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6. Six Long-Standing Questions about Antibiotic Prophylaxis in Surgery.

Author

Sartelli, Massimo, Boermeester, Marja A., Cainzos, Miguel, Coccolini, Federico, de Jonge, Stijn W., Rasa, Kemal, Dellinger, E. Patchen, McNamara, Deborah A., Fry, Donald E., Cui, Yunfeng, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, Gkiokas, George, Hardcastle, Timothy C., Itani, Kamal M. F., Isik, Arda, Labricciosa, Francesco Maria, Lohsiriwat, Varut, and Marwah, Sanjay

Subjects
ANTIBIOTIC prophylaxis, SURGICAL site infections, SURGICAL site, SURGERY
Abstract

Surgical site infections (SSIs) are the most common adverse event occurring in surgical patients. Optimal prevention of SSIs requires the bundled integration of a variety of measures before, during, and after surgery. Surgical antibiotic prophylaxis (SAP) is an effective measure for preventing SSIs. It aims to counteract the inevitable introduction of bacteria that colonize skin or mucosa into the surgical site during the intervention. This document aims to guide surgeons in appropriate administration of SAP by addressing six key questions. The expert panel identifies a list of principles in response to these questions that every surgeon around the world should always respect in administering SAP. [ABSTRACT FROM AUTHOR]

Published
2023
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10. The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections.

Author

Sartelli, Massimo, Chichom-Mefire, Alain, Labricciosa, Francesco M., Hardcastle, Timothy, Abu-Zidan, Fikri M., Adesunkanmi, Abdulrashid K., Ansaloni, Luca, Bala, Miklosh, Balogh, Zsolt J., Beltrán, Marcelo A., Ben-Ishay, Offir, Biffl, Walter L., Birindelli, Arianna, Cainzos, Miguel A., Catalini, Gianbattista, Ceresoli, Marco, Jusoh, Asri Che, Chiara, Osvaldo, Coccolini, Federico, and Coimbra, Raul

Subjects
PERITONITIS, SEPTICEMIA treatment, INTRA-abdominal infections, ANTI-infective agents, HOSPITAL emergency services, MEDICAL quality control, MEDICAL protocols, RESUSCITATION, EVIDENCE-based medicine, EARLY diagnosis, THERAPEUTICS
Abstract

Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in the emergency departments worldwide. The cornerstones of effective treatment of IAIs are early recognition, adequate source control, and appropriate antimicrobial therapy. Prompt resuscitation of patients with ongoing sepsis is of utmost important. In hospitals worldwide, non-acceptance of, or lack of access to, accessible evidence-based practices and guidelines result in overall poorer outcome of patients suffering IAIs. The aim of this paper is to promote global standards of care in IAIs and update the 2013 WSES guidelines for management of intra-abdominal infections. [ABSTRACT FROM AUTHOR]

Published
2017
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11. World Society of Emergency Surgery (WSES) guidelines for management of skin and soft tissue infections.

Author

Sartelli, Massimo, Malangoni, Mark A., May, Addison K., Viale, Pierluigi, Kao, Lillian S., Catena, Fausto, Ansaloni, Luca, Moore, Ernest E., Moore, Fred A., Peitzman, Andrew B., Coimbra, Raul, Leppaniemi, Ari, Kluger, Yoram, Biffl, Walter, Koike, Kaoru, Girardis, Massimo, Ordonez, Carlos A., Tavola, Mario, Cainzos, Miguel, and Di Saverio, Salomone

Subjects
DEBRIDEMENT, COMMUNICABLE disease treatment, SKIN disease treatment, ABSCESSES, ANTIBIOTICS, CELLULITIS, COMPUTED tomography, DIET therapy, HYPERBARIC oxygenation, IMMUNOGLOBULINS, MAGNETIC resonance imaging, MEDICAL protocols, MYOSITIS, SURGICAL site infections, FOURNIER gangrene, NECROTIZING fasciitis, METHICILLIN-resistant staphylococcus aureus, SOFT tissue infections, DIAGNOSIS, THERAPEUTICS
Abstract

Skin and soft tissue infections (SSTIs) encompass a variety of pathological conditions ranging from simple superficial infections to severe necrotizing soft tissue infections. Necrotizing soft tissue infections (NSTIs) are potentially life-threatening infections of any layer of the soft tissue compartment associated with widespread necrosis and systemic toxicity. Successful management of NSTIs involves prompt recognition, timely surgical debridement or drainage, resuscitation and appropriate antibiotic therapy. A worldwide international panel of experts developed evidence-based guidelines for management of soft tissue infections. The multifaceted nature of these infections has led to a collaboration among surgeons, intensive care and infectious diseases specialists, who have shared these guidelines, implementing clinical practice recommendations. [ABSTRACT FROM AUTHOR]

Published
2014
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12. Informed Consent in Surgery.

Author

Cainzos, Miguel and González-Vinagre, S.

Subjects
*INFORMED consent (Medical law), *PROFESSIONAL ethics of surgeons, *MEDICAL ethics, *MEDICAL laws, *PATIENT education, *PHYSICIAN-patient relations
Abstract

The article discusses issues concerning informed consent in surgery, wherein the patient is described as an independent adult who has the competence to authorize an action that may affect their health. Topics discussed include the role of surgeons in obtaining informed consent in the clinical setting, the new context of the patient-surgeon relationship and the components of informed consent such as preconditions, information provided to the patient, and information disclosure.

Published
2014
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13. Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Author

Sartelli, Massimo, Weber, Dieter G., Ruppé, Etienne, Bassetti, Matteo, Wright, Brian J., Ansaloni, Luca, Catena, Fausto, Coccolini, Federico, Abu-Zidan, Fikri M., Coimbra, Raul, Moore, Ernest E., Moore, Frederick A., Maier, Ronald V., De Waele, Jan J., Kirkpatrick, Andrew W., Griffiths, Ewen A., Eckmann, Christian, Brink, Adrian J., Mazuski, John E., May, Addison K., Sawyer, Rob G., Mertz, Dominik, Montravers, Philippe, Kumar, Anand, Roberts, Jason A., Vincent, Jean-Louis, Watkins, Richard R., Lowman, Warren, Spellberg, Brad, Abbott, Iain J., Adesunkanmi, Abdulrashid Kayode, Al-Dahir, Sara, Al-Hasan, Majdi N., Agresta, Ferdinando, Althani, Asma A., Ansari, Shamshul, Ansumana, Rashid, Augustin, Goran, Bala, Miklosh, Balogh, Zsolt J., Baraket, Oussama, Bhangu, Aneel, Beltrán, Marcelo A., Bernhard, Michael, Biffl, Walter L., Boermeester, Marja A., Brecher, Stephen M., Cherry-Bukowiec, Jill R., Buyne, Otmar R., Cainzos, Miguel A., Cairns, Kelly A., Camacho-Ortiz, Adrian, Chandy, Sujith J., Che Jusoh, Asri, Chichom-Mefire, Alain, Colijn, Caroline, Corcione, Francesco, Cui, Yunfeng, Curcio, Daniel, Delibegovic, Samir, Demetrashvili, Zaza, De Simone, Belinda, Dhingra, Sameer, Diaz, José J., Di Carlo, Isidoro, Dillip, Angel, Di Saverio, Salomone, Doyle, Michael P., Dorj, Gereltuya, Dogjani, Agron, Dupont, Hervé, Eachempati, Soumitra R., Enani, Mushira Abdulaziz, Egiev, Valery N., Elmangory, Mutasim M., Ferrada, Paula, Fitchett, Joseph R., Fraga, Gustavo P., Guessennd, Nathalie, Giamarellou, Helen, Ghnnam, Wagih, Gkiokas, George, Goldberg, Staphanie R., Gomes, Carlos Augusto, Gomi, Harumi, Guzmán-Blanco, Manuel, Haque, Mainul, Hansen, Sonja, Hecker, Andreas, Heizmann, Wolfgang R., Herzog, Torsten, Hodonou, Adrien Montcho, Hong, Suk-Kyung, Kafka-Ritsch, Reinhold, Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar, Kees, Martin G., Kenig, Jakub, Kiguba, Ronald, Kim, Peter K., Kluger, Yoram, Khokha, Vladimir, Koike, Kaoru, Kok, Kenneth Y. Y., Kong, Victory, Knox, Matthew C., Inaba, Kenji, Isik, Arda, Iskandar, Katia, Ivatury, Rao R., Labbate, Maurizio, Labricciosa, Francesco M., Laterre, Pierre-François, Latifi, Rifat, Lee, Jae Gil, Lee, Young Ran, Leone, Marc, Leppaniemi, Ari, Li, Yousheng, Liang, Stephen Y., Loho, Tonny, Maegele, Marc, Malama, Sydney, Marei, Hany E., Martin-Loeches, Ignacio, Marwah, Sanjay, Massele, Amos, McFarlane, Michael, Melo, Renato Bessa, Negoi, Ionut, Nicolau, David P., Nord, Carl Erik, Ofori-Asenso, Richard, Omari, AbdelKarim H., Ordonez, Carlos A., Ouadii, Mouaqit, Pereira Júnior, Gerson Alves, Piazza, Diego, Pupelis, Guntars, Rawson, Timothy Miles, Rems, Miran, Rizoli, Sandro, Rocha, Claudio, Sakakhushev, Boris, Sanchez-Garcia, Miguel, Sato, Norio, Segovia Lohse, Helmut A., Sganga, Gabriele, Siribumrungwong, Boonying, Shelat, Vishal G., Soreide, Kjetil, Soto, Rodolfo, Talving, Peep, Tilsed, Jonathan V., Timsit, Jean-Francois, Trueba, Gabriel, Trung, Ngo Tat, Ulrych, Jan, van Goor, Harry, Vereczkei, Andras, Vohra, Ravinder S., Wani, Imtiaz, Uhl, Waldemar, Xiao, Yonghong, Yuan, Kuo-Ching, Zachariah, Sanoop K., Zahar, Jean-Ralph, Zakrison, Tanya L., Corcione, Antonio, Melotti, Rita M., Viscoli, Claudio, and Viale, Perluigi

Abstract

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.

Published
2016
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14. WSES guidelines for management of Clostridium difficile infection in surgical patients

Author

Sartelli, Massimo, Malangoni, Mark A., Abu-Zidan, Fikri M., Griffiths, Ewen A., Di Bella, Stefano, McFarland, Lynne V., Eltringham, Ian, Shelat, Vishal G., Velmahos, George C., Kelly, Ciarán P., Khanna, Sahil, Abdelsattar, Zaid M., Alrahmani, Layan, Ansaloni, Luca, Augustin, Goran, Bala, Miklosh, Barbut, Frédéric, Ben-Ishay, Offir, Bhangu, Aneel, Biffl, Walter L., Brecher, Stephen M., Camacho-Ortiz, Adrián, Caínzos, Miguel A., Canterbury, Laura A., Catena, Fausto, Chan, Shirley, Cherry-Bukowiec, Jill R., Clanton, Jesse, Coccolini, Federico, Cocuz, Maria Elena, Coimbra, Raul, Cook, Charles H., Cui, Yunfeng, Czepiel, Jacek, Das, Koray, Demetrashvili, Zaza, Di Carlo, Isidoro, Di Saverio, Salomone, Dumitru, Irina Magdalena, Eckert, Catherine, Eckmann, Christian, Eiland, Edward H., Enani, Mushira Abdulaziz, Faro, Mario, Ferrada, Paula, Forrester, Joseph Derek, Fraga, Gustavo P., Frossard, Jean Louis, Galeiras, Rita, Ghnnam, Wagih, Gomes, Carlos Augusto, Gorrepati, Venkata, Ahmed, Mohamed Hassan, Herzog, Torsten, Humphrey, Felicia, Kim, Jae Il, Isik, Arda, Ivatury, Rao, Lee, Yeong Yeh, Juang, Paul, Furuya-Kanamori, Luis, Karamarkovic, Aleksandar, Kim, Peter K, Kluger, Yoram, Ko, Wen Chien, LaBarbera, Francis D., Lee, Jae Gil, Leppaniemi, Ari, Lohsiriwat, Varut, Marwah, Sanjay, Mazuski, John E., Metan, Gokhan, Moore, Ernest E., Moore, Frederick Alan, Nord, Carl Erik, Ordoñez, Carlos A., Júnior, Gerson Alves Pereira, Petrosillo, Nicola, Portela, Francisco, Puri, Basant K., Ray, Arnab, Raza, Mansoor, Rems, Miran, Sakakushev, Boris E., Sganga, Gabriele, Spigaglia, Patrizia, Stewart, David B., Tattevin, Pierre, Timsit, Jean Francois, To, Kathleen B., Tranà, Cristian, Uhl, Waldemar, Urbánek, Libor, van Goor, Harry, Vassallo, Angela, Zahar, Jean Ralph, Caproli, Emanuele, and Viale, Pierluigi

Abstract

In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency Surgery (WSES) guidelines for management of CDI in surgical patients.

Published
2015
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