiara, O, Wani, I, Stahel, P, Di Saverio, S, Scalea, T, Soreide, K, Sakakushev, B, Amico, F, Martino, C, Hecker, A, De'Angelis, N, Chirica, M, Galante, J, Kirkpatrick, A, Pikoulis, E, Kluger, Y, Bensard, D, Ansaloni, L, Fraga, G, Civil, I, Tebala, G, Di Carlo, I, Cui, Y, Coimbra, R, Agnoletti, V, Sall, I, Tan, E, Picetti, E, Litvin, A, Damaskos, D, Inaba, K, Leung, J, Maier, R, Biffl, W, Leppaniemi, A, Moore, E, Gurusamy, K, Catena, F, Podda M., De Simone B., Ceresoli M., Virdis F., Favi F., Wiik Larsen J., Coccolini F., Sartelli M., Pararas N., Beka S. G., Bonavina L., Bova R., Pisanu A., Abu-Zidan F., Balogh Z., Chiara O., Wani I., Stahel P., Di Saverio S., Scalea T., Soreide K., Sakakushev B., Amico F., Martino C., Hecker A., de'Angelis N., Chirica M., Galante J., Kirkpatrick A., Pikoulis E., Kluger Y., Bensard D., Ansaloni L., Fraga G., Civil I., Tebala G. D., Di Carlo I., Cui Y., Coimbra R., Agnoletti V., Sall I., Tan E., Picetti E., Litvin A., Damaskos D., Inaba K., Leung J., Maier R., Biffl W., Leppaniemi A., Moore E., Gurusamy K., and Catena F.

Abstract

Background: In 2017, the World Society of Emergency Surgery published its guidelines for the management of adult and pediatric patients with splenic trauma. Several issues regarding the follow-up of patients with splenic injuries treated with NOM remained unsolved. Methods: Using a modified Delphi method, we sought to explore ongoing areas of controversy in the NOM of splenic trauma and reach a consensus among a group of 48 international experts from five continents (Africa, Europe, Asia, Oceania, America) concerning optimal follow-up strategies in patients with splenic injuries treated with NOM. Results: Consensus was reached on eleven clinical research questions and 28 recommendations with an agreement rate ≥ 80%. Mobilization after 24 h in low-grade splenic trauma patients (WSES Class I, AAST Grades I–II) was suggested, while in patients with high-grade splenic injuries (WSES Classes II–III, AAST Grades III–V), if no other contraindications to early mobilization exist, safe mobilization of the patient when three successive hemoglobins 8 h apart after the first are within 10% of each other was considered safe according to the panel. The panel suggests adult patients to be admitted to hospital for 1 day (for low-grade splenic injuries—WSES Class I, AAST Grades I–II) to 3 days (for high-grade splenic injuries—WSES Classes II–III, AAST Grades III–V), with those with high-grade injuries requiring admission to a monitored setting. In the absence of specific complications, the panel suggests DVT and VTE prophylaxis with LMWH to be started within 48–72 h from hospital admission. The panel suggests splenic artery embolization (SAE) as the first-line intervention in patients with hemodynamic stability and arterial blush on CT scan, irrespective of injury grade. Regarding patients with WSES Class II blunt splenic injuries (AAST Grade III) without contrast extravasation, a low threshold for SAE has been suggested in the presence of risk factors for NOM failure. The panel als

Published
2022

10. Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Author

Cobianchi, L, Dal Mas, F, Massaro, M, Biffl, W, Catena, F, Coccolini, F, Dionigi, B, Dionigi, P, Di Saverio, S, Fugazzola, P, Kluger, Y, Leppaniemi, A, Moore, E, Sartelli, M, Velmahos, G, Woltz, S, Angelos, P, Ansaloni, L, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Agrusa, A, Akin, E, Alexandrino, H, Ali, S, Almeida, P, Amico, F, Ammendola, M, Andreuccetti, J, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bagnoli, C, Bains, L, Balalis, D, Baldini, E, Baraket, O, Barone, M, Barreras, J, Bellanova, G, Biancuzzi, H, Bignell, M, Bini, R, Bissacco, D, Boati, P, Bottari, A, Bouliaris, K, Brillantino, A, Buonomo, L, Buscemi, S, Calu, V, Campo Dall'Orto, R, Campostrini, S, Carvas, J, Casoni Pattacini, G, Celentano, V, Ceresoli, M, Chirica, M, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Conti, L, Dantas Costa, S, D'Acapito, F, Damaskos, D, Das, K, Davies, R, De Beaux, A, De Simone, B, Demetrashvili, Z, Demetriades, A, Denicolai, S, Di Buono, G, Di Carlo, I, Diaconescu, B, Dibra, R, Dios-Barbeito, S, Dogjani, A, Domanin, M, D'Oria, M, Duran Munoz-Cruzado, V, East, B, Ekwen, G, Elbaih, A, Escalera-Antezana, J, Esposito, G, Farre, R, Ferrario di Tor Vajana, A, Cordeiro Fonseca, V, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Gachabayov, M, Garcia Vazquez, A, Ghannam, W, Gioco, R, Giraudo, G, Giuffrida, M, Giulii Capponi, M, Gomes, C, Teixeira Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Griffiths, E, Haidar, M, Hamid, H, Harddastle, T, Healey, A, Hecker, M, Hernandez Garcia, E, Huaman, E, Hutan, M, Ioannidis, O, Isik, A, Ismail, A, Ismail, N, Jang, J, Kaafarani, H, Kalipershad, S, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Kavalakat, A, Kechagias, A, Kenig, J, Khan, J, Khokha, V, Klappenbach, R, Kobe, Y, Kong, V, Korkolis, D, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Licari, L, Litvin, A, Loftus, T, Lohsiriwat, V, Lopes Moreira, C, Lostoridis, E, Luna, A, Luppi, D, Machain, G, Maegele, M, Maggiore, D, Maier, R, Manangi, M, Manetti, A, Mantoglu, B, Mariani, F, Marinis, A, Sbalcheiro Mariot, E, Marseglia, G, Martellucci, J, Martines, G, Martinez Perez, A, Mascagni, P, Massalou, D, Melo, R, Miceli, L, Mingoli, A, Mishra, T, Mohamedahmed, A, Mohan, R, Morales-Garcia, D, Mustafa, S, Naimzada, M, Negoi, I, Nguyen, C, Nidaw, M, Nigri, G, Ogundipe, H, Oliveri, C, Olmi, S, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papis, D, Pararas, N, Pata, F, Paterson-Brown, S, Pavone, G, Pecchini, F, Pellino, G, Pelloni, M, Peloso, A, Perea del Pozo, E, Goncalves Pereira, R, Monteiro Pereira, B, Lizarazu Perez, A, Perrone, G, Pesce, A, Petracca, G, Piccoli, M, Piccolo, D, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Podda, M, Previtali, P, Privitera, F, Punzo, C, Quiodettis, M, Qvist, N, Rahim, R, Reinisch-Liese, A, Rodriguez-Luna, M, Roizblatt, D, Roscio, F, Rossi, S, Ruta, F, Sakakushev, B, Salamea, J, Sall, I, Sammartano, F, Sanchez Arteaga, A, Sanchez-Cordero, S, Sasia, D, Sawyer, R, Seretis, C, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Simoes, R, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Soreide, K, Spada, F, Stahel, P, Sydorchuk, L, Sydorchuk, R, Syed, A, Tallon-Aguilar, L, Tan, J, Tan, E, Tarasconi, A, Tartaglia, D, Tartaglia, N, Taylor, J, Tebala, G, Teuben, M, Tolonen, M, Tomasicchio, G, Triantafyllou, T, Trigiante, G, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Ugarte-Sierra, B, Ukkonen, M, Vassiliu, P, Verde, J, Veroux, M, Vilallonga, R, Visconti, D, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Wong, T, Xenaki, S, Yu, B, Yule, S, Zakaria, A, Zambrano, D, Zese, M, Cobianchi L., Dal Mas F., Massaro M., Biffl W., Catena F., Coccolini F., Dionigi B., Dionigi P., Di Saverio S., Fugazzola P., Kluger Y., Leppaniemi A., Moore E. E., Sartelli M., Velmahos G., Woltz S., Angelos P., Ansaloni L., Abdelmalik A., Abebe N. S., Abu-Zidan F. M., Adam Y. A. Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S. M., Almeida P. M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I. H., Atanasov B. T., Augustin G., Awad S. S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J. A., Bellanova G., Biancuzzi H., Bignell M. B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L. A., Buscemi S., Calu V., Campo Dall'Orto R., Campostrini S., Carvas J. M., Casoni Pattacini G., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colak E., Conti L., Dantas Costa S., D'Acapito F., Damaskos D., Das K., Davies R. J., De Beaux A. C., De Simone B., Demetrashvili Z., Demetriades A. K., Denicolai S., Di Buono G., Di Carlo I., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G. T., Elbaih A. H., Escalera-Antezana J. P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Gachabayov M., Garcia Vazquez A. A., Ghannam W. M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C. A., Teixeira Gonsaga R. A., Gonullu E., Goosen J., Goranovic T., Griffiths E. A., Haidar M. G., Hamid H. K. S., Harddastle T. C., Healey A. J., Hecker M., Hernandez Garcia E. F., Huaman E. C., Hutan M., Ioannidis O., Isik A., Ismail A. M. H., Ismail N., Jang J. Y., Kaafarani H. M. A., Kalipershad S. N. R., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A. J., Kechagias A., Kenig J., Khan J. S., Khokha V., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Loftus T. J., Lohsiriwat V., Lopes Moreira C. C., Lostoridis E., Luna A. T., Luppi D., Machain G. M., Maegele M., Maggiore D., Maier R. V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E. A., Marseglia G. R., Martellucci J., Martines G., Martinez Perez A., Mascagni P., Massalou D., Melo R. B., Miceli L., Mingoli A., Mishra T. S., Mohamedahmed A. Y. Y., Mohan R., Morales-Garcia D., Mustafa S. M. S., Naimzada M. D., Negoi I., Nguyen C., Nidaw M. K., Nigri G., Ogundipe H. D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Paterson-Brown S., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Piccolo D., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M. A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M. R., Roizblatt D., Roscio F. P. M., Rossi S., Ruta F., Sakakushev B. E., Salamea J. C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R. G., Seretis C., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Simoes R. L., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Spada F., Stahel P., Sydorchuk L., Sydorchuk R., Syed A. M., Tallon-Aguilar L., Tan J. H., Tan E., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G. D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P. G., Verde J. M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Wong T. H., Xenaki S., Yu B., Yule S., Zakaria A. D., Zambrano D. A., Zese M., Cobianchi, L, Dal Mas, F, Massaro, M, Biffl, W, Catena, F, Coccolini, F, Dionigi, B, Dionigi, P, Di Saverio, S, Fugazzola, P, Kluger, Y, Leppaniemi, A, Moore, E, Sartelli, M, Velmahos, G, Woltz, S, Angelos, P, Ansaloni, L, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Agrusa, A, Akin, E, Alexandrino, H, Ali, S, Almeida, P, Amico, F, Ammendola, M, Andreuccetti, J, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bagnoli, C, Bains, L, Balalis, D, Baldini, E, Baraket, O, Barone, M, Barreras, J, Bellanova, G, Biancuzzi, H, Bignell, M, Bini, R, Bissacco, D, Boati, P, Bottari, A, Bouliaris, K, Brillantino, A, Buonomo, L, Buscemi, S, Calu, V, Campo Dall'Orto, R, Campostrini, S, Carvas, J, Casoni Pattacini, G, Celentano, V, Ceresoli, M, Chirica, M, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Conti, L, Dantas Costa, S, D'Acapito, F, Damaskos, D, Das, K, Davies, R, De Beaux, A, De Simone, B, Demetrashvili, Z, Demetriades, A, Denicolai, S, Di Buono, G, Di Carlo, I, Diaconescu, B, Dibra, R, Dios-Barbeito, S, Dogjani, A, Domanin, M, D'Oria, M, Duran Munoz-Cruzado, V, East, B, Ekwen, G, Elbaih, A, Escalera-Antezana, J, Esposito, G, Farre, R, Ferrario di Tor Vajana, A, Cordeiro Fonseca, V, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Gachabayov, M, Garcia Vazquez, A, Ghannam, W, Gioco, R, Giraudo, G, Giuffrida, M, Giulii Capponi, M, Gomes, C, Teixeira Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Griffiths, E, Haidar, M, Hamid, H, Harddastle, T, Healey, A, Hecker, M, Hernandez Garcia, E, Huaman, E, Hutan, M, Ioannidis, O, Isik, A, Ismail, A, Ismail, N, Jang, J, Kaafarani, H, Kalipershad, S, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Kavalakat, A, Kechagias, A, Kenig, J, Khan, J, Khokha, V, Klappenbach, R, Kobe, Y, Kong, V, Korkolis, D, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Licari, L, Litvin, A, Loftus, T, Lohsiriwat, V, Lopes Moreira, C, Lostoridis, E, Luna, A, Luppi, D, Machain, G, Maegele, M, Maggiore, D, Maier, R, Manangi, M, Manetti, A, Mantoglu, B, Mariani, F, Marinis, A, Sbalcheiro Mariot, E, Marseglia, G, Martellucci, J, Martines, G, Martinez Perez, A, Mascagni, P, Massalou, D, Melo, R, Miceli, L, Mingoli, A, Mishra, T, Mohamedahmed, A, Mohan, R, Morales-Garcia, D, Mustafa, S, Naimzada, M, Negoi, I, Nguyen, C, Nidaw, M, Nigri, G, Ogundipe, H, Oliveri, C, Olmi, S, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papis, D, Pararas, N, Pata, F, Paterson-Brown, S, Pavone, G, Pecchini, F, Pellino, G, Pelloni, M, Peloso, A, Perea del Pozo, E, Goncalves Pereira, R, Monteiro Pereira, B, Lizarazu Perez, A, Perrone, G, Pesce, A, Petracca, G, Piccoli, M, Piccolo, D, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Podda, M, Previtali, P, Privitera, F, Punzo, C, Quiodettis, M, Qvist, N, Rahim, R, Reinisch-Liese, A, Rodriguez-Luna, M, Roizblatt, D, Roscio, F, Rossi, S, Ruta, F, Sakakushev, B, Salamea, J, Sall, I, Sammartano, F, Sanchez Arteaga, A, Sanchez-Cordero, S, Sasia, D, Sawyer, R, Seretis, C, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Simoes, R, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Soreide, K, Spada, F, Stahel, P, Sydorchuk, L, Sydorchuk, R, Syed, A, Tallon-Aguilar, L, Tan, J, Tan, E, Tarasconi, A, Tartaglia, D, Tartaglia, N, Taylor, J, Tebala, G, Teuben, M, Tolonen, M, Tomasicchio, G, Triantafyllou, T, Trigiante, G, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Ugarte-Sierra, B, Ukkonen, M, Vassiliu, P, Verde, J, Veroux, M, Vilallonga, R, Visconti, D, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Wong, T, Xenaki, S, Yu, B, Yule, S, Zakaria, A, Zambrano, D, Zese, M, Cobianchi L., Dal Mas F., Massaro M., Biffl W., Catena F., Coccolini F., Dionigi B., Dionigi P., Di Saverio S., Fugazzola P., Kluger Y., Leppaniemi A., Moore E. E., Sartelli M., Velmahos G., Woltz S., Angelos P., Ansaloni L., Abdelmalik A., Abebe N. S., Abu-Zidan F. M., Adam Y. A. Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S. M., Almeida P. M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I. H., Atanasov B. T., Augustin G., Awad S. S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J. A., Bellanova G., Biancuzzi H., Bignell M. B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L. A., Buscemi S., Calu V., Campo Dall'Orto R., Campostrini S., Carvas J. M., Casoni Pattacini G., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colak E., Conti L., Dantas Costa S., D'Acapito F., Damaskos D., Das K., Davies R. J., De Beaux A. C., De Simone B., Demetrashvili Z., Demetriades A. K., Denicolai S., Di Buono G., Di Carlo I., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G. T., Elbaih A. H., Escalera-Antezana J. P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Gachabayov M., Garcia Vazquez A. A., Ghannam W. M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C. A., Teixeira Gonsaga R. A., Gonullu E., Goosen J., Goranovic T., Griffiths E. A., Haidar M. G., Hamid H. K. S., Harddastle T. C., Healey A. J., Hecker M., Hernandez Garcia E. F., Huaman E. C., Hutan M., Ioannidis O., Isik A., Ismail A. M. H., Ismail N., Jang J. Y., Kaafarani H. M. A., Kalipershad S. N. R., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A. J., Kechagias A., Kenig J., Khan J. S., Khokha V., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Loftus T. J., Lohsiriwat V., Lopes Moreira C. C., Lostoridis E., Luna A. T., Luppi D., Machain G. M., Maegele M., Maggiore D., Maier R. V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E. A., Marseglia G. R., Martellucci J., Martines G., Martinez Perez A., Mascagni P., Massalou D., Melo R. B., Miceli L., Mingoli A., Mishra T. S., Mohamedahmed A. Y. Y., Mohan R., Morales-Garcia D., Mustafa S. M. S., Naimzada M. D., Negoi I., Nguyen C., Nidaw M. K., Nigri G., Ogundipe H. D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Paterson-Brown S., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Piccolo D., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M. A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M. R., Roizblatt D., Roscio F. P. M., Rossi S., Ruta F., Sakakushev B. E., Salamea J. C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R. G., Seretis C., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Simoes R. L., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Spada F., Stahel P., Sydorchuk L., Sydorchuk R., Syed A. M., Tallon-Aguilar L., Tan J. H., Tan E., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G. D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P. G., Verde J. M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Wong T. H., Xenaki S., Yu B., Yule S., Zakaria A. D., Zambrano D. A., and Zese M.

Abstract

Background: Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods: The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results: Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions: Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence: Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance.

Published
2022

11. Operative management of acute abdomen after bariatric surgery in the emergency setting: the OBA guidelines

Author

De Simone, B, Chouillard, E, Ramos, A, Donatelli, G, Pintar, T, Gupta, R, Renzi, F, Mahawar, K, Madhok, B, Maccatrozzo, S, Abu-Zidan, F, E. Moore, E, Weber, D, Coccolini, F, Di Saverio, S, Kirkpatrick, A, Shelat, V, Amico, F, Pikoulis, E, Ceresoli, M, Galante, J, Wani, I, De' Angelis, N, Hecker, A, Sganga, G, Tan, E, Balogh, Z, Bala, M, Coimbra, R, Damaskos, D, Ansaloni, L, Sartelli, M, Parasas, N, Kluger, Y, Chahine, E, Agnoletti, V, Fraga, G, Biffl, W, Catena, F, De Simone B., Chouillard E., Ramos A. C., Donatelli G., Pintar T., Gupta R., Renzi F., Mahawar K., Madhok B., Maccatrozzo S., Abu-Zidan F. M., E. Moore E., Weber D. G., Coccolini F., Di Saverio S., Kirkpatrick A., Shelat V. G., Amico F., Pikoulis E., Ceresoli M., Galante J. M., Wani I., De' Angelis N., Hecker A., Sganga G., Tan E., Balogh Z. J., Bala M., Coimbra R., Damaskos D., Ansaloni L., Sartelli M., Parasas N., Kluger Y., Chahine E., Agnoletti V., Fraga G., Biffl W. L., Catena F., De Simone, B, Chouillard, E, Ramos, A, Donatelli, G, Pintar, T, Gupta, R, Renzi, F, Mahawar, K, Madhok, B, Maccatrozzo, S, Abu-Zidan, F, E. Moore, E, Weber, D, Coccolini, F, Di Saverio, S, Kirkpatrick, A, Shelat, V, Amico, F, Pikoulis, E, Ceresoli, M, Galante, J, Wani, I, De' Angelis, N, Hecker, A, Sganga, G, Tan, E, Balogh, Z, Bala, M, Coimbra, R, Damaskos, D, Ansaloni, L, Sartelli, M, Parasas, N, Kluger, Y, Chahine, E, Agnoletti, V, Fraga, G, Biffl, W, Catena, F, De Simone B., Chouillard E., Ramos A. C., Donatelli G., Pintar T., Gupta R., Renzi F., Mahawar K., Madhok B., Maccatrozzo S., Abu-Zidan F. M., E. Moore E., Weber D. G., Coccolini F., Di Saverio S., Kirkpatrick A., Shelat V. G., Amico F., Pikoulis E., Ceresoli M., Galante J. M., Wani I., De' Angelis N., Hecker A., Sganga G., Tan E., Balogh Z. J., Bala M., Coimbra R., Damaskos D., Ansaloni L., Sartelli M., Parasas N., Kluger Y., Chahine E., Agnoletti V., Fraga G., Biffl W. L., and Catena F.

Abstract

Background: Patients presenting with acute abdominal pain that occurs after months or years following bariatric surgery may present for assessment and management in the local emergency units. Due to the large variety of surgical bariatric techniques, emergency surgeons have to be aware of the main functional outcomes and long-term surgical complications following the most performed bariatric surgical procedures. The purpose of these evidence-based guidelines is to present a consensus position from members of the WSES in collaboration with IFSO bariatric experienced surgeons, on the management of acute abdomen after bariatric surgery focusing on long-term complications in patients who have undergone laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. Method: A working group of experienced general, acute care, and bariatric surgeons was created to carry out a systematic review of the literature following the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) and to answer the PICO questions formulated after the Operative management in bariatric acute abdomen survey. The literature search was limited to late/long-term complications following laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. Conclusions: The acute abdomen after bariatric surgery is a common cause of admission in emergency departments. Knowledge of the most common late/long-term complications (> 4 weeks after surgical procedure) following sleeve gastrectomy and Roux-en-Y gastric bypass and their anatomy leads to a focused management in the emergency setting with good outcomes and decreased morbidity and mortality rates. A close collaboration between emergency surgeons, radiologists, endoscopists, and anesthesiologists is mandatory in the management of this group of patients in the emergency setting.

Published
2022

12. It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

Author

Sartelli, M, Labricciosa, F, Coccolini, F, Coimbra, R, Abu-Zidan, F, Ansaloni, L, Al-Hasan, M, Ansari, S, Barie, P, Cainzos, M, Ceresoli, M, Chiarugi, M, Claridge, J, Cicuttin, E, Dellinger, E, Fry, D, Guirao, X, Hardcastle, T, Hecker, A, Leppaniemi, A, Litvin, A, Marwah, S, Maseda, E, Mazuski, J, Memish, Z, Kirkpatrick, A, Pagani, L, Podda, M, Rasa, H, Sakakushev, B, Sawyer, R, Tumietto, F, Xiao, Y, Aboubreeg, W, Adamou, H, Akhmeteli, L, Akin, E, Alberio, M, Alconchel, F, Magagi, I, Arauz, A, Argenio, G, Atanasov, B, Atici, S, Awad, S, Baili, E, Bains, L, Bala, M, Baraket, O, Baral, S, Belskii, V, Benboubker, M, Ben-Ishay, O, Bordoni, P, Boumediene, A, Brisinda, G, Cavazzuti, L, Chandy, S, Chiarello, M, Cillara, N, Clarizia, G, Cocuz, M, Cocuz, I, Conti, L, Coppola, R, Cui, Y, Czepiel, J, D'Acapito, F, Damaskos, D, Das, K, De Simone, B, Delibegovic, S, Demetrashvili, Z, Detanac, D, Dhingra, S, Di Bella, S, Dimitrov, E, Dogjani, A, D'Oria, M, Dumitru, I, Elmangory, M, Enciu, O, Fantoni, M, Filipescu, D, Fleres, F, Foghetti, D, Fransvea, P, Gachabayov, M, Galeiras, R, Gattuso, G, Ghannam, W, Ghisetti, V, Giraudo, G, Gonfa, K, Gonullu, E, Hamad, Y, Hecker, M, Isik, A, Ismail, N, Ismail, A, Jain, S, Kanj, S, Kapoor, G, Karaiskos, I, Kavalakat, A, Kenig, J, Khamis, F, Khokha, V, Kiguba, R, Kim, J, Kobe, Y, Kok, K, Kovacevic, B, Kryvoruchko, I, Kuriyama, A, Landaluce-Olavarria, A, Lasithiotakis, K, Lohsiriwat, V, Lostoridis, E, Luppi, D, Vega, G, Maegele, M, Marinis, A, Martines, G, Martinez-Perez, A, Massalou, D, Mesina, C, Metan, G, Miranda-Novales, M, Mishra, S, Mohamed, M, Mohamedahmed, A, Mora-Guzman, I, Mulita, F, Musina, A, Navsaria, P, Negoi, I, Nita, G, O'Connor, D, Ordonez, C, Pantalone, D, Panyko, A, Papadopoulos, A, Pararas, N, Pata, F, Patel, T, Pellino, G, Perra, T, Perrone, G, Pesce, A, Pintar, T, Popivanov, G, Porcu, A, Quiodettis, M, Rahim, R, Mitul, A, Reichert, M, Rems, M, Campbell, G, Rocha-Pereira, N, Rodrigues, G, Villamil, G, Rossi, S, Sall, I, Kafil, H, Sasia, D, Seni, J, Seretis, C, Serradilla-Martin, M, Shelat, V, Siribumrungwong, B, Slavchev, M, Solaini, L, Tan, B, Tarasconi, A, Tartaglia, D, Toma, E, Tomadze, G, Toro, A, Tovani-Palone, M, van Goor, H, Vasilescu, A, Vereczkei, A, Veroux, M, Weckmann, S, Widmer, L, Yahya, A, Zachariah, S, Zakaria, A, Zubareva, N, Zuidema, W, Di Carlo, I, Cortese, F, Baiocchi, G, Maier, R, Catena, F, Sartelli M., Labricciosa F. M., Coccolini F., Coimbra R., Abu-Zidan F. M., Ansaloni L., Al-Hasan M. N., Ansari S., Barie P. S., Cainzos M. A., Ceresoli M., Chiarugi M., Claridge J. A., Cicuttin E., Dellinger E. P., Fry D. E., Guirao X., Hardcastle T. C., Hecker A., Leppaniemi A. K., Litvin A., Marwah S., Maseda E., Mazuski J. E., Memish Z. A., Kirkpatrick A. W., Pagani L., Podda M., Rasa H. K., Sakakushev B. E., Sawyer R. G., Tumietto F., Xiao Y., Aboubreeg W. F., Adamou H., Akhmeteli L., Akin E., Alberio M. G., Alconchel F., Magagi I. A., Arauz A. B., Argenio G., Atanasov B. C., Atici S. D., Awad S. S., Baili E., Bains L., Bala M., Baraket O., Baral S., Belskii V. A., Benboubker M., Ben-Ishay O., Bordoni P., Boumediene A., Brisinda G., Cavazzuti L., Chandy S. J., Chiarello M. M., Cillara N., Clarizia G., Cocuz M. -E., Cocuz I. G., Conti L., Coppola R., Cui Y., Czepiel J., D'Acapito F., Damaskos D., Das K., De Simone B., Delibegovic S., Demetrashvili Z., Detanac D. S., Dhingra S., Di Bella S., Dimitrov E. N., Dogjani A., D'Oria M., Dumitru I. M., Elmangory M. M., Enciu O., Fantoni M., Filipescu D., Fleres F., Foghetti D., Fransvea P., Gachabayov M., Galeiras R., Gattuso G., Ghannam W. M., Ghisetti V., Giraudo G., Gonfa K. B., Gonullu E., Hamad Y. T. E. Y., Hecker M., Isik A., Ismail N., Ismail A., Jain S. A., Kanj S. S., Kapoor G., Karaiskos I., Kavalakat A. J., Kenig J., Khamis F., Khokha V., Kiguba R., Kim J. I., Kobe Y., Kok K. Y. Y., Kovacevic B. M., Kryvoruchko I. A., Kuriyama A., Landaluce-Olavarria A., Lasithiotakis K., Lohsiriwat V., Lostoridis E., Luppi D., Vega G. M. M., Maegele M., Marinis A., Martines G., Martinez-Perez A., Massalou D., Mesina C., Metan G., Miranda-Novales M. G., Mishra S. K., Mohamed M. I. H., Mohamedahmed A. Y. Y., Mora-Guzman I., Mulita F., Musina A. -M., Navsaria P. H., Negoi I., Nita G. E., O'Connor D. B., Ordonez C. A., Pantalone D., Panyko A., Papadopoulos A., Pararas N., Pata F., Patel T., Pellino G., Perra T., Perrone G., Pesce A., Pintar T., Popivanov G. I., Porcu A., Quiodettis M. A., Rahim R., Mitul A. R., Reichert M., Rems M., Campbell G. Y. R., Rocha-Pereira N., Rodrigues G., Villamil G. E. R., Rossi S., Sall I., Kafil H. S., Sasia D., Seni J., Seretis C., Serradilla-Martin M., Shelat V. G., Siribumrungwong B., Slavchev M., Solaini L., Tan B. K., Tarasconi A., Tartaglia D., Toma E. A., Tomadze G., Toro A., Tovani-Palone M. R., van Goor H., Vasilescu A., Vereczkei A., Veroux M., Weckmann S. A., Widmer L. W., Yahya A. I., Zachariah S. K., Zakaria A. D., Zubareva N., Zuidema W. P., Di Carlo I., Cortese F., Baiocchi G. L., Maier R. V., Catena F., Sartelli, M, Labricciosa, F, Coccolini, F, Coimbra, R, Abu-Zidan, F, Ansaloni, L, Al-Hasan, M, Ansari, S, Barie, P, Cainzos, M, Ceresoli, M, Chiarugi, M, Claridge, J, Cicuttin, E, Dellinger, E, Fry, D, Guirao, X, Hardcastle, T, Hecker, A, Leppaniemi, A, Litvin, A, Marwah, S, Maseda, E, Mazuski, J, Memish, Z, Kirkpatrick, A, Pagani, L, Podda, M, Rasa, H, Sakakushev, B, Sawyer, R, Tumietto, F, Xiao, Y, Aboubreeg, W, Adamou, H, Akhmeteli, L, Akin, E, Alberio, M, Alconchel, F, Magagi, I, Arauz, A, Argenio, G, Atanasov, B, Atici, S, Awad, S, Baili, E, Bains, L, Bala, M, Baraket, O, Baral, S, Belskii, V, Benboubker, M, Ben-Ishay, O, Bordoni, P, Boumediene, A, Brisinda, G, Cavazzuti, L, Chandy, S, Chiarello, M, Cillara, N, Clarizia, G, Cocuz, M, Cocuz, I, Conti, L, Coppola, R, Cui, Y, Czepiel, J, D'Acapito, F, Damaskos, D, Das, K, De Simone, B, Delibegovic, S, Demetrashvili, Z, Detanac, D, Dhingra, S, Di Bella, S, Dimitrov, E, Dogjani, A, D'Oria, M, Dumitru, I, Elmangory, M, Enciu, O, Fantoni, M, Filipescu, D, Fleres, F, Foghetti, D, Fransvea, P, Gachabayov, M, Galeiras, R, Gattuso, G, Ghannam, W, Ghisetti, V, Giraudo, G, Gonfa, K, Gonullu, E, Hamad, Y, Hecker, M, Isik, A, Ismail, N, Ismail, A, Jain, S, Kanj, S, Kapoor, G, Karaiskos, I, Kavalakat, A, Kenig, J, Khamis, F, Khokha, V, Kiguba, R, Kim, J, Kobe, Y, Kok, K, Kovacevic, B, Kryvoruchko, I, Kuriyama, A, Landaluce-Olavarria, A, Lasithiotakis, K, Lohsiriwat, V, Lostoridis, E, Luppi, D, Vega, G, Maegele, M, Marinis, A, Martines, G, Martinez-Perez, A, Massalou, D, Mesina, C, Metan, G, Miranda-Novales, M, Mishra, S, Mohamed, M, Mohamedahmed, A, Mora-Guzman, I, Mulita, F, Musina, A, Navsaria, P, Negoi, I, Nita, G, O'Connor, D, Ordonez, C, Pantalone, D, Panyko, A, Papadopoulos, A, Pararas, N, Pata, F, Patel, T, Pellino, G, Perra, T, Perrone, G, Pesce, A, Pintar, T, Popivanov, G, Porcu, A, Quiodettis, M, Rahim, R, Mitul, A, Reichert, M, Rems, M, Campbell, G, Rocha-Pereira, N, Rodrigues, G, Villamil, G, Rossi, S, Sall, I, Kafil, H, Sasia, D, Seni, J, Seretis, C, Serradilla-Martin, M, Shelat, V, Siribumrungwong, B, Slavchev, M, Solaini, L, Tan, B, Tarasconi, A, Tartaglia, D, Toma, E, Tomadze, G, Toro, A, Tovani-Palone, M, van Goor, H, Vasilescu, A, Vereczkei, A, Veroux, M, Weckmann, S, Widmer, L, Yahya, A, Zachariah, S, Zakaria, A, Zubareva, N, Zuidema, W, Di Carlo, I, Cortese, F, Baiocchi, G, Maier, R, Catena, F, Sartelli M., Labricciosa F. M., Coccolini F., Coimbra R., Abu-Zidan F. M., Ansaloni L., Al-Hasan M. N., Ansari S., Barie P. S., Cainzos M. A., Ceresoli M., Chiarugi M., Claridge J. A., Cicuttin E., Dellinger E. P., Fry D. E., Guirao X., Hardcastle T. C., Hecker A., Leppaniemi A. K., Litvin A., Marwah S., Maseda E., Mazuski J. E., Memish Z. A., Kirkpatrick A. W., Pagani L., Podda M., Rasa H. K., Sakakushev B. E., Sawyer R. G., Tumietto F., Xiao Y., Aboubreeg W. F., Adamou H., Akhmeteli L., Akin E., Alberio M. G., Alconchel F., Magagi I. A., Arauz A. B., Argenio G., Atanasov B. C., Atici S. D., Awad S. S., Baili E., Bains L., Bala M., Baraket O., Baral S., Belskii V. A., Benboubker M., Ben-Ishay O., Bordoni P., Boumediene A., Brisinda G., Cavazzuti L., Chandy S. J., Chiarello M. M., Cillara N., Clarizia G., Cocuz M. -E., Cocuz I. G., Conti L., Coppola R., Cui Y., Czepiel J., D'Acapito F., Damaskos D., Das K., De Simone B., Delibegovic S., Demetrashvili Z., Detanac D. S., Dhingra S., Di Bella S., Dimitrov E. N., Dogjani A., D'Oria M., Dumitru I. M., Elmangory M. M., Enciu O., Fantoni M., Filipescu D., Fleres F., Foghetti D., Fransvea P., Gachabayov M., Galeiras R., Gattuso G., Ghannam W. M., Ghisetti V., Giraudo G., Gonfa K. B., Gonullu E., Hamad Y. T. E. Y., Hecker M., Isik A., Ismail N., Ismail A., Jain S. A., Kanj S. S., Kapoor G., Karaiskos I., Kavalakat A. J., Kenig J., Khamis F., Khokha V., Kiguba R., Kim J. I., Kobe Y., Kok K. Y. Y., Kovacevic B. M., Kryvoruchko I. A., Kuriyama A., Landaluce-Olavarria A., Lasithiotakis K., Lohsiriwat V., Lostoridis E., Luppi D., Vega G. M. M., Maegele M., Marinis A., Martines G., Martinez-Perez A., Massalou D., Mesina C., Metan G., Miranda-Novales M. G., Mishra S. K., Mohamed M. I. H., Mohamedahmed A. Y. Y., Mora-Guzman I., Mulita F., Musina A. -M., Navsaria P. H., Negoi I., Nita G. E., O'Connor D. B., Ordonez C. A., Pantalone D., Panyko A., Papadopoulos A., Pararas N., Pata F., Patel T., Pellino G., Perra T., Perrone G., Pesce A., Pintar T., Popivanov G. I., Porcu A., Quiodettis M. A., Rahim R., Mitul A. R., Reichert M., Rems M., Campbell G. Y. R., Rocha-Pereira N., Rodrigues G., Villamil G. E. R., Rossi S., Sall I., Kafil H. S., Sasia D., Seni J., Seretis C., Serradilla-Martin M., Shelat V. G., Siribumrungwong B., Slavchev M., Solaini L., Tan B. K., Tarasconi A., Tartaglia D., Toma E. A., Tomadze G., Toro A., Tovani-Palone M. R., van Goor H., Vasilescu A., Vereczkei A., Veroux M., Weckmann S. A., Widmer L. W., Yahya A. I., Zachariah S. K., Zakaria A. D., Zubareva N., Zuidema W. P., Di Carlo I., Cortese F., Baiocchi G. L., Maier R. V., and Catena F.

Abstract

Background: The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants’ perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods: A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results: Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for

Published
2022

13. Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Author

Cobianchi L., Dal Mas F., Massaro M., Biffl W., Catena F., Coccolini F., Dionigi B., Dionigi P., Di Saverio S., Fugazzola P., Kluger Y., Leppaniemi A., Moore E. E., Sartelli M., Velmahos G., Woltz S., Angelos P., Ansaloni L., Abdelmalik A., Abebe N. S., Abu-Zidan F. M., Adam Y. A. Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S. M., Almeida P. M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I. H., Atanasov B. T., Augustin G., Awad S. S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J. A., Bellanova G., Biancuzzi H., Bignell M. B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L. A., Buscemi S., Calu V., Campo Dall'Orto R., Campostrini S., Carvas J. M., Casoni Pattacini G., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colak E., Conti L., Dantas Costa S., D'Acapito F., Damaskos D., Das K., Davies R. J., De Beaux A. C., De Simone B., Demetrashvili Z., Demetriades A. K., Denicolai S., Di Buono G., Di Carlo I., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G. T., Elbaih A. H., Escalera-Antezana J. P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Gachabayov M., Garcia Vazquez A. A., Ghannam W. M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C. A., Teixeira Gonsaga R. A., Gonullu E., Goosen J., Goranovic T., Griffiths E. A., Haidar M. G., Hamid H. K. S., Harddastle T. C., Healey A. J., Hecker M., Hernandez Garcia E. F., Huaman E. C., Hutan M., Ioannidis O., Isik A., Ismail A. M. H., Ismail N., Jang J. Y., Kaafarani H. M. A., Kalipershad S. N. R., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A. J., Kechagias A., Kenig J., Khan J. S., Khokha V., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Loftus T. J., Lohsiriwat V., Lopes Moreira C. C., Lostoridis E., Luna A. T., Luppi D., Machain G. M., Maegele M., Maggiore D., Maier R. V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E. A., Marseglia G. R., Martellucci J., Martines G., Martinez Perez A., Mascagni P., Massalou D., Melo R. B., Miceli L., Mingoli A., Mishra T. S., Mohamedahmed A. Y. Y., Mohan R., Morales-Garcia D., Mustafa S. M. S., Naimzada M. D., Negoi I., Nguyen C., Nidaw M. K., Nigri G., Ogundipe H. D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Paterson-Brown S., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Piccolo D., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M. A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M. R., Roizblatt D., Roscio F. P. M., Rossi S., Ruta F., Sakakushev B. E., Salamea J. C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R. G., Seretis C., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Simoes R. L., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Spada F., Stahel P., Sydorchuk L., Sydorchuk R., Syed A. M., Tallon-Aguilar L., Tan J. H., Tan E., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G. D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P. G., Verde J. M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Wong T. H., Xenaki S., Yu B., Yule S., Zakaria A. D., Zambrano D. A., Zese M., Cobianchi, L, Dal Mas, F, Massaro, M, Biffl, W, Catena, F, Coccolini, F, Dionigi, B, Dionigi, P, Di Saverio, S, Fugazzola, P, Kluger, Y, Leppaniemi, A, Moore, E, Sartelli, M, Velmahos, G, Woltz, S, Angelos, P, Ansaloni, L, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Agrusa, A, Akin, E, Alexandrino, H, Ali, S, Almeida, P, Amico, F, Ammendola, M, Andreuccetti, J, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bagnoli, C, Bains, L, Balalis, D, Baldini, E, Baraket, O, Barone, M, Barreras, J, Bellanova, G, Biancuzzi, H, Bignell, M, Bini, R, Bissacco, D, Boati, P, Bottari, A, Bouliaris, K, Brillantino, A, Buonomo, L, Buscemi, S, Calu, V, Campo Dall'Orto, R, Campostrini, S, Carvas, J, Casoni Pattacini, G, Celentano, V, Ceresoli, M, Chirica, M, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Conti, L, Dantas Costa, S, D'Acapito, F, Damaskos, D, Das, K, Davies, R, De Beaux, A, De Simone, B, Demetrashvili, Z, Demetriades, A, Denicolai, S, Di Buono, G, Di Carlo, I, Diaconescu, B, Dibra, R, Dios-Barbeito, S, Dogjani, A, Domanin, M, D'Oria, M, Duran Munoz-Cruzado, V, East, B, Ekwen, G, Elbaih, A, Escalera-Antezana, J, Esposito, G, Farre, R, Ferrario di Tor Vajana, A, Cordeiro Fonseca, V, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Gachabayov, M, Garcia Vazquez, A, Ghannam, W, Gioco, R, Giraudo, G, Giuffrida, M, Giulii Capponi, M, Gomes, C, Teixeira Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Griffiths, E, Haidar, M, Hamid, H, Harddastle, T, Healey, A, Hecker, M, Hernandez Garcia, E, Huaman, E, Hutan, M, Ioannidis, O, Isik, A, Ismail, A, Ismail, N, Jang, J, Kaafarani, H, Kalipershad, S, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Kavalakat, A, Kechagias, A, Kenig, J, Khan, J, Khokha, V, Klappenbach, R, Kobe, Y, Kong, V, Korkolis, D, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Licari, L, Litvin, A, Loftus, T, Lohsiriwat, V, Lopes Moreira, C, Lostoridis, E, Luna, A, Luppi, D, Machain, G, Maegele, M, Maggiore, D, Maier, R, Manangi, M, Manetti, A, Mantoglu, B, Mariani, F, Marinis, A, Sbalcheiro Mariot, E, Marseglia, G, Martellucci, J, Martines, G, Martinez Perez, A, Mascagni, P, Massalou, D, Melo, R, Miceli, L, Mingoli, A, Mishra, T, Mohamedahmed, A, Mohan, R, Morales-Garcia, D, Mustafa, S, Naimzada, M, Negoi, I, Nguyen, C, Nidaw, M, Nigri, G, Ogundipe, H, Oliveri, C, Olmi, S, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papis, D, Pararas, N, Pata, F, Paterson-Brown, S, Pavone, G, Pecchini, F, Pellino, G, Pelloni, M, Peloso, A, Perea del Pozo, E, Goncalves Pereira, R, Monteiro Pereira, B, Lizarazu Perez, A, Perrone, G, Pesce, A, Petracca, G, Piccoli, M, Piccolo, D, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Podda, M, Previtali, P, Privitera, F, Punzo, C, Quiodettis, M, Qvist, N, Rahim, R, Reinisch-Liese, A, Rodriguez-Luna, M, Roizblatt, D, Roscio, F, Rossi, S, Ruta, F, Sakakushev, B, Salamea, J, Sall, I, Sammartano, F, Sanchez Arteaga, A, Sanchez-Cordero, S, Sasia, D, Sawyer, R, Seretis, C, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Simoes, R, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Soreide, K, Spada, F, Stahel, P, Sydorchuk, L, Sydorchuk, R, Syed, A, Tallon-Aguilar, L, Tan, J, Tan, E, Tarasconi, A, Tartaglia, D, Tartaglia, N, Taylor, J, Tebala, G, Teuben, M, Tolonen, M, Tomasicchio, G, Triantafyllou, T, Trigiante, G, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Ugarte-Sierra, B, Ukkonen, M, Vassiliu, P, Verde, J, Veroux, M, Vilallonga, R, Visconti, D, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Wong, T, Xenaki, S, Yu, B, Yule, S, Zakaria, A, Zambrano, D, Zese, M, Cobianchi L., Dal Mas F., Massaro M., Biffl W., Catena F., Coccolini F., Dionigi B., Dionigi P., Di Saverio S., Fugazzola P., Kluger Y., Leppaniemi A., Moore E.E., Sartelli M., Velmahos G., Woltz S., Angelos P., Ansaloni L., Abdelmalik A., Abebe N.S., Abu-Zidan F.M., Adam Y.A.Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S.M., Almeida P.M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I.H., Atanasov B.T., Augustin G., Awad S.S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J.A., Bellanova G., Biancuzzi H., Bignell M.B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L.A., Buscemi S., Calu V., Campo Dall'Orto R., Campostrini S., Carvas J.M., Casoni Pattacini G., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S.P.B., Colak E., Conti L., Dantas Costa S., D'Acapito F., Damaskos D., Das K., Davies R.J., De Beaux A.C., De Simone B., Demetrashvili Z., Demetriades A.K., Denicolai S., Di Buono G., Di Carlo I., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G.T., Elbaih A.H., Escalera-Antezana J.P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G.P., Fransvea P., Gachabayov M., Garcia Vazquez A.A., Ghannam W.M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C.A., Teixeira Gonsaga R.A., Gonullu E., Goosen J., Goranovic T., Griffiths E.A., Haidar M.G., Hamid H.K.S., Harddastle T.C., Healey A.J., Hecker M., Hernandez Garcia E.F., Huaman E.C., Hutan M., Ioannidis O., Isik A., Ismail A.M.H., Ismail N., Jang J.Y., Kaafarani H.M.A., Kalipershad S.N.R., Kaplan L.J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A.J., Kechagias A., Kenig J., Khan J.S., Khokha V., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Loftus T.J., Lohsiriwat V., Lopes Moreira C.C., Lostoridis E., Luna A.T., Luppi D., Machain G.M., Maegele M., Maggiore D., Maier R.V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E.A., Marseglia G.R., Martellucci J., Martines G., Martinez Perez A., Mascagni P., Massalou D., Melo R.B., Miceli L., Mingoli A., Mishra T.S., Mohamedahmed A.Y.Y., Mohan R., Morales-Garcia D., Mustafa S.M.S., Naimzada M.D., Negoi I., Nguyen C., Nidaw M.K., Nigri G., Ogundipe H.D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Paterson-Brown S., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Piccolo D., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M.A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M.R., Roizblatt D., Roscio F.P.M., Rossi S., Ruta F., Sakakushev B.E., Salamea J.C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R.G., Seretis C., Serradilla-Martin M., Shelat V.G., Shlyapnikov S., Simoes R.L., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Spada F., Stahel P., Sydorchuk L., Sydorchuk R., Syed A.M., Tallon-Aguilar L., Tan J.H., Tan E., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G.D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P.G., Verde J.M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L.W., Wilson M.S.J., Wong T.H., Xenaki S., Yu B., Yule S., Zakaria A.D., Zambrano D.A., Zese M., HUS Abdominal Center, II kirurgian klinikka, and Helsinki University Hospital Area

Subjects
Ethics, Patient Care Team, Diversity, Acute care surgery, 3126 Surgery, anesthesiology, intensive care, radiology, Trauma surgery, Settore SECS-P/10 - Organizzazione Aziendale, Settore MED/18 - Chirurgia Generale, Settore SECS-P/07 - Economia Aziendale, Surveys and Questionnaires, Emergency Medicine, Humans, Surveys and Questionnaire, Surgery, Team dynamics, Ethic, Team dynamic, Human
Abstract

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance.

Published
2022

14. Team dynamics in emergency surgery teams: results from a first international survey

Author

Cobianchi, L, Dal Mas, F, Massaro, M, Fugazzola, P, Coccolini, F, Kluger, Y, Leppaniemi, A, Moore, E, Sartelli, M, Angelos, P, Ansaloni, L, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Agrusa, A, Akin, E, Alexandrino, H, Ali, S, Almeida, P, Amico, F, Ammendola, M, Andreuccetti, J, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bagnoli, C, Bains, L, Balalis, D, Baldini, E, Baraket, O, Barone, M, Barreras, J, Bellanova, G, Biancuzzi, H, Bignell, M, Bini, R, Bissacco, D, Boati, P, Bottari, A, Bouliaris, K, Brillantino, A, Buonomo, L, Buscemi, S, Calu, V, Campo Dall'Orto, R, Carvas, J, Casoni Pattacini, G, Catena, F, Celentano, V, Ceresoli, M, Chirica, M, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Conti, L, Dantas Costa, S, D'Acapito, F, Damaskos, D, Das, K, Davies, R, De Beaux, A, De Simone, B, Demetrashvili, Z, Demetriades, A, Denicolai, S, Di Buono, G, Di Carlo, I, Di Saverio, S, Diaconescu, B, Dibra, R, Dios-Barbeito, S, Dogjani, A, Domanin, M, D'Oria, M, Duran Munoz-Cruzado, V, East, B, Ekwen, G, Elbaih, A, Escalera-Antezana, J, Esposito, G, Farre, R, Ferrario di Tor Vajana, A, Cordeiro Fonseca, V, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Gachabayov, M, Garcia Vazquez, A, Ghannam, W, Gioco, R, Giraudo, G, Giuffrida, M, Giulii Capponi, M, Gomes, C, Teixeira Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Griffiths, E, Haidar, M, Hamid, H, Harddastle, T, Hecker, M, Hernandez Garcia, E, Cancio Huaman, E, Hutan, M, Ioannidis, O, Isik, A, Ismail, A, Ismail, N, Jang, J, Kalipershad, S, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Kavalakat, A, Kechagias, A, Kenig, J, Khan, J, Khokha, V, Klappenbach, R, Kobe, Y, Kong, V, Korkolis, D, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Licari, L, Litvin, A, Lohsiriwat, V, Lopes Moreira, C, Lostoridis, E, Tovar Luna, A, Luppi, D, Machain, G, Maegele, M, Maggiore, D, Maier, R, Manangi, M, Manetti, A, Mantoglu, B, Mariani, F, Marinis, A, Sbalcheiro Mariot, E, Martines, G, Martinez Perez, A, Mascagni, P, Massalou, D, Bessa Melo, R, Miceli, L, Mingoli, A, Mishra, T, Mohamedahmed, A, Mohan, R, Morales-Garcia, D, Mustafa, S, Naimzada, M, Negoi, I, Nidaw, M, Nigri, G, Ogundipe, H, Oliveri, C, Olmi, S, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papis, D, Pararas, N, Pata, F, Pavone, G, Pecchini, F, Pellino, G, Pelloni, M, Peloso, A, Perea Del Pozo, E, Goncalves Pereira, R, Monteiro Pereira, B, Lizarazu Perez, A, Perrone, G, Pesce, A, Petracca, G, Piccoli, M, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Podda, M, Previtali, P, Privitera, F, Punzo, C, Quiodettis, M, Qvist, N, Rahim, R, Reinisch-Liese, A, Rodriguez-Luna, M, Roizblatt, D, Roscio, F, Rossi, S, Sakakushev, B, Salamea, J, Sall, I, Sammartano, F, Sanchez Arteaga, A, Sanchez-Cordero, S, Sasia, D, Sawyer, R, Seretis, C, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Lages Simoes, R, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Soreide, K, Sydorchuk, L, Sydorchuk, R, Syed, A, Tallon-Aguilar, L, Tan, J, Tarasconi, A, Tartaglia, D, Tartaglia, N, Taylor, J, Tebala, G, Teuben, M, Tolonen, M, Tomasicchio, G, Triantafyllou, T, Trigiante, G, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Ugarte-Sierra, B, Ukkonen, M, Vassiliu, P, Verde, J, Veroux, M, Vilallonga, R, Visconti, D, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Wong, T, Xenaki, S, Yu, B, Zakaria, A, Zambrano, D, Zese, M, Cobianchi L., Dal Mas F., Massaro M., Fugazzola P., Coccolini F., Kluger Y., Leppaniemi A., Moore E. E., Sartelli M., Angelos P., Ansaloni L., Abdelmalik A., Abebe N. S., Abu-Zidan F. M., Adam Y. A. Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S. M., Almeida P. M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I. H., Atanasov B. T., Augustin G., Awad S. S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J. A., Bellanova G., Biancuzzi H., Bignell M. B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L. A., Buscemi S., Calu V., Campo Dall'Orto R., Carvas J. M., Casoni Pattacini G., Catena F., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colak E., Conti L., Dantas Costa S., D'acapito F., Damaskos D., Das K., Davies R. J., De Beaux A. C., De Simone B., Demetrashvili Z., Demetriades A. K., Denicolai S., Di Buono G., Di Carlo I., Di Saverio S., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G. T., Elbaih A. H., Escalera-Antezana J. P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Gachabayov M., Garcia Vazquez A., Ghannam W. M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C. A., Teixeira Gonsaga R. A., Gonullu E., Goosen J., Goranovic T., Griffiths E. A., Haidar M. G., Hamid H. K. S., Harddastle T. C., Hecker M., Hernandez Garcia E. F., Cancio Huaman E., Hutan M., Ioannidis O., Isik A., Ismail A. M. H., Ismail N., Jang J. Y., Kalipershad S. N. R., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A. J., Kechagias A., Kenig J., Khan J. S., Khokha V., Klappenbach R. F., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Lohsiriwat V., Lopes Moreira C. C., Lostoridis E., Tovar Luna A., Luppi D., Machain G. M., Maegele M., Maggiore D., Maier R. V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E. A., Martines G., Martinez Perez A., Mascagni P., Massalou D., Bessa Melo R., Miceli L., Mingoli A., Mishra T. S., Mohamedahmed A. Y. Y., Mohan R., Morales-Garcia D., Mustafa S. M. S., Naimzada M. D., Negoi I., Nidaw M. K., Nigri G., Ogundipe H. D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea Del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M. A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M. R., Roizblatt D., Roscio F. P. M., Rossi S., Sakakushev B. E., Salamea J. C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R. G., Seretis C., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Lages Simoes R., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Sydorchuk L., Sydorchuk R., Syed A. M., Tallon-Aguilar L., Tan J. H., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G. D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P. G., Verde J. M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Wong T. H., Xenaki S., Yu B., Zakaria A. D., Zambrano D. A., Zese M., Cobianchi, L, Dal Mas, F, Massaro, M, Fugazzola, P, Coccolini, F, Kluger, Y, Leppaniemi, A, Moore, E, Sartelli, M, Angelos, P, Ansaloni, L, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Agrusa, A, Akin, E, Alexandrino, H, Ali, S, Almeida, P, Amico, F, Ammendola, M, Andreuccetti, J, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bagnoli, C, Bains, L, Balalis, D, Baldini, E, Baraket, O, Barone, M, Barreras, J, Bellanova, G, Biancuzzi, H, Bignell, M, Bini, R, Bissacco, D, Boati, P, Bottari, A, Bouliaris, K, Brillantino, A, Buonomo, L, Buscemi, S, Calu, V, Campo Dall'Orto, R, Carvas, J, Casoni Pattacini, G, Catena, F, Celentano, V, Ceresoli, M, Chirica, M, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Conti, L, Dantas Costa, S, D'Acapito, F, Damaskos, D, Das, K, Davies, R, De Beaux, A, De Simone, B, Demetrashvili, Z, Demetriades, A, Denicolai, S, Di Buono, G, Di Carlo, I, Di Saverio, S, Diaconescu, B, Dibra, R, Dios-Barbeito, S, Dogjani, A, Domanin, M, D'Oria, M, Duran Munoz-Cruzado, V, East, B, Ekwen, G, Elbaih, A, Escalera-Antezana, J, Esposito, G, Farre, R, Ferrario di Tor Vajana, A, Cordeiro Fonseca, V, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Gachabayov, M, Garcia Vazquez, A, Ghannam, W, Gioco, R, Giraudo, G, Giuffrida, M, Giulii Capponi, M, Gomes, C, Teixeira Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Griffiths, E, Haidar, M, Hamid, H, Harddastle, T, Hecker, M, Hernandez Garcia, E, Cancio Huaman, E, Hutan, M, Ioannidis, O, Isik, A, Ismail, A, Ismail, N, Jang, J, Kalipershad, S, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Kavalakat, A, Kechagias, A, Kenig, J, Khan, J, Khokha, V, Klappenbach, R, Kobe, Y, Kong, V, Korkolis, D, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Licari, L, Litvin, A, Lohsiriwat, V, Lopes Moreira, C, Lostoridis, E, Tovar Luna, A, Luppi, D, Machain, G, Maegele, M, Maggiore, D, Maier, R, Manangi, M, Manetti, A, Mantoglu, B, Mariani, F, Marinis, A, Sbalcheiro Mariot, E, Martines, G, Martinez Perez, A, Mascagni, P, Massalou, D, Bessa Melo, R, Miceli, L, Mingoli, A, Mishra, T, Mohamedahmed, A, Mohan, R, Morales-Garcia, D, Mustafa, S, Naimzada, M, Negoi, I, Nidaw, M, Nigri, G, Ogundipe, H, Oliveri, C, Olmi, S, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papis, D, Pararas, N, Pata, F, Pavone, G, Pecchini, F, Pellino, G, Pelloni, M, Peloso, A, Perea Del Pozo, E, Goncalves Pereira, R, Monteiro Pereira, B, Lizarazu Perez, A, Perrone, G, Pesce, A, Petracca, G, Piccoli, M, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Podda, M, Previtali, P, Privitera, F, Punzo, C, Quiodettis, M, Qvist, N, Rahim, R, Reinisch-Liese, A, Rodriguez-Luna, M, Roizblatt, D, Roscio, F, Rossi, S, Sakakushev, B, Salamea, J, Sall, I, Sammartano, F, Sanchez Arteaga, A, Sanchez-Cordero, S, Sasia, D, Sawyer, R, Seretis, C, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Lages Simoes, R, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Soreide, K, Sydorchuk, L, Sydorchuk, R, Syed, A, Tallon-Aguilar, L, Tan, J, Tarasconi, A, Tartaglia, D, Tartaglia, N, Taylor, J, Tebala, G, Teuben, M, Tolonen, M, Tomasicchio, G, Triantafyllou, T, Trigiante, G, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Ugarte-Sierra, B, Ukkonen, M, Vassiliu, P, Verde, J, Veroux, M, Vilallonga, R, Visconti, D, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Wong, T, Xenaki, S, Yu, B, Zakaria, A, Zambrano, D, Zese, M, Cobianchi L., Dal Mas F., Massaro M., Fugazzola P., Coccolini F., Kluger Y., Leppaniemi A., Moore E. E., Sartelli M., Angelos P., Ansaloni L., Abdelmalik A., Abebe N. S., Abu-Zidan F. M., Adam Y. A. Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S. M., Almeida P. M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I. H., Atanasov B. T., Augustin G., Awad S. S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J. A., Bellanova G., Biancuzzi H., Bignell M. B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L. A., Buscemi S., Calu V., Campo Dall'Orto R., Carvas J. M., Casoni Pattacini G., Catena F., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colak E., Conti L., Dantas Costa S., D'acapito F., Damaskos D., Das K., Davies R. J., De Beaux A. C., De Simone B., Demetrashvili Z., Demetriades A. K., Denicolai S., Di Buono G., Di Carlo I., Di Saverio S., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G. T., Elbaih A. H., Escalera-Antezana J. P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Gachabayov M., Garcia Vazquez A., Ghannam W. M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C. A., Teixeira Gonsaga R. A., Gonullu E., Goosen J., Goranovic T., Griffiths E. A., Haidar M. G., Hamid H. K. S., Harddastle T. C., Hecker M., Hernandez Garcia E. F., Cancio Huaman E., Hutan M., Ioannidis O., Isik A., Ismail A. M. H., Ismail N., Jang J. Y., Kalipershad S. N. R., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A. J., Kechagias A., Kenig J., Khan J. S., Khokha V., Klappenbach R. F., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Lohsiriwat V., Lopes Moreira C. C., Lostoridis E., Tovar Luna A., Luppi D., Machain G. M., Maegele M., Maggiore D., Maier R. V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E. A., Martines G., Martinez Perez A., Mascagni P., Massalou D., Bessa Melo R., Miceli L., Mingoli A., Mishra T. S., Mohamedahmed A. Y. Y., Mohan R., Morales-Garcia D., Mustafa S. M. S., Naimzada M. D., Negoi I., Nidaw M. K., Nigri G., Ogundipe H. D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea Del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M. A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M. R., Roizblatt D., Roscio F. P. M., Rossi S., Sakakushev B. E., Salamea J. C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R. G., Seretis C., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Lages Simoes R., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Sydorchuk L., Sydorchuk R., Syed A. M., Tallon-Aguilar L., Tan J. H., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G. D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P. G., Verde J. M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Wong T. H., Xenaki S., Yu B., Zakaria A. D., Zambrano D. A., and Zese M.

Abstract

Background: Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma’s causes or the patient’s personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes. Methods: An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the software R, and reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results: Findings highlight how several surgeons are still unsure about the meaning and potential of knowledge translation and its mechanisms. Tools like training, clinical guidelines, and non-technical skills are recognized and used in clinical practice. Others, like patients’ and stakeholders’ engagement, are hardly implemented, despite their increasing importance in the modern healthcare scenario. Several difficulties in working as a team are described, including the lack of time, communication, training, trust, and ego. Discussion: Scientific societies should take the lead in offering training and support about the abovementioned topics. Dedicated educational initiatives, practical cases and experiences, workshops and symposia may allow mitigating the difficulties highlighted by the survey’s participants, boosting the performance of emergency teams. Additional investigation of the survey results and its characteristics may lead to more further specific suggestions and potential solutions.

Published
2021

15. Team dynamics in emergency surgery teams: results from a first international survey

Author

Cobianchi L., Dal Mas F., Massaro M., Fugazzola P., Coccolini F., Kluger Y., Leppaniemi A., Moore E. E., Sartelli M., Angelos P., Ansaloni L., Abdelmalik A., Abebe N. S., Abu-Zidan F. M., Adam Y. A. Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S. M., Almeida P. M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I. H., Atanasov B. T., Augustin G., Awad S. S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J. A., Bellanova G., Biancuzzi H., Bignell M. B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L. A., Buscemi S., Calu V., Campo Dall'Orto R., Carvas J. M., Casoni Pattacini G., Catena F., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S. P. B., Colak E., Conti L., Dantas Costa S., D'acapito F., Damaskos D., Das K., Davies R. J., De Beaux A. C., De Simone B., Demetrashvili Z., Demetriades A. K., Denicolai S., Di Buono G., Di Carlo I., Di Saverio S., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G. T., Elbaih A. H., Escalera-Antezana J. P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G. P., Fransvea P., Gachabayov M., Garcia Vazquez A., Ghannam W. M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C. A., Teixeira Gonsaga R. A., Gonullu E., Goosen J., Goranovic T., Griffiths E. A., Haidar M. G., Hamid H. K. S., Harddastle T. C., Hecker M., Hernandez Garcia E. F., Cancio Huaman E., Hutan M., Ioannidis O., Isik A., Ismail A. M. H., Ismail N., Jang J. Y., Kalipershad S. N. R., Kaplan L. J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A. J., Kechagias A., Kenig J., Khan J. S., Khokha V., Klappenbach R. F., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Lohsiriwat V., Lopes Moreira C. C., Lostoridis E., Tovar Luna A., Luppi D., Machain G. M., Maegele M., Maggiore D., Maier R. V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E. A., Martines G., Martinez Perez A., Mascagni P., Massalou D., Bessa Melo R., Miceli L., Mingoli A., Mishra T. S., Mohamedahmed A. Y. Y., Mohan R., Morales-Garcia D., Mustafa S. M. S., Naimzada M. D., Negoi I., Nidaw M. K., Nigri G., Ogundipe H. D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea Del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M. A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M. R., Roizblatt D., Roscio F. P. M., Rossi S., Sakakushev B. E., Salamea J. C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R. G., Seretis C., Serradilla-Martin M., Shelat V. G., Shlyapnikov S., Lages Simoes R., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Sydorchuk L., Sydorchuk R., Syed A. M., Tallon-Aguilar L., Tan J. H., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G. D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P. G., Verde J. M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L. W., Wilson M. S. J., Wong T. H., Xenaki S., Yu B., Zakaria A. D., Zambrano D. A., Zese M., Cobianchi, L., Dal Mas, F., Massaro, M., Fugazzola, P., Coccolini, F., Kluger, Y., Leppaniemi, A., Moore, E. E., Sartelli, M., Angelos, P., Ansaloni, L., Abdelmalik, A., Abebe, N. S., Abu-Zidan, F. M., Adam, Y. A. Y., Adamou, H., Agrusa, A., Akin, E., Alexandrino, H., Ali, S. M., Almeida, P. M., Amico, F., Ammendola, M., Andreuccetti, J., Aparicio-Sanchez, D., Ardito, A., Argenio, G., Askevold, I. H., Atanasov, B. T., Augustin, G., Awad, S. S., Bagnoli, C., Bains, L., Balalis, D., Baldini, E., Baraket, O., Barone, M., Barreras, J. A., Bellanova, G., Biancuzzi, H., Bignell, M. B., Bini, R., Bissacco, D., Boati, P., Bottari, A., Bouliaris, K., Brillantino, A., Buonomo, L. A., Buscemi, S., Calu, V., Campo Dall'Orto, R., Carvas, J. M., Casoni Pattacini, G., Catena, F., Celentano, V., Ceresoli, M., Chirica, M., Cianci, P., Cillara, N., Cimbanassi, S., Cioffi, S. P. B., Colak, E., Conti, L., Dantas Costa, S., D'Acapito, F., Damaskos, D., Das, K., Davies, R. J., De Beaux, A. C., De Simone, B., Demetrashvili, Z., Demetriades, A. K., Denicolai, S., Di Buono, G., Di Carlo, I., Di Saverio, S., Diaconescu, B., Dibra, R., Dios-Barbeito, S., Dogjani, A., Domanin, M., D'Oria, M., Duran Munoz-Cruzado, V., East, B., Ekwen, G. T., Elbaih, A. H., Escalera-Antezana, J. P., Esposito, G., Farre, R., Ferrario di Tor Vajana, A., Cordeiro Fonseca, V., Forfori, F., Fortuna, L., Fradelos, E., Fraga, G. P., Fransvea, P., Gachabayov, M., Garcia Vazquez, A., Ghannam, W. M., Gioco, R., Giraudo, G., Giuffrida, M., Giulii Capponi, M., Gomes, C. A., Teixeira Gonsaga, R. A., Gonullu, E., Goosen, J., Goranovic, T., Griffiths, E. A., Haidar, M. G., Hamid, H. K. S., Harddastle, T. C., Hecker, M., Hernandez Garcia, E. F., Cancio Huaman, E., Hutan, M., Ioannidis, O., Isik, A., Ismail, A. M. H., Ismail, N., Jang, J. Y., Kalipershad, S. N. R., Kaplan, L. J., Kara, Y., Karamagioli, E., Karamarkovia, A., Kavalakat, A. J., Kechagias, A., Kenig, J., Khan, J. S., Khokha, V., Klappenbach, R. F., Klappenbach, R., Kobe, Y., Kong, V., Korkolis, D., Kurihara, H., Kuriyama, A., Landaluce-Olavarria, A., Licari, L., Litvin, A., Lohsiriwat, V., Lopes Moreira, C. C., Lostoridis, E., Tovar Luna, A., Luppi, D., Machain, G. M., Maegele, M., Maggiore, D., Maier, R. V., Manangi, M., Manetti, A., Mantoglu, B., Mariani, F., Marinis, A., Sbalcheiro Mariot, E. A., Martines, G., Martinez Perez, A., Mascagni, P., Massalou, D., Bessa Melo, R., Miceli, L., Mingoli, A., Mishra, T. S., Mohamedahmed, A. Y. Y., Mohan, R., Morales-Garcia, D., Mustafa, S. M. S., Naimzada, M. D., Negoi, I., Nidaw, M. K., Nigri, G., Ogundipe, H. D., Oliveri, C., Olmi, S., Pagani, L., Palomba, G., Pantalone, D., Panyko, A., Paolillo, C., Papis, D., Pararas, N., Pata, F., Pavone, G., Pecchini, F., Pellino, G., Pelloni, M., Peloso, A., Perea Del Pozo, E., Goncalves Pereira, R., Monteiro Pereira, B., Lizarazu Perez, A., Perrone, G., Pesce, A., Petracca, G., Piccoli, M., Picetti, E., Pikoulis, E., Pintar, T., Pirozzolo, G., Podda, M., Previtali, P., Privitera, F., Punzo, C., Quiodettis, M. A., Qvist, N., Rahim, R., Reinisch-Liese, A., Rodriguez-Luna, M. R., Roizblatt, D., Roscio, F. P. M., Rossi, S., Sakakushev, B. E., Salamea, J. C., Sall, I., Sammartano, F., Sanchez Arteaga, A., Sanchez-Cordero, S., Sasia, D., Sawyer, R. G., Seretis, C., Serradilla-Martin, M., Shelat, V. G., Shlyapnikov, S., Lages Simoes, R., Siribumrungwong, B., Slavchev, M., Solaini, L., Soldini, G., Soreide, K., Sydorchuk, L., Sydorchuk, R., Syed, A. M., Tallon-Aguilar, L., Tan, J. H., Tarasconi, A., Tartaglia, D., Tartaglia, N., Taylor, J., Tebala, G. D., Teuben, M., Tolonen, M., Tomasicchio, G., Triantafyllou, T., Trigiante, G., Turrado-Rodriguez, V., Tutino, R., Uccelli, M., Ugarte-Sierra, B., Ukkonen, M., Vassiliu, P. G., Verde, J. M., Veroux, M., Vilallonga, R., Visconti, D., Waledziak, M., Wannatoop, T., Widmer, L. W., Wilson, M. S. J., Wong, T. H., Xenaki, S., Yu, B., Zakaria, A. D., Zambrano, D. A., Zese, M., Cobianchi L., Dal Mas F., Massaro M., Fugazzola P., Coccolini F., Kluger Y., Leppaniemi A., Moore E.E., Sartelli M., Angelos P., Ansaloni L., Abdelmalik A., Abebe N.S., Abu-Zidan F.M., Adam Y.A.Y., Adamou H., Agrusa A., Akin E., Alexandrino H., Ali S.M., Almeida P.M., Amico F., Ammendola M., Andreuccetti J., Aparicio-Sanchez D., Ardito A., Argenio G., Askevold I.H., Atanasov B.T., Augustin G., Awad S.S., Bagnoli C., Bains L., Balalis D., Baldini E., Baraket O., Barone M., Barreras J.A., Bellanova G., Biancuzzi H., Bignell M.B., Bini R., Bissacco D., Boati P., Bottari A., Bouliaris K., Brillantino A., Buonomo L.A., Buscemi S., Calu V., Campo Dall'Orto R., Carvas J.M., Casoni Pattacini G., Catena F., Celentano V., Ceresoli M., Chirica M., Cianci P., Cillara N., Cimbanassi S., Cioffi S.P.B., Colak E., Conti L., Dantas Costa S., D'acapito F., Damaskos D., Das K., Davies R.J., De Beaux A.C., De Simone B., Demetrashvili Z., Demetriades A.K., Denicolai S., Di Buono G., Di Carlo I., Di Saverio S., Diaconescu B., Dibra R., Dios-Barbeito S., Dogjani A., Domanin M., D'Oria M., Duran Munoz-Cruzado V., East B., Ekwen G.T., Elbaih A.H., Escalera-Antezana J.P., Esposito G., Farre R., Ferrario di Tor Vajana A., Cordeiro Fonseca V., Forfori F., Fortuna L., Fradelos E., Fraga G.P., Fransvea P., Gachabayov M., Garcia Vazquez A., Ghannam W.M., Gioco R., Giraudo G., Giuffrida M., Giulii Capponi M., Gomes C.A., Teixeira Gonsaga R.A., Gonullu E., Goosen J., Goranovic T., Griffiths E.A., Haidar M.G., Hamid H.K.S., Harddastle T.C., Hecker M., Hernandez Garcia E.F., Cancio Huaman E., Hutan M., Ioannidis O., Isik A., Ismail A.M.H., Ismail N., Jang J.Y., Kalipershad S.N.R., Kaplan L.J., Kara Y., Karamagioli E., Karamarkovia A., Kavalakat A.J., Kechagias A., Kenig J., Khan J.S., Khokha V., Klappenbach R.F., Klappenbach R., Kobe Y., Kong V., Korkolis D., Kurihara H., Kuriyama A., Landaluce-Olavarria A., Licari L., Litvin A., Lohsiriwat V., Lopes Moreira C.C., Lostoridis E., Tovar Luna A., Luppi D., Machain G.M., Maegele M., Maggiore D., Maier R.V., Manangi M., Manetti A., Mantoglu B., Mariani F., Marinis A., Sbalcheiro Mariot E.A., Martines G., Martinez Perez A., Mascagni P., Massalou D., Bessa Melo R., Miceli L., Mingoli A., Mishra T.S., Mohamedahmed A.Y.Y., Mohan R., Morales-Garcia D., Mustafa S.M.S., Naimzada M.D., Negoi I., Nidaw M.K., Nigri G., Ogundipe H.D., Oliveri C., Olmi S., Pagani L., Palomba G., Pantalone D., Panyko A., Paolillo C., Papis D., Pararas N., Pata F., Pavone G., Pecchini F., Pellino G., Pelloni M., Peloso A., Perea Del Pozo E., Goncalves Pereira R., Monteiro Pereira B., Lizarazu Perez A., Perrone G., Pesce A., Petracca G., Piccoli M., Picetti E., Pikoulis E., Pintar T., Pirozzolo G., Podda M., Previtali P., Privitera F., Punzo C., Quiodettis M.A., Qvist N., Rahim R., Reinisch-Liese A., Rodriguez-Luna M.R., Roizblatt D., Roscio F.P.M., Rossi S., Sakakushev B.E., Salamea J.C., Sall I., Sammartano F., Sanchez Arteaga A., Sanchez-Cordero S., Sasia D., Sawyer R.G., Seretis C., Serradilla-Martin M., Shelat V.G., Shlyapnikov S., Lages Simoes R., Siribumrungwong B., Slavchev M., Solaini L., Soldini G., Soreide K., Sydorchuk L., Sydorchuk R., Syed A.M., Tallon-Aguilar L., Tan J.H., Tarasconi A., Tartaglia D., Tartaglia N., Taylor J., Tebala G.D., Teuben M., Tolonen M., Tomasicchio G., Triantafyllou T., Trigiante G., Turrado-Rodriguez V., Tutino R., Uccelli M., Ugarte-Sierra B., Ukkonen M., Vassiliu P.G., Verde J.M., Veroux M., Vilallonga R., Visconti D., Waledziak M., Wannatoop T., Widmer L.W., Wilson M.S.J., Wong T.H., Xenaki S., Yu B., Zakaria A.D., Zambrano D.A., Zese M., Cobianchi, L, Dal Mas, F, Massaro, M, Fugazzola, P, Coccolini, F, Kluger, Y, Leppaniemi, A, Moore, E, Sartelli, M, Angelos, P, Ansaloni, L, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Agrusa, A, Akin, E, Alexandrino, H, Ali, S, Almeida, P, Amico, F, Ammendola, M, Andreuccetti, J, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bagnoli, C, Bains, L, Balalis, D, Baldini, E, Baraket, O, Barone, M, Barreras, J, Bellanova, G, Biancuzzi, H, Bignell, M, Bini, R, Bissacco, D, Boati, P, Bottari, A, Bouliaris, K, Brillantino, A, Buonomo, L, Buscemi, S, Calu, V, Campo Dall'Orto, R, Carvas, J, Casoni Pattacini, G, Catena, F, Celentano, V, Ceresoli, M, Chirica, M, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Conti, L, Dantas Costa, S, D'Acapito, F, Damaskos, D, Das, K, Davies, R, De Beaux, A, De Simone, B, Demetrashvili, Z, Demetriades, A, Denicolai, S, Di Buono, G, Di Carlo, I, Di Saverio, S, Diaconescu, B, Dibra, R, Dios-Barbeito, S, Dogjani, A, Domanin, M, D'Oria, M, Duran Munoz-Cruzado, V, East, B, Ekwen, G, Elbaih, A, Escalera-Antezana, J, Esposito, G, Farre, R, Ferrario di Tor Vajana, A, Cordeiro Fonseca, V, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Gachabayov, M, Garcia Vazquez, A, Ghannam, W, Gioco, R, Giraudo, G, Giuffrida, M, Giulii Capponi, M, Gomes, C, Teixeira Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Griffiths, E, Haidar, M, Hamid, H, Harddastle, T, Hecker, M, Hernandez Garcia, E, Cancio Huaman, E, Hutan, M, Ioannidis, O, Isik, A, Ismail, A, Ismail, N, Jang, J, Kalipershad, S, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Kavalakat, A, Kechagias, A, Kenig, J, Khan, J, Khokha, V, Klappenbach, R, Kobe, Y, Kong, V, Korkolis, D, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Licari, L, Litvin, A, Lohsiriwat, V, Lopes Moreira, C, Lostoridis, E, Tovar Luna, A, Luppi, D, Machain, G, Maegele, M, Maggiore, D, Maier, R, Manangi, M, Manetti, A, Mantoglu, B, Mariani, F, Marinis, A, Sbalcheiro Mariot, E, Martines, G, Martinez Perez, A, Mascagni, P, Massalou, D, Bessa Melo, R, Miceli, L, Mingoli, A, Mishra, T, Mohamedahmed, A, Mohan, R, Morales-Garcia, D, Mustafa, S, Naimzada, M, Negoi, I, Nidaw, M, Nigri, G, Ogundipe, H, Oliveri, C, Olmi, S, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papis, D, Pararas, N, Pata, F, Pavone, G, Pecchini, F, Pellino, G, Pelloni, M, Peloso, A, Perea Del Pozo, E, Goncalves Pereira, R, Monteiro Pereira, B, Lizarazu Perez, A, Perrone, G, Pesce, A, Petracca, G, Piccoli, M, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Podda, M, Previtali, P, Privitera, F, Punzo, C, Quiodettis, M, Qvist, N, Rahim, R, Reinisch-Liese, A, Rodriguez-Luna, M, Roizblatt, D, Roscio, F, Rossi, S, Sakakushev, B, Salamea, J, Sall, I, Sammartano, F, Sanchez Arteaga, A, Sanchez-Cordero, S, Sasia, D, Sawyer, R, Seretis, C, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Lages Simoes, R, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Soreide, K, Sydorchuk, L, Sydorchuk, R, Syed, A, Tallon-Aguilar, L, Tan, J, Tarasconi, A, Tartaglia, D, Tartaglia, N, Taylor, J, Tebala, G, Teuben, M, Tolonen, M, Tomasicchio, G, Triantafyllou, T, Trigiante, G, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Ugarte-Sierra, B, Ukkonen, M, Vassiliu, P, Verde, J, Veroux, M, Vilallonga, R, Visconti, D, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Wong, T, Xenaki, S, Yu, B, Zakaria, A, Zambrano, D, and Zese, M

Subjects
RD1-811, media_common.quotation_subject, education, Trauma leaders, Context (language use), Knowledge translation, Trauma leader, Trauma teams, Knowledge translation, Team dynamics, Non-technical skills, Trauma leaders, Settore SECS-P/07 - Economia Aziendale, Multidisciplinary approach, Surveys and Questionnaires, Health care, Medicine, Humans, Non-technical skill, knowledge translation, non-technical skills, team dynamics, trauma leaders, trauma teams, humans, surveys and questionnaires, patient care team, Function (engineering), Trauma teams, Non-technical skills, media_common, Patient Care Team, Medical education, Teamwork, RC86-88.9, business.industry, Team dynamics, Correction, Medical emergencies. Critical care. Intensive care. First aid, Checklist, Emergency Medicine, Surgery, The Internet, Team dynamic, business, Trauma team, Research Article
Abstract

Background Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma’s causes or the patient’s personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes. Methods An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the software R, and reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results Findings highlight how several surgeons are still unsure about the meaning and potential of knowledge translation and its mechanisms. Tools like training, clinical guidelines, and non-technical skills are recognized and used in clinical practice. Others, like patients’ and stakeholders’ engagement, are hardly implemented, despite their increasing importance in the modern healthcare scenario. Several difficulties in working as a team are described, including the lack of time, communication, training, trust, and ego. Discussion Scientific societies should take the lead in offering training and support about the abovementioned topics. Dedicated educational initiatives, practical cases and experiences, workshops and symposia may allow mitigating the difficulties highlighted by the survey’s participants, boosting the performance of emergency teams. Additional investigation of the survey results and its characteristics may lead to more further specific suggestions and potential solutions.

Published
2021

16. It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

Author

Sartelli, M., Labricciosa, F. M., Coccolini, F., Coimbra, R., Abu-Zidan, F. M., Ansaloni, L., Al-Hasan, M. N., Ansari, S., Barie, P. S., Cainzos, M. A., Ceresoli, M., Chiarugi, M., Claridge, J. A., Cicuttin, E., Dellinger, E. P., Fry, D. E., Guirao, X., Hardcastle, T. C., Hecker, A., Leppaniemi, A. K., Litvin, A., Marwah, S., Maseda, E., Mazuski, J. E., Memish, Z. A., Kirkpatrick, A. W., Pagani, L., Podda, Maria Vittoria, Rasa, H. K., Sakakushev, B. E., Sawyer, R. G., Tumietto, F., Xiao, Y., Aboubreeg, W. F., Adamou, H., Akhmeteli, L., Akin, E., Alberio, M. G., Alconchel, F., Magagi, I. A., Arauz, A. B., Argenio, G., Atanasov, B. C., Atici, S. D., Awad, S. S., Baili, E., Bains, L., Bala, M., Baraket, O., Baral, S., Belskii, V. A., Benboubker, M., Ben-Ishay, O., Bordoni, P., Boumediene, A., Brisinda, Giuseppe, Cavazzuti, L., Chandy, S. J., Chiarello, M. M., Cillara, N., Clarizia, G., Cocuz, M. -E., Cocuz, I. G., Conti, L., Coppola, R., Cui, Y., Czepiel, J., D'Acapito, Fabrizio, Damaskos, D., Das, Anil Kumar, De Simone, B., Delibegovic, S., Demetrashvili, Z., Detanac, D. S., Dhingra, S., Di Bella, S., Dimitrov, E. N., Dogjani, A., D'Oria, M., Dumitru, I. M., Elmangory, M. M., Enciu, O., Fantoni, M., Filipescu, D., Fleres, F., Foghetti, D., Fransvea, Pietro, Gachabayov, M., Galeiras, R., Gattuso, G., Ghannam, W. M., Ghisetti, Valeria, Giraudo, G., Gonfa, K. B., Gonullu, E., Hamad, Y. T. E. Y., Hecker, M., Isik, A., Ismail, N., Ismail, A., Jain, S. A., Kanj, S. S., Kapoor, G., Karaiskos, I., Kavalakat, A. J., Kenig, J., Khamis, F., Khokha, V., Kiguba, R., Kim, J. I., Kobe, Y., Kok, K. Y. Y., Kovacevic, B. M., Kryvoruchko, I. A., Kuriyama, A., Landaluce-Olavarria, A., Lasithiotakis, K., Lohsiriwat, V., Lostoridis, E., Luppi, D., Vega, G. M. M., Maegele, M., Marinis, A., Martines, G., Martinez-Perez, A., Massalou, D., Mesina, C., Metan, G., Miranda-Novales, M. G., Mishra, S. K., Mohamed, M. I. H., Mohamedahmed, A. Y. Y., Mora-Guzman, I., Mulita, F., Musina, A. -M., Navsaria, P. H., Negoi, I., Nita, G. E., O'Connor, D. B., Ordonez, C. A., Pantalone, D., Panyko, A., Papadopoulos, A., Pararas, N., Pata, F., Patel, T., Pellino, Giuseppe, Perra, T., Perrone, G., Pesce, Antonio, Pintar, T., Popivanov, G. I., Porcu, A., Quiodettis, M. A., Rahim, R., Mitul, A. R., Reichert, M., Rems, M., Campbell, G. Y. R., Rocha-Pereira, N., Rodrigues, G., Villamil, G. E. R., Rossi, S., Sall, I., Kafil, H. S., Sasia, D., Seni, J., Seretis, C., Serradilla-Martin, M., Shelat, V. G., Siribumrungwong, B., Slavchev, M., Solaini, L., Tan, B. K., Tarasconi, A., Tartaglia, D., Toma, E. A., Tomadze, G., Toro, A., Tovani-Palone, M. R., van Goor, H., Vasilescu, A., Vereczkei, A., Veroux, M., Weckmann, S. A., Widmer, L. W., Yahya, A. I., Zachariah, S. K., Zakaria, A. D., Zubareva, N., Zuidema, W. P., Di Carlo, I., Cortese, Francesco, Baiocchi, G. L., Maier, R. V., Catena, F., Podda M. (ORCID:0000-0002-2779-8417), Brisinda G. (ORCID:0000-0001-8820-9471), D'Acapito F., Das K., Fransvea P. (ORCID:0000-0003-4969-3373), Ghisetti V., Pellino G., Pesce A., Cortese F., Sartelli, M., Labricciosa, F. M., Coccolini, F., Coimbra, R., Abu-Zidan, F. M., Ansaloni, L., Al-Hasan, M. N., Ansari, S., Barie, P. S., Cainzos, M. A., Ceresoli, M., Chiarugi, M., Claridge, J. A., Cicuttin, E., Dellinger, E. P., Fry, D. E., Guirao, X., Hardcastle, T. C., Hecker, A., Leppaniemi, A. K., Litvin, A., Marwah, S., Maseda, E., Mazuski, J. E., Memish, Z. A., Kirkpatrick, A. W., Pagani, L., Podda, Maria Vittoria, Rasa, H. K., Sakakushev, B. E., Sawyer, R. G., Tumietto, F., Xiao, Y., Aboubreeg, W. F., Adamou, H., Akhmeteli, L., Akin, E., Alberio, M. G., Alconchel, F., Magagi, I. A., Arauz, A. B., Argenio, G., Atanasov, B. C., Atici, S. D., Awad, S. S., Baili, E., Bains, L., Bala, M., Baraket, O., Baral, S., Belskii, V. A., Benboubker, M., Ben-Ishay, O., Bordoni, P., Boumediene, A., Brisinda, Giuseppe, Cavazzuti, L., Chandy, S. J., Chiarello, M. M., Cillara, N., Clarizia, G., Cocuz, M. -E., Cocuz, I. G., Conti, L., Coppola, R., Cui, Y., Czepiel, J., D'Acapito, Fabrizio, Damaskos, D., Das, Anil Kumar, De Simone, B., Delibegovic, S., Demetrashvili, Z., Detanac, D. S., Dhingra, S., Di Bella, S., Dimitrov, E. N., Dogjani, A., D'Oria, M., Dumitru, I. M., Elmangory, M. M., Enciu, O., Fantoni, M., Filipescu, D., Fleres, F., Foghetti, D., Fransvea, Pietro, Gachabayov, M., Galeiras, R., Gattuso, G., Ghannam, W. M., Ghisetti, Valeria, Giraudo, G., Gonfa, K. B., Gonullu, E., Hamad, Y. T. E. Y., Hecker, M., Isik, A., Ismail, N., Ismail, A., Jain, S. A., Kanj, S. S., Kapoor, G., Karaiskos, I., Kavalakat, A. J., Kenig, J., Khamis, F., Khokha, V., Kiguba, R., Kim, J. I., Kobe, Y., Kok, K. Y. Y., Kovacevic, B. M., Kryvoruchko, I. A., Kuriyama, A., Landaluce-Olavarria, A., Lasithiotakis, K., Lohsiriwat, V., Lostoridis, E., Luppi, D., Vega, G. M. M., Maegele, M., Marinis, A., Martines, G., Martinez-Perez, A., Massalou, D., Mesina, C., Metan, G., Miranda-Novales, M. G., Mishra, S. K., Mohamed, M. I. H., Mohamedahmed, A. Y. Y., Mora-Guzman, I., Mulita, F., Musina, A. -M., Navsaria, P. H., Negoi, I., Nita, G. E., O'Connor, D. B., Ordonez, C. A., Pantalone, D., Panyko, A., Papadopoulos, A., Pararas, N., Pata, F., Patel, T., Pellino, Giuseppe, Perra, T., Perrone, G., Pesce, Antonio, Pintar, T., Popivanov, G. I., Porcu, A., Quiodettis, M. A., Rahim, R., Mitul, A. R., Reichert, M., Rems, M., Campbell, G. Y. R., Rocha-Pereira, N., Rodrigues, G., Villamil, G. E. R., Rossi, S., Sall, I., Kafil, H. S., Sasia, D., Seni, J., Seretis, C., Serradilla-Martin, M., Shelat, V. G., Siribumrungwong, B., Slavchev, M., Solaini, L., Tan, B. K., Tarasconi, A., Tartaglia, D., Toma, E. A., Tomadze, G., Toro, A., Tovani-Palone, M. R., van Goor, H., Vasilescu, A., Vereczkei, A., Veroux, M., Weckmann, S. A., Widmer, L. W., Yahya, A. I., Zachariah, S. K., Zakaria, A. D., Zubareva, N., Zuidema, W. P., Di Carlo, I., Cortese, Francesco, Baiocchi, G. L., Maier, R. V., Catena, F., Podda M. (ORCID:0000-0002-2779-8417), Brisinda G. (ORCID:0000-0001-8820-9471), D'Acapito F., Das K., Fransvea P. (ORCID:0000-0003-4969-3373), Ghisetti V., Pellino G., Pesce A., and Cortese F.

Abstract

Background: The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants’ perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods: A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results: Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for

Published
2022

17. The Operative management in Bariatric Acute abdomen (OBA) Survey: long-term complications of bariatric surgery and the emergency surgeon's point of view

Author

De Simone B, Ansaloni L, Sartelli M, Kluger Y, Abu-Zidan F, Biffl W, Heyer A, Coccolini F, Baiocchi G, Catena F, Campanile F, Mario D, Raziel A, Zaccaroni A, Tarasconi A, Dazzi A, Lasithiotakisi K, Maccatrozzo S, Ioannidis O, Pata F, Waledziak M, Dogjani A, Ariffin A, Khokha V, Kho L, Kessel B, Negoi I, Lostoridis E, Conti L, Ponchietti L, Papadia F, Ghilardi G, Calu V, Bilecik T, Alemu B, Reichert M, Hutan M, Seretis C, Radu M, Gomes C, Karateke F, da Fonseca V, Isik A, Nikolopoulos I, Fomin A, Ghnnam W, Sydorchuk R, Paolillo C, Sagnotta A, Solaini L, Sawyer R, Spain D, McFarlane M, Arvieux C, Litvin A, Pereira B, Maurel T, Barberis A, Gachabayov M, O'Connor D, Cruz D, Colak E, Mesina C, Manzano-Nunez R, Abdelkarim, Pintar T, Koshy R, Triantos G, Gautam S, Guner A, Ordonez C, Manatakis D, Chiarugi M, Buonomo L, Major P, Andreas H, Roberts D, Cherry-Bukowiec J, Das K, Costanzi A, van Goor H, Kok K, Martinez-Perez A, Villa R, Fattori L, Nita G, Damaskos D, Yuan K, Lizarazu A, Kelly M, Di Carlo I, Ceresoli M, Galleano R, Herzog, Chatzakis C, Bala M, Piscioneri F, Bonilauri S, Lohse H, Demetrashvili Z, Smirnov D, Kim D, Martina F, Bruni G, Campanelli G, Cavalli M, Kong V, Michalopoulos N, Cui Y, Diana M, and OBA Trial Supporters

Subjects
Acute abdomen, Emergency surgery, Outcome bariatric surgery, Abdominal pain after bariatric surgery, Complication bariatric surgery
Abstract

Background The number of bariatric procedures is increasing worldwide. No consensus or guidelines about the emergency management of long-term complications following bariatric surgery are currently available. The aim of this study is to investigate by a web survey how an emergency surgeon approaches this unique group of patients in an emergency medical scenario and to report their personal experience. Method An international web survey was sent to 197 emergency surgeons with the aim to collect data about emergency surgeons' experience in the management of patients admitted in the emergency department for acute abdominal pain after bariatric surgery. The survey was conceived as a questionnaire composed by 26 (multiple choice and open) questions and approved by a steering committee. Results One hundred seventeen international emergency surgeons decided to join the project and answered to the web survey with a response rate of 59.39%. Conclusions The aim of this WSES web survey was to highlight the current management of patients previously submitted to bariatric surgical procedures by ES. Emergency surgeons must be mindful of postoperative bariatric surgery complications. CT scan with oral intestinal opacification may be useful in making a diagnosis if carefully interpreted by the radiologist and the surgeon. In case of inconclusive clinical and radiological findings, when symptoms fail to improve, surgical exploration for bariatric patients presenting acute abdominal pain, by laparoscopy if expertise is available, is mandatory in the first 12-24 h, to have good outcomes and decrease morbidity rate.

Published
2020

18. IROA: International Register of Open Abdomen, preliminary results (vol 12, pg 13, 2017)

Author

Coccolini F, Montori G, Ceresoli M, Catena F, Ivatury R, Sugrue M, Sartelli M, Fugazzola P, Corbella D, Salvetti F, Negoi I, Zese M, Occhionorelli S, Maccatrozzo S, Shlyapnikov S, Galatioto C, Chiarugi M, Demetrashvili Z, Dondossola D, Yovtchev Y, Ioannidis O, Novelli G, Nacoti M, Khor D, Inaba K, Demetriades D, Kaussen T, Jusoh AC, Ghannam W, Sakakushev B, Guetta O, Dogjani A, Costa S, Singh S, Damaskos D, Isik A, Yuan KC, Trotta F, Rausei S, Martinez-Perez A, Bellanova G, Fonseca VC, Hernández F, Marinis A, Fernandes W, Quiodettis M, Bala M, Vereczkei A, Curado RL, Fraga GP, Pereira BM, Gachabayov M, Chagerben GP, Arellano ML, Ozyazici S, Costa G, Tezcaner T, and Ansaloni L

Abstract

[This corrects the article DOI: 10.1186/s13017-017-0123-8.].

Published
2017

19. Follow-up strategies for patients with splenic trauma managed non-operatively: the 2022 World Society of Emergency Surgery consensus document

Author

Mauro Podda, Belinda De Simone, Marco Ceresoli, Francesco Virdis, Francesco Favi, Johannes Wiik Larsen, Federico Coccolini, Massimo Sartelli, Nikolaos Pararas, Solomon Gurmu Beka, Luigi Bonavina, Raffaele Bova, Adolfo Pisanu, Fikri Abu-Zidan, Zsolt Balogh, Osvaldo Chiara, Imtiaz Wani, Philip Stahel, Salomone Di Saverio, Thomas Scalea, Kjetil Soreide, Boris Sakakushev, Francesco Amico, Costanza Martino, Andreas Hecker, Nicola de’Angelis, Mircea Chirica, Joseph Galante, Andrew Kirkpatrick, Emmanouil Pikoulis, Yoram Kluger, Denis Bensard, Luca Ansaloni, Gustavo Fraga, Ian Civil, Giovanni Domenico Tebala, Isidoro Di Carlo, Yunfeng Cui, Raul Coimbra, Vanni Agnoletti, Ibrahima Sall, Edward Tan, Edoardo Picetti, Andrey Litvin, Dimitrios Damaskos, Kenji Inaba, Jeffrey Leung, Ronald Maier, Walt Biffl, Ari Leppaniemi, Ernest Moore, Kurinchi Gurusamy, Fausto Catena, Podda, M, De Simone, B, Ceresoli, M, Virdis, F, Favi, F, Wiik Larsen, J, Coccolini, F, Sartelli, M, Pararas, N, Beka, S, Bonavina, L, Bova, R, Pisanu, A, Abu-Zidan, F, Balogh, Z, Chiara, O, Wani, I, Stahel, P, Di Saverio, S, Scalea, T, Soreide, K, Sakakushev, B, Amico, F, Martino, C, Hecker, A, De'Angelis, N, Chirica, M, Galante, J, Kirkpatrick, A, Pikoulis, E, Kluger, Y, Bensard, D, Ansaloni, L, Fraga, G, Civil, I, Tebala, G, Di Carlo, I, Cui, Y, Coimbra, R, Agnoletti, V, Sall, I, Tan, E, Picetti, E, Litvin, A, Damaskos, D, Inaba, K, Leung, J, Maier, R, Biffl, W, Leppaniemi, A, Moore, E, Gurusamy, K, and Catena, F

Subjects
Adult, Consensus, Nonoperative management, Follow-up, Consensu, Abdominal Injuries, Heparin, Low-Molecular-Weight, Wounds, Nonpenetrating, Trauma, Hemoglobins, Embolization, Emergency Medicine, Humans, Diagnostic imaging, Surgery, Prospective Studies, Child, Conservative treatment, Spleen, Follow-Up Studies
Abstract

BackgroundIn 2017, the World Society of Emergency Surgery published its guidelines for the management of adult and pediatric patients with splenic trauma. Several issues regarding the follow-up of patients with splenic injuries treated with NOM remained unsolved.MethodsUsing a modified Delphi method, we sought to explore ongoing areas of controversy in the NOM of splenic trauma and reach a consensus among a group of 48 international experts from five continents (Africa, Europe, Asia, Oceania, America) concerning optimal follow-up strategies in patients with splenic injuries treated with NOM.ResultsConsensus was reached on eleven clinical research questions and 28 recommendations with an agreement rate ≥ 80%. Mobilization after 24 h in low-grade splenic trauma patients (WSES Class I, AAST Grades I–II) was suggested, while in patients with high-grade splenic injuries (WSES Classes II–III, AAST Grades III–V), if no other contraindications to early mobilization exist, safe mobilization of the patient when three successive hemoglobins 8 h apart after the first are within 10% of each other was considered safe according to the panel. The panel suggests adult patients to be admitted to hospital for 1 day (for low-grade splenic injuries—WSES Class I, AAST Grades I–II) to 3 days (for high-grade splenic injuries—WSES Classes II–III, AAST Grades III–V), with those with high-grade injuries requiring admission to a monitored setting. In the absence of specific complications, the panel suggests DVT and VTE prophylaxis with LMWH to be started within 48–72 h from hospital admission. The panel suggests splenic artery embolization (SAE) as the first-line intervention in patients with hemodynamic stability and arterial blush on CT scan, irrespective of injury grade. Regarding patients with WSES Class II blunt splenic injuries (AAST Grade III) without contrast extravasation, a low threshold for SAE has been suggested in the presence of risk factors for NOM failure. The panel also suggested angiography and eventual SAE in all hemodynamically stable adult patients with WSES Class III injuries (AAST Grades IV–V), even in the absence of CT blush, especially when concomitant surgery that requires change of position is needed. Follow-up imaging with contrast-enhanced ultrasound/CT scan in 48–72 h post-admission of trauma in splenic injuries WSES Class II (AAST Grade III) or higher treated with NOM was considered the best strategy for timely detection of vascular complications.ConclusionThis consensus document could help guide future prospective studies aiming at validating the suggested strategies through the implementation of prospective trauma databases and the subsequent production of internationally endorsed guidelines on the issue.

Published
2022

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