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4. Acute cholecystitis management in high-risk, critically ill, and unfit-for-surgery patients: the Italian Society of Emergency Surgery and Trauma (SICUT) guidelines

Author

Coccolini, Federico, Cucinotta, Eugenio, Mingoli, Andrea, Zago, Mauro, Altieri, Gaia, Biloslavo, Alan, Caronna, Roberto, Cengeli, Ismail, Cicuttin, Enrico, Cirocchi, Roberto, Cobuccio, Luigi, Costa, Gianluca, Cozza, Valerio, Cremonini, Camilla, Del Vecchio, Giovanni, Dinatale, Giuseppe, Fico, Valeria, Galatioto, Christian, Kuriara, Hayato, Lacavalla, Domenico, La Greca, Antonio, Larghi, Alberto, Mariani, Diego, Mirco, Paolo, Occhionorelli, Savino, Parini, Dario, Polistina, Francesco, Rimbas, Mihai, Sapienza, Paolo, Tartaglia, Dario, Tropeano, Giuseppe, Venezia, Piero, Venezia, Dario Francesco, Zaghi, Claudia, and Chiarugi, Massimo

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

Author

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

Subjects
Acute appendicitis, Acute care surgery, Acute cholecystitis, Acute diverticulitis, Acute pancreatitis, Acute peritonitis, Adhesive small bowel obstruction, Colo–rectal emergencies, Emergency general surgery, Guidelines, Incarcerated/complicated ventral/inguinal hernia, Laparoscopic approach, Laparoscopy, Mesenteric ischemia, Minimally invasive surgery/approach, Penetrating/blunt abdominal trauma, Perforated peptic ulcer, Recommendations, Trauma surgery hemodynamic stability, Humans, Emergencies, Retrospective Studies, Laparoscopy, Abdomen, Abdominal Injuries, Randomized Controlled Trials as Topic
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

7. Strategies to prevent blood loss and reduce transfusion in emergency general surgery, WSES-AAST consensus paper

Author

Federico Coccolini, Aryeh Shander, Marco Ceresoli, Ernest Moore, Brian Tian, Dario Parini, Massimo Sartelli, Boris Sakakushev, Krstina Doklestich, Fikri Abu-Zidan, Tal Horer, Vishal Shelat, Timothy Hardcastle, Elena Bignami, Andrew Kirkpatrick, Dieter Weber, Igor Kryvoruchko, Ari Leppaniemi, Edward Tan, Boris Kessel, Arda Isik, Camilla Cremonini, Francesco Forfori, Lorenzo Ghiadoni, Massimo Chiarugi, Chad Ball, Pablo Ottolino, Andreas Hecker, Diego Mariani, Ettore Melai, Manu Malbrain, Vanessa Agostini, Mauro Podda, Edoardo Picetti, Yoram Kluger, Sandro Rizoli, Andrey Litvin, Ron Maier, Solomon Gurmu Beka, Belinda De Simone, Miklosh Bala, Aleix Martinez Perez, Carlos Ordonez, Zenon Bodnaruk, Yunfeng Cui, Augusto Perez Calatayud, Nicola de Angelis, Francesco Amico, Emmanouil Pikoulis, Dimitris Damaskos, Raul Coimbra, Mircea Chirica, Walter L. Biffl, and Fausto Catena

Subjects
Blood management, Mortality, Morbidity, Policy, Management, Jehovah’s witnesses, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Emergency general surgeons often provide care to severely ill patients requiring surgical interventions and intensive support. One of the primary drivers of morbidity and mortality is perioperative bleeding. In general, when addressing life threatening haemorrhage, blood transfusion can become an essential part of overall resuscitation. However, under all circumstances, indications for blood transfusion must be accurately evaluated. When patients decline blood transfusions, regardless of the reason, surgeons should aim to provide optimal care and respect and accommodate each patient’s values and target the best outcome possible given the patient’s desires and his/her clinical condition. The aim of this position paper was to perform a review of the existing literature and to provide comprehensive recommendations on organizational, surgical, anaesthetic, and haemostatic strategies that can be used to provide optimal peri-operative blood management, reduce, or avoid blood transfusions and ultimately improve patient outcomes.

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

Author

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

Subjects
Abdominal wall incision, Closure technique, Emergency, Incisional hernia, Laparotomy closure, Midline incision, Wound complications, Wound dehiscence, Humans, Laparotomy, Abdominal Wound Closure Techniques, Suture Techniques, Incisional Hernia, Reoperation
Abstract

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

Published
2023

9. Strategies to prevent blood loss and reduce transfusion in emergency general surgery, WSES-AAST consensus paper

Author

Coccolini, Federico, Shander, Aryeh, Ceresoli, Marco, Moore, Ernest, Tian, Brian, Parini, Dario, Sartelli, Massimo, Sakakushev, Boris, Doklestich, Krstina, Abu-Zidan, Fikri, Horer, Tal, Shelat, Vishal, Hardcastle, Timothy, Bignami, Elena, Kirkpatrick, Andrew, Weber, Dieter, Kryvoruchko, Igor, Leppaniemi, Ari, Tan, Edward, Kessel, Boris, Isik, Arda, Cremonini, Camilla, Forfori, Francesco, Ghiadoni, Lorenzo, Chiarugi, Massimo, Ball, Chad, Ottolino, Pablo, Hecker, Andreas, Mariani, Diego, Melai, Ettore, Malbrain, Manu, Agostini, Vanessa, Podda, Mauro, Picetti, Edoardo, Kluger, Yoram, Rizoli, Sandro, Litvin, Andrey, Maier, Ron, Beka, Solomon Gurmu, De Simone, Belinda, Bala, Miklosh, Perez, Aleix Martinez, Ordonez, Carlos, Bodnaruk, Zenon, Cui, Yunfeng, Calatayud, Augusto Perez, de Angelis, Nicola, Amico, Francesco, Pikoulis, Emmanouil, Damaskos, Dimitris, Coimbra, Raul, Chirica, Mircea, Biffl, Walter L., and Catena, Fausto

Published
2024
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11. FADS1/2 control lipid metabolism and ferroptosis susceptibility in triple-negative breast cancer

Author

Nicla Lorito, Angela Subbiani, Alfredo Smiriglia, Marina Bacci, Francesca Bonechi, Laura Tronci, Elisabetta Romano, Alessia Corrado, Dario Livio Longo, Marta Iozzo, Luigi Ippolito, Giuseppina Comito, Elisa Giannoni, Icro Meattini, Alexandra Avgustinova, Paola Chiarugi, Angela Bachi, and Andrea Morandi

Subjects
Ferroptosis, Lipid Metabolism, Polyunsaturated Fatty Acids, Desaturases, Lipid Droplets, Medicine (General), R5-920, Genetics, QH426-470
Abstract

Abstract Triple-negative breast cancer (TNBC) has limited therapeutic options, is highly metastatic and characterized by early recurrence. Lipid metabolism is generally deregulated in TNBC and might reveal vulnerabilities to be targeted or used as biomarkers with clinical value. Ferroptosis is a type of cell death caused by iron-dependent lipid peroxidation which is facilitated by the presence of polyunsaturated fatty acids (PUFA). Here we identify fatty acid desaturases 1 and 2 (FADS1/2), which are responsible for PUFA biosynthesis, to be highly expressed in a subset of TNBC with a poorer prognosis. Lipidomic analysis, coupled with functional metabolic assays, showed that FADS1/2 high-expressing TNBC are susceptible to ferroptosis-inducing agents and that targeting FADS1/2 by both genetic interference and pharmacological approach renders those tumors ferroptosis-resistant while unbalancing PUFA/MUFA ratio by the supplementation of exogenous PUFA sensitizes resistant tumors to ferroptosis induction. Last, inhibiting lipid droplet (LD) formation and turnover suppresses the buffering capacity of LD and potentiates iron-dependent cell death. These findings have been validated in vitro and in vivo in mouse- and human-derived clinically relevant models and in a retrospective cohort of TNBC patients.

Published
2024
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13. Long-Term Treatment Over 52 Weeks with Monthly Fremanezumab in Drug-Resistant Migraine: A Prospective Multicenter Cohort Study

Author

Caponnetto, Valeria, Russo, Antonio, Silvestro, Marcello, Tessitore, Alessandro, De Icco, Roberto, Vaghi, Gloria, Sances, Grazia, Tassorelli, Cristina, Baraldi, Carlo, Castro, Flavia Lo, Guerzoni, Simona, Prudenzano, Maria Pia, Fallacara, Adriana, Gentile, Martino, Ornello, Raffaele, Onofri, Agnese, Burgalassi, Andrea, Chiarugi, Alberto, De Cesaris, Francesco, Granato, Antonio, Casalena, Alfonsina, De Tommaso, Marina, Mampreso, Edoardo, Merlo, Paola, Coppola, Gianluca, Battistini, Stefania, Rebecchi, Valentina, Rainero, Innocenzo, Sepe, Federica Nicoletta, Dalla Volta, Giorgio, Sacco, Simona, Geppetti, Pierangelo, and Iannone, Luigi Francesco

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

Author

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

Subjects
Bowel ischemia, Guidelines, Mesenteric arterial occlusion, Mesenteric artery stenting, Mesenteric ischemia, Recommendations, World Society of Emergency Surgery, Humans, Mesenteric Ischemia, Mesenteric Vascular Occlusion, Endovascular Procedures, Ischemia, Intestines
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

16. Anatomy and Classification of Pelvic Trauma

Author

Jacopo Giuliani, Riccardo Guelfi, Camilla Cremonini, Dario Tartaglia, Giuseppe Zocco, Massimo Chiarugi, and Federico Coccolini

Subjects
Pelvic Fracture, Blunt Trauma, Hemodynamic Status, Bleeding, Vascular Injuries, Diseases of the circulatory (Cardiovascular) system, RC666-701, Surgery, RD1-811
Abstract

Pelvic fracture is one of the most complex injuries in trauma treatment. Bleeding continues to be one of the primary causes of death from pelvic fracture, and the severity of bleeding is not necessarily correlated with the fracture pattern. The priorities in managing pelvic fractures include controlling bleeding. Historically, classification systems only consider the anatomical fracture pattern, which does not correlate with the outcomes. The World Society of Emergency Surgery (WSES) classification considers both the pelvic fracture pattern and the hemodynamic condition of the patient. Vascular injuries caused by pelvic fractures are potentially lethal because they often manifest as non-compressible multifocal venous bleeding (80–85% of pelvic bleeding) and less frequently as arterial bleeding (15–20% of pelvic bleeding). The presence of vascular injury and open pelvic fractures are independent factors contributing to mortality. Another fundamental factor in the management of pelvic vascular trauma is time [1]. In this context, the assessment of potentially significant vascular injury and timely hemorrhage control should be the highest priorities in the acute management of these injuries. Classification of pelvic injuries that considers both the fracture pattern and the hemodynamic status of the patient, such as the WSES classification, appears to have greater utility in clinical practice compared to the diffused anatomical classification.

Published
2024
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17. Acute Colonic Diverticulitis

Author

Tartaglia, Dario, Coccolini, Federico, Mazzoni, Alessio, Genovese, Valerio, Cremonini, Camilla, Cicuttin, Enrico, Chiarugi, Massimo, Coccolini, Federico, Series Editor, Coimbra, Raul, Series Editor, Kirkpatrick, Andrew W., Series Editor, Di Saverio, Salomone, Series Editor, Ansaloni, Luca, Editorial Board Member, Balogh, Zsolt, Editorial Board Member, Biffl, Walt, Editorial Board Member, Catena, Fausto, Editorial Board Member, Davis, Kimberly, Editorial Board Member, Ferrada, Paula, Editorial Board Member, Fraga, Gustavo, Editorial Board Member, Ivatury, Rao, Editorial Board Member, Kluger, Yoram, Editorial Board Member, Leppaniemi, Ari, Editorial Board Member, Maier, Ron, Editorial Board Member, Moore, Ernest E., Editorial Board Member, Napolitano, Lena, Editorial Board Member, Peitzman, Andrew, Editorial Board Member, Reilly, Patrick, Editorial Board Member, Rizoli, Sandro, Editorial Board Member, Sakakushev, Boris E., Editorial Board Member, Sartelli, Massimo, Editorial Board Member, Scalea, Thomas, Editorial Board Member, Spain, David, Editorial Board Member, Stahel, Philip, Editorial Board Member, Sugrue, Michael, Editorial Board Member, Velmahos, George, Editorial Board Member, Weber, Dieter, Editorial Board Member, Podda, Mauro, editor, Lim, Robert B., editor, and Chiarugi, Massimo, editor

Published
2023
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18. Post-traumatic Diaphragmatic Hernia

Author

Cremonini, Camilla, Cicuttin, Enrico, Tartaglia, Dario, Strambi, Silvia, Musetti, Serena, Chiarugi, Massimo, Coccolini, Federico, Coccolini, Federico, Series Editor, Coimbra, Raul, Series Editor, Kirkpatrick, Andrew W., Series Editor, Di Saverio, Salomone, Series Editor, Ansaloni, Luca, Editorial Board Member, Balogh, Zsolt, Editorial Board Member, Biffl, Walt, Editorial Board Member, Catena, Fausto, Editorial Board Member, Davis, Kimberly, Editorial Board Member, Ferrada, Paula, Editorial Board Member, Fraga, Gustavo, Editorial Board Member, Ivatury, Rao, Editorial Board Member, Kluger, Yoram, Editorial Board Member, Leppaniemi, Ari, Editorial Board Member, Maier, Ron, Editorial Board Member, Moore, Ernest E., Editorial Board Member, Napolitano, Lena, Editorial Board Member, Peitzman, Andrew, Editorial Board Member, Reilly, Patrick, Editorial Board Member, Rizoli, Sandro, Editorial Board Member, Sakakushev, Boris E., Editorial Board Member, Sartelli, Massimo, Editorial Board Member, Scalea, Thomas, Editorial Board Member, Spain, David, Editorial Board Member, Stahel, Philip, Editorial Board Member, Sugrue, Michael, Editorial Board Member, Velmahos, George, Editorial Board Member, Weber, Dieter, Editorial Board Member, Podda, Mauro, editor, Lim, Robert B., editor, and Chiarugi, Massimo, editor

Published
2023
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19. Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines.

Author

Coccolini, Federico, Corradi, Francesco, Sartelli, Massimo, Coimbra, Raul, Kryvoruchko, Igor, Leppaniemi, Ari, Doklestic, Krstina, Bignami, Elena, Biancofiore, Giandomenico, Bala, Miklosh, Marco, Ceresoli, Damaskos, Dimitris, Biffl, Walt, Fugazzola, Paola, Santonastaso, Domenico, Agnoletti, Vanni, Sbarbaro, Catia, Nacoti, Mirco, Hardcastle, Timothy, Mariani, Diego, De Simone, Belinda, Tolonen, Matti, Ball, Chad, Podda, Mauro, Di Carlo, Isidoro, Di Saverio, Salomone, Navsaria, Pradeep, Bonavina, Luigi, Abu-Zidan, Fikri, Soreide, Kjetil, Fraga, Gustavo, Carvalho, Vanessa, Batista, Sergio, Hecker, Andreas, Cucchetti, Alessandro, Ercolani, Giorgio, Tartaglia, Dario, Wani, Imtiaz, Kurihara, Hayato, Tan, Edward, Litvin, Andrey, Melotti, Rita, Sganga, Gabriele, Zoro, Tamara, Isirdi, Alessandro, DeAngelis, Nicola, Weber, Dieter, Hodonou, Adrien, tenBroek, Richard, Parini, Dario, Khan, Jim, Sbrana, Giovanni, Coniglio, Carlo, Giarratano, Antonino, Gratarola, Angelo, Zaghi, Claudia, Romeo, Oreste, Kelly, Michael, Forfori, Francesco, Chiarugi, Massimo, Moore, Ernest, Catena, Fausto, Malbrain, Manu, and Galante, Joseph

Subjects
Acute, Emergency, Morbidity, Pain, Surgery, Treatment, Abdomen, Analgesics, Anesthesia, Humans, Pain, Postoperative, Perioperative Care, United States
Abstract

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

Published
2022

20. The LIFE TRIAD of emergency general surgery.

Author

Coccolini, Federico, Sartelli, Massimo, Kluger, Yoram, Osipov, Aleksei, Cui, Yunfeng, Beka, Solomon, Kirkpatrick, Andrew, Sall, Ibrahima, Moore, Ernest, Biffl, Walter, Litvin, Andrey, Pisano, Michele, Magnone, Stefano, Picetti, Edoardo, de Angelis, Nicola, Stahel, Philip, Ansaloni, Luca, Tan, Edward, Abu-Zidan, Fikri, Ceresoli, Marco, Hecker, Andreas, Chiara, Osvaldo, Sganga, Gabriele, Khokha, Vladimir, di Saverio, Salomone, Sakakushev, Boris, Campanelli, Giampiero, Fraga, Gustavo, Wani, Imtiaz, Broek, Richard, Cicuttin, Enrico, Cremonini, Camilla, Tartaglia, Dario, Soreide, Kjetil, de Moya, Marc, Koike, Kaoru, De Simone, Belinda, Balogh, Zsolt, Amico, Francesco, Shelat, Vishal, Pikoulis, Emmanouil, Di Carlo, Isidoro, Bonavina, Luigi, Leppaniemi, Ari, Marzi, Ingo, Ivatury, Rao, Khan, Jim, Maier, Ronald, Hardcastle, Timothy, Isik, Arda, Podda, Mauro, Tolonen, Matti, Rasa, Kemal, Navsaria, Pradeep, Demetrashvili, Zaza, Tarasconi, Antonio, Carcoforo, Paolo, Sibilla, Maria, Baiocchi, Gian, Pararas, Nikolaos, Weber, Dieter, Chiarugi, Massimo, Catena, Fausto, and Galante, Joseph

Subjects
Data, Effectiveness, Emergency General Surgery, Formation, Learning, Outcomes, Planning, Hospitals, Humans, Registries, Surgeons
Abstract

Emergency General Surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and non-traumatic acute conditions during the same admission in the hospital by general emergency surgeons and other specialists. It is the most diffused surgical discipline in the world. To live and grow strong EGS necessitates three fundamental parts: emergency and elective continuous surgical practice, evidence generation through clinical registries and data accrual, and indications and guidelines production: the LIFE TRIAD.

Published
2022

21. More early bleeds associated with high baseline direct oral anticoagulant levels in atrial fibrillation: the MAS study

Author

Testa, Sophie, Dellanoce, Claudia, Paoletti, Oriana, Morandini, Rossella, Tala, Maurizio, Ciampa, Antonio, Gaeta, Martina, Chiarugi, Paolo, Casini, Monica, Guerri, Valentina, Santoro, Rita Carlotta, Iannaccaro, Piergiorgio, Iannone, Angela Maria, Campagna, Maddalena, De Candia, Erica, Alberelli, Maria Adele, Basso, Maria, De Cristofaro, Raimondo, Di Gennaro, Leonardo, Ferretti, Antonietta, Sorrentino, Silvia, Pignatelli, Pasquale, Menichelli, Danilo, Pastori, Daniele, Saliola, Mirella, Faioni, Elena Maria, Avarello, Ilaria, Razzari, Cristina, Chistolini, Antonio, Aprile, Simona Michela, Santoro, Cristina, Serrao, Alessandra, Esteban, Maria del Pilar, Ricca, Sergio, Marietta, Marco, Arletti, Laura, Coluccio, Valeria, Debbia, Giulia, Grisolia, Deborah, Serra, Domizio, Orselli, Alberto, Pescarollo, Alessandra, Verna, Sandra, Di Gregorio, Patrizia, Cassetti, Giuseppina, Molteni, Mauro, Monelli, Mauro, Paparo, Carmelo, Resani, Guido, Di Gregorio, Nicoletta, Grassi, Davide, Lodigiani, Corrado, Banfi, Elena, Ferrazzi, Paola, Librè, Luca, Pacetti, Veronica, Sacco, Clara, Bucciarelli, Paolo, Martinelli, Ida, Abbattista, Maria, Artoni, Andrea, Capecchi, Marco, Gianniello, Francesca, Scimeca, Barbara, Turrini, Anna, Moretta, Francesca, Parise, Giorgio, Zeccardo, Ciro, Fregoni, Vittorio, Balboni, Massimo, Leggio, Federico, Poli, Daniela, Ria, Luigi, Spagnolo, Marina, Dirienzo, Giovanni, Dirienzo, Lavinia, Fuzio, Diana, Donadini, Marco Paolo, Squizzato, Alessandro, Ageno, Walter, Colombo, Giovanna, Galliazzo, Silvia, Gallo, Andrea, Tamborini Permunian, Eleonora, Virano, Alexandra, Falanga, Anna, Barcella, Luca, Gamba, Sara, Lerede, Teresa, Maggioni, Anna, Russo, Laura, Schieppati, Francesca, Zunino, Federica, Barillari, Giovanni, Bertone, Antonella, Poz, Alessandra, Venturelli, Ugo, Serricchio, Giuseppina, Brevi, Francesca, Palareti, Gualtiero, Legnani, Cristina, Cini, Michela, Antonucci, Emilia, Tripodi, Armando, and Tosetto, Alberto

Published
2024
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23. Validation of the Italian version of the Cluster Headache Impact Questionnaire (CHIQ)

Author

Onofri, Agnese, Iannone, Luigi Francesco, Granato, Antonio, Garascia, Gabriele, Bartole, Luca, Manganotti, Paolo, Vollono, Catello, Romozzi, Marina, Sottani, Costanza, Calabresi, Paolo, Tassorelli, Cristina, Sances, Grazia, Allena, Marta, De Icco, Roberto, De Cesaris, Francesco, Burgalassi, Andrea, Chiarugi, Alberto, Baraldi, Carlo, Guerzoni, Simona, Prudenzano, Maria Pia, Fallacara, Adriana, Albanese, Maria, Rainero, Innocenzo, Coppola, Gianluca, Casalena, Alfonsina, Mampreso, Edoardo, Pistoia, Francesca, Sarchielli, Paola, Morson, Marisa, Sacco, Simona, Geppetti, Pierangelo, and Ornello, Raffaele

Published
2023
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24. 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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25. Thrombotic events associated with low baseline direct oral anticoagulant levels in atrial fibrillation: the MAS study

Author

Testa, Sophie, Dellanoce, Claudia, Paoletti, Oriana, Morandini, Rossella, Tala, Maurizio, Ciampa, Antonio, Gaeta, Martina, Chiarugi, Paolo, Casini, Monica, Guerri, Valentina, Santoro, Rita Carlotta, Iannaccaro, Piergiorgio, Iannone, Angela Maria, Campagna, Maddalena, De Candia, Erica, Alberelli, Maria Adele, Basso, Maria, De Cristofaro, Raimondo, Di Gennaro, Leonardo, Ferretti, Antonietta, Sorrentino, Silvia, Pignatelli, Pasquale, Menichelli, Danilo, Pastori, Daniele, Saliola, Mirella, Faioni, Elena Maria, Avarello, Ilaria, Razzari, Cristina, Chistolini, Antonio, Aprile, Simona Michela, Santoro, Cristina, Serrao, Alessandra, Esteban, Maria del Pilar, Ricca, Sergio, Marietta, Marco, Arletti, Laura, Coluccio, Valeria, Debbia, Giulia, Grisolia, Deborah, Serra, Domizio, Orselli, Alberto, Pescarollo, Alessandra, Verna, Sandra, Di Gregorio, Patrizia, Cassetti, Giuseppina, Molteni, Mauro, Monelli, Mauro, Paparo, Carmelo, Resani, Guido, Di Gregorio, Nicoletta, Grassi, Davide, Lodigiani, Corrado, Banfi, Elena, Ferrazzi, Paola, Librè, Luca, Pacetti, Veronica, Sacco, Clara, Bucciarelli, Paolo, Martinelli, Ida, Abbattista, Maria, Artoni, Andrea, Capecchi, Marco, Gianniello, Francesca, Scimeca, Barbara, Turrini, Anna, Moretta, Francesca, Parise, Giorgio, Zeccardo, Ciro, Fregoni, Vittorio, Balboni, Massimo, Leggio, Federico, Poli, Daniela, Ria, Luigi, Spagnolo, Marina, Dirienzo, Giovanni, Dirienzo, Lavinia, Fuzio, Diana, Donadini, Marco Paolo, Squizzato, Alessandro, Ageno, Walter, Colombo, Giovanna, Galliazzo, Silvia, Gallo, Andrea, Permunian, Eleonora Tamborini, Virano, Alexandra, Falanga, Anna, Barcella, Luca, Gamba, Sara, Lerede, Teresa, Maggioni, Anna, Russo, Laura, Schieppati, Francesca, Zunino, Federica, Barillari, Giovanni, Bertone, Antonella, Poz, Alessandra, Venturelli, Ugo, Serricchio, Giuseppina, Brevi, Francesca, Palareti, Gualtiero, Legnani, Cristina, Cini, Michela, Antonucci, Emilia, Tripodi, Armando, and Tosetto, Alberto

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

Author

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

Published
2023
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27. 2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery

Author

de’Angelis, Nicola, Schena, Carlo Alberto, Marchegiani, Francesco, Reitano, Elisa, De Simone, Belinda, Wong, Geoffrey Yuet Mun, Martínez-Pérez, Aleix, Abu-Zidan, Fikri M., Agnoletti, Vanni, Aisoni, Filippo, Ammendola, Michele, Ansaloni, Luca, Bala, Miklosh, Biffl, Walter, Ceccarelli, Graziano, Ceresoli, Marco, Chiara, Osvaldo, Chiarugi, Massimo, Cimbanassi, Stefania, Coccolini, Federico, Coimbra, Raul, Di Saverio, Salomone, Diana, Michele, Dioguardi Burgio, Marco, Fraga, Gustavo, Gavriilidis, Paschalis, Gurrado, Angela, Inchingolo, Riccardo, Ingels, Alexandre, Ivatury, Rao, Kashuk, Jeffry L., Khan, Jim, Kirkpatrick, Andrew W., Kim, Fernando J., Kluger, Yoram, Lakkis, Zaher, Leppäniemi, Ari, Maier, Ronald V., Memeo, Riccardo, Moore, Ernest E., Ordoñez, Carlos A., Peitzman, Andrew B., Pellino, Gianluca, Picetti, Edoardo, Pikoulis, Manos, Pisano, Michele, Podda, Mauro, Romeo, Oreste, Rosa, Fausto, Tan, Edward, Ten Broek, Richard P., Testini, Mario, Tian Wei Cheng, Brian Anthony, Weber, Dieter, Sacco, Emilio, Sartelli, Massimo, Tonsi, Alfredo, Dal Moro, Fabrizio, and Catena, Fausto

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

Author

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

Published
2023
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30. The unrestricted global effort to complete the COOL trial

Author

Kirkpatrick, Andrew W., Coccolini, Federico, Tolonen, Matti, Minor, Samuel, Catena, Fausto, Gois, Jr., Emanuel, Doig, Christopher J., Hill, Michael D., Ansaloni, Luca, Chiarugi, Massimo, Tartaglia, Dario, Ioannidis, Orestis, Sugrue, Michael, Colak, Elif, Hameed, S. Morad, Lampela, Hanna, Agnoletti, Vanni, McKee, Jessica L., Garraway, Naisan, Sartelli, Massimo, Ball, Chad G., Parry, Neil G., Voght, Kelly, Julien, Lisa, Kroeker, Jenna, Roberts, Derek J., Faris, Peter, Tiruta, Corina, Moore, Ernest E., Ammons, Lee Anne, Anestiadou, Elissavet, Bendinelli, Cino, Bouliaris, Konstantinos, Carroll, Rosemarry, Ceresoli, Marco, Favi, Francesco, Gurrado, Angela, Rezende-Neto, Joao, Isik, Arda, Cremonini, Camilla, Strambi, Silivia, Koukoulis, Georgios, Testini, Mario, Trpcic, Sandy, Pasculli, Alessandro, Picariello, Erika, Abu-Zidan, Fikri, Adeyeye, Ademola, Augustin, Goran, Alconchel, Felipe, Altinel, Yuksel, Hernandez Amin, Luz Adriana, Aranda-Narváez, José Manuel, Baraket, Oussama, Biffl, Walter L., Baiocchi, Gian Luca, Bonavina, Luigi, Brisinda, Giuseppe, Cardinali, Luca, Celotti, Andrea, Chaouch, Mohamed, Chiarello, Maria, Costa, Gianluca, de’Angelis, Nicola, De Manzini, Nicolo, Delibegovic, Samir, Di Saverio, Salomone, De Simone, Belinda, Dubuisson, Vincent, Fransvea, Pietro, Garulli, Gianluca, Giordano, Alessio, Gomes, Carlos, Hayati, Firdaus, Huang, Jinjian, Ibrahim, Aini Fahriza, Huei, Tan Jih, Jailani, Ruhi Fadzlyana, Khan, Mansoor, Luna, Alfonso Palmieri, Malbrain, Manu L. N. G., Marwah, Sanjay, McBeth, Paul, Mihailescu, Andrei, Morello, Alessia, Mulita, Francesk, Murzi, Valentina, Mohammad, Ahmad Tarmizi, Parmar, Simran, Pak, Ajay, Wong, Michael Pak-Kai, Pantalone, Desire, Podda, Mauro, Puccioni, Caterina, Rasa, Kemal, Ren, Jianan, Roscio, Francesco, Gonzalez-Sanchez, Antonio, Sganga, Gabriele, Scheiterle, Maximilian, Slavchev, Mihail, Smirnov, Dmitry, Tosi, Lorenzo, Trivedi, Anand, Vega, Jaime Andres Gonzalez, Waledziak, Maciej, Xenaki, Sofia, Winter, Desmond, Wu, Xiuwen, Zakaria, Andee Dzulkarnean, and Zakaria, Zaidi

Published
2023
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32. Rimegepant as an acute treatment in a refractory migraine patient non-responder to two anti-CGRP monoclonal antibodies and triptans: Case report and pharmacological considerations

Author

Andrea Burgalassi, Giulia Vigani, Alberto Boccalini, Francesco De Cesaris, Guido Mannaioni, Alberto Chiarugi, Pierangelo Geppetti, and Luigi Francesco Iannone

Subjects
Therapeutics. Pharmacology, RM1-950, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Background: Small molecule receptor antagonists (gepants), or monoclonal antibodies (mAbs) against calcitonin gene-related peptide (CGRP) have recently become available for migraine prophylaxis and/or acute treatment. Considering their shared mechanisms of action, if the failure to an anti-CGRP(R) mAbs preclude the effectiveness of gepants or vice versa is still unknown. Herein, we report the first case of a patient with refractory migraine responsive to the acute use of rimegepant that previously failed two different anti-CGRP(R) mAbs and with no response to other acute treatments. Finally, we performed a literature review on the use of gepants in patients that failed other anti-CGRP and/or triptans. Case: A 56-year-old female with a long history of chronic migraine without aura, fulfilling the EHF definition for a diagnosis of refractory migraine. Overall, the patient treated five not-consecutive migraine attacks. All of them were treated according to the predefined criteria. The mean (±SD) NRS before rimegepant assumption was 7.8 ± 0.9, all attacks cause at least severe impairment at onset, and no rescue medications were used. Pain free at 2 hours was achieved in three out of five attacks (60.0%), with no recurrence of migraine in the following 24 hours. The patient reported also a sustained benefit the day after the drug assumption. The response pain free was achieved after a mean time of 13.3 ± 4.5 minutes considering only attacks successfully treated (three out of five attacks). No adverse events were reported. Conclusions: In conclusion, rimegepant for acute treatment may be a viable option in patients with partial or no response to triptans that failed preventive treatments targeting the CGRP pathway, regardless to ligand or receptor. The failure of anti-CGRP(R) mAbs does not necessarily preclude the use of gepants (acute and/or preventive), but further studies are urgently needed to provide evidence on the efficacy of these treatments in managing drug-resistant migraine and to identify novel treatments for patients.

Published
2024
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33. The mitochondriogenic but not the immunosuppressant effects of mTOR inhibitors prompt neuroprotection and delay disease evolution in a mouse model of progressive multiple sclerosis

Author

Daniela Buonvicino, Sara Pratesi, Giuseppe Ranieri, Alessandra Pistolesi, Daniele Guasti, and Alberto Chiarugi

Subjects
Progressive EAE, Dexamethasone, Fingolimod, Rapamycin, Mitochondria, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Introduction: Purportedly, the progression of multiple sclerosis (MS) occurs when neurodegenerative processes due to derangement of axonal bioenergetics take over the autoimmune response. However, a clear picture of the causative interrelationship between autoimmunity and axonal mitochondrial dysfunction in progressive MS (PMS) pathogenesis waits to be provided. Methods: In the present study, by adopting the NOD mouse model of PMS, we compared the pharmacological effects of the immunosuppressants dexamethasone and fingolimod with those of mTOR inhibitors rapamycin and everolimus that, in addition to immunosuppression, also regulate mitochondrial functioning. Female Non-Obese Diabetic (NOD) mice were immunized with MOG35–55 and treated with drugs to evaluate functional, immune and mitochondrial parameters during disease evolution. Results: We found that dexamethasone and fingolimod did not affect the pattern of progression as well as survival. Conversely, mTOR inhibitors rapamycin and everolimus delayed disease progression and robustly extended survival of immunized mice. The same effects were obtained when treatment was delayed by 30 days after immunization. Remarkably, dexamethasone and fingolimod prompted the same degree of immunosuppression of rapamycin within both spleen and spinal cord of mice. However, only rapamycin prompted mitochondriogenesis by increasing mitochondrial content, and expression of several mitochondrial respiratory complex subunits, thereby preventing mtDNA reduction in the spinal cords of immunized mice. These pharmacodynamic effects were not reproduced in healthy NOD mice, suggesting a disease context-dependent pharmacodynamic effect. Discussion: Data corroborate the key role of mitochondriogenesis to treatment of MS progression, and for the first time disclose the translational potential of mTOR inhibitors in PMS therapy.

Published
2024
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34. WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections.

Author

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

Subjects
Necrotizing infections, Necrotizing soft-tissue infections, Skin and soft-tissue infections, Critical Pathways, Humans, Soft Tissue Infections, United States
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

36. Right Colon

Author

Strambi, Silvia, Tartaglia, Dario, Cremonini, Camilla, Musetti, Serena, Chiarugi, Massimo, Coccolini, Federico, Coccolini, Federico, Series Editor, Coimbra, Raul, Series Editor, Kirkpatrick, Andrew W., Series Editor, Di Saverio, Salomone, Series Editor, Ansaloni, Luca, Editorial Board Member, Balogh, Zsolt, Editorial Board Member, Biffl, Walt, Editorial Board Member, Catena, Fausto, Editorial Board Member, Davis, Kimberly, Editorial Board Member, Ferrada, Paula, Editorial Board Member, Fraga, Gustavo, Editorial Board Member, Ivatury, Rao, Editorial Board Member, Kluger, Yoram, Editorial Board Member, Leppaniemi, Ari, Editorial Board Member, Maier, Ron, Editorial Board Member, Moore, Ernest E., Editorial Board Member, Napolitano, Lena, Editorial Board Member, Peitzman, Andrew, Editorial Board Member, Reilly, Patrick, Editorial Board Member, Rizoli, Sandro, Editorial Board Member, Sakakushev, Boris E., Editorial Board Member, Sartelli, Massimo, Editorial Board Member, Scalea, Thomas, Editorial Board Member, Spain, David, Editorial Board Member, Stahel, Philip, Editorial Board Member, Sugrue, Michael, Editorial Board Member, Velmahos, George, Editorial Board Member, Weber, Dieter, Editorial Board Member, Tarasconi, Antonio, editor, Bui, Simona, editor, Chirica, Mircea, editor, Roth, Gaël, editor, and Nahmias, Jeffry, editor

Published
2023
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37. Kidney and Urotrauma

Author

Coccolini, Federico, Cremonini, Camilla, Chiarugi, Massimo, Coccolini, Federico, editor, and Catena, Fausto, editor

Published
2023
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38. Liver Trauma

Author

Coccolini, Federico, Cremonini, Camilla, Chiarugi, Massimo, Coccolini, Federico, editor, and Catena, Fausto, editor

Published
2023
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40. Integrated Science of Global Epidemics 2050

Author

Rezaei, Nima, Saghazadeh, Amene, Jraifi, Abdelilah, Siani, Alessandro, Arredondo, Ana Maria Perez, Onoja, Anyebe Bernard, Hamada, Atsuo, Darouichi, Aziz, Son, Barbara W. K., Casais, Beatriz, Zhou, Bingjie, Paital, Biswaranjan, Cremonini, Camilla, Lucatero, Carlos Rodríguez, Liew, Christina, Bales, Connie W., Tartaglia, Dario, Schmiege, Dennis, Munguía-Izquierdo, Diego, Anugwom, Edlyne E., Naumova, Elena N., Cicuttin, Enrico, Coccolini, Federico, Samanta, G. P., Young, Gerald, Martínez-Pérez, Guillermo Z., Kadan, Gül, Kipruto, Hillary, Elmouki, Ilias, Asamani, James Avoka, Bueno-Antequera, Javier, Felappi, Jéssica Francine, Proença, João F., Stone, John, Gottlieb, Jordyn, Ntajal, Joshua, Paris, Juliana Minetto Gellert, Nabyonga-Orem, Juliet, Das, Kabita, Starr, Kathryn N. Porter, Anugwom, Kenechukwu N., Njabo, Kevin Y., Patel, Krupali, Zhong, Ling, Pattanaik, Manaswini, Miller, Marshall G., Chiarugi, Massimo, Hartwick, Meghan A., Savi, Merveille Koissi, Yoshikawa, Minako Jen, Sharif, Nadim, Aral, Neriman, Rahyani, Ni Komang Yuni, Mitchell, Nia S., Simpson, Ryan B., Yasobant, Sandul, Saha, Sangeeta, Cuschieri, Sarah, Liang, Shiwei, Dey, Shuvra Kanti, Grech, Stephan, Sinha, Tapen, Falkenberg, Timo, Wiwanitkit, Viroj, Jiang, Xu, and Rezaei, Nima, Editor-in-Chief

Published
2023
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42. Updates in the Management of Complex Liver Trauma

Author

Coccolini, Federico, Tartaglia, Dario, Guelfi, Riccardo, Cremonini, Camilla, Cicuttin, Enrico, Chiarugi, Massimo, Aseni, Paolo, editor, Grande, Antonino Massimiliano, editor, Leppäniemi, Ari, editor, and Chiara, Osvaldo, editor

Published
2023
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43. 2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery

Author

Nicola de’Angelis, Carlo Alberto Schena, Francesco Marchegiani, Elisa Reitano, Belinda De Simone, Geoffrey Yuet Mun Wong, Aleix Martínez-Pérez, Fikri M. Abu-Zidan, Vanni Agnoletti, Filippo Aisoni, Michele Ammendola, Luca Ansaloni, Miklosh Bala, Walter Biffl, Graziano Ceccarelli, Marco Ceresoli, Osvaldo Chiara, Massimo Chiarugi, Stefania Cimbanassi, Federico Coccolini, Raul Coimbra, Salomone Di Saverio, Michele Diana, Marco Dioguardi Burgio, Gustavo Fraga, Paschalis Gavriilidis, Angela Gurrado, Riccardo Inchingolo, Alexandre Ingels, Rao Ivatury, Jeffry L. Kashuk, Jim Khan, Andrew W. Kirkpatrick, Fernando J. Kim, Yoram Kluger, Zaher Lakkis, Ari Leppäniemi, Ronald V. Maier, Riccardo Memeo, Ernest E. Moore, Carlos A. Ordoñez, Andrew B. Peitzman, Gianluca Pellino, Edoardo Picetti, Manos Pikoulis, Michele Pisano, Mauro Podda, Oreste Romeo, Fausto Rosa, Edward Tan, Richard P. Ten Broek, Mario Testini, Brian Anthony Tian Wei Cheng, Dieter Weber, Emilio Sacco, Massimo Sartelli, Alfredo Tonsi, Fabrizio Dal Moro, and Fausto Catena

Subjects
Iatrogenic urinary tract injury, Ureteral injury, Bladder injury, Urinary injury prevention, Urinary injury diagnosis, Urinary injury management, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Iatrogenic urinary tract injury (IUTI) is a severe complication of emergency digestive surgery. It can lead to increased postoperative morbidity and mortality and have a long-term impact on the quality of life. The reported incidence of IUTIs varies greatly among the studies, ranging from 0.3 to 1.5%. Given the high volume of emergency digestive surgery performed worldwide, there is a need for well-defined and effective strategies to prevent and manage IUTIs. Currently, there is a lack of consensus regarding the prevention, detection, and management of IUTIs in the emergency setting. The present guidelines, promoted by the World Society of Emergency Surgery (WSES), were developed following a systematic review of the literature and an international expert panel discussion. The primary aim of these WSES guidelines is to provide evidence-based recommendations to support clinicians and surgeons in the prevention, detection, and management of IUTIs during emergency digestive surgery. The following key aspects were considered: (1) effectiveness of preventive interventions for IUTIs during emergency digestive surgery; (2) intra-operative detection of IUTIs and appropriate management strategies; (3) postoperative detection of IUTIs and appropriate management strategies and timing; and (4) effectiveness of antibiotic therapy (including type and duration) in case of IUTIs.

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

Author

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

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

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

Published
2023
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45. 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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50. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections.

Author

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

Subjects
Intra-abdominal infections, Peritonitis, Sepsis, Anti-Bacterial Agents, Anti-Infective Agents, Critical Pathways, Humans, Intraabdominal Infections, Treatment Outcome
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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