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1. Are we ready for 'green surgery' to promote environmental sustainability in the operating room? Results from the WSES STAR investigation

Author

Francesca Dal Mas, Lorenzo Cobianchi, Daniele Piccolo, Jeremy Balch, Helena Biancuzzi, Walter L. Biffl, Stefano Campostrini, Enrico Cicuttin, Federico Coccolini, Dimitris Damaskos, Amanda C. Filiberto, Claudia Filisetti, Gustavo Fraga, Simone Frassini, Paola Fugazzola, Timothy Hardcastle, Haytham M. Kaafarani, Yoran Kluger, Maurizio Massaro, Jacopo Martellucci, Ernest Moore, Federico Ruta, Massimo Sartelli, Philip F. Stahel, George Velmahos, Dieter G. Weber, Fausto Catena, Tyler J. Loftus, Luca Ansaloni, and the STAR Study Group

Subjects
Environmental Sustainability, Sustainability, Trauma and emergency surgery, survey, Green, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background The importance of environmental sustainability is acknowledged in all sectors, including healthcare. To meet the United Nations Sustainable Development Goals 2030 Agenda, healthcare will need a paradigm shift toward more environmentally sustainable practices that will also impact clinical decision-making. The study investigates trauma and emergency surgeons’ perception, acceptance, and employment of environmentally friendly habits. Methods An online survey based on the most recent literature regarding environmental sustainability in healthcare and surgery was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to the 917 WSES members through the society’s website and Twitter/X profile. Results 450 surgeons from 55 countries participated in the survey. Results underline both a generally positive attitude toward environmental sustainability but also a lack of knowledge about several concepts and practices, especially concerning the potential contribution to patient care. Discussion The topic of environmental sustainability in healthcare and surgery is still in its infancy. There is a clear lack of salient guidance and knowledge, and there is a critical need for governments, institutions, health agencies, and scientific societies to promote, disseminate, and report environmentally friendly initiatives and their potential impacts while employing an interdisciplinary approach.

Published
2024
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2. ECLAPTE: Effective Closure of LAParoTomy in Emergency—2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

Author

Simone Frassini, Lorenzo Cobianchi, Paola Fugazzola, Walter L. Biffl, Federico Coccolini, Dimitrios Damaskos, Ernest E. Moore, Yoram Kluger, Marco Ceresoli, Raul Coimbra, Justin Davies, Andrew Kirkpatrick, Isidoro Di Carlo, Timothy C. Hardcastle, Arda Isik, Massimo Chiarugi, Kurinchi Gurusamy, Ronald V. Maier, Helmut A. Segovia Lohse, Hans Jeekel, Marja A. Boermeester, Fikri Abu-Zidan, Kenji Inaba, Dieter G. Weber, Goran Augustin, Luigi Bonavina, George Velmahos, Massimo Sartelli, Salomone Di Saverio, Richard P. G. Ten Broek, Stefano Granieri, Francesca Dal Mas, Camilla Nikita Farè, Jacopo Peverada, Simone Zanghì, Jacopo Viganò, Matteo Tomasoni, Tommaso Dominioni, Enrico Cicuttin, Andreas Hecker, Giovanni D. Tebala, Joseph M. Galante, Imtiaz Wani, Vladimir Khokha, Michael Sugrue, Thomas M. Scalea, Edward Tan, Mark A. Malangoni, Nikolaos Pararas, Mauro Podda, Belinda De Simone, Rao Ivatury, Yunfeng Cui, Jeffry Kashuk, Andrew Peitzman, Fernando Kim, Emmanouil Pikoulis, Gabriele Sganga, Osvaldo Chiara, Michael D. Kelly, Ingo Marzi, Edoardo Picetti, Vanni Agnoletti, Nicola De’Angelis, Giampiero Campanelli, Marc de Moya, Andrey Litvin, Aleix Martínez-Pérez, Ibrahima Sall, Sandro Rizoli, Gia Tomadze, Boris Sakakushev, Philip F. Stahel, Ian Civil, Vishal Shelat, David Costa, Alain Chichom-Mefire, Rifat Latifi, Mircea Chirica, Francesco Amico, Amyn Pardhan, Vidya Seenarain, Nikitha Boyapati, Basil Hatz, Travis Ackermann, Sandun Abeyasundara, Linda Fenton, Frank Plani, Rohit Sarvepalli, Omid Rouhbakhshfar, Pamela Caleo, Victor Ho-Ching Yau, Kristenne Clement, Erasmia Christou, Ana María González Castillo, Preet K. S. Gosal, Sunder Balasubramaniam, Jeremy Hsu, Kamon Banphawatanarak, Michele Pisano, Toro Adriana, Altomare Michele, Stefano P. B. Cioffi, Andrea Spota, Fausto Catena, and Luca Ansaloni

Subjects
Laparotomy closure, Midline incision, Emergency, Abdominal wall incision, Closure technique, Incisional hernia, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy.

Published
2023
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3. Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the S.P.Ri.M.A.C.C. study

Author

Paola Fugazzola, Lorenzo Cobianchi, Marcello Di Martino, Matteo Tomasoni, Francesca Dal Mas, Fikri M. Abu-Zidan, Vanni Agnoletti, Marco Ceresoli, Federico Coccolini, Salomone Di Saverio, Tommaso Dominioni, Camilla Nikita Farè, Simone Frassini, Giulia Gambini, Ari Leppäniemi, Marcello Maestri, Elena Martín-Pérez, Ernest E. Moore, Valeria Musella, Andrew B. Peitzman, Ángela de la Hoz Rodríguez, Benedetta Sargenti, Massimo Sartelli, Jacopo Viganò, Andrea Anderloni, Walter Biffl, Fausto Catena, Luca Ansaloni, and the S.P.Ri.M.A.C.C. Collaborative Group

Subjects
Cholecystectomy, Acute cholecystitis, Surgical risk, POSSUM, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Less invasive alternatives than early cholecystectomy (EC) for acute calculous cholecystitis (ACC) treatment have been spreading in recent years. We still lack a reliable tool to select high-risk patients who could benefit from these alternatives. Our study aimed to prospectively validate the Chole-risk score in predicting postoperative complications in patients undergoing EC for ACC compared with other preoperative risk prediction models. Method The S.P.Ri.M.A.C.C. study is a World Society of Emergency Surgery prospective multicenter observational study. From 1st September 2021 to 1st September 2022, 1253 consecutive patients admitted in 79 centers were included. The inclusion criteria were a diagnosis of ACC and to be a candidate for EC. A Cochran-Armitage test of the trend was run to determine whether a linear correlation existed between the Chole-risk score and a complicated postoperative course. To assess the accuracy of the analyzed prediction models—POSSUM Physiological Score (PS), modified Frailty Index, Charlson Comorbidity Index, American Society of Anesthesiologist score (ASA), APACHE II score, and ACC severity grade—receiver operating characteristic (ROC) curves were generated. The area under the ROC curve (AUC) was used to compare the diagnostic abilities. Results A 30-day major morbidity of 6.6% and 30-day mortality of 1.1% were found. Chole-risk was validated, but POSSUM PS was the best risk prediction model for a complicated course after EC for ACC (in-hospital mortality: AUC 0.94, p

Published
2023
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4. Correction: ECLAPTE: Effective Closure of LAParoTomy in Emergency—2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

Author

Simone Frassini, Lorenzo Cobianchi, Paola Fugazzola, Walter L. Biffl, Federico Coccolini, Dimitrios Damaskos, Ernest E. Moore, Yoram Kluger, Marco Ceresoli, Raul Coimbra, Justin Davies, Andrew Kirkpatrick, Isidoro Di Carlo, Timothy C. Hardcastle, Arda Isik, Massimo Chiarugi, Kurinchi Gurusamy, Ronald V. Maier, Helmut A. Segovia Lohse, Hans Jeekel, Marja A. Boermeester, Fikri Abu-Zidan, Kenji Inaba, Dieter G. Weber, Goran Augustin, Luigi Bonavina, George Velmahos, Massimo Sartelli, Salomone Di Saverio, Richard P. G. Ten Broek, Stefano Granieri, Francesca Dal Mas, Camilla Nikita Farè, Jacopo Peverada, Simone Zanghì, Jacopo Viganò, Matteo Tomasoni, Tommaso Dominioni, Enrico Cicuttin, Andreas Hecker, Giovanni D. Tebala, Joseph M. Galante, Imtiaz Wani, Vladimir Khokha, Michael Sugrue, Thomas M. Scalea, Edward Tan, Mark A. Malangoni, Nikolaos Pararas, Mauro Podda, Belinda De Simone, Rao Ivatury, Yunfeng Cui, Jeffry Kashuk, Andrew Peitzman, Fernando Kim, Emmanouil Pikoulis, Gabriele Sganga, Osvaldo Chiara, Michael D. Kelly, Ingo Marzi, Edoardo Picetti, Vanni Agnoletti, Nicola De’Angelis, Giampiero Campanelli, Marc de Moya, Andrey Litvin, Aleix Martínez-Pérez, Ibrahima Sall, Sandro Rizoli, Gia Tomadze, Boris Sakakushev, Philip F. Stahel, Ian Civil, Vishal Shelat, David Costa, Alain Chichom-Mefire, Rifat Latifi, Mircea Chirica, Francesco Amico, Amyn Pardhan, Vidya Seenarain, Nikitha Boyapati, Basil Hatz, Travis Ackermann, Sandun Abeyasundara, Linda Fenton, Frank Plani, Rohit Sarvepalli, Omid Rouhbakhshfar, Pamela Caleo, Victor Ho-Ching Yau, Kristenne Clement, Erasmia Christou, Ana María González Castillo, Preet K. S. Gosal, Sunder Balasubramaniam, Jeremy Hsu, Kamon Banphawatanarak, Michele Pisano, Adriana Toro, Altomare Michele, Stefano P. B. Cioffi, Andrea Spota, Fausto Catena, and Luca Ansaloni

Subjects
Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published
2023
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