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1. WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections

Author

Massimo Sartelli, Federico Coccolini, Yoram Kluger, Ervis Agastra, Fikri M. Abu-Zidan, Ashraf El Sayed Abbas, Luca Ansaloni, Abdulrashid Kayode Adesunkanmi, Goran Augustin, Miklosh Bala, Oussama Baraket, Walter L. Biffl, Marco Ceresoli, Elisabetta Cerutti, Osvaldo Chiara, Enrico Cicuttin, Massimo Chiarugi, Raul Coimbra, Daniela Corsi, Francesco Cortese, Yunfeng Cui, Dimitris Damaskos, Nicola de’Angelis, Samir Delibegovic, Zaza Demetrashvili, Belinda De Simone, Stijn W. de Jonge, Stefano Di Bella, Salomone Di Saverio, Therese M. Duane, Paola Fugazzola, Joseph M. Galante, Wagih Ghnnam, George Gkiokas, Carlos Augusto Gomes, Ewen A. Griffiths, Timothy C. Hardcastle, Andreas Hecker, Torsten Herzog, Aleksandar Karamarkovic, Vladimir Khokha, Peter K. Kim, Jae Il Kim, Andrew W. Kirkpatrick, Victor Kong, Renol M. Koshy, Kenji Inaba, Arda Isik, Rao Ivatury, Francesco M. Labricciosa, Yeong Yeh Lee, Ari Leppäniemi, Andrey Litvin, Davide Luppi, Ronald V. Maier, Athanasios Marinis, Sanjay Marwah, Cristian Mesina, Ernest E. Moore, Frederick A. Moore, Ionut Negoi, Iyiade Olaoye, Carlos A. Ordoñez, Mouaqit Ouadii, Andrew B. Peitzman, Gennaro Perrone, Tadeja Pintar, Giuseppe Pipitone, Mauro Podda, Kemal Raşa, Julival Ribeiro, Gabriel Rodrigues, Ines Rubio-Perez, Ibrahima Sall, Norio Sato, Robert G. Sawyer, Vishal G. Shelat, Michael Sugrue, Antonio Tarasconi, Matti Tolonen, Bruno Viaggi, Andrea Celotti, Claudio Casella, Leonardo Pagani, Sameer Dhingra, Gian Luca Baiocchi, and Fausto Catena

Subjects
Skin and soft-tissue infections, Necrotizing soft-tissue infections, Necrotizing infections, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections. Together, the World Society of Emergency Surgery, the Global Alliance for Infections in Surgery, the Surgical Infection Society-Europe, The World Surgical Infection Society, and the American Association for the Surgery of Trauma have jointly completed an international multi-society document to promote global standards of care in SSTIs guiding clinicians by describing reasonable approaches to the management of SSTIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting evidence was shared by an international task force with different clinical backgrounds.

Published
2022
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2. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections

Author

Massimo Sartelli, Federico Coccolini, Yoram Kluger, Ervis Agastra, Fikri M. Abu-Zidan, Ashraf El Sayed Abbas, Luca Ansaloni, Abdulrashid Kayode Adesunkanmi, Boyko Atanasov, Goran Augustin, Miklosh Bala, Oussama Baraket, Suman Baral, Walter L. Biffl, Marja A. Boermeester, Marco Ceresoli, Elisabetta Cerutti, Osvaldo Chiara, Enrico Cicuttin, Massimo Chiarugi, Raul Coimbra, Elif Colak, Daniela Corsi, Francesco Cortese, Yunfeng Cui, Dimitris Damaskos, Nicola de’ Angelis, Samir Delibegovic, Zaza Demetrashvili, Belinda De Simone, Stijn W. de Jonge, Sameer Dhingra, Stefano Di Bella, Francesco Di Marzo, Salomone Di Saverio, Agron Dogjani, Therese M. Duane, Mushira Abdulaziz Enani, Paola Fugazzola, Joseph M. Galante, Mahir Gachabayov, Wagih Ghnnam, George Gkiokas, Carlos Augusto Gomes, Ewen A. Griffiths, Timothy C. Hardcastle, Andreas Hecker, Torsten Herzog, Syed Mohammad Umar Kabir, Aleksandar Karamarkovic, Vladimir Khokha, Peter K. Kim, Jae Il Kim, Andrew W. Kirkpatrick, Victor Kong, Renol M. Koshy, Igor A. Kryvoruchko, Kenji Inaba, Arda Isik, Katia Iskandar, Rao Ivatury, Francesco M. Labricciosa, Yeong Yeh Lee, Ari Leppäniemi, Andrey Litvin, Davide Luppi, Gustavo M. Machain, Ronald V. Maier, Athanasios Marinis, Cristina Marmorale, Sanjay Marwah, Cristian Mesina, Ernest E. Moore, Frederick A. Moore, Ionut Negoi, Iyiade Olaoye, Carlos A. Ordoñez, Mouaqit Ouadii, Andrew B. Peitzman, Gennaro Perrone, Manos Pikoulis, Tadeja Pintar, Giuseppe Pipitone, Mauro Podda, Kemal Raşa, Julival Ribeiro, Gabriel Rodrigues, Ines Rubio-Perez, Ibrahima Sall, Norio Sato, Robert G. Sawyer, Helmut Segovia Lohse, Gabriele Sganga, Vishal G. Shelat, Ian Stephens, Michael Sugrue, Antonio Tarasconi, Joel Noutakdie Tochie, Matti Tolonen, Gia Tomadze, Jan Ulrych, Andras Vereczkei, Bruno Viaggi, Chiara Gurioli, Claudio Casella, Leonardo Pagani, Gian Luca Baiocchi, and Fausto Catena

Subjects
Intra-abdominal infections, Peritonitis, Sepsis, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in hospitals worldwide. The cornerstones of effective treatment of IAIs include early recognition, adequate source control, appropriate antimicrobial therapy, and prompt physiologic stabilization using a critical care environment, combined with an optimal surgical approach. Together, the World Society of Emergency Surgery (WSES), the Global Alliance for Infections in Surgery (GAIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), and the American Association for the Surgery of Trauma (AAST) have jointly completed an international multi-society document in order to facilitate clinical management of patients with IAIs worldwide building evidence-based clinical pathways for the most common IAIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting information was shared by an international task force from 46 countries with different clinical backgrounds. The aim of the document is to promote global standards of care in IAIs providing guidance to clinicians by describing reasonable approaches to the management of IAIs.

Published
2021
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3. Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study

Author

Massimo Sartelli, Fikri M. Abu-Zidan, Francesco M. Labricciosa, Yoram Kluger, Federico Coccolini, Luca Ansaloni, Ari Leppäniemi, Andrew W. Kirkpatrick, Matti Tolonen, Cristian Tranà, Jean-Marc Regimbeau, Timothy Hardcastle, Renol M. Koshy, Ashraf Abbas, Ulaş Aday, A. R. K. Adesunkanmi, Adesina Ajibade, Lali Akhmeteli, Emrah Akın, Nezih Akkapulu, Alhenouf Alotaibi, Fatih Altintoprak, Dimitrios Anyfantakis, Boyko Atanasov, Goran Augustin, Constança Azevedo, Miklosh Bala, Dimitrios Balalis, Oussama Baraket, Suman Baral, Or Barkai, Marcelo Beltran, Roberto Bini, Konstantinos Bouliaris, Ana B. Caballero, Valentin Calu, Marco Catani, Marco Ceresoli, Vasileios Charalampakis, Asri Che Jusoh, Massimo Chiarugi, Nicola Cillara, Raquel Cobos Cuesta, Luigi Cobuccio, Gianfranco Cocorullo, Elif Colak, Luigi Conti, Yunfeng Cui, Belinda De Simone, Samir Delibegovic, Zaza Demetrashvili, Demetrios Demetriades, Ana Dimova, Agron Dogjani, Mushira Enani, Federica Farina, Francesco Ferrara, Domitilla Foghetti, Tommaso Fontana, Gustavo P. Fraga, Mahir Gachabayov, Grelpois Gérard, Wagih Ghnnam, Teresa Giménez Maurel, Georgios Gkiokas, Carlos A. Gomes, Ali Guner, Sanjay Gupta, Andreas Hecker, Elcio S. Hirano, Adrien Hodonou, Martin Hutan, Igor Ilaschuk, Orestis Ioannidis, Arda Isik, Georgy Ivakhov, Sumita Jain, Mantas Jokubauskas, Aleksandar Karamarkovic, Robin Kaushik, Jakub Kenig, Vladimir Khokha, Denis Khokha, Jae Il Kim, Victor Kong, Dimitris Korkolis, Vitor F. Kruger, Ashok Kshirsagar, Romeo Lages Simões, Andrea Lanaia, Konstantinos Lasithiotakis, Pedro Leão, Miguel León Arellano, Holger Listle, Andrey Litvin, Aintzane Lizarazu Pérez, Eudaldo Lopez-Tomassetti Fernandez, Eftychios Lostoridis, Davide Luppi, Gustavo M. Machain V, Piotr Major, Dimitrios Manatakis, Marianne Marchini Reitz, Athanasios Marinis, Daniele Marrelli, Aleix Martínez-Pérez, Sanjay Marwah, Michael McFarlane, Mirza Mesic, Cristian Mesina, Nickos Michalopoulos, Evangelos Misiakos, Felipe Gonçalves Moreira, Ouadii Mouaqit, Ali Muhtaroglu, Noel Naidoo, Ionut Negoi, Zane Nikitina, Ioannis Nikolopoulos, Gabriela-Elisa Nita, Savino Occhionorelli, Iyiade Olaoye, Carlos A. Ordoñez, Zeynep Ozkan, Ajay Pal, Gian M. Palini, Kyriaki Papageorgiou, Dimitris Papagoras, Francesco Pata, Michał Pędziwiatr, Jorge Pereira, Gerson A. Pereira Junior, Gennaro Perrone, Tadeja Pintar, Magdalena Pisarska, Oleksandr Plehutsa, Mauro Podda, Gaetano Poillucci, Martha Quiodettis, Tuba Rahim, Daniel Rios-Cruz, Gabriel Rodrigues, Dmytry Rozov, Boris Sakakushev, Ibrahima Sall, Alexander Sazhin, Miguel Semião, Taanya Sharda, Vishal Shelat, Giovanni Sinibaldi, Dmitrijs Skicko, Matej Skrovina, Dimitrios Stamatiou, Marco Stella, Marcin Strzałka, Ruslan Sydorchuk, Ricardo A. Teixeira Gonsaga, Joel Noutakdie Tochie, Gia Tomadze, Lara Ugoletti, Jan Ulrych, Toomas Ümarik, Mustafa Y. Uzunoglu, Alin Vasilescu, Osborne Vaz, Andras Vereczkei, Nutu Vlad, Maciej Walędziak, Ali I. Yahya, Omer Yalkin, Tonguç U. Yilmaz, Ali Ekrem Ünal, Kuo-Ching Yuan, Sanoop K. Zachariah, Justas Žilinskas, Maurizio Zizzo, Vittoria Pattonieri, Gian Luca Baiocchi, and Fausto Catena

Subjects
Acute peritonitis, Source control, Early warning score, Emergency surgery, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted. Methods This worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018. Results A total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47 years (interquartile range [IQR] 28–66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6 days (IQR 4–10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80 years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate ≥ 22 breaths/min, systolic blood pressure < 100 mmHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO2) < 90% in air, platelet count < 50,000 cells/mm3, and lactate > 4 mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0–1, 22.7% for those who had scores of 2–3, 46.8% for those who had scores of 4–5, and 86.7% for those who have scores of 7–8. Conclusions The simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality.

Published
2019
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4. 2019 update of the WSES guidelines for management of Clostridioides (Clostridium) difficile infection in surgical patients

Author

Massimo Sartelli, Stefano Di Bella, Lynne V. McFarland, Sahil Khanna, Luis Furuya-Kanamori, Nadir Abuzeid, Fikri M. Abu-Zidan, Luca Ansaloni, Goran Augustin, Miklosh Bala, Offir Ben-Ishay, Walter L. Biffl, Stephen M. Brecher, Adrián Camacho-Ortiz, Miguel A. Caínzos, Shirley Chan, Jill R. Cherry-Bukowiec, Jesse Clanton, Federico Coccolini, Maria E. Cocuz, Raul Coimbra, Francesco Cortese, Yunfeng Cui, Jacek Czepiel, Zaza Demetrashvili, Isidoro Di Carlo, Salomone Di Saverio, Irina M. Dumitru, Christian Eckmann, Edward H. Eiland, Joseph D. Forrester, Gustavo P. Fraga, Jean L. Frossard, Donald E. Fry, Rita Galeiras, Wagih Ghnnam, Carlos A. Gomes, Ewen A. Griffiths, Xavier Guirao, Mohamed H. Ahmed, Torsten Herzog, Jae Il Kim, Tariq Iqbal, Arda Isik, Kamal M. F. Itani, Francesco M. Labricciosa, Yeong Y. Lee, Paul Juang, Aleksandar Karamarkovic, Peter K. Kim, Yoram Kluger, Ari Leppaniemi, Varut Lohsiriwat, Gustavo M. Machain, Sanjay Marwah, John E. Mazuski, Gokhan Metan, Ernest E. Moore, Frederick A. Moore, Carlos A. Ordoñez, Leonardo Pagani, Nicola Petrosillo, Francisco Portela, Kemal Rasa, Miran Rems, Boris E. Sakakushev, Helmut Segovia-Lohse, Gabriele Sganga, Vishal G. Shelat, Patrizia Spigaglia, Pierre Tattevin, Cristian Tranà, Libor Urbánek, Jan Ulrych, Pierluigi Viale, Gian L. Baiocchi, and Fausto Catena

Subjects
Clostridioides difficile infection, Clostridium difficile infection, Pseudomembranous colitis, Antimicrobial treatment, Fecal microbiota transplantation, Infection control, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract In the last three decades, Clostridium difficile infection (CDI) has increased in incidence and severity in many countries worldwide. The increase in CDI incidence has been particularly apparent among surgical patients. Therefore, prevention of CDI and optimization of management in the surgical patient are paramount. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of CDI in surgical patients according to the most recent available literature. The update includes recent changes introduced in the management of this infection.

Published
2019
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5. Knowledge, awareness, and attitude towards infection prevention and management among surgeons: identifying the surgeon champion

Author

Massimo Sartelli, Yoram Kluger, Luca Ansaloni, Federico Coccolini, Gian Luca Baiocchi, Timothy C. Hardcastle, Ernest E. Moore, Addison K. May, Kamal M. F. Itani, Donald E. Fry, Marja A. Boermeester, Xavier Guirao, Lena Napolitano, Robert G. Sawyer, Kemal Rasa, Fikri M. Abu-Zidan, Abdulrashid K. Adesunkanmi, Boyko Atanasov, Goran Augustin, Miklosh Bala, Miguel A. Cainzos, Alain Chichom-Mefire, Francesco Cortese, Dimitris Damaskos, Samir Delibegovic, Zaza Demetrashvili, Belinda De Simone, Therese M. Duane, Wagih Ghnnam, George Gkiokas, Carlos A. Gomes, Andreas Hecker, Aleksandar Karamarkovic, Jakub Kenig, Vladimir Khokha, Victor Kong, Arda Isik, Ari Leppäniemi, Andrey Litvin, Eftychios Lostoridis, Gustavo M. Machain, Sanjay Marwah, Michael McFarlane, Cristian Mesina, Ionut Negoi, Iyiade Olaoye, Tadeja Pintar, Guntars Pupelis, Miran Rems, Ines Rubio-Perez, Boris Sakakushev, Helmut Segovia-Lohse, Boonying Siribumrungwong, Peep Talving, Jan Ulrych, András G. Vereczkei, Francesco M. Labricciosa, and Fausto Catena

Subjects
Surgeon, Infection, Prevention, Antibiotic therapy, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Despite evidence supporting the effectiveness of best practices of infection prevention and management, many surgeons worldwide fail to implement them. Evidence-based practices tend to be underused in routine practice. Surgeons with knowledge in surgical infections should provide feedback to prescribers and integrate best practices among surgeons and implement changes within their team. Identifying a local opinion leader to serve as a champion within the surgical department may be important. The “surgeon champion” can integrate best clinical practices of infection prevention and management, drive behavior change in their colleagues, and interact with both infection control teams in promoting antimicrobial stewardship.

Published
2018
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6. Raising concerns about the Sepsis-3 definitions

Author

Massimo Sartelli, Yoram Kluger, Luca Ansaloni, Timothy C. Hardcastle, Jordi Rello, Richard R. Watkins, Matteo Bassetti, Eleni Giamarellou, Federico Coccolini, Fikri M. Abu-Zidan, Abdulrashid K. Adesunkanmi, Goran Augustin, Gian L. Baiocchi, Miklosh Bala, Oussema Baraket, Marcelo A. Beltran, Asri Che Jusoh, Zaza Demetrashvili, Belinda De Simone, Hamilton P. de Souza, Yunfeng Cui, R. Justin Davies, Sameer Dhingra, Jose J. Diaz, Salomone Di Saverio, Agron Dogjani, Mutasim M. Elmangory, Mushira A. Enani, Paula Ferrada, Gustavo P. Fraga, Sabrina Frattima, Wagih Ghnnam, Carlos A. Gomes, Souha S. Kanj, Aleksandar Karamarkovic, Jakub Kenig, Faryal Khamis, Vladimir Khokha, Kaoru Koike, Kenneth Y. Y. Kok, Arda Isik, Francesco M. Labricciosa, Rifat Latifi, Jae G. Lee, Andrey Litvin, Gustavo M. Machain, Ramiro Manzano-Nunez, Piotr Major, Sanjay Marwah, Michael McFarlane, Ziad A. Memish, Cristian Mesina, Ernest E. Moore, Frederick A. Moore, Noel Naidoo, Ionut Negoi, Richard Ofori-Asenso, Iyiade Olaoye, Carlos A. Ordoñez, Mouaqit Ouadii, Ciro Paolillo, Edoardo Picetti, Tadeja Pintar, Alfredo Ponce-de-Leon, Guntars Pupelis, Tarcisio Reis, Boris Sakakushev, Hossein Samadi Kafil, Norio Sato, Jay N. Shah, Boonying Siribumrungwong, Peep Talving, Cristian Tranà, Jan Ulrych, Kuo-Ching Yuan, and Fausto Catena

Subjects
Sepsis, Septic shock, Organ dysfunction, Infections, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract The Global Alliance for Infections in Surgery appreciates the great effort of the task force who derived and validated the Sepsis-3 definitions and considers the new definitions an important step forward in the evolution of our understanding of sepsis. Nevertheless, more than a year after their publication, we have a few concerns regarding the use of the Sepsis-3 definitions.

Published
2018
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