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1. Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper

Author

Giacomo Sermonesi, Riccardo Bertelli, Fredric M. Pieracci, Zsolt J. Balogh, Raul Coimbra, Joseph M. Galante, Andreas Hecker, Dieter Weber, Zachary M. Bauman, Susan Kartiko, Bhavik Patel, SarahAnn S. Whitbeck, Thomas W. White, Kevin N. Harrell, Daniele Perrina, Alessia Rampini, Brian Tian, Francesco Amico, Solomon G. Beka, Luigi Bonavina, Marco Ceresoli, Lorenzo Cobianchi, Federico Coccolini, Yunfeng Cui, Francesca Dal Mas, Belinda De Simone, Isidoro Di Carlo, Salomone Di Saverio, Agron Dogjani, Andreas Fette, Gustavo P. Fraga, Carlos Augusto Gomes, Jim S. Khan, Andrew W. Kirkpatrick, Vitor F. Kruger, Ari Leppäniemi, Andrey Litvin, Andrea Mingoli, David Costa Navarro, Eliseo Passera, Michele Pisano, Mauro Podda, Emanuele Russo, Boris Sakakushev, Domenico Santonastaso, Massimo Sartelli, Vishal G. Shelat, Edward Tan, Imtiaz Wani, Fikri M. Abu-Zidan, Walter L. Biffl, Ian Civil, Rifat Latifi, Ingo Marzi, Edoardo Picetti, Manos Pikoulis, Vanni Agnoletti, Francesca Bravi, Carlo Vallicelli, Luca Ansaloni, Ernest E. Moore, and Fausto Catena

Subjects
Rib fractures, Surgical stabilization of rib fractures (SSRF), Flail chest, Multiple rib fractures, Thoracic/chest trauma injury, Rib fixation, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Rib fractures are one of the most common traumatic injuries and may result in significant morbidity and mortality. Despite growing evidence, technological advances and increasing acceptance, surgical stabilization of rib fractures (SSRF) remains not uniformly considered in trauma centers. Indications, contraindications, appropriate timing, surgical approaches and utilized implants are part of an ongoing debate. The present position paper, which is endorsed by the World Society of Emergency Surgery (WSES), and supported by the Chest Wall Injury Society, aims to provide a review of the literature investigating the use of SSRF in rib fracture management to develop graded position statements, providing an updated guide and reference for SSRF. Methods This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of experts then critically revised the manuscript and discussed it in detail, to develop a consensus on the position statements. Results A total of 287 studies (systematic reviews, randomized clinical trial, prospective and retrospective comparative studies, case series, original articles) have been selected from an initial pool of 9928 studies. Thirty-nine graded position statements were put forward to address eight crucial aspects of SSRF: surgical indications, contraindications, optimal timing of surgery, preoperative imaging evaluation, rib fracture sites for surgical fixation, management of concurrent thoracic injuries, surgical approach, stabilization methods and material selection. Conclusion This consensus document addresses the key focus questions on surgical treatment of rib fractures. The expert recommendations clarify current evidences on SSRF indications, timing, operative planning, approaches and techniques, with the aim to guide clinicians in optimizing the management of rib fractures, to improve patient outcomes and direct future research.

Published
2024
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2. Cesena guidelines: WSES consensus statement on laparoscopic-first approach to general surgery emergencies and abdominal trauma

Author

Giacomo Sermonesi, Brian W. C. A. Tian, Carlo Vallicelli, Fikri M. Abu‑Zidan, Dimitris Damaskos, Michael Denis Kelly, Ari Leppäniemi, Joseph M. Galante, Edward Tan, Andrew W. Kirkpatrick, Vladimir Khokha, Oreste Marco Romeo, Mircea Chirica, Manos Pikoulis, Andrey Litvin, Vishal Girishchandra Shelat, Boris Sakakushev, Imtiaz Wani, Ibrahima Sall, Paola Fugazzola, Enrico Cicuttin, Adriana Toro, Francesco Amico, Francesca Dal Mas, Belinda De Simone, Michael Sugrue, Luigi Bonavina, Giampiero Campanelli, Paolo Carcoforo, Lorenzo Cobianchi, Federico Coccolini, Massimo Chiarugi, Isidoro Di Carlo, Salomone Di Saverio, Mauro Podda, Michele Pisano, Massimo Sartelli, Mario Testini, Andreas Fette, Sandro Rizoli, Edoardo Picetti, Dieter Weber, Rifat Latifi, Yoram Kluger, Zsolt Janos Balogh, Walter Biffl, Hans Jeekel, Ian Civil, Andreas Hecker, Luca Ansaloni, Francesca Bravi, Vanni Agnoletti, Solomon Gurmu Beka, Ernest Eugene Moore, and Fausto Catena

Subjects
Laparoscopy, Laparoscopic approach, Minimally invasive surgery/approach, Emergency general surgery, Acute care surgery, Trauma surgery hemodynamic stability, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Laparoscopy is widely adopted across nearly all surgical subspecialties in the elective setting. Initially finding indication in minor abdominal emergencies, it has gradually become the standard approach in the majority of elective general surgery procedures. Despite many technological advances and increasing acceptance, the laparoscopic approach remains underutilized in emergency general surgery and in abdominal trauma. Emergency laparotomy continues to carry a high morbidity and mortality. In recent years, there has been a growing interest from emergency and trauma surgeons in adopting minimally invasive surgery approaches in the acute surgical setting. The present position paper, supported by the World Society of Emergency Surgery (WSES), aims to provide a review of the literature to reach a consensus on the indications and benefits of a laparoscopic-first approach in patients requiring emergency abdominal surgery for general surgery emergencies or abdominal trauma. Methods This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of 54 experts then critically revised the manuscript and discussed it in detail, to develop a consensus on a position statement. Results A total of 323 studies (systematic review and meta-analysis, randomized clinical trial, retrospective comparative cohort studies, case series) have been selected from an initial pool of 7409 studies. Evidence demonstrates several benefits of the laparoscopic approach in stable patients undergoing emergency abdominal surgery for general surgical emergencies or abdominal trauma. The selection of a stable patient seems to be of paramount importance for a safe adoption of a laparoscopic approach. In hemodynamically stable patients, the laparoscopic approach was found to be safe, feasible and effective as a therapeutic tool or helpful to identify further management steps and needs, resulting in improved outcomes, regardless of conversion. Appropriate patient selection, surgeon experience and rigorous minimally invasive surgical training, remain crucial factors to increase the adoption of laparoscopy in emergency general surgery and abdominal trauma. Conclusions The WSES expert panel suggests laparoscopy as the first approach for stable patients undergoing emergency abdominal surgery for general surgery emergencies and abdominal trauma.

Published
2023
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3. Enhanced perioperative care in emergency general surgery: the WSES position paper

Author

Marco Ceresoli, Marco Braga, Nicola Zanini, Fikri M. Abu-Zidan, Dario Parini, Thomas Langer, Massimo Sartelli, Dimitrios Damaskos, Walter L. Biffl, Francesco Amico, Luca Ansaloni, Zsolt J. Balogh, Luigi Bonavina, Ian Civil, Enrico Cicuttin, Mircea Chirica, Yunfeng Cui, Belinda De Simone, Isidoro Di Carlo, Andreas Fette, Giuseppe Foti, Michele Fogliata, Gustavo P. Fraga, Paola Fugazzola, Joseph M. Galante, Solomon Gurmu Beka, Andreas Hecker, Johannes Jeekel, Andrew W. Kirkpatrick, Kaoru Koike, Ari Leppäniemi, Ingo Marzi, Ernest E. Moore, Edoardo Picetti, Emmanouil Pikoulis, Michele Pisano, Mauro Podda, Boris E. Sakakushev, Vishal G. Shelat, Edward Tan, Giovanni D. Tebala, George Velmahos, Dieter G. Weber, Vanni Agnoletti, Yoram Kluger, Gianluca Baiocchi, Fausto Catena, and Federico Coccolini

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

Abstract Enhanced perioperative care protocols become the standard of care in elective surgery with a significant improvement in patients’ outcome. The key element of the enhanced perioperative care protocol is the multimodal and interdisciplinary approach targeted to the patient, focused on a holistic approach to reduce surgical stress and improve perioperative recovery. Enhanced perioperative care in emergency general surgery is still a debated topic with little evidence available. The present position paper illustrates the existing evidence about perioperative care in emergency surgery patients with a focus on each perioperative intervention in the preoperative, intraoperative and postoperative phase. For each item was proposed and approved a statement by the WSES collaborative group.

Published
2023
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4. Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines

Author

Federico Coccolini, Massimo Sartelli, Robert Sawyer, Kemal Rasa, Bruno Viaggi, Fikri Abu-Zidan, Kjetil Soreide, Timothy Hardcastle, Deepak Gupta, Cino Bendinelli, Marco Ceresoli, Vishal G. Shelat, Richard ten Broek, Gian Luca Baiocchi, Ernest E. Moore, Ibrahima Sall, Mauro Podda, Luigi Bonavina, Igor A. Kryvoruchko, Philip Stahel, Kenji Inaba, Philippe Montravers, Boris Sakakushev, Gabriele Sganga, Paolo Ballestracci, Manu L. N. G. Malbrain, Jean-Louis Vincent, Manos Pikoulis, Solomon Gurmu Beka, Krstina Doklestic, Massimo Chiarugi, Marco Falcone, Elena Bignami, Viktor Reva, Zaza Demetrashvili, Salomone Di Saverio, Matti Tolonen, Pradeep Navsaria, Miklosh Bala, Zsolt Balogh, Andrey Litvin, Andreas Hecker, Imtiaz Wani, Andreas Fette, Belinda De Simone, Rao Ivatury, Edoardo Picetti, Vladimir Khokha, Edward Tan, Chad Ball, Carlo Tascini, Yunfeng Cui, Raul Coimbra, Michael Kelly, Costanza Martino, Vanni Agnoletti, Marja A. Boermeester, Nicola De’Angelis, Mircea Chirica, Walt L. Biffl, Luca Ansaloni, Yoram Kluger, Fausto Catena, and Andrew W. Kirkpatrick

Subjects
Source control, Emergency, Infections, Abdominal, Surgery, Trauma, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Intra-abdominal infections (IAI) are among the most common global healthcare challenges and they are usually precipitated by disruption to the gastrointestinal (GI) tract. Their successful management typically requires intensive resource utilization, and despite the best therapies, morbidity and mortality remain high. One of the main issues required to appropriately treat IAI that differs from the other etiologies of sepsis is the frequent requirement to provide physical source control. Fortunately, dramatic advances have been made in this aspect of treatment. Historically, source control was left to surgeons only. With new technologies non-surgical less invasive interventional procedures have been introduced. Alternatively, in addition to formal surgery open abdomen techniques have long been proposed as aiding source control in severe intra-abdominal sepsis. It is ironic that while a lack or even delay regarding source control clearly associates with death, it is a concept that remains poorly described. For example, no conclusive definition of source control technique or even adequacy has been universally accepted. Practically, source control involves a complex definition encompassing several factors including the causative event, source of infection bacteria, local bacterial flora, patient condition, and his/her eventual comorbidities. With greater understanding of the systemic pathobiology of sepsis and the profound implications of the human microbiome, adequate source control is no longer only a surgical issue but one that requires a multidisciplinary, multimodality approach. Thus, while any breach in the GI tract must be controlled, source control should also attempt to control the generation and propagation of the systemic biomediators and dysbiotic influences on the microbiome that perpetuate multi-system organ failure and death. Given these increased complexities, the present paper represents the current opinions and recommendations for future research of the World Society of Emergency Surgery, of the Global Alliance for Infections in Surgery of Surgical Infection Society Europe and Surgical Infection Society America regarding the concepts and operational adequacy of source control in intra-abdominal infections.

Published
2023
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5. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery

Author

Miklosh Bala, Fausto Catena, Jeffry Kashuk, Belinda De Simone, Carlos Augusto Gomes, Dieter Weber, Massimo Sartelli, Federico Coccolini, Yoram Kluger, Fikri M. Abu-Zidan, Edoardo Picetti, Luca Ansaloni, Goran Augustin, Walter L. Biffl, Marco Ceresoli, Osvaldo Chiara, Massimo Chiarugi, Raul Coimbra, Yunfeng Cui, Dimitris Damaskos, Salomone Di Saverio, Joseph M. Galante, Vladimir Khokha, Andrew W. Kirkpatrick, Kenji Inaba, Ari Leppäniemi, Andrey Litvin, Andrew B. Peitzman, Vishal G. Shelat, Michael Sugrue, Matti Tolonen, Sandro Rizoli, Ibrahima Sall, Solomon G. Beka, Isidoro Di Carlo, Richard Ten Broek, Chirika Mircea, Giovanni Tebala, Michele Pisano, Harry van Goor, Ronald V. Maier, Hans Jeekel, Ian Civil, Andreas Hecker, Edward Tan, Kjetil Soreide, Matthew J. Lee, Imtiaz Wani, Luigi Bonavina, Mark A. Malangoni, Kaoru Koike, George C. Velmahos, Gustavo P. Fraga, Andreas Fette, Nicola de’Angelis, Zsolt J. Balogh, Thomas M. Scalea, Gabriele Sganga, Michael D. Kelly, Jim Khan, Philip F. Stahel, and Ernest E. Moore

Subjects
Mesenteric ischemia, Mesenteric arterial occlusion, Mesenteric artery stenting, Bowel ischemia, Guidelines, Recommendations, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

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
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6. It’s time for a minimum synoptic operation template in patients undergoing laparoscopic cholecystectomy: a systematic review

Author

Niall O’Connor, Michael Sugrue, Conor Melly, Gearoid McGeehan, Magda Bucholc, Aileen Crawford, Paul O’Connor, Fikri Abu-Zidan, Imtiaz Wani, Zsolt J. Balogh, Vishal G. Shelat, Giovanni D. Tebala, Belinda De Simone, Hani O. Eid, Mircea Chirica, Gustavo P. Fraga, Salomone Di Saverio, Edoardo Picetti, Luigi Bonavina, Marco Ceresoli, Andreas Fette, Boris Sakakushe, Emmanouil Pikoulis, Raul Coimbra, Richard ten Broek, Andreas Hecker, Ari Leppäniemi, Andrey Litvin, Philip Stahel, Edward Tan, Kaoru Koike, Fausto Catena, Michele Pisano, Federico Coccolini, and Alison Johnston

Subjects
Laparoscopic cholecystectomy, Synoptic reporting, Operation notes, Patient safety, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Despite the call to enhance accuracy and value of operation records few international recommended minimal standards for operative notes documentation have been described. This study undertook a systematic review of existing operative reporting systems for laparoscopic cholecystectomy (LC) to fashion a comprehensive, synoptic operative reporting template for the future. Methods A search for all relevant articles was conducted using PubMed version of Medline, Scopus and Web of Science databases in June 2021, for publications from January 1st 2011 to October 25th 2021, using the keywords: laparoscopic cholecystectomy AND operation notes OR operative notes OR proforma OR documentation OR report OR narrative OR audio-visual OR synoptic OR digital. Two reviewers (NOC, GMC) independently assessed each published study using a MINORS score of ≥ 16 for comparative and ≥ 10 for non-comparative for inclusion. This systematic review followed PRISMA guidelines and was registered with PROSPERO. Synoptic operative templates from published data were assimilated into one “ideal” laparoscopic operative report template following international input from the World Society of Emergency Surgery board. Results A total of 3567 articles were reviewed. Following MINORS grading 25 studies were selected spanning 14 countries and 4 continents. Twenty-two studies were prospective. A holistic overview of the operative procedure documentation was reported in 6/25 studies and a further 19 papers dealt with selective surgical aspects of LC. A unique synoptic LC operative reporting template was developed and translated into Chinese/Mandarin, French and Arabic. Conclusion This systematic review identified a paucity of publications dealing with operative reporting of LC. The proposed new template may be integrated digitally with hospitals’ medical systems and include additional narrative text and audio-visual data. The template may help define new OR (operating room) recording standards and impact on care for patients undergoing LC.

Published
2022
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7. Associated rare anomalies in prune belly syndrome: A case report

Author

Andreas Fette

Subjects
Prune belly syndrome, Megapenis and phimosis, Urethra and lung anomalies, Newborn, Pediatrics, RJ1-570, Surgery, RD1-811
Abstract

The triad of deficient abdominal wall musculature, undescended testes and urinary tract anomalies characterizes the Prune Belly Syndrome (PBS). PBS can be associated with other comorbid urological and non urological conditions. But the full pathogenesis and best treatment is still a matter of debate. A term newborn with a classical PBS (Woodhouse Group 2, Smith and Woodard Group 2) plus lung hypoplasia and funnel chest deformity, a megapenis with a tight phimosis and an obturated anterior urethra is presented. Unfortunately, the baby died in urosepsis and renal failure in his 3rd week of life, despite urine drainage surgery and peritoneal dialysis undertaken. According to the best of our knowledge, this is an unique combination of rare anomalies in PBS patients.

Published
2015
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8. Propranolol in Use for Treatment of Complex Infant Hemangiomas: Literature Review Regarding Current Guidelines for Preassessment and Standards of Care before Initiation of Therapy

Author

Andreas Fette

Subjects
Technology, Medicine, Science
Abstract

In 2008, the positive effects of propranolol on infantile hemangiomas (IH) have been discovered serendipitously by Léauté-Labrèze and her coworkers. Since then, propranolol has been in use in allday clinical practice worldwide for treatment of IH. It even caused some kind of paradigm shift in the overall management of these lesions, though propranolol is still not FDA approved, respectively, in “off-label” use for this indication in the majority of institutions. Thus, the aim of this communication is to evaluate the literature for current evidence regarding guidelines for preassessment and standards of care before initiation of therapy.

Published
2013
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9. New perspectives in pediatric trauma care

Author

Andreas Fette

Subjects
Medicine (General), R5-920
Abstract

Andreas FettePediatric Surgery, Children’s Care Center, SRH Klinikum Suhl/Thueringen, GermanyAbstract: An “American-style” pediatric trauma care symposia consisting of lectures, workshops, and skill stations was held at a pediatric trauma center to improve pre- and post-hospital care for children, facilitate communication, and to set up standards within the regional rescue chain.Keywords: trauma care, children, inhouse-training

Published
2008

10. Pediatric trauma and emergency surgery: an international cross-sectional survey among WSES members

Author

Reichert, Martin, Sartelli, Massimo, Askevold, Ingolf H, Braun, Jaqueline, Weigand, Markus A, Hecker, Matthias, Agnoletti, Vanni, Coccolini, Federico, Catena, Fausto, Padberg, Winfried, Riedel, Jens G, Hecker, Andreas, Agron Dogjani, Akira Kuriyama, Alberto Porcu, Aleix Martínez-Pérez, Alessandro Coppola, Alessandro Spolini, Alessio Giordano, Alexandros Kyriakidis, Ali Yasen Y Mohamedahmed, Anastasia Vasilopoulou, Andee Dzulkarnaen Zakaria, Andrea Balla, Andreas Fette, Andrey Litvin, Anna Guariniello, Arda Isik, Aristotelis Kechagias, Ashrarur Rahman Mitul, Belinda De Simone, Biagio Zampogna, Bruno Sensi, Carlo Gazia, Charalampos Seretis, Cristine Brooke, Davide Luppi, Diego Coletta, Diego Sasia, Diletta Corallino, Dimitrios Chatzipetris, Dimitrios Schizas, Eftychios Lostoridis, Elmuiz A Hsabo, Emmanouil Kaouras, Emmanuel Schneck, Enrico Pinotti, Evgeni Dimitrov, Fabrizio D'Acapito, Federica Saraceno, Fikri Abu-Zidan, Francesca Maria Silvestri, Francesco Favi, Francesco Fleres, Francesk Mulita, Gabriela Nita, Gennaro Martines, Gennaro Mazzarella, Gennaro Perrone, Giorgio Giraudo, Giulia Bacchiocchi, Giulio Argenio, Giuseppe Brisinda, Giuseppe Currò, Giuseppe Palomba, Gustavo P Fraga, Hytham K S Hamid, Ioannis Katsaros, Ionut Negoi, Joel Noutakdie Tochie, Justin Davies, Kenneth Y Y Kok, Konstantinos G Apostolou, Konstantinos Lasithiotakis, Konstantinos Tsekouras, Larysa Sydorchuk, Leandro Siragusa, Leonardo Solaini, Luca Ferrario, Luis Buonomo, Maciej Walędziak, Mahir Gachabayov, Maloni Bulanauca, Manish Kumar Agrawal, Marco Ceresoli, Maria Chiara Ranucci, Maria Petridou, Mario D'Oria, Massimiliano Veroux, Maximos Frountzas, Michel Paul Johan Teuben, Miklosh Bala, Mirja Amadea Minger, Miroslava Gonçalves, Natasha Sharma, Nicolò Tamini, Noushif Medappil, Orestis Ioannidis, Pietro Bisagni, Razrim Rahim, Ricardo Alessandro Teixeira Gonsaga, Roberta Ragozzino, Roberto Bini, Roberto Cammarata, Ruslan Sydorchuk, Salomone Di Saverio, Selmy S Awad, Semra Demirli Atici, Serhat Meric, Sharfuddin Chowdhury, Sofia Xenaki, Tadeja Pintar, Teresa Perra, Timothy C Hardcastle, Valerio Voglino, Varut Lohsiriwat, Victor Kong, Voskidis Christos, Wietse Zuidema, Reichert, Martin, Sartelli, Massimo, Askevold, Ingolf H, Braun, Jaqueline, Weigand, Markus A, Hecker, Matthia, Agnoletti, Vanni, Coccolini, Federico, Catena, Fausto, Padberg, Winfried, Riedel, Jens G, Hecker, Andrea, Agron Dogjani, Akira Kuriyama, Alberto Porcu, Aleix Martínez-Pérez, Alessandro Coppola, Alessandro Spolini, Alessio Giordano, Alexandros Kyriakidis, Ali Yasen Y Mohamedahmed, Anastasia Vasilopoulou, Andee Dzulkarnaen Zakaria, Andrea Balla, Andreas Fette, Andrey Litvin, Anna Guariniello, Arda Isik, Aristotelis Kechagias, Ashrarur Rahman Mitul, Belinda De Simone, Biagio Zampogna, Bruno Sensi, Carlo Gazia, Charalampos Seretis, Cristine Brooke, Davide Luppi, Diego Coletta, Diego Sasia, Diletta Corallino, Dimitrios Chatzipetris, Dimitrios Schizas, Eftychios Lostoridis, Elmuiz A Hsabo, Emmanouil Kaouras, Emmanuel Schneck, Enrico Pinotti, Evgeni Dimitrov, Fabrizio D'Acapito, Federica Saraceno, Fikri Abu-Zidan, Francesca Maria Silvestri, Francesco Favi, Francesco Fleres, Francesk Mulita, Gabriela Nita, Gennaro Martines, Gennaro Mazzarella, Gennaro Perrone, Giorgio Giraudo, Giulia Bacchiocchi, Giulio Argenio, Giuseppe Brisinda, Giuseppe Currò, Giuseppe Palomba, Gustavo P Fraga, Hytham K S Hamid, Ioannis Katsaros, Ionut Negoi, Joel Noutakdie Tochie, Justin Davies, Kenneth Y Y Kok, Konstantinos G Apostolou, Konstantinos Lasithiotakis, Konstantinos Tsekouras, Larysa Sydorchuk, Leandro Siragusa, Leonardo Solaini, Luca Ferrario, Luis Buonomo, Maciej Walędziak, Mahir Gachabayov, Maloni Bulanauca, Manish Kumar Agrawal, Marco Ceresoli, Maria Chiara Ranucci, Maria Petridou, Mario D'Oria, Massimiliano Veroux, Maximos Frountzas, Michel Paul Johan Teuben, Miklosh Bala, Mirja Amadea Minger, Miroslava Gonçalves, Natasha Sharma, Nicolò Tamini, Noushif Medappil, Orestis Ioannidis, Pietro Bisagni, Razrim Rahim, Ricardo Alessandro Teixeira Gonsaga, Roberta Ragozzino, Roberto Bini, Roberto Cammarata, Ruslan Sydorchuk, Salomone Di Saverio, Selmy S Awad, Semra Demirli Atici, Serhat Meric, Sharfuddin Chowdhury, Sofia Xenaki, Tadeja Pintar, Teresa Perra, Timothy C Hardcastle, Valerio Voglino, Varut Lohsiriwat, Victor Kong, Voskidis Christos, Wietse Zuidema, Reichert, M, Sartelli, M, Askevold, I, Braun, J, Weigand, M, Hecker, M, Agnoletti, V, Coccolini, F, Catena, F, Padberg, W, Riedel, J, Hecker, A, Dogjani, A, Kuriyama, A, Porcu, A, Martinez-Perez, A, Coppola, A, Spolini, A, Giordano, A, Kyriakidis, A, Mohamedahmed, A, Vasilopoulou, A, Zakaria, A, Balla, A, Fette, A, Litvin, A, Guariniello, A, Isik, A, Kechagias, A, Mitul, A, De Simone, B, Zampogna, B, Sensi, B, Gazia, C, Seretis, C, Brooke, C, Luppi, D, Coletta, D, Sasia, D, Corallino, D, Chatzipetris, D, Schizas, D, Lostoridis, E, Hsabo, E, Kaouras, E, Schneck, E, Pinotti, E, Dimitrov, E, D'Acapito, F, Saraceno, F, Abu-Zidan, F, Silvestri, F, Favi, F, Fleres, F, Mulita, F, Nita, G, Martines, G, Mazzarella, G, Perrone, G, Giraudo, G, Bacchiocchi, G, Argenio, G, Brisinda, G, Curro, G, Palomba, G, Fraga, G, Hamid, H, Katsaros, I, Negoi, I, Tochie, J, Davies, J, Kok, K, Apostolou, K, Lasithiotakis, K, Tsekouras, K, Sydorchuk, L, Siragusa, L, Solaini, L, Ferrario, L, Buonomo, L, Waledziak, M, Gachabayov, M, Bulanauca, M, Agrawal, M, Ceresoli, M, Ranucci, M, Petridou, M, D'Oria, M, Veroux, M, Frountzas, M, Teuben, M, Bala, M, Minger, M, Goncalves, M, Sharma, N, Tamini, N, Medappil, N, Ioannidis, O, Bisagni, P, Rahim, R, Gonsaga, R, Ragozzino, R, Bini, R, Cammarata, R, Sydorchuk, R, Di Saverio, S, Awad, S, Atici, S, Meric, S, Chowdhury, S, Xenaki, S, Pintar, T, Perra, T, Hardcastle, T, Voglino, V, Lohsiriwat, V, Kong, V, Christos, V, Zuidema, W, Surgery, AMS - Musculoskeletal Health, APH - Quality of Care, and Other Research

Subjects
appendicitis, children, emergency, emergency surgery, injury, pediatric surgery, pediatric trauma, trauma surgery, wses, Pediatric trauma, Emergency, Emergency Medicine, Emergency surgery, Appendiciti, Surgery, Injury, WSES, Pediatric surgery, Appendicitis, Children, Trauma surgery
Abstract

Background In contrast to adults, the situation for pediatric trauma care from an international point of view and the global management of severely injured children remain rather unclear. The current study investigates structural management of pediatric trauma in centers of different trauma levels as well as experiences with pediatric trauma management around the world. Methods A web-survey had been distributed to the global mailing list of the World Society of Emergency Surgery from 10/2021–03/2022, investigating characteristics of respondents and affiliated hospitals, case-load of pediatric trauma patients, capacities and infrastructure for critical care in children, trauma team composition, clinical work-up and individual experiences with pediatric trauma management in response to patients´ age. The collaboration group was subdivided regarding sizes of affiliated hospitals to allow comparisons concerning hospital volumes. Comparable results were conducted to statistical analysis. Results A total of 133 participants from 34 countries, i.e. 5 continents responded to the survey. They were most commonly affiliated with larger hospitals (> 500 beds in 72.9%) and with level I or II trauma centers (82.0%), respectively. 74.4% of hospitals offer unrestricted pediatric medical care, but only 63.2% and 42.9% of the participants had sufficient experiences with trauma care in children ≤ 10 and ≤ 5 years of age (p = 0.0014). This situation is aggravated in participants from smaller hospitals (p 500 in-hospital beds), larger hospitals were more likely affiliated with advanced trauma centers, more elaborated pediatric intensive care infrastructure (p p = 0.0938) and have higher case-loads of severely injured children p = 0.0009). Therefore, the majority of larger hospitals reserve either pediatric surgery departments or board-certified pediatric surgeons (p Conclusions Multi-professional management of pediatric trauma and individual experiences with severely injured children depend on volumes, level of trauma centers and infrastructure of the hospital. However, respondents from hospitals at all levels of trauma care complain about an alarming lack of knowledge on pediatric trauma management.

Published
2023
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11. Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Author

Reichert, Martin, Sartelli, Massimo, Weigand, Markus A, Hecker, Matthias, Oppelt, Philip U, Noll, Julia, Askevold, Ingolf H, Liese, Juliane, Padberg, Winfried, Coccolini, Federico, Catena, Fausto, Hecker, Andreas, Adam Peckham-Cooper, Adrian Camacho-Ortiz, Aikaterini T. Mastoraki, Aitor Landaluce-Olavarria, Ajay Kumar Pal, Akira Kuriyama, Alain Chichom-Mefire, Alberto Porcu, Aleix Martínez-Pérez, Aleksandar R. Karamarkovic, Aleksei V. Osipov, Alessandro Coppola, Alessandro Cucchetti, Alessandro Spolini, Alessio Giordano, Alexander Reinisch-Liese, Alfie J. Kavalakat, Alin Vasilescu, Amin Alamin, Amit Gupta, Ana Maria Dascalu, Ana-Maria Musina, Anargyros Bakopoulos, Andee Dzulkarnaen Zakaria, Andras Vereczkei, Andrea Balla, Andrea Bottari, Andreas Baumann, Andreas Fette, Andrey Litvin, Aniella Katharina Reichert, Anna Guariniello, Anna Paspala, Anne-Sophie Schneck, Antonio Brillantino, Antonio Pesce, Arda Isik, Ari Kalevi Leppäniemi, Aristeidis Papadopoulos, Aristotelis Kechagias, Ashraf Yehya Abdalla Mohamed, Ashrarur Rahman Mitul, Athanasios Marinis, Athanasios Syllaios, Baris Mantoglu, Belinda De Simone, Benjamin Stefan Weiss, Bernd Pösentrup, Biagio Picardi, Biagio Zampogna, Boris Eugeniev Sakakushev, Boyko Chavdarov Atanasov, Bruno Nardo, Bulent Calik, Camilla Cremonini, Carlos A. Ordoñez, Charalampos Seretis, Chiara Cascone, Christos Chouliaras, Cino Bendinelli, Claudia Lopes, Claudio Guerci, Clemens Weber, Constantinos Nastos, Cristian Mesina, Damiano Caputo, Damien Massalou, Davide Cavaliere, Deborah A. McNamara, Demetrios Demetriades, Desirè Pantalone, Diego Coletta, Diego Sasia, Diego Visconti, Dieter G. Weber, Diletta Corallino, Dimitrios Chatzipetris, Dimitrios K. Manatakis, Dimitrios Ntourakis, Dimitrios Papaconstantinou, Dimitrios Schizas, Dimosthenis Chrysikos, Dmitry Mikhailovich Adamovich, Doaa Elkafrawy, Dragos Seban, Edgar Fernando Hernandez García, Edoardo Baldini, Edoardo Picetti, Edward C. T. H. Tan, Efstratia Baili, Eftychios Lostoridis, Elena Adelina Toma, Elif Colak, Elisabetta Cerutti, Elmin Steyn, Elmuiz A. Hsabo, Emmanouil Ioannis Kapetanakis, Emmanouil Kaouras, Emmanuel Schneck, Emrah Akin, Emre Gonullu, Enes çelik, Enrico Cicuttin, Enrico Pinotti, Erik Johnsson, Ernest E. Moore, Ervis Agastra, Evgeni Nikolaev Dimitrov, Ewen A. Griffiths, Fabrizio D’Acapito, Federica Saraceno, Felipe Alconchel, Felix Alexander Zeppernick, Fernando Machado Rodríguez, Fikri Abu-Zidan, Francesca Pecchini, Francesco Favi, Francesco Ferrara, Francesco Fleres, Francesco Pata, Francesco Pietro Maria Roscio, Francesk Mulita, Frank J. M. F. Dor, Fredrik Linder, Gabriel Dimofte, Gabriel Rodrigues, Gabriela Nita, Gabriele Sganga, Gennaro Martines, Gennaro Mazzarella, Gennaro Perrone, George Velmahos, Georgios D. Lianos, Gia Tomadze, Gian Luca Baiocchi, Giancarlo D’Ambrosio, Gianluca Pellino, Gianmaria Casoni Pattacini, Giorgio Giraudo, Giorgio Lisi, Giovanni Domenico Tebala, Giovanni Pirozzolo, Giulia Montori, Giulio Argenio, Giuseppe Brisinda, Giuseppe Currò, Giuseppe Giuliani, Giuseppe Palomba, Giuseppe Roscitano, Gökhan Avşar, Goran Augustin, Guglielmo Clarizia, Gustavo M. Machain Vega, Gustavo P. Fraga, Harsheet Sethi, Hazim Abdulnassir Eltyeb, Helmut A. Segovia Lohse, Herald René Segovia Lohse, Hüseyin Bayhan, Hytham K. S. Hamid, Igor A. Kryvoruchko, Immacolata Iannone, Imtiaz Wani, Ioannis I. Lazaridis, Ioannis Katsaros, Ioannis Nikolopoulos, Ionut Negoi, Isabella Reccia, Isidoro Di Carlo, Iyiade Olatunde Olaoye, Jacek Czepiel, Jae Il Kim, Jeremy Meyer, Jesus Manuel Saenz Terrazas, Joel Noutakdie Tochie, Joseph M. Galante, Justin Davies, Kapil Sugand, Kebebe Bekele Gonfa, Kemal Rasa, Kenneth Y. Y. Kok, Konstantinos G. Apostolou, Konstantinos Lasithiotakis, Konstantinos Tsekouras, Kumar Angamuthu, Lali Akhmeteli, Larysa Sydorchuk, Laura Fortuna, Leandro Siragusa, Leonardo Pagani, Leonardo Solaini, Lisa A. Miller, Lovenish Bains, Luca Ansaloni, Luca Ferrario, Luigi Bonavina, Luigi Conti, Luis Antonio Buonomo, Luis Tallon-Aguilar, Lukas Tomczyk, Lukas Werner Widmer, Maciej Walędziak, Mahir Gachabayov, Maloni M. Bulanauca, Manu L. N. G. Malbrain, Marc Maegele, Marco Catarci, Marco Ceresoli, Maria Chiara Ranucci, Maria Ioanna Antonopoulou, Maria Papadoliopoulou, Maria Rosaria Valenti, Maria Sotiropoulou, Mario D’Oria, Mario Serradilla Martín, Markus Hirschburger, Massimiliano Veroux, Massimo Fantoni, Matteo Nardi, Matti Tolonen, Mauro Montuori, Mauro Podda, Maximilian Scheiterle, Maximos Frountzas, Mehmet Sarıkaya, Mehmet Yildirim, Michael Bender, Michail Vailas, Michel Teuben, Michela Campanelli, Michele Ammendola, Michele Malerba, Michele Pisano, Mihaela Pertea, Mihail Slavchev, Mika Ukkonen, Miklosh Bala, Mircea Chirica, Mirko Barone, Mohamed Maher Shaat, Mohammed Jibreel Suliman Mohammed, Mona Awad Akasha Abuelgasim, Monika Gureh, Mouaqit Ouadii, Mujdat Balkan, Mumin Mohamed, Musluh Hakseven, Natalia Velenciuc, Nicola Cillara, Nicola de’Angelis, Nicolò Tamini, Nikolaos J. Zavras, Nikolaos Machairas, Nikolaos Michalopoulos, Nikolaos N. Koliakos, Nikolaos Pararas, Noel E. Donlon, Noushif Medappil, Offir Ben-Ishay, Olmi Stefano, Omar Islam, Ömer Tammo, Orestis Ioannidis, Oscar Aparicio, Oussama Baraket, Pankaj Kumar, Pasquale Cianci, Per Örtenwall, Petar Angelov Uchikov, Philip de Reuver, Philip F. Stahel, Philip S. Barie, Micaela Piccoli, Piotr Major, Pradeep H. Navsaria, Prakash Kumar Sasmal, Raul Coimbra, Razrim Rahim, Recayi Çapoğlu, Renol M. Koshy, Ricardo Alessandro Teixeira Gonsaga, Riccardo Pertile, Rifat Ramadan Mussa Mohamed, Rıza Deryol, Robert G. Sawyer, Roberta Angelico, Roberta Ragozzino, Roberto Bini, Roberto Cammarata, Rosa Scaramuzzo, Rossella Gioco, Ruslan Sydorchuk, Salma Ahmed, Salomone Di Saverio, Sameh Hany Emile, Samir Delibegovic, Sanjay Marwah, Savvas Symeonidis, Scott G. Thomas, Sebahattin Demir, Selmy S. Awad, Semra Demirli Atici, Serge Chooklin, Serhat Meric, Sevcan Sarıkaya, Sharfuddin Chowdhury, Shaza Faycal Mirghani, Sherry M. Wren, Simone Gargarella, Simone Rossi Del Monte, Sofia Esposito, Sofia Xenaki, Soliman Fayez Ghedan Mohamed, Solomon Gurmu Beka, Sorinel Lunca, Spiros G. Delis, Spyridon Dritsas, Stefan Morarasu, Stefano Magnone, Stefano Rossi, Stefanos Bitsianis, Stylianos Kykalos, Suman Baral, Sumita A. Jain, Syed Muhammad Ali, Tadeja Pintar, Tania Triantafyllou, Tarik Delko, Teresa Perra, Theodoros A. Sidiropoulos, Thomas M. Scalea, Tim Oliver Vilz, Timothy Craig Hardcastle, Tongporn Wannatoop, Torsten Herzog, Tushar Subhadarshan Mishra, Ugo Boggi, Valentin Calu, Valentina Tomajer, Vanni Agnoletti, Varut Lohsiriwat, Victor Kong, Virginia Durán Muñoz-Cruzado, Vishal G. Shelat, Vladimir Khokha, Wagih Mommtaz Ghannam, Walter L. Biffl, Wietse Zuidema, Yasin Kara, Yoshiro Kobe, Zaza Demetrashvili, Ziad A. Memish, Zoilo Madrazo, Zsolt J. Balogh, Zulfu Bayhan, Surgery, AMS - Musculoskeletal Health, Other Research, APH - Quality of Care, Reichert, Martin, Sartelli, Massimo, Weigand, Markus A, Hecker, Matthia, Oppelt, Philip U, Noll, Julia, Askevold, Ingolf H, Liese, Juliane, Padberg, Winfried, Coccolini, Federico, Catena, Fausto, Hecker, Andrea, Adam Peckham-Cooper, Adrian Camacho-Ortiz, Aikaterini T. Mastoraki, Aitor Landaluce-Olavarria, Ajay Kumar Pal, Akira Kuriyama, Alain Chichom-Mefire, Alberto Porcu, Aleix Martínez-Pérez, Aleksandar R. Karamarkovic, Aleksei V. Osipov, Alessandro Coppola, Alessandro Cucchetti, Alessandro Spolini, Alessio Giordano, Alexander Reinisch-Liese, Alfie J. Kavalakat, Alin Vasilescu, Amin Alamin, Amit Gupta, Ana Maria Dascalu, Ana-Maria Musina, Anargyros Bakopoulos, Andee Dzulkarnaen Zakaria, Andras Vereczkei, Andrea Balla, Andrea Bottari, Andreas Baumann, Andreas Fette, Andrey Litvin, Aniella Katharina Reichert, Anna Guariniello, Anna Paspala, Anne-Sophie Schneck, Antonio Brillantino, Antonio Pesce, Arda Isik, Ari Kalevi Leppäniemi, Aristeidis Papadopoulos, Aristotelis Kechagias, Ashraf Yehya Abdalla Mohamed, Ashrarur Rahman Mitul, Athanasios Marinis, Athanasios Syllaios, Baris Mantoglu, Belinda De Simone, Benjamin Stefan Weiss, Bernd Pösentrup, Biagio Picardi, Biagio Zampogna, Boris Eugeniev Sakakushev, Boyko Chavdarov Atanasov, Bruno Nardo, Bulent Calik, Camilla Cremonini, Carlos A. Ordoñez, Charalampos Seretis, Chiara Cascone, Christos Chouliaras, Cino Bendinelli, Claudia Lopes, Claudio Guerci, Clemens Weber, Constantinos Nastos, Cristian Mesina, Damiano Caputo, Damien Massalou, Davide Cavaliere, Deborah A. McNamara, Demetrios Demetriades, Desirè Pantalone, Diego Coletta, Diego Sasia, Diego Visconti, Dieter G. Weber, Diletta Corallino, Dimitrios Chatzipetris, Dimitrios K. Manatakis, Dimitrios Ntourakis, Dimitrios Papaconstantinou, Dimitrios Schizas, Dimosthenis Chrysikos, Dmitry Mikhailovich Adamovich, Doaa Elkafrawy, Dragos Seban, Edgar Fernando Hernandez García, Edoardo Baldini, Edoardo Picetti, Edward C. T. H. Tan, Efstratia Baili, Eftychios Lostoridis, Elena Adelina Toma, Elif Colak, Elisabetta Cerutti, Elmin Steyn, Elmuiz A. Hsabo, Emmanouil Ioannis Kapetanakis, Emmanouil Kaouras, Emmanuel Schneck, Emrah Akin, Emre Gonullu, Enes çelik, Enrico Cicuttin, Enrico Pinotti, Erik Johnsson, Ernest E. Moore, Ervis Agastra, Evgeni Nikolaev Dimitrov, Ewen A. Griffiths, Fabrizio D’Acapito, Federica Saraceno, Felipe Alconchel, Felix Alexander Zeppernick, Fernando Machado Rodríguez, Fikri Abu-Zidan, Francesca Pecchini, Francesco Favi, Francesco Ferrara, Francesco Fleres, Francesco Pata, Francesco Pietro Maria Roscio, Francesk Mulita, Frank J. M. F. Dor, Fredrik Linder, Gabriel Dimofte, Gabriel Rodrigues, Gabriela Nita, Gabriele Sganga, Gennaro Martines, Gennaro Mazzarella, Gennaro Perrone, George Velmahos, Georgios D. Lianos, Gia Tomadze, Gian Luca Baiocchi, Giancarlo D’Ambrosio, Gianluca Pellino, Gianmaria Casoni Pattacini, Giorgio Giraudo, Giorgio Lisi, Giovanni Domenico Tebala, Giovanni Pirozzolo, Giulia Montori, Giulio Argenio, Giuseppe Brisinda, Giuseppe Currò, Giuseppe Giuliani, Giuseppe Palomba, Giuseppe Roscitano, Gökhan Avşar, Goran Augustin, Guglielmo Clarizia, Gustavo M. Machain Vega, Gustavo P. Fraga, Harsheet Sethi, Hazim Abdulnassir Eltyeb, Helmut A. Segovia Lohse, Herald René Segovia Lohse, Hüseyin Bayhan, Hytham K. S. Hamid, Igor A. Kryvoruchko, Immacolata Iannone, Imtiaz Wani, Ioannis I. Lazaridis, Ioannis Katsaros, Ioannis Nikolopoulos, Ionut Negoi, Isabella Reccia, Isidoro Di Carlo, Iyiade Olatunde Olaoye, Jacek Czepiel, Jae Il Kim, Jeremy Meyer, Jesus Manuel Saenz Terrazas, Joel Noutakdie Tochie, Joseph M. Galante, Justin Davies, Kapil Sugand, Kebebe Bekele Gonfa, Kemal Rasa, Kenneth Y. Y. Kok, Konstantinos G. Apostolou, Konstantinos Lasithiotakis, Konstantinos Tsekouras, Kumar Angamuthu, Lali Akhmeteli, Larysa Sydorchuk, Laura Fortuna, Leandro Siragusa, Leonardo Pagani, Leonardo Solaini, Lisa A. Miller, Lovenish Bains, Luca Ansaloni, Luca Ferrario, Luigi Bonavina, Luigi Conti, Luis Antonio Buonomo, Luis Tallon-Aguilar, Lukas Tomczyk, Lukas Werner Widmer, Maciej Walędziak, Mahir Gachabayov, Maloni M. Bulanauca, Manu L. N. G. Malbrain, Marc Maegele, Marco Catarci, Marco Ceresoli, Maria Chiara Ranucci, Maria Ioanna Antonopoulou, Maria Papadoliopoulou, Maria Rosaria Valenti, Maria Sotiropoulou, Mario D’Oria, Mario Serradilla Martín, Markus Hirschburger, Massimiliano Veroux, Massimo Fantoni, Matteo Nardi, Matti Tolonen, Mauro Montuori, Mauro Podda, Maximilian Scheiterle, Maximos Frountzas, Mehmet Sarıkaya, Mehmet Yildirim, Michael Bender, Michail Vailas, Michel Teuben, Michela Campanelli, Michele Ammendola, Michele Malerba, Michele Pisano, Mihaela Pertea, Mihail Slavchev, Mika Ukkonen, Miklosh Bala, Mircea Chirica, Mirko Barone, Mohamed Maher Shaat, Mohammed Jibreel Suliman Mohammed, Mona Awad Akasha Abuelgasim, Monika Gureh, Mouaqit Ouadii, Mujdat Balkan, Mumin Mohamed, Musluh Hakseven, Natalia Velenciuc, Nicola Cillara, Nicola de’Angelis, Nicolò Tamini, Nikolaos J. Zavras, Nikolaos Machairas, Nikolaos Michalopoulos, Nikolaos N. Koliakos, Nikolaos Pararas, Noel E. Donlon, Noushif Medappil, Offir Ben-Ishay, Olmi Stefano, Omar Islam, Ömer Tammo, Orestis Ioannidis, Oscar Aparicio, Oussama Baraket, Pankaj Kumar, Pasquale Cianci, Per Örtenwall, Petar Angelov Uchikov, Philip de Reuver, Philip F. Stahel, Philip S. Barie, Micaela Piccoli, Piotr Major, Pradeep H. Navsaria, Prakash Kumar Sasmal, Raul Coimbra, Razrim Rahim, Recayi Çapoğlu, Renol M. Koshy, Ricardo Alessandro Teixeira Gonsaga, Riccardo Pertile, Rifat Ramadan Mussa Mohamed, Rıza Deryol, Robert G. Sawyer, Roberta Angelico, Roberta Ragozzino, Roberto Bini, Roberto Cammarata, Rosa Scaramuzzo, Rossella Gioco, Ruslan Sydorchuk, Salma Ahmed, Salomone Di Saverio, Sameh Hany Emile, Samir Delibegovic, Sanjay Marwah, Savvas Symeonidis, Scott G. Thomas, Sebahattin Demir, Selmy S. Awad, Semra Demirli Atici, Serge Chooklin, Serhat Meric, Sevcan Sarıkaya, Sharfuddin Chowdhury, Shaza Faycal Mirghani, Sherry M. Wren, Simone Gargarella, Simone Rossi Del Monte, Sofia Esposito, Sofia Xenaki, Soliman Fayez Ghedan Mohamed, Solomon Gurmu Beka, Sorinel Lunca, Spiros G. Delis, Spyridon Dritsas, Stefan Morarasu, Stefano Magnone, Stefano Rossi, Stefanos Bitsianis, Stylianos Kykalos, Suman Baral, Sumita A. Jain, Syed Muhammad Ali, Tadeja Pintar, Tania Triantafyllou, Tarik Delko, Teresa Perra, Theodoros A. Sidiropoulos, Thomas M. Scalea, Tim Oliver Vilz, Timothy Craig Hardcastle, Tongporn Wannatoop, Torsten Herzog, Tushar Subhadarshan Mishra, Ugo Boggi, Valentin Calu, Valentina Tomajer, Vanni Agnoletti, Varut Lohsiriwat, Victor Kong, Virginia Durán Muñoz-Cruzado, Vishal G. Shelat, Vladimir Khokha, Wagih Mommtaz Ghannam, Walter L. Biffl, Wietse Zuidema, Yasin Kara, Yoshiro Kobe, Zaza Demetrashvili, Ziad A. Memish, Zoilo Madrazo, Zsolt J. Balogh, Zulfu Bayhan, Reichert, M, Sartelli, M, Weigand, M, Hecker, M, Oppelt, P, Noll, J, Askevold, I, Liese, J, Padberg, W, Coccolini, F, Catena, F, Hecker, A, Peckham-Cooper, A, Camacho-Ortiz, A, Mastoraki, A, Landaluce-Olavarria, A, Pal, A, Kuriyama, A, Chichom-Mefire, A, Porcu, A, Martinez-Perez, A, Karamarkovic, A, Osipov, A, Coppola, A, Cucchetti, A, Spolini, A, Giordano, A, Reinisch-Liese, A, Kavalakat, A, Vasilescu, A, Alamin, A, Gupta, A, Dascalu, A, Musina, A, Bakopoulos, A, Zakaria, A, Vereczkei, A, Balla, A, Bottari, A, Baumann, A, Fette, A, Litvin, A, Reichert, A, Guariniello, A, Paspala, A, Schneck, A, Brillantino, A, Pesce, A, Isik, A, Leppaniemi, A, Papadopoulos, A, Kechagias, A, Mohamed, A, Mitul, A, Marinis, A, Syllaios, A, Mantoglu, B, De Simone, B, Weiss, B, Posentrup, B, Picardi, B, Zampogna, B, Sakakushev, B, Atanasov, B, Nardo, B, Calik, B, Cremonini, C, Ordonez, C, Seretis, C, Cascone, C, Chouliaras, C, Bendinelli, C, Lopes, C, Guerci, C, Weber, C, Nastos, C, Mesina, C, Caputo, D, Massalou, D, Cavaliere, D, Mcnamara, D, Demetriades, D, Pantalone, D, Coletta, D, Sasia, D, Visconti, D, Weber, D, Corallino, D, Chatzipetris, D, Manatakis, D, Ntourakis, D, Papaconstantinou, D, Schizas, D, Chrysikos, D, Adamovich, D, Elkafrawy, D, Seban, D, Garcia, E, Baldini, E, Picetti, E, Tan, E, Baili, E, Lostoridis, E, Toma, E, Colak, E, Cerutti, E, Steyn, E, Hsabo, E, Kapetanakis, E, Kaouras, E, Schneck, E, Akin, E, Gonullu, E, Celik, E, Cicuttin, E, Pinotti, E, Johnsson, E, Moore, E, Agastra, E, Dimitrov, E, Griffiths, E, D'Acapito, F, Saraceno, F, Alconchel, F, Zeppernick, F, Rodriguez, F, Abu-Zidan, F, Pecchini, F, Favi, F, Ferrara, F, Fleres, F, Pata, F, Roscio, F, Mulita, F, Dor, F, Linder, F, Dimofte, G, Rodrigues, G, Nita, G, Sganga, G, Martines, G, Mazzarella, G, Perrone, G, Velmahos, G, Lianos, G, Tomadze, G, Baiocchi, G, D'Ambrosio, G, Pellino, G, Pattacini, G, Giraudo, G, Lisi, G, Tebala, G, Pirozzolo, G, Montori, G, Argenio, G, Brisinda, G, Curro, G, Giuliani, G, Palomba, G, Roscitano, G, Avsar, G, Augustin, G, Clarizia, G, Vega, G, Fraga, G, Sethi, H, Eltyeb, H, Lohse, H, Bayhan, H, Hamid, H, Kryvoruchko, I, Iannone, I, Wani, I, Lazaridis, I, Katsaros, I, Nikolopoulos, I, Negoi, I, Reccia, I, Di Carlo, I, Olaoye, I, Czepiel, J, Kim, J, Meyer, J, Terrazas, J, Tochie, J, Galante, J, Davies, J, Sugand, K, Gonfa, K, Rasa, K, Kok, K, Apostolou, K, Lasithiotakis, K, Tsekouras, K, Angamuthu, K, Akhmeteli, L, Sydorchuk, L, Fortuna, L, Siragusa, L, Pagani, L, Solaini, L, Miller, L, Bains, L, Ansaloni, L, Ferrario, L, Bonavina, L, Conti, L, Buonomo, L, Tallon-Aguilar, L, Tomczyk, L, Widmer, L, Waledziak, M, Gachabayov, M, Bulanauca, M, Malbrain, M, Maegele, M, Catarci, M, Ceresoli, M, Ranucci, M, Antonopoulou, M, Papadoliopoulou, M, Valenti, M, Sotiropoulou, M, D'Oria, M, Martin, M, Hirschburger, M, Veroux, M, Fantoni, M, Nardi, M, Tolonen, M, Montuori, M, Podda, M, Scheiterle, M, Frountzas, M, Sarikaya, M, Yildirim, M, Bender, M, Vailas, M, Teuben, M, Campanelli, M, Ammendola, M, Malerba, M, Pisano, M, Pertea, M, Slavchev, M, Ukkonen, M, Bala, M, Chirica, M, Barone, M, Shaat, M, Mohammed, M, Abuelgasim, M, Gureh, M, Ouadii, M, Balkan, M, Mohamed, M, Hakseven, M, Velenciuc, N, Cillara, N, De'Angelis, N, Tamini, N, Zavras, N, Machairas, N, Michalopoulos, N, Koliakos, N, Pararas, N, Donlon, N, Medappil, N, Ben-Ishay, O, Stefano, O, Islam, O, Tammo, O, Ioannidis, O, Aparicio, O, Baraket, O, Kumar, P, Cianci, P, Ortenwall, P, Uchikov, P, de Reuver, P, Stahel, P, Barie, P, Piccoli, M, Major, P, Navsaria, P, Sasmal, P, Coimbra, R, Rahim, R, Capoglu, R, Koshy, R, Gonsaga, R, Pertile, R, Mohamed, R, Deryol, R, Sawyer, R, Angelico, R, Ragozzino, R, Bini, R, Cammarata, R, Scaramuzzo, R, Gioco, R, Sydorchuk, R, Ahmed, S, Di Saverio, S, Emile, S, Delibegovic, S, Marwah, S, Symeonidis, S, Thomas, S, Demir, S, Awad, S, Atici, S, Chooklin, S, Meric, S, Sarikaya, S, Chowdhury, S, Mirghani, S, Wren, S, Gargarella, S, Del Monte, S, Esposito, S, Xenaki, S, Mohamed, S, Beka, S, Lunca, S, Delis, S, Dritsas, S, Morarasu, S, Magnone, S, Rossi, S, Bitsianis, S, Kykalos, S, Baral, S, Jain, S, Ali, S, Pintar, T, Triantafyllou, T, Delko, T, Perra, T, Sidiropoulos, T, Scalea, T, Vilz, T, Hardcastle, T, Wannatoop, T, Herzog, T, Mishra, T, Boggi, U, Calu, V, Tomajer, V, Agnoletti, V, Lohsiriwat, V, Kong, V, Munoz-Cruzado, V, Shelat, V, Khokha, V, Ghannam, W, Biffl, W, Zuidema, W, Kara, Y, Kobe, Y, Demetrashvili, Z, Memish, Z, Madrazo, Z, Balogh, Z, and Bayhan, Z

Subjects
Cross-Sectional Studie, ddc:610, Capacity, Pandemic, SARS-CoV-2, COVID-19, WSES, Time to intervention, Appendicitis, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Cross-Sectional Studies, Emergency, Quarantine, Emergency Medicine, Emergency surgery, Humans, Surgery, Appendiciti, COVID-19, SARS-CoV-2, Pandemic, Emergency surgery, Emergency, Appendicitis, WSES, Time to intervention, Capacity, Quarantine, Pandemics, Diverticulitis, Human
Abstract

Background The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years.

Published
2022
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12. General Aspects on Post Partum Care of Laparoschisis in Newborns —A Pediatric Surgeon’s View Point

Author

Andreas Fette

Subjects
medicine.medical_specialty, business.industry, Critically ill, education, Pediatric Surgeon, Postpartal care, Clinical Practice, Abdominal wall, medicine.anatomical_structure, Obstetrics and gynaecology, medicine, Intensive care medicine, business, Post partum
Abstract

In this communication, a short overview about congenital abdominal wall defects—laparoschisis is given. Focusing on all day clinical practice, possible surgical therapies and best postpartal care for these critically ill newborn babies are presented for the obstetrician in charge from a neonatal surgeon’s viewpoint.

Published
2017
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13. Common Pediatric Surgical Emergencies

Author

Andreas Fette

Subjects
medicine.medical_specialty, Rehabilitation, business.industry, medicine.medical_treatment, Anastomosis, Short bowel syndrome, medicine.disease, digestive system, digestive system diseases, Surgery, Resection, Abdominal incision, Stoma closure, surgical procedures, operative, Stoma (medicine), Medicine, business, Mucous fistula
Abstract

During surgery preserving as much viable intestine as possible is of key importance. Only perforated or clearly diseased/necrotic bowel should be resected. After resection, either a proximal stoma and anastomoses of the distal defunctionalized segments or multiple stomas are created. The stoma or mucous fistula can be brought out through your abdominal incision. Stoma closure will be performed after complete rehabilitation of the intestine. Common long-term complications include strictures and short bowel syndrome. In summary, despite the fact that most cases of early NEC can be managed successfully nonoperative, prompt surgical intervention is usually required for advanced or perforated NEC and virtually all FIPs.

Published
2017
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15. Psycho-medical aspects on migrants health of III? world pediatric surgical patients

Author

Istvan Szilard, Kurosh Paya, and Andreas Fette

Subjects
medicine.medical_specialty, Rehabilitation, business.industry, medicine.medical_treatment, Socialization, Traumatic stress, World wide, Globalization, Nursing, Pediatric surgery, Health care, medicine, business, Surgical patients
Abstract

The constantly expanding world wide mobility and globalization within the pediatric community puts new demands on pediatric surgical health care systems worldwide. Forcing carers to pay attention not only on their best surgical and medical performance like in the past. In contrary, they are forced to pay much more attention on psycho-medical aspects like finance, rehabilitation, socialization and integration, culture, management and logistics, health edu-cation and language skills. Then, according to our opinion these aspects should be considered as Post Traumatic Stress Disorder (PTSD)-like syndrome and treated accordingly. Then handling this problem succesfully, would be essential for the future survival of any health care system.

Published
2011
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16. Elastisch – Stabile Markraumschienung (ESMS) von Unterarmschaftfrakturen im Kindesalter

Author

Angelika S. Zettl, Andreas Fette, Frank-Martin Haecker, Sonja Feichter, and Johannes Mayr

Subjects
Gynecology, medicine.medical_specialty, business.industry, medicine, Orthopedics and Sports Medicine, Surgery, business
Abstract

Schnelle, minimal invasive und belastungsstabile innere Schienung von dislozierten Unterarmschaftfrakturen im Kindesalter, die auf eine Gipsruhigstellung verzichten kann. Dislozierte Unterarmschaftfrakturen, bis II° offen, fur Patienten im Alter von 4–18 Jahren mit dem Wunsch nach schneller Mobilisation und sicherer Stabilisation zur Vermeidung von neuerlichen Fehlstellungen. Hohergradig offene Frakturen mit stark verschmutzten Wunden. Sklerosierter, nicht passierbarer Markraum oder floride Osteomyelitis. Geschlossene achsengerechte Reposition der Fraktur. Einfuhren und Vorschieben von vorgebogenen Markraumschienen uber kleine Op-Zugange. Die Markraumschienenspitzen werden nach Auffadeln der Fragmentenden zur Aufspannung der Membrana interossea gegeneinander gedreht und dadurch die Fraktur stabil retiniert. Unmittelbar postoperativ ist die Osteosynthese ubungs- und (alltags-) belastungsstabil. Fur 1 Woche kann der Arm zur rascheren Abschwellung mit einer Schiene ruhiggestellt oder in einer Armschlinge getragen werden. Die Sportfreigabe erfolgt in der Regel nach ca. 8 Wochen. Die Metallentfernung wird fur 6–8 Monate postoperativ geplant. Im Zeitraum von Januar 2000 bis Juli 2003 wurden 141 Kinder (99 Jungen, 42 Madchen) aufgrund einer dislozierten Unterarmschaftfraktur operiert und mit einer ESMS – Osteosynthese versorgt. Das Durchschnittsalter der Kinder lag bei 9.3 Jahren (2–15 Jahre). In der Mehrzahl der Falle war der linke Vorderarm betroffen [links 80 (61%), rechts 51 (39%)]. Die durchschnittliche Hospitalisationszeit der Kinder war 1.1 Tage (0–5 Tage). Bei 108 Patienten konnte eine geschlossene Reposition mit nachfolgender ESMS-Osteosynthese von Radius und Ulna vorgenommen werden. Bei 23 Kindern war aufgrund eines Repositionshindernisses (z. B. Weichteil-interponat) eine offene Reposition erforderlich (Radius: 9, Ulna: 6, Radius und Ulna: 8). Zusammenfassend fand sich bei 129 Patienten (98.5%) langfristig ein gutes Ergebnis, definiert als knochern konsolidierte Fraktur, kosmetisch gutes Ergebnis, keine bleibende Bewegungseinschrankung, kein Fehlwachstum sowie kein neurologisches Defizit. Bei insgesamt 13 Kindern (9.9%) zeigte sich postoperativ eine OP-bedingte Komplikation, welche bei 11 (8.4%) dieser 13 Patienten temporar auftrat und im weiteren Verlauf bzw. nach Metallentfernung spontan sistierte. Bei 2 Patienten (1.5%) war aufgrund persistierender Beschwerden eine operative Revision erforderlich (Neurolyse bei anhaltenden Dysaesthesien: 1; vorzeitige Metallentfernung bei Implantatinfekt: 1).

Published
2009
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17. A Pediatric Civil War Burn Victim

Author

Andreas Fette

Subjects
Male, Warfare, Coping (psychology), Injury control, Attitude of Health Personnel, education, Poison control, Psychology, Child, Nursing Staff, Hospital, Suicide prevention, Occupational safety and health, Life Change Events, Nursing, Risk Factors, Germany, Adaptation, Psychological, Injury prevention, Humans, Medicine, Child, health care economics and organizations, Advanced and Specialized Nursing, business.industry, Communication Barriers, Social Support, Human factors and ergonomics, social sciences, Plastic Surgery Procedures, medicine.disease, humanities, Medical–Surgical Nursing, Spanish Civil War, Angola, Caregivers, Surgery, Medical emergency, Burns, Psychological Theory, business, Attitude to Health, Child, Hospitalized, Stress, Psychological
Abstract

A patient's and the caregivers' threats and reliefs during nursing of a pediatric civil war burn victim, treated through a charity grant in a Western hospital, are discussed and supported by a literature review.

Published
2009
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18. Use of microsurgical laser in paediatric surgery and paediatric neurosurgery

Author

K. F. Kothbauer, Andreas Fette, and K. Yonekawa

Subjects
medicine.medical_specialty, Paediatric surgery, business.industry, Biomedical Engineering, Biophysics, Health Informatics, Bioengineering, Surgical access, Surgery, Biomaterials, Hemostasis, Medicine, Neurosurgery, business, Laser scalpel, Tissue Dissection, Information Systems
Abstract

Our descriptive technical report on 7 children describes the microsurgical laser scalpel as an useful tool for removal of firm and soft lesions from a variety of delicate tissues. It combines precise atraumatic tissue dissection with immediate hemostasis while having no adverse side effects on adjacent and neighbouring tissues even through a limited surgical access.

Published
2006
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19. Integra artificial skin® in use for full-thickness burn surgery: Benefits or harms on patient outcome

Author

Andreas Fette

Subjects
medicine.medical_specialty, integumentary system, business.industry, Chondroitin Sulfates, Treatment outcome, Biomedical Engineering, Biophysics, Health Informatics, Bioengineering, Human skin, Artificial skin, Surgery, Biomaterials, Full thickness burn, Treatment Outcome, Integra artificial skin, Humans, Medicine, Full thickness, Collagen, Burns, business, Total body surface area, Information Systems
Abstract

Full thickness burns usually lead to a great loss of skin and physiological instability because human skin is not only the biggest organ of our body it is the most important protection barrier as well. As natural skin has only limited options to recover, there is a great need for the development of synthetic skin in order to save patients with these high total body surface area full-thickness burns. Many artificial skin substitutes have been developed for this purpose so far. The benefits and harms of one substitute - Integra artificial skin® - are discussed in a critical literature review.

Published
2005
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20. Thoracoplasty for treatment of asphyxiating thoracic dysplasia in a newborn

Author

Alexander Rokitansky and Andreas Fette

Subjects
Reoperation, Gynecology, Asphyxia Neonatorum, medicine.medical_specialty, business.industry, Infant, Newborn, Pneumonia, General Medicine, Thorax, medicine.disease, Respiration, Artificial, Spondylocostal dysostosis, Musculoskeletal Abnormalities, Surgery, Asphyxiating thoracic dysplasia, Tracheostomy, Pediatrics, Perinatology and Child Health, Humans, Medicine, Female, Thoracoplasty, business
Abstract

In our case report and literature review, we report about a female newborn with severe asphyxiating thoracic dysplasia of the spondylocostal dysostosis classification to whom an expandable thoracoplasty with metal implants offered survival and discharge at home from newborn to infancy.

Published
2005
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21. Minimal Access Laser Therapy (Malt) of Genitary Hemangiomas in Girls

Author

Andreas Fette

Subjects
medicine.medical_specialty, Laser therapy, Minimal access, business.industry, Nd:YAG laser, medicine, Effective treatment, Major cosmetic, business, Surgery
Abstract

Objective: Hemangiomas in the sensitive genital area of the female body are a constant major cosmetic concern. In the majority of cases they are even complicated by ulceration and/or hemorrhage as well. In addition, their delicate location make genitary hemangiomas like their facial counterparts prone to psychosocial disorders, too. Therefore, to find the best and most effective treatment for the individual case is still an ongoing debate. Patients and methods: We treated 5 girls (Median age: 6 mos, range: 2.5-118 mos) with ulcerating and/or bleeding complex genitary hemangiomas (“capillary”, cavernous”, “mixed”) with minimal access laser therapy (MALT). The 1064 nm Nd:YAG laser was applied in compression or intralesional bare fibre technique with cooling of the skin under general anesthesia. Median energy applied ranged from 500 to 13 075 J/cm2/session in the individual patient. Results: Bleeding and ulceration could be stopped usually within the first laser session, while involution started during the following sessions. Conclusion: Our minimal access laser therapy (MALT) with a commercial Nd:YAG laser device seems to be promising alternative in the treatment of this specific condition.

Published
2014
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22. Sildenafil in Use for Treatment of Pulmonary Hypertension in Congenital Diaphragmatic Hernia: Short Literature Review

Author

Andreas Fette

Subjects
medicine.medical_specialty, Sildenafil, business.industry, Congenital diaphragmatic hernia, medicine.disease, Omics, Pulmonary hypertension, Surgery, chemistry.chemical_compound, Erectile dysfunction, chemistry, Concomitant, medicine, Intensive care medicine, business, Beneficial effects
Abstract

Congenital Diaphragmatic Hernia (CDH) is a complex malformation in the newborn baby. The management, either surgical or non-surgical is an ongoing challenge. Especially in regard to the question how to treat the concomitant pulmonary hypertension best. Here sildenafil, more commonly known in the public as Viagra® and for the treatment of erectile dysfunction seems to have beneficial effects in pulmonary hypertension treatment of CDH patients as well. Thus, this short review aims to evaluate the actual literature for current evidence and practical application.

Published
2014
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23. The Distal Forearm Region - Ultrasonographic Anatomy in Children and Adolescents

Author

Wolfgang Grechenig, Johannes Mayr, Ursula Seebacher, Andreas Weiglein, Andreas Fette, and Sergio B. Sesia

Subjects
Distal forearm, medicine.medical_specialty, business.industry, Pediatric surgery, medicine, Traumatology, Anatomy, business
Abstract

Johannes M. Mayr1,*, Wolfgang Grechenig2, Ursula Seebacher3, Andreas Fette3, Andreas H. Weiglein4 and Sergio Sesia1 1Department of Pediatric Surgery, University Children’s Hospital Basel, Basel, 2Medical University of Graz, Graz, Department of Traumatology 3Medical University of Graz, Department of Pediatric Surgery 4Department of Anatomy, Medical University of Graz, Graz 1Switzerland 2,3,4Austria

Published
2012

24. Case report: Dieterich's disease in a teenage boy

Author

Andreas Fette

Subjects
Male, medicine.medical_specialty, Adolescent, business.industry, General surgery, Osteonecrosis, Hand surgery, Dieterich's disease, Metacarpal Bones, Radiography, Pediatrics, Perinatology and Child Health, Medicine, Humans, Orthopedics and Sports Medicine, Range of Motion, Articular, business, Range of motion
Abstract

Aseptic metacarpal head necrosis or 'Dieterich disease' is a rare condition, especially in children or adolescents, not routinely described in hand surgery literature reviews. This case report presents course and treatment of a teenage boy with the exceptional fifth ray involved.

Published
2009

25. Discussing the relationship between quality care and cost-effective care in Swiss pediatric wound care

Author

Andreas Fette

Subjects
Advanced and Specialized Nursing, Wound Healing, Cost–benefit analysis, business.industry, Cost-Benefit Analysis, MEDLINE, Validity, Reproducibility of Results, Context (language use), Audit, Health Care Costs, Medical–Surgical Nursing, Wound care, Ambulatory care, Nursing, Health care, Practice Guidelines as Topic, Medicine, Humans, Wounds and Injuries, Surgery, business, Child, Switzerland
Abstract

The growing individual and public demand for high-quality care within a context of restricted budgets dominates the political as well as medical agenda. This demand for "quality care" has developed an "industry" and lobby relating to auditing practice even in the small subpopulation of pediatric surgical patients. With children, complex and nonhealing wounds are quite rare, but there are pressures to provide modern and high-quality wound care even in Switzerland. Thus, in accordance with practice in neighboring countries, guidelines for wound care have been established in the Swiss healthcare sector. Their validity and reliability in the context of cost-effective versus quality care are critically discussed in this paper.

Published
2006

26. Influence of silicone on abnormal scarring

Author

Andreas Fette

Subjects
Financial costs, medicine.medical_specialty, Time Factors, Scar assessment, Administration, Cutaneous, Silicone Gels, chemistry.chemical_compound, Cicatrix, Silicone, Clinical Protocols, medicine, Humans, Intensive care medicine, Nursing Assessment, Advanced and Specialized Nursing, Clinical Trials as Topic, Evidence-Based Medicine, business.industry, Patient Selection, Abnormal scarring, Treatment options, Bandages, Medical–Surgical Nursing, Treatment Outcome, chemistry, Keloid, Abnormal skin, Surgery, business
Abstract

The problem of scarring represents a large area of an unmet medical need, since people with abnormal skin scarring may face physical and psychological consequences that may be associated with substantial emotional and financial costs. To date, treatment options are to leave the scar alone or use invasive or noninvasive management. Silicone is the key in noninvasive management, with the following overall results reported: great improvement of the scar appearance, easy to apply, painless, and almost free of side effects. When analyzing all presented results in this research sample, it becomes obvious that they are mainly based on subjective, not well-defined scar assessment by the individual without comparison to controls or rating against validated scores and therefore lacking real scientific or evidence-based criteria.

Published
2006

27. Ultrasound detection of soft and bony tissues in congenital hand malformations. Examples taken in daily paediatric surgical clinics

Author

Andreas Fette

Subjects
Male, medicine.medical_specialty, Triphalangeal thumb, Biomedical Engineering, Biophysics, Health Informatics, Bioengineering, Paediatric surgeon, Pediatrics, Bone and Bones, Biomaterials, medicine, Humans, Medical diagnosis, Ultrasonography, Bony tissue, business.industry, Ultrasound, medicine.disease, Surgery, Surgical clinics, Bony Tissues, Connective Tissue, Child, Preschool, Female, business, Hand Deformities, Congenital, Surgery Department, Hospital, Congenital hand malformations, Switzerland, Information Systems
Abstract

According to the everyday use of ultrasound in the whole field of paediatric surgery we would like to define its potential role in the assessment of congenital hand malformation (CHM). We therefore tested it for several diagnoses like digitus saltans, camptodactylism, triphalangeal thumb and syndrome-associated malformations in comparison as well as in addition to clinical and x-ray findings. All soft and bony tissue details could be displayed reasonable giving the paediatric surgeon additional information. Additional information that is available at the bedside, non-invasive, less costly and does not use ionising radiation.

Published
2006

28. Treatment of pressure ulcers with topical negative pressure versus traditional wound management methods: a research sampler

Author

Andreas Fette

Subjects
Advanced and Specialized Nursing, Platelet-Derived Growth Factor, Pressure Ulcer, medicine.medical_specialty, Wound Healing, Vacuum, business.industry, Swine, medicine.medical_treatment, MEDLINE, Surgical debridement, Bandages, Surgery, Medical–Surgical Nursing, Disease Models, Animal, Wound management, medicine, Animals, Humans, Wound healing, business, Saline
Abstract

The treatment of pressure ulcers is still a matter of debate. The pros and cons of topical negative pressure versus traditional saline wet-to-moist dressings, platelet-derived growth factor, and surgical debridement are discussed in the literature review. This article examines literature that relates to the mechanism of action and efficacy of topical negative pressure.

Published
2005

29. Tracheobronchial injuries in childhood: review of two cases

Author

Michael E. Höllwarth and Andreas Fette

Subjects
Male, medicine.medical_specialty, Bronchi, Wounds, Penetrating, Delayed diagnosis, Lesion, Bronchoscopy, medicine, Humans, Child, Mediastinal Emphysema, Rupture, Bronchus, medicine.diagnostic_test, business.industry, Respiratory disease, General Medicine, medicine.disease, Tracheobronchial injury, Surgery, Nonoperative treatment, Radiography, Trachea, medicine.anatomical_structure, Pediatrics, Perinatology and Child Health, Accidental Falls, medicine.symptom, business
Abstract

Penetrating injuries of the tracheobronchial tree in children are very rare. With prompt diagnosis nonoperative treatment seems to be appropriate and safe without complications. Delayed diagnosis may result in surgical exploration with severe complications afterwards caused by poor condition at the time of intervention. Two children with penetrating tracheobronchial injuries were referred to our pediatric surgical center in the last 12 years. A 10-year-old boy suffered an iatrogenic penetrating injury of the tracheobronchial tree, and a 6-year-old boy a direct penetrating injury of the distal trachea in an agricultural accident. Cervical emphysema and bronchoscopy identified the lesion in these patients. Both of them could be treated conservatively without any sequelae.

Published
2001

31. Treatment of varicoceles in childhood and adolescence with Tauber's antegrade scrotal sclerotherapy

Author

Johannes Mayr and Andreas Fette

Subjects
Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Varicocele, Polidocanol, Polyethylene Glycols, Scrotum, Hydrocele, Sclerotherapy, medicine, Effective treatment, Humans, Child, business.industry, General Medicine, medicine.disease, Sclerosing Solutions, Surgery, medicine.anatomical_structure, El Niño, Pediatrics, Perinatology and Child Health, Complication, business
Abstract

Purpose: The aim of this study was to evaluate surgical complications and the outcome of grade II and III varicoceles treated with Tauber's antegrade scrotal sclerotherapy. Methods: A total of 21 patients with a median age of 13 (range, 10 to 21) years and left-sided grade II and III varicoceles were treated with Tauber's antegrade scrotal sclerotherapy and underwent follow-up over a median period of 23 months (range, 9 to 35). Results: One grade II varicocele persisted after antegrade sclerotherapy for 6 months. After a second sclerotherapy 6 months later, no further recurrence was detected. One patient with a grade II to III varicocele had a grade I varicocele recurrence 14 months after operation. Three patients showed a slight hydrocele postoperatively. Conclusion: This limited series indicates that Tauber's antegrade scrotal sclerotherapy is a safe and effective treatment for grade II and III varicoceles in children and adolescents. J Pediatr Surg 35:1222-1225. Copyright © 2000 by W.B. Saunders Company.

Published
2000

32. Correspondence

Author

Andreas Fette and Marcus G. Schwoebel

Subjects
medicine.medical_specialty, medicine.anatomical_structure, business.industry, medicine.medical_treatment, General surgery, Pediatrics, Perinatology and Child Health, Medicine, Rectum, Surgery, General Medicine, business, Evisceration (ophthalmology)
Published
2009
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