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

Author: Frassini, S, Cobianchi, L, Fugazzola, P, Biffl, W, Coccolini, F, Damaskos, D, Moore, E, Kluger, Y, Ceresoli, M, Coimbra, R, Davies, J, Kirkpatrick, A, Di Carlo, I, Hardcastle, T, Isik, A, Chiarugi, M, Gurusamy, K, Maier, R, Segovia Lohse, H, Jeekel, H, Boermeester, M, Abu-Zidan, F, Inaba, K, Weber, D, Augustin, G, Bonavina, L, Velmahos, G, Sartelli, M, Di Saverio, S, Ten Broek, R, Granieri, S, Dal Mas, F, Fare, C, Peverada, J, Zanghi, S, Vigano, J, Tomasoni, M, Dominioni, T, Cicuttin, E, Hecker, A, Tebala, G, Galante, J, Wani, I, Khokha, V, Sugrue, M, Scalea, T, Tan, E, Malangoni, M, Pararas, N, Podda, M, De Simone, B, Ivatury, R, Cui, Y, Kashuk, J, Peitzman, A, Kim, F, Pikoulis, E, Sganga, G, Chiara, O, Kelly, M, Marzi, I, Picetti, E, Agnoletti, V, De'Angelis, N, Campanelli, G, de Moya, M, Litvin, A, Martinez-Perez, A, Sall, I, Rizoli, S, Tomadze, G, Sakakushev, B, Stahel, P, Civil, I, Shelat, V, Costa, D, Chichom-Mefire, A, Latifi, R, Chirica, M, Amico, F, Pardhan, A, Seenarain, V, Boyapati, N, Hatz, B, Ackermann, T, Abeyasundara, S, Fenton, L, Plani, F, Sarvepalli, R, Rouhbakhshfar, O, Caleo, P, Ho-Ching Yau, V, Clement, K, Christou, E, Castillo, A, Gosal, P, Balasubramaniam, S, Hsu, J, Banphawatanarak, K, Pisano, M, Adriana, T, Michele, A, Cioffi, S, Spota, A, Catena, F, Ansaloni, L, Frassini S., Cobianchi L., Fugazzola P., Biffl W. L., Coccolini F., Damaskos D., Moore E. E., Kluger Y., Ceresoli M., Coimbra R., Davies J., Kirkpatrick A., Di Carlo I., Hardcastle T. C., Isik A., Chiarugi M., Gurusamy K., Maier R. V., Segovia Lohse H. A., Jeekel H., Boermeester M. A., Abu-Zidan F., Inaba K., Weber D. G., Augustin G., Bonavina L., Velmahos G., Sartelli M., Di Saverio S., Ten Broek R. P. G., Granieri S., Dal Mas F., Fare C. N., Peverada J., Zanghi S., Vigano J., Tomasoni M., Dominioni T., Cicuttin E., Hecker A., Tebala G. D., Galante J. M., Wani I., Khokha V., Sugrue M., Scalea T. M., Tan E., Malangoni M. A., Pararas N., Podda M., De Simone B., Ivatury R., Cui Y., Kashuk J., Peitzman A., Kim F., Pikoulis E., Sganga G., Chiara O., Kelly M. D., Marzi I., Picetti E., Agnoletti V., De'Angelis N., Campanelli G., de Moya M., Litvin A., Martinez-Perez A., Sall I., Rizoli S., Tomadze G., Sakakushev B., Stahel P. F., Civil I., Shelat V., Costa D., Chichom-Mefire A., Latifi R., Chirica M., Amico F., Pardhan A., Seenarain V., Boyapati N., Hatz B., Ackermann T., Abeyasundara S., Fenton L., Plani F., Sarvepalli R., Rouhbakhshfar O., Caleo P., Ho-Ching Yau V., Clement K., Christou E., Castillo A. M. G., Gosal P. K. S., Balasubramaniam S., Hsu J., Banphawatanarak K., Pisano M., Adriana T., Michele A., Cioffi S. P. B., Spota A., Catena F., Ansaloni L., Frassini, S, Cobianchi, L, Fugazzola, P, Biffl, W, Coccolini, F, Damaskos, D, Moore, E, Kluger, Y, Ceresoli, M, Coimbra, R, Davies, J, Kirkpatrick, A, Di Carlo, I, Hardcastle, T, Isik, A, Chiarugi, M, Gurusamy, K, Maier, R, Segovia Lohse, H, Jeekel, H, Boermeester, M, Abu-Zidan, F, Inaba, K, Weber, D, Augustin, G, Bonavina, L, Velmahos, G, Sartelli, M, Di Saverio, S, Ten Broek, R, Granieri, S, Dal Mas, F, Fare, C, Peverada, J, Zanghi, S, Vigano, J, Tomasoni, M, Dominioni, T, Cicuttin, E, Hecker, A, Tebala, G, Galante, J, Wani, I, Khokha, V, Sugrue, M, Scalea, T, Tan, E, Malangoni, M, Pararas, N, Podda, M, De Simone, B, Ivatury, R, Cui, Y, Kashuk, J, Peitzman, A, Kim, F, Pikoulis, E, Sganga, G, Chiara, O, Kelly, M, Marzi, I, Picetti, E, Agnoletti, V, De'Angelis, N, Campanelli, G, de Moya, M, Litvin, A, Martinez-Perez, A, Sall, I, Rizoli, S, Tomadze, G, Sakakushev, B, Stahel, P, Civil, I, Shelat, V, Costa, D, Chichom-Mefire, A, Latifi, R, Chirica, M, Amico, F, Pardhan, A, Seenarain, V, Boyapati, N, Hatz, B, Ackermann, T, Abeyasundara, S, Fenton, L, Plani, F, Sarvepalli, R, Rouhbakhshfar, O, Caleo, P, Ho-Ching Yau, V, Clement, K, Christou, E, Castillo, A, Gosal, P, Balasubramaniam, S, Hsu, J, Banphawatanarak, K, Pisano, M, Adriana, T, Michele, A, Cioffi, S, Spota, A, Catena, F, Ansaloni, L, Frassini S., Cobianchi L., Fugazzola P., Biffl W. L., Coccolini F., Damaskos D., Moore E. E., Kluger Y., Ceresoli M., Coimbra R., Davies J., Kirkpatrick A., Di Carlo I., Hardcastle T. C., Isik A., Chiarugi M., Gurusamy K., Maier R. V., Segovia Lohse H. A., Jeekel H., Boermeester M. A., Abu-Zidan F., Inaba K., Weber D. G., Augustin G., Bonavina L., Velmahos G., Sartelli M., Di Saverio S., Ten Broek R. P. G., Granieri S., Dal Mas F., Fare C. N., Peverada J., Zanghi S., Vigano J., Tomasoni M., Dominioni T., Cicuttin E., Hecker A., Tebala G. D., Galante J. M., Wani I., Khokha V., Sugrue M., Scalea T. M., Tan E., Malangoni M. A., Pararas N., Podda M., De Simone B., Ivatury R., Cui Y., Kashuk J., Peitzman A., Kim F., Pikoulis E., Sganga G., Chiara O., Kelly M. D., Marzi I., Picetti E., Agnoletti V., De'Angelis N., Campanelli G., de Moya M., Litvin A., Martinez-Perez A., Sall I., Rizoli S., Tomadze G., Sakakushev B., Stahel P. F., Civil I., Shelat V., Costa D., Chichom-Mefire A., Latifi R., Chirica M., Amico F., Pardhan A., Seenarain V., Boyapati N., Hatz B., Ackermann T., Abeyasundara S., Fenton L., Plani F., Sarvepalli R., Rouhbakhshfar O., Caleo P., Ho-Ching Yau V., Clement K., Christou E., Castillo A. M. G., Gosal P. K. S., Balasubramaniam S., Hsu J., Banphawatanarak K., Pisano M., Adriana T., Michele A., Cioffi S. P. B., Spota A., Catena F., and Ansaloni L.
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

2. The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study

Author: De Simone, B, Kluger, Y, Moore, E, Sartelli, M, Abu-Zidan, F, Coccolini, F, Ansaloni, L, Tebala, G, Di Saverio, S, Di Carlo, I, Sakakushev, B, Bonavina, L, Sugrue, M, Galante, J, Ivatury, R, Picetti, E, Chirica, M, Wani, I, Bala, M, Sall, I, Kirkpatrick, A, Shelat, V, Pikoulis, E, Leppäniemi, A, Tan, E, Broek, R, Gurmu Beka, S, Litvin, A, Chouillard, E, Coimbra, R, Cui, Y, De’ Angelis, N, Sganga, G, Stahel, P, Agnoletti, V, Rampini, A, Damaskos, D, Carcoforo, P, Biffl, W, Hecker, A, Di Salomone, S, Balogh, Z, Beka, S, Velmahos, G, Ceresoli, M, Chiara, O, Leppaniemi, A, Marzi, I, Inaba, K, Khokha, V, Reva, V, Khan, M, Toro, A, de’ Angelis, N, Malangoni, M, Scozzafava, E, Civil, I, Maier, R, Weber, D, Chiarugi, M, Soreide, K, Testini, M, Bravi, F, Catena, F, De Simone B., Kluger Y., Moore E. E., Sartelli M., Abu-Zidan F. M., Coccolini F., Ansaloni L., Tebala G. D., Di Saverio S., Di Carlo I., Sakakushev B. E., Bonavina L., Sugrue M., Galante J. M., Ivatury R., Picetti E., Chirica M., Wani I., Bala M., Sall I., Kirkpatrick A. W., Shelat V. G., Pikoulis E., Leppäniemi A., Tan E., Broek R. P. G. t., Gurmu Beka S., Litvin A., Chouillard E., Coimbra R., Cui Y., De’ Angelis N., Sganga G., Stahel P. F., Agnoletti V., Rampini A., Shelat V., Damaskos D., Carcoforo P., Biffl W. L., Hecker A., Kirkpatrick A., Di Salomone S., Balogh Z., Beka S. G., Broek R. T., Velmahos G., Sakakushev B., Ceresoli M., Chiara O., Stahel P., Leppaniemi A., Marzi I., Inaba K., Khokha V., Reva V., Khan M., Toro A., de’ Angelis N., Malangoni M., Scozzafava E., Civil I., Maier R., Weber D., Chiarugi M., Soreide K., Testini M., Bravi F., Maier R. V., Catena F., De Simone, B, Kluger, Y, Moore, E, Sartelli, M, Abu-Zidan, F, Coccolini, F, Ansaloni, L, Tebala, G, Di Saverio, S, Di Carlo, I, Sakakushev, B, Bonavina, L, Sugrue, M, Galante, J, Ivatury, R, Picetti, E, Chirica, M, Wani, I, Bala, M, Sall, I, Kirkpatrick, A, Shelat, V, Pikoulis, E, Leppäniemi, A, Tan, E, Broek, R, Gurmu Beka, S, Litvin, A, Chouillard, E, Coimbra, R, Cui, Y, De’ Angelis, N, Sganga, G, Stahel, P, Agnoletti, V, Rampini, A, Damaskos, D, Carcoforo, P, Biffl, W, Hecker, A, Di Salomone, S, Balogh, Z, Beka, S, Velmahos, G, Ceresoli, M, Chiara, O, Leppaniemi, A, Marzi, I, Inaba, K, Khokha, V, Reva, V, Khan, M, Toro, A, de’ Angelis, N, Malangoni, M, Scozzafava, E, Civil, I, Maier, R, Weber, D, Chiarugi, M, Soreide, K, Testini, M, Bravi, F, Catena, F, De Simone B., Kluger Y., Moore E. E., Sartelli M., Abu-Zidan F. M., Coccolini F., Ansaloni L., Tebala G. D., Di Saverio S., Di Carlo I., Sakakushev B. E., Bonavina L., Sugrue M., Galante J. M., Ivatury R., Picetti E., Chirica M., Wani I., Bala M., Sall I., Kirkpatrick A. W., Shelat V. G., Pikoulis E., Leppäniemi A., Tan E., Broek R. P. G. t., Gurmu Beka S., Litvin A., Chouillard E., Coimbra R., Cui Y., De’ Angelis N., Sganga G., Stahel P. F., Agnoletti V., Rampini A., Shelat V., Damaskos D., Carcoforo P., Biffl W. L., Hecker A., Kirkpatrick A., Di Salomone S., Balogh Z., Beka S. G., Broek R. T., Velmahos G., Sakakushev B., Ceresoli M., Chiara O., Stahel P., Leppaniemi A., Marzi I., Inaba K., Khokha V., Reva V., Khan M., Toro A., de’ Angelis N., Malangoni M., Scozzafava E., Civil I., Maier R., Weber D., Chiarugi M., Soreide K., Testini M., Bravi F., Maier R. V., and Catena F.
Abstract: Background: Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The “timing in acute care surgery” (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts. Methods: This is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4–5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease. Results: Four polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority. Conclusion: The new TACS classificat
Published: 2023

3. The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study

Author: De Simone B., Kluger Y., Moore E. E., Sartelli M., Abu-Zidan F. M., Coccolini F., Ansaloni L., Tebala G. D., Di Saverio S., Di Carlo I., Sakakushev B. E., Bonavina L., Sugrue M., Galante J. M., Ivatury R., Picetti E., Chirica M., Wani I., Bala M., Sall I., Kirkpatrick A. W., Shelat V. G., Pikoulis E., Leppäniemi A., Tan E., Broek R. P. G. t., Gurmu Beka S., Litvin A., Chouillard E., Coimbra R., Cui Y., De’ Angelis N., Sganga G., Stahel P. F., Agnoletti V., Rampini A., Shelat V., Damaskos D., Carcoforo P., Biffl W. L., Hecker A., Kirkpatrick A., Di Salomone S., Balogh Z., Beka S. G., Broek R. T., Velmahos G., Sakakushev B., Ceresoli M., Chiara O., Stahel P., Leppaniemi A., Marzi I., Inaba K., Khokha V., Reva V., Khan M., Toro A., de’ Angelis N., Malangoni M., Scozzafava E., Civil I., Maier R., Weber D., Chiarugi M., Soreide K., Testini M., Bravi F., Maier R. V., Catena F., De Simone, B, Kluger, Y, Moore, E, Sartelli, M, Abu-Zidan, F, Coccolini, F, Ansaloni, L, Tebala, G, Di Saverio, S, Di Carlo, I, Sakakushev, B, Bonavina, L, Sugrue, M, Galante, J, Ivatury, R, Picetti, E, Chirica, M, Wani, I, Bala, M, Sall, I, Kirkpatrick, A, Shelat, V, Pikoulis, E, Leppäniemi, A, Tan, E, Broek, R, Gurmu Beka, S, Litvin, A, Chouillard, E, Coimbra, R, Cui, Y, De’ Angelis, N, Sganga, G, Stahel, P, Agnoletti, V, Rampini, A, Damaskos, D, Carcoforo, P, Biffl, W, Hecker, A, Di Salomone, S, Balogh, Z, Beka, S, Velmahos, G, Ceresoli, M, Chiara, O, Leppaniemi, A, Marzi, I, Inaba, K, Khokha, V, Reva, V, Khan, M, Toro, A, de’ Angelis, N, Malangoni, M, Scozzafava, E, Civil, I, Maier, R, Weber, D, Chiarugi, M, Soreide, K, Testini, M, Bravi, F, and Catena, F
Subjects: Healthcare system, Delay in surgery, Operating room management, Delphi method, Emergency surgery, Priority, Time to surgery, Timing in acute care surgery (TACS), Triage, Classification
Abstract: Background: Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The “timing in acute care surgery” (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts. Methods: This is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4–5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease. Results: Four polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority. Conclusion: The new TACS classification is a comprehensive, simple, clear and reproducible triage system which can be used to assess the severity of the patient and the surgical disease, to reduce the time to access to the operating room, and to manage the emergency surgical patients within a “safe” timeframe. By including well-defined surgical diseases in the different colour-code classes of priority, validated through a Delphi consensus, the new TACS improves communication among surgeons, between surgeons and anaesthesiologists and decreases conflicts and waste and waiting time in accessing the operating room for emergency surgical patients.
Published: 2023

4. Acute mesenteric ischemia: updated guidelines of the World Society of Emergency Surgery

Author: Bala, M, Catena, F, Kashuk, J, De Simone, B, Gomes, C, Weber, D, Sartelli, M, Coccolini, F, Kluger, Y, Abu-Zidan, F, Picetti, E, Ansaloni, L, Augustin, G, Biffl, W, Ceresoli, M, Chiara, O, Chiarugi, M, Coimbra, R, Cui, Y, Damaskos, D, Di Saverio, S, Galante, J, Khokha, V, Kirkpatrick, A, Inaba, K, Leppaniemi, A, Litvin, A, Peitzman, A, Shelat, V, Sugrue, M, Tolonen, M, Rizoli, S, Sall, I, Beka, S, Di Carlo, I, Ten Broek, R, Mircea, C, Tebala, G, Pisano, M, van Goor, H, Maier, R, Jeekel, H, Civil, I, Hecker, A, Tan, E, Soreide, K, Lee, M, Wani, I, Bonavina, L, Malangoni, M, Koike, K, Velmahos, G, Fraga, G, Fette, A, De'Angelis, N, Balogh, Z, Scalea, T, Sganga, G, Kelly, M, Khan, J, Stahel, P, Moore, E, Bala M., Catena F., Kashuk J., De Simone B., Gomes C. A., Weber D., Sartelli M., Coccolini F., Kluger Y., Abu-Zidan F. M., Picetti E., Ansaloni L., Augustin G., Biffl W. L., Ceresoli M., Chiara O., Chiarugi M., Coimbra R., Cui Y., Damaskos D., Di Saverio S., Galante J. M., Khokha V., Kirkpatrick A. W., Inaba K., Leppaniemi A., Litvin A., Peitzman A. B., Shelat V. G., Sugrue M., Tolonen M., Rizoli S., Sall I., Beka S. G., Di Carlo I., Ten Broek R., Mircea C., Tebala G., Pisano M., van Goor H., Maier R. V., Jeekel H., Civil I., Hecker A., Tan E., Soreide K., Lee M. J., Wani I., Bonavina L., Malangoni M. A., Koike K., Velmahos G. C., Fraga G. P., Fette A., de'Angelis N., Balogh Z. J., Scalea T. M., Sganga G., Kelly M. D., Khan J., Stahel P. F., Moore E. E., Bala, M, Catena, F, Kashuk, J, De Simone, B, Gomes, C, Weber, D, Sartelli, M, Coccolini, F, Kluger, Y, Abu-Zidan, F, Picetti, E, Ansaloni, L, Augustin, G, Biffl, W, Ceresoli, M, Chiara, O, Chiarugi, M, Coimbra, R, Cui, Y, Damaskos, D, Di Saverio, S, Galante, J, Khokha, V, Kirkpatrick, A, Inaba, K, Leppaniemi, A, Litvin, A, Peitzman, A, Shelat, V, Sugrue, M, Tolonen, M, Rizoli, S, Sall, I, Beka, S, Di Carlo, I, Ten Broek, R, Mircea, C, Tebala, G, Pisano, M, van Goor, H, Maier, R, Jeekel, H, Civil, I, Hecker, A, Tan, E, Soreide, K, Lee, M, Wani, I, Bonavina, L, Malangoni, M, Koike, K, Velmahos, G, Fraga, G, Fette, A, De'Angelis, N, Balogh, Z, Scalea, T, Sganga, G, Kelly, M, Khan, J, Stahel, P, Moore, E, Bala M., Catena F., Kashuk J., De Simone B., Gomes C. A., Weber D., Sartelli M., Coccolini F., Kluger Y., Abu-Zidan F. M., Picetti E., Ansaloni L., Augustin G., Biffl W. L., Ceresoli M., Chiara O., Chiarugi M., Coimbra R., Cui Y., Damaskos D., Di Saverio S., Galante J. M., Khokha V., Kirkpatrick A. W., Inaba K., Leppaniemi A., Litvin A., Peitzman A. B., Shelat V. G., Sugrue M., Tolonen M., Rizoli S., Sall I., Beka S. G., Di Carlo I., Ten Broek R., Mircea C., Tebala G., Pisano M., van Goor H., Maier R. V., Jeekel H., Civil I., Hecker A., Tan E., Soreide K., Lee M. J., Wani I., Bonavina L., Malangoni M. A., Koike K., Velmahos G. C., Fraga G. P., Fette A., de'Angelis N., Balogh Z. J., Scalea T. M., Sganga G., Kelly M. D., Khan J., Stahel P. F., and Moore E. E.
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

5. The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study

Author: De Simone, B. Kluger, Y. Moore, E.E. Sartelli, M. Abu-Zidan, F.M. Coccolini, F. Ansaloni, L. Tebala, G.D. Di Saverio, S. Di Carlo, I. Sakakushev, B.E. Bonavina, L. Sugrue, M. Galante, J.M. Ivatury, R. Picetti, E. Chirica, M. Wani, I. Bala, M. Sall, I. Kirkpatrick, A.W. Shelat, V.G. Pikoulis, E. Leppäniemi, A. Tan, E. Broek, R.P.G. Gurmu Beka, S. Litvin, A. Chouillard, E. Coimbra, R. Cui, Y. De’ Angelis, N. Sganga, G. Stahel, P.F. Agnoletti, V. Rampini, A. Shelat, V. Damaskos, D. Carcoforo, P. Biffl, W.L. Bonavina, L. Hecker, A. Di Carlo, I. Abu-Zidan, F.M. Galante, J.M. Kirkpatrick, A. Sartelli, M. Picetti, E. Coimbra, R. Di Salomone, S. Balogh, Z. Beka, S.G. Broek, R.T. Velmahos, G. Sakakushev, B. Tan, E. Ceresoli, M. Chiara, O. Stahel, P. Agnoletti, V. Pikoulis, E. Leppaniemi, A. Marzi, I. Sall, I. Inaba, K. Khokha, V. Wani, I. Reva, V. Moore, E.E. Ansaloni, L. Khan, M. Toro, A. Litvin, A. de’ Angelis, N. Malangoni, M. Kluger, Y. Scozzafava, E. Chirica, M. Civil, I. Maier, R. Weber, D. Chiarugi, M. Ivatury, R. Soreide, K. Sganga, G. Cui, Y. Testini, M. Bravi, F. Maier, R.V. Biffl, W.L. Catena, F. WSES TACS panel of experts and De Simone, B. Kluger, Y. Moore, E.E. Sartelli, M. Abu-Zidan, F.M. Coccolini, F. Ansaloni, L. Tebala, G.D. Di Saverio, S. Di Carlo, I. Sakakushev, B.E. Bonavina, L. Sugrue, M. Galante, J.M. Ivatury, R. Picetti, E. Chirica, M. Wani, I. Bala, M. Sall, I. Kirkpatrick, A.W. Shelat, V.G. Pikoulis, E. Leppäniemi, A. Tan, E. Broek, R.P.G. Gurmu Beka, S. Litvin, A. Chouillard, E. Coimbra, R. Cui, Y. De’ Angelis, N. Sganga, G. Stahel, P.F. Agnoletti, V. Rampini, A. Shelat, V. Damaskos, D. Carcoforo, P. Biffl, W.L. Bonavina, L. Hecker, A. Di Carlo, I. Abu-Zidan, F.M. Galante, J.M. Kirkpatrick, A. Sartelli, M. Picetti, E. Coimbra, R. Di Salomone, S. Balogh, Z. Beka, S.G. Broek, R.T. Velmahos, G. Sakakushev, B. Tan, E. Ceresoli, M. Chiara, O. Stahel, P. Agnoletti, V. Pikoulis, E. Leppaniemi, A. Marzi, I. Sall, I. Inaba, K. Khokha, V. Wani, I. Reva, V. Moore, E.E. Ansaloni, L. Khan, M. Toro, A. Litvin, A. de’ Angelis, N. Malangoni, M. Kluger, Y. Scozzafava, E. Chirica, M. Civil, I. Maier, R. Weber, D. Chiarugi, M. Ivatury, R. Soreide, K. Sganga, G. Cui, Y. Testini, M. Bravi, F. Maier, R.V. Biffl, W.L. Catena, F. WSES TACS panel of experts
Abstract: Background: Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The “timing in acute care surgery” (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts. Methods: This is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4–5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease. Results: Four polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority. Conclusion: The new TACS classificat
Published: 2023

6. Oxygen transport and organ dysfunction in the older trauma patient

Author: Epstein, C. D., Peerless, J., Martin, J., and Malangoni, M.
Published: 2002

7. Management of intra-abdominal infections: Recommendations by the WSES 2016 consensus conference

Author: Sartelli, M, Catena, F, Abu-Zidan, F, Ansaloni, L, Biffl, W, Boermeester, M, Ceresoli, M, Chiara, O, Coccolini, F, De Waele, J, Di Saverio, S, Eckmann, C, Fraga, G, Giannella, M, Girardis, M, Griffiths, E, Kashuk, J, Kirkpatrick, A, Khokha, V, Kluger, Y, Labricciosa, F, Leppaniemi, A, Maier, R, May, A, Malangoni, M, Martin-Loeches, I, Mazuski, J, Montravers, P, Peitzman, A, Pereira, B, Reis, T, Sakakushev, B, Sganga, G, Soreide, K, Sugrue, M, Ulrych, J, Vincent, J, Viale, P, Moore, E, Sartelli M., Catena F., Abu-Zidan F. M., Ansaloni L., Biffl W. L., Boermeester M. A., Ceresoli M., Chiara O., Coccolini F., De Waele J. J., Di Saverio S., Eckmann C., Fraga G. P., Giannella M., Girardis M., Griffiths E. A., Kashuk J., Kirkpatrick A. W., Khokha V., Kluger Y., Labricciosa F. M., Leppaniemi A., Maier R. V., May A. K., Malangoni M., Martin-Loeches I., Mazuski J., Montravers P., Peitzman A., Pereira B. M., Reis T., Sakakushev B., Sganga G., Soreide K., Sugrue M., Ulrych J., Vincent J. -L., Viale P., Moore E. E., Sartelli, M, Catena, F, Abu-Zidan, F, Ansaloni, L, Biffl, W, Boermeester, M, Ceresoli, M, Chiara, O, Coccolini, F, De Waele, J, Di Saverio, S, Eckmann, C, Fraga, G, Giannella, M, Girardis, M, Griffiths, E, Kashuk, J, Kirkpatrick, A, Khokha, V, Kluger, Y, Labricciosa, F, Leppaniemi, A, Maier, R, May, A, Malangoni, M, Martin-Loeches, I, Mazuski, J, Montravers, P, Peitzman, A, Pereira, B, Reis, T, Sakakushev, B, Sganga, G, Soreide, K, Sugrue, M, Ulrych, J, Vincent, J, Viale, P, Moore, E, Sartelli M., Catena F., Abu-Zidan F. M., Ansaloni L., Biffl W. L., Boermeester M. A., Ceresoli M., Chiara O., Coccolini F., De Waele J. J., Di Saverio S., Eckmann C., Fraga G. P., Giannella M., Girardis M., Griffiths E. A., Kashuk J., Kirkpatrick A. W., Khokha V., Kluger Y., Labricciosa F. M., Leppaniemi A., Maier R. V., May A. K., Malangoni M., Martin-Loeches I., Mazuski J., Montravers P., Peitzman A., Pereira B. M., Reis T., Sakakushev B., Sganga G., Soreide K., Sugrue M., Ulrych J., Vincent J. -L., Viale P., and Moore E. E.
Abstract: This paper reports on the consensus conference on the management of intra-abdominal infections (IAIs) which was held on July 23, 2016, in Dublin, Ireland, as a part of the annual World Society of Emergency Surgery (WSES) meeting. This document covers all aspects of the management of IAIs. The Grading of Recommendations Assessment, Development and Evaluation recommendation is used, and this document represents the executive summary of the consensus conference findings.
Published: 2017

8. Effect of Therapeutic Gamma-Interferon Administration on Wound Infection After Resuscitated Hemorrhagic Shock

Author: Livingston, D. H., Malangoni, M. A., Faist, Eugen, editor, Ninnemann, John L., editor, and Green, Douglas R., editor
Published: 1989
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9. Proceedings of resources for optimal care of acute care and emergency surgery consensus summit Donegal Ireland

Author: Sugrue, M., primary, Maier, R., additional, Moore, E. E., additional, Boermeester, M., additional, Catena, F., additional, Coccolini, F., additional, Leppaniemi, A., additional, Peitzman, A., additional, Velmahos, G., additional, Ansaloni, L., additional, Abu-Zidan, F., additional, Balfe, P., additional, Bendinelli, C., additional, Biffl, W., additional, Bowyer, M., additional, DeMoya, M., additional, De Waele, J., additional, Di Saverio, S., additional, Drake, A., additional, Fraga, G. P., additional, Hallal, A., additional, Henry, C., additional, Hodgetts, T., additional, Hsee, L., additional, Huddart, S., additional, Kirkpatrick, A. W., additional, Kluger, Y., additional, Lawler, L., additional, Malangoni, M. A., additional, Malbrain, M., additional, MacMahon, P., additional, Mealy, K., additional, O’Kane, M., additional, Loughlin, P., additional, Paduraru, M., additional, Pearce, L., additional, Pereira, B. M., additional, Priyantha, A., additional, Sartelli, M., additional, Soreide, K., additional, Steele, C., additional, Thomas, S., additional, Vincent, J. L., additional, and Woods, L., additional
Published: 2017
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10. Effect of Splenectomy Upon the Antibody Response to Pneumococcal Immunization

Author: Malangoni, M. A., Peyton, J. C., Faist, Eugen, editor, Ninnemann, John L., editor, and Green, Douglas R., editor
Published: 1989
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11. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus

Author: Acosta, Jm, Amann, St, Andren Sandberg, A, Aranha, Gv, Asciutti, S, Banks, Pa, Barauskas, G, Baron, Th, Bassi, Claudio, Behrman, S, Behms, Ke, Belliappa, V, Berzin, Tm, Besselink, Mg, Bhasin, Dk, Biankin, A, Bishop, Md, Bollen, Tl, Bonini, Cj, Bradley, El, Buechler, M, Carter, Michael Ross, Cavestro, Gm, Chari, St, Chavez Rodriguez, Jj, da Cunha, Je, D'Agostino, H, De Campos, T, Delakidis, S, de Madaria, E, Deprez, Ph, Dervenis, C, Disario, Ja, Doria, C, Falconi, Massimo, Fernandez del Castillo, C, Freeny, Pc, Frey, Cf, Friess, H, Frossard, Jl, Fuchshuber, P, Gallagher, Sf, Gardner, Tb, Garg, Pk, Ghattas, G, Glasgow, R, Gonzalez, Ja, Gooszen, Hg, Gress, Tm, Gumbs, Aa, Halliburton, C, Helton, S, Hill, Mc, Horvath, Kd, Hoyos, S, Imrie, Cw, Isenmann, R, Izbicki, Jr, Johnson, Cd, Karagiannis, Ja, Klar, E, Kolokythas, O, Lau, J, Litvin, Aa, Longnecker, Ds, Lowenfels, Ab, Mackey, R, Mah'Moud, M, Malangoni, M, Mcfadden, Dw, Mishra, G, Moody, Fg, Morgan, De, Morinville, V, Mortele, Kj, Neoptolemos, Jp, Nordback, I, Pap, A, Papachristou, Gi, Parks, R, Pedrazolli, S, Pelaez Luna, M, Pezzilli, R, Pitt, Ha, Prosanto, C, Ramesh, H, Ramirez, Fc, Raper, Se, Rasheed, A, Reed, Dn, Romangnuolo, J, Rossaak, J, Sanabria, J, Sarr, Mg, Schaefer, C, Schmidt, J, Schmidt, Pn, Serrablo, A, Senkowski, Ck, Sharma, M, Sigman, Km, Singh, P, Stefanidis, G, Steinberg, W, Steiner, J, Strasberg, S, Strum, W, Takada, T, Tanaka, M, Thoeni, Rf, Tsiotos, Gg, Van Santvoort, H, Vaccaro, M, Vege, Ss, Villavicencio, Rl, Vrochides, D, Wagner, M, Warshaw, Al, Wilcox, Cm, Windsor, Ja, Wysocki, P, Yadav, D, Zenilman, Me, Zyromski, N. j., Banks, P, Bollen, T, Dervenis, C, Gooszen, H, Johnson, C, Sarr, M, Tsiotos, G, Vege, S, Cavestro, GIULIA MARTINA, and ACUTE PANCREATITIS CLASSIFICATION WORKING, Group
Subjects: Clinical deffinitions, medicine.medical_specialty, CIENCIAS MÉDICAS Y DE LA SALUD, Exacerbation, MEDLINE, Medicina Clínica, Disease, Guideline, Severity of Illness Index, Atlanta classification, Cystogastrostomy, purl.org/becyt/ford/3.2 [https], Severity of illness, medicine, Humans, Acute Disease, Disease Progression, Pancreatitis, Tomography, X-Ray Computed, Ranson criteria, Intensive care medicine, Tomography, business.industry, Gastroenterology, medicine.disease, Acute pancreatitis, X-Ray Computed, Surgery, Evaluation of complex medical interventions [NCEBP 2], purl.org/becyt/ford/3 [https], Medicina Critica y de Emergencia, business
Abstract: Background and objective: The Atlanta classification of acute pancreatitis enabled standardised reporting of research and aided communication between clinicians. Deficiencies identified and improved understanding of the disease make a revision necessary. Methods: A web-based consultation was undertaken in 2007 to ensure wide participation of pancreatologists. After an initial meeting, the Working Group sent a draft document to 11 national and international pancreatic associations. This working draft was forwarded to all members. Revisions were made in response to comments, and the web-based consultation was repeated three times. The final consensus was reviewed, and only statements based on published evidence were retained. Results: The revised classification of acute pancreatitis identified two phases of the disease: early and late. Severity is classified as mild, moderate or severe. Mild acute pancreatitis, the most common form, has no organ failure, local or systemic complications and usually resolves in the first week. Moderately severe acute pancreatitis is defined by the presence of transient organ failure, local complications or exacerbation of co-morbid disease. Severe acute pancreatitis is defined by persistent organ failure, that is, organ failure >48 h. Local complications are peripancreatic fluid collections, pancreatic and peripancreatic necrosis (sterile or infected), pseudocyst and walled-off necrosis (sterile or infected). We present a standardised template for reporting CT images. Conclusions: This international, web-based consensus provides clear definitions to classify acute pancreatitis using easily identified clinical and radiologic criteria. The wide consultation among pancreatologists to reach this consensus should encourage widespread adoption. Fil: Banks, Peter A.. Harvard Medical School; Estados Unidos Fil: Bollen, Thomas L.. St Antonius Hospital; Países Bajos Fil: Dervenis, Christos. Agia Olga Hospital; Grecia Fil: Gooszen, Hein G.. Radboud Universiteit Nijmegen; Países Bajos Fil: Johnson, Colin D.. University Hospital Southampton; Reino Unido Fil: Sarr, Michael G.. Mayo Clinic; Estados Unidos Fil: Tsiotos, Gregory G.. Metropolitan Hospital; Grecia Fil: Vege, Santhi Swaroop. Metropolitan Hospital; Grecia Fil: Vaccaro, Maria Ines. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Acute Pancreatitis Classification Working Group. No especifica
Published: 2013
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12. WSES guidelines for management of Clostridium difficile infection in surgical patients

Author: Sartelli, M., Malangoni, M. A., Abu-Zidan, F. M., Griffiths, E. A., Di Bella, S., Mcfarland, L. V., Eltringham, I., Shelat, V. G., Velmahos, G. C., Kelly, C. P., Khanna, S., Abdelsattar, Z. M., Alrahmani, L., Ansaloni, L., Augustin, G., Bala, M., Barbut, F., Ben-Ishay, O., Bhangu, A., Biffl, W. L., Brecher, S. M., Camacho-Ortiz, A., Cainzos, M. A., Canterbury, L. A., Catena, F., Chan, S., Cherry-Bukowiec, J. R., Clanton, J., Coccolini, F., Cocuz, M. E., Coimbra, R., Cook, C. H., Cui, Y., Czepiel, J., Das, K., Demetrashvili, Z., Di Carlo, I., Di Saverio, S., Dumitru, I. M., Eckert, C., Eckmann, C., Eiland, E. H., Enani, M. A., Faro, M., Ferrada, P., Forrester, J. D., Fraga, G. P., Frossard, J. L., Galeiras, R., Ghnnam, W., Gomes, C. A., Gorrepati, V., Ahmed, M. H., Herzog, T., Humphrey, F., Kim, J. I., Isik, A., Ivatury, R., Lee, Y. Y., Juang, P., Furuya-Kanamori, L., Karamarkovic, A., Kim, P. K., Kluger, Y., Ko, W. C., Labarbera, F. D., Lee, J. G., Leppaniemi, A., Lohsiriwat, V., Marwah, S., Mazuski, J. E., Metan, G., Moore, E. E., Moore, F. A., Nord, C. E., Ordonez, C. A., Junior, G. A. P., Petrosillo, N., Portela, F., Puri, B. K., Ray, A., Raza, M., Rems, M., Sakakushev, B. E., Sganga, Gabriele, Spigaglia, P., Stewart, D. B., Tattevin, P., Timsit, J. F., To, K. B., Trana, C., Uhl, W., Urbanek, L., van Goor, H., Vassallo, A., Zahar, J. R., Caproli, E., Viale, P., Sganga G. (ORCID:0000-0001-5079-0395), Sartelli, M., Malangoni, M. A., Abu-Zidan, F. M., Griffiths, E. A., Di Bella, S., Mcfarland, L. V., Eltringham, I., Shelat, V. G., Velmahos, G. C., Kelly, C. P., Khanna, S., Abdelsattar, Z. M., Alrahmani, L., Ansaloni, L., Augustin, G., Bala, M., Barbut, F., Ben-Ishay, O., Bhangu, A., Biffl, W. L., Brecher, S. M., Camacho-Ortiz, A., Cainzos, M. A., Canterbury, L. A., Catena, F., Chan, S., Cherry-Bukowiec, J. R., Clanton, J., Coccolini, F., Cocuz, M. E., Coimbra, R., Cook, C. H., Cui, Y., Czepiel, J., Das, K., Demetrashvili, Z., Di Carlo, I., Di Saverio, S., Dumitru, I. M., Eckert, C., Eckmann, C., Eiland, E. H., Enani, M. A., Faro, M., Ferrada, P., Forrester, J. D., Fraga, G. P., Frossard, J. L., Galeiras, R., Ghnnam, W., Gomes, C. A., Gorrepati, V., Ahmed, M. H., Herzog, T., Humphrey, F., Kim, J. I., Isik, A., Ivatury, R., Lee, Y. Y., Juang, P., Furuya-Kanamori, L., Karamarkovic, A., Kim, P. K., Kluger, Y., Ko, W. C., Labarbera, F. D., Lee, J. G., Leppaniemi, A., Lohsiriwat, V., Marwah, S., Mazuski, J. E., Metan, G., Moore, E. E., Moore, F. A., Nord, C. E., Ordonez, C. A., Junior, G. A. P., Petrosillo, N., Portela, F., Puri, B. K., Ray, A., Raza, M., Rems, M., Sakakushev, B. E., Sganga, Gabriele, Spigaglia, P., Stewart, D. B., Tattevin, P., Timsit, J. F., To, K. B., Trana, C., Uhl, W., Urbanek, L., van Goor, H., Vassallo, A., Zahar, J. R., Caproli, E., Viale, P., and Sganga G. (ORCID:0000-0001-5079-0395)
Abstract: In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency Surgery (WSES) guidelines for management of CDI in surgical patients.
Published: 2015

13. 2013 WSES guidelines for management of intra-abdominal infections

Author: Sartelli, M, Viale, P, Catena, F, Ansaloni, L, Moore, E, Malangoni, M, Moore, FA, Velmahos, G, Coimbra, R, Ivatury, R, Peitzman, A, Koike, K, Leppaniemi, A, Biffl, W, Burlew, CC, Balogh, ZJ, Boffard, K, Bendinelli, C, Gupta, S, Kluger, Y, Agresta, F, Di Saverio, S, Wani, I, Escalona, A, Ordonez, C, Fraga, GP, Junior, GAP, Bala, M, Cui, Y, Marwah, S, Sakakushev, B, Kong, V, Naidoo, N, Ahmed, A, Abbas, A, Guercioni, G, Vettoretto, N, Díaz-Nieto, R, Gerych, I, Tranà, C, Faro, MP, Yuan, KC, Kok, KYY, Mefire, AC, Lee, JG, Hong, SK, Ghnnam, W, Siribumrungwong, B, Sato, N, Murata, K, Irahara, T, Coccolini, F, Lohse, HAS, Verni, A, Shoko, T, Sartelli, M, Viale, P, Catena, F, Ansaloni, L, Moore, E, Malangoni, M, Moore, FA, Velmahos, G, Coimbra, R, Ivatury, R, Peitzman, A, Koike, K, Leppaniemi, A, Biffl, W, Burlew, CC, Balogh, ZJ, Boffard, K, Bendinelli, C, Gupta, S, Kluger, Y, Agresta, F, Di Saverio, S, Wani, I, Escalona, A, Ordonez, C, Fraga, GP, Junior, GAP, Bala, M, Cui, Y, Marwah, S, Sakakushev, B, Kong, V, Naidoo, N, Ahmed, A, Abbas, A, Guercioni, G, Vettoretto, N, Díaz-Nieto, R, Gerych, I, Tranà, C, Faro, MP, Yuan, KC, Kok, KYY, Mefire, AC, Lee, JG, Hong, SK, Ghnnam, W, Siribumrungwong, B, Sato, N, Murata, K, Irahara, T, Coccolini, F, Lohse, HAS, Verni, A, and Shoko, T
Abstract: Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The 2013 update of the World Society of Emergency Surgery (WSES) guidelines for the management of intra-abdominal infections contains evidence-based recommendations for management of patients with intra-abdominal infections.© 2013 Sartelli et al.; licensee BioMed Central Ltd.
Published: 2013

14. Is Xanthine Oxidase an Alternate Generator of Nitric Oxide During In Vivo Hypoxia?

Author: Sanson, A. J., primary, Malangoni, M. A., additional, and Malangoni, M., additional
Published: 2003
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15. Complicated skin and soft-tissue infections: diagnostic approach and empiric treatment options.

Author: Merlino, J. I, primary and Malangoni, M. A, additional
Published: 2007
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16. HYPOXIA CAUSES INCREASED NITRIC OXIDE (NO) AND CYTOKINE PRODUCTION WITH A DELAYED T CELL RESPONSE

Author: Kozik, D., primary, Sanson, A., additional, and Malangoni, M. A., additional
Published: 1999
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17. OXYGEN TRANSPORT PARAMETERS AS PREDICTORS OF MORBIDITY AND MORTALITY IN PATIENTS WITH RUPTURED ABDOMINAL AORTIC ANEURYSMS (RAAA)

Author: Peerless, Joel R., primary, Piotrowski, J. J., additional, Alexander, J. A., additional, Pinchak, A. C., additional, and Malangoni, M. A., additional
Published: 1995
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18. EXTENT OF DISABILITY FOLLOWING TRAUMATIC EXTREMITY AMPUTATION

Author: Livingston, D., primary, Keenan, D., additional, Elcavage, J., additional, Kim, D., additional, Malangoni, M., additional, Livingston, David H., additional, and Ross, Stephen, additional
Published: 1994
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19. Organ Injury Scaling, 11

Author: MOORE, E. E., primary, COGBILL, T. H., additional, MALANGONI, M. A., additional, JURKOVICH, G. J., additional, CHAMPION, H. R., additional, GENNARELLI, T. A., additional, McANINCH, J. W., additional, PACHTER, H. L., additional, SHACKFORD, S. R., additional, and TRAFTON, P. G., additional
Published: 1990
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20. Comparison of methods of measurements of oxygen consumption in mechanically ventilated patients with multiple trauma: the Fick method versus indirect calorimetry.

Author: Epstein CD, Peerless JR, Martin JE, Malangoni MA, Epstein, C D, Peerless, J R, Martin, J E, and Malangoni, M A
Published: 2000
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21. Oxygen consumption in the early postinjury period: use of continuous, on-line indirect calorimetry.

Author: Peerless JR, Epstein CD, Martin JE, Pinchak AC, Malangoni MA, Peerless, J R, Epstein, C D, Martin, J E, Pinchak, A C, and Malangoni, M A
Published: 2000

22. Free fluid on abdominal computed tomography without solid organ injury after blunt abdominal injury does not mandate celiotomy

Author: Livingston, D. H., Lavery, R. F., Passannante, M. R., Skurnick, J. H., Baker, S., Fabian, T. C., Fry, D. E., and Malangoni, M. A.
Published: 2001
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23. Geriatric trauma hospitalization in the United States

Author: Rzepka, S. G., Malangoni, M. A., and Rimm, A. A.
Published: 2001
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24. Improved outcome after early fixation of acetabular fractures

Author: Plaisier, B. R., Meldon, S. W., Super, D. M., and Malangoni, M. A.
Published: 2000
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25. Single versus combination antimicrobial therapy for ventilator-associated pneumonia

Author: Malangoni, M. A.
Published: 2000
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26. Organ Injury Scaling.

Author: MOORE, E. E., SHACKFORD, S. R., PACHTER, H. L., McANINCH, J. W., BROWNER, B. D., CHAMPION, H. R., FLINT, L. M., GENNARELLI, T. A., MALANGONI, M. A., RAMENOFSKY, M. L., and TRAFTON, P. G.
Published: 1989
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27. Proximal gastric vagotomy for duodenal ulcer disease.

Author: MALANGONI, MARK A., MULLINS, RICHARD J., Malangoni, M A, and Mullins, R J
Published: 1989
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28. TREATMENT OF INTRAABDOMINAL INFECTIONS IS APPROPRIATE WITH SINGLE AGENT OR COMBINATION ANTIBIOTIC THERAPY

Author: Malangoni, M. A., primary
Published: 1986
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29. RHABDOMYOMA OF THE ABDOMINAL WALL

Author: Guiseffi, S. A., primary, Malangoni, M. A., additional, and Madiedo, G., additional
Published: 1983
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30. Response to immunization after partial and total splenectomy

Author: Dawes, L G, primary, Malangoni, M A, additional, and Spiegel, C A, additional
Published: 1986
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31. A Refinement in the Technique of Perihepatic Packing

Author: McHenry, C. R., Fedele, G. M., and Malangoni, M. A.
Published: 1994
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32. Pneumonia in the Surgical Intensive Care Unit: Factors Determining Successful Outcome

Author: Malangoni, M. A., Crafton, R., and Mocek, F. C.
Published: 1994
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33. 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, Ernest E. Moore, Bala, M, Catena, F, Kashuk, J, De Simone, B, Gomes, C, Weber, D, Sartelli, M, Coccolini, F, Kluger, Y, Abu-Zidan, F, Picetti, E, Ansaloni, L, Augustin, G, Biffl, W, Ceresoli, M, Chiara, O, Chiarugi, M, Coimbra, R, Cui, Y, Damaskos, D, Di Saverio, S, Galante, J, Khokha, V, Kirkpatrick, A, Inaba, K, Leppaniemi, A, Litvin, A, Peitzman, A, Shelat, V, Sugrue, M, Tolonen, M, Rizoli, S, Sall, I, Beka, S, Di Carlo, I, Ten Broek, R, Mircea, C, Tebala, G, Pisano, M, van Goor, H, Maier, R, Jeekel, H, Civil, I, Hecker, A, Tan, E, Soreide, K, Lee, M, Wani, I, Bonavina, L, Malangoni, M, Koike, K, Velmahos, G, Fraga, G, Fette, A, De'Angelis, N, Balogh, Z, Scalea, T, Sganga, G, Kelly, M, Khan, J, Stahel, P, and Moore, E
Subjects: Endovascular Procedures, Mesenteric artery stenting, Guideline, Recommendation, Bowel ischemia, Intestines, Mesenteric ischemia, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], Ischemia, Mesenteric Vascular Occlusion, World Society of Emergency Surgery, Emergency Medicine, Humans, Surgery, Mesenteric arterial occlusion
Abstract: Contains fulltext : 288450.pdf (Publisher’s version ) (Open Access) 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

34. Complicated intra-abdominal infections worldwide : the definitive data of the CIAOW Study

Author: Sartelli, Massimo, Catena, Fausto, Ansaloni, Luca, Coccolini, Frederico, Corbella, Davide, Moore, Ernest, Malangoni, Mark, Velmahos, George, Coimbra, Raul, Koike, Kaoru, Leppaniemi, Ari, Biffl, Walter, Balogh, Zsolt, Bendinelli, Cino, Gupta, Sanjay, Kluger, Yoram, Agresta, Ferdinando, Di Saverio, Salmone, Tugnoli, Gregorio, Jovine, Elio, Ordonez, Carlos, Whelan, James, Fraga, Gustavo, Carlos, Gomes, Augusto, Pereira, Gerson, Yuan, Kuo-Ching, Bala, Miklosh, Peev, Miroslav, Ben-Ishay, Offir, Cui, Yunfeng, Marwah, Sanjay, Zachariah, Sanoop, Wani Imtiaz, Rangarajan, Muthukumaran, Sakakushev, Boris, Kong, Victor, Ahmed, Adamu, Abbas, Ashraf, Gonsaga, Ricardo, Guercioni, Gianluca, Vettoretto, Nereo, Poiasina, Elia, Díaz-Nieto, Rafael, Massalou, Damien, Skrovina, Matej, Gerych, Ihor, Augustin, Goran, Kenig, Jakub, Khokha, Vladimir, Tranà, Cristian, Kok, Kenneth, Mefire, Alain, Lee, Jae, Hong, Suk-Kyung, Lohse, Helmut, Ghnnam, Wagih, Verni, Alfredo, Lohsiriwat, Varut, Siribumrungwong, Boonying, El Zalabany, Tamer, Tavares, Alberto, Baiocchi, Gianluca, Das, Koray, Jarry, Julien, Zida, Maurice, Sato, Norio, Murata, Kiyoshi, Shoko, Tomohisa, Irahara, Takayuki, Hamedelneel, Ahmed, Naidoo, Noel, Adesunkanmi, Abdul, Kobe, Yoshiro, Ishii, Wataru, Oka, Kazuyuki, Izawa, Yoshimitsu, Hamid, Hytham, Khan, Iqbal, Attri, AK, Sharma, Rajeev, Sanjuan, Juan, Badiel, Marisol, Barnabé, Rita, II kirurgian klinikka, [Sartelli, M] Department of Surgery, Macerata Hospital, Macerata, Italy. [Catena, F] Emergency Surgery, Maggiore Parma Hospital, Parma, Italy. [Ansaloni, L, Coccolini, F, Poiasina, E] Department of General Surgery, Ospedali Riuniti, Bergamo, Italy. [Corbella, D] Department of Anestesiology, Ospedali Riuniti, Bergamo, Italy. [Moore, EE, Biffl, W] Department of Surgery, Denver Health Medical Center, Denver, USA. [Malangoni, M] American Board of Surgery, Philadelphia, USA. [Velmahos, G, Peev, MP] Division of Trauma, Emergency Surgery and Surgical Critical Care, Harvard Medical School, Massachusetts General Hospital, Massachusetts, USA. [Coimbra, R] Department of Surgery, UC San Diego Health System, San Diego, USA. [Koike, K] Department of Primary Care & Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. [Leppaniemi, A] Department of Abdominal Surgery, University Hospital Meilahti, Helsinki, Finland. [Balogh, Z, Bendinelli, C] Department of Surgery, University of Newcastle, Newcastle, NSW, Australia. [Gupta, S] Department of Surgery, Govt Medical College and Hospital, Chandigarh, India. [Kluger, Y, Ben-Ishay, O, Attri, A, Sharma, R] Department of General Surgery, Rambam Health Care Campus, Haifa, Israel. [Agresta, F] Department of Surgery, Adria Hospital Adria, Adria, Italy. [Di Saverio, S, Tugnoli, G] Trauma Surgery Unit, Maggiore Hospital, Bologna, Italy. [Jovine, E, Bananbé, R] Department of Surgery, Maggiore Hospital, Bologna, Italy. [Ordoñez, CA, Sanjuán, J, Badiel, M] Department of Surgery, Fundación Valle del Lilí, Cali, Colombia. [Whelan, JF] Division of Trauma/Critical Care Department of Surgery Virginia Commonwealth University, Richmond, VA, USA. [Fraga, GP] Division of Trauma Surgery, Campinas University, Campinas, Brazil. [Gomes, CA] Department of Surgery, Monte Sinai Hospital, Juiz de Fora, Brazil. [Pereira, CA] Department of Surgery, Emergency Unit, Ribeirão Preto, Brazil. [Yuan, KC]Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan. [Bala, M] Department of General Surgery, Hadassah Medical Center, Jerusalem, Israel. [Cui, Y] Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China. [Marwah, S] Department of Surgery, Pt BDS Post-graduate Institute of Medical Sciences, Rohtak, India. [Zachariah, S] Department of Surgery, MOSC Medical College, Cochin, India. [Wani, I] Department of Surgery, SKIMS, Srinagar, India. [Rangarajan, M] Department of Surgery, Kovai Medical Center, Coimbatore, India. [Shakakusev, B] First Clinic of General Surgery, University Hospital/UMBAL/St George Plovdiv, Plovdiv, Bulgaria. [Kong, V] Department of Surgery, Edendale Surgery, Pietermaritzburg, Republic of South Africa. [Ahmed, A] Department of Surgery, Ahmadu Bello University Teaching Hospital Zaria, Kaduna, Nigeria. [Abbas, A, Ghnnam, W] Department of Surgery, Mansoura University Hospital, Mansoura, Egypt. [Gonsaga, RA] Department of Surgery, Faculdades Integradas Padre Albino, Catanduva, Brazil. [Guercioni, G] Department of Surgery, Mazzoni Hospital, Ascoli Piceno, Italy. [Vettoretto, N] Department of Surgery, Mellini Hospital, Chiari, BS, Italy. [Díaz-Nieto, R] Department of General and Digestive Surgery, Virgen de la Victoria, University Hospital, Málaga, Spain. [Massalou, D] Department of General Surgery and Surgical Oncology, Université de Nice Sophia-Antipolis, Universitary Hospital of Nice, Nice, France. [Skrovina, M] Department of Surgery, Hospital and Oncological Centre, Novy Jicin, Czech Republic. [Gerych, I] Department of General Surgery, Lviv Emergency Hospital, Lviv, Ukraine. [Augustin, G] Department of Surgery, University Hospital Center Zagreb, Zagreb, Croatia. [Kenig, J] 3rd Department of General Surger Jagiellonian Univeristy, Narutowicz Hospital, Krakow, Poland. [Khokha, V] Department of Surgery, Mozyr City Hospital, Mozyr, Belarus. [Tranà, C] Department of Surgery, Ancona University, Ancona, Italy. [Kok, KY] Department of Surgery, Ripas Hospital, Bandar Seri Begawan, Brunei. [Mefire, AC] Clinical Sciences, Regional Hospitals Limbe and Buea, Limbe, Cameroon. [Lee, JG] Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. [Hong, SK] Division of Trauma and Surgical Critical Care, Department of Surgery, University of Ulsan, Seoul, Republic of Korea. [Lohse, HA] II Cátedra de Clínica Quirúrgica, Hospital de Clínicas, Asuncion, Paraguay. [Verni, A] Department of Surgery, Cutral Có Clinic, Cutral Có, Argentina. [Lohsiriwat, V] Department of Surgery, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand. [Siribumrungwong, B] Department of Surgery, Thammasat University Hospital, Pathumthani, Thailand. [El Zalabany, T] Department of Surgery, Bahrain Defence Force Hospital, Manama, Bahrain. [Tavares, A] Department of Surgery, Hospital Regional de Alta Especialidad del Bajio, Leon, Mexico. [Baiocchi, G] Clinical and Experimental Sciences, Brescia Ospedali Civili, Brescia, Italy. [Das, K] General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey. [Jarry, J] Visceral Surgery, Military Hospital Desgenettes, Lyon, France. [Zida, M] Visceral Surgery, Teaching Hospital Yalgado Ouedraogo, Ouedraogo, Burkina Faso. [Murata, K] Department of Acute and Critical care medicine, Tokyo Medical and Dental University, Tokyo, Japan. [Shoko, T] he Shock Trauma and Emergency Medical Center, Matsudo City Hospital, Chiba, Japan. [Irahara, T] Emergency and Critical Care Center of Nippon Medical School, Tama-Nagayama Hospital, Tokyo, Japan. [Hamedelneel, AO] Department of Surgery, Our Lady of Lourdes Hospital, Drogheda, Ireland. [Naidoo, N] Department of Surgery, Port Shepstone Hospital, Port Shepstone, South Africa. [Adesunkanmi, AR] Department of Surgery, Obafemi Awolowo UNiversity Hospital, Ile-Ife, Nigeria. [Kobe, Y] Department of Emergency and Critical Care Medicine, Chiba University Hospital, Chiba, Japan. [Ishii, W] Department of Emergency and Critical Care Medicine, Chiba University Hospital, Chiba, Japan, and Depatment of Emergency Medicine, Kyoto Second Red Cross Hospital, Kyoto, Japan. [Oka, K] Tajima emergency & Critical Care Medical Center, Toyooka Public Hospital, Toyooka, Hyogo, Japan. [Izawa, Y] Emergency and Critical Care Medicine, Jichi Medical University, Shimotsuke, Japan. [Hamid, H] Department of Surgery, Mayo General Hospital Castlebar Co. Mayo, Castlebar, Ireland.
Subjects: Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Digestive System Surgical Procedures [Medical Subject Headings], APPENDICEAL ABSCESS, medicine.medical_treatment, Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection [Medical Subject Headings], Phenomena and Processes::Microbiological Phenomena::Drug Resistance, Microbial [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drainage [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Reoperation [Medical Subject Headings], Study Protocol, Infección hospitalaria, Procedimientos quirúrgicos del sistema digestivo, Diseases::Bacterial Infections and Mycoses::Infection::Sepsis [Medical Subject Headings], Publication Characteristics::Study Characteristics::Multicenter Study [Medical Subject Headings], Enfermedad crítica, Adulto, Mortality rate, Farmacoresistencia microbiana, Immunosuppression, Diverticulitis, Humanos, 3. Good health, Emergency Medicine, Diseases::Digestive System Diseases::Peritoneal Diseases::Peritonitis [Medical Subject Headings], KLEBSIELLA-PNEUMONIAE, Reoperación, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Critical Illness [Medical Subject Headings], medicine.medical_specialty, CHOLECYSTECTOMY, education, Peritonitis, RELAPAROTOMY, Diseases::Bacterial Infections and Mycoses::Infection::Suppuration::Abscess::Abdominal Abscess [Medical Subject Headings], SECONDARY PERITONITIS, Internal medicine, complicated intra-abdomina infections, appendicitis, cholecystitis, postoperative, colonic perforation, gastroduodenal perforation, diverticulitis, small bowel perforation, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], medicine, MANAGEMENT, METAANALYSIS, Estudio multicéntrico, Diseases::Bacterial Infections and Mycoses::Infection::Intraabdominal Infections [Medical Subject Headings], SEPSIS, business.industry, Abdominal Infection, Absceso abdominal, ACUTE CHOLECYSTITIS, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, Infecciones intraabdominales, Appendicitis, Surgery, Cholecystitis, Drenaje, Cholecystectomy, business, DIVERTICULITIS
Abstract: Journal Article; The CIAOW study (Complicated intra-abdominal infections worldwide observational study) is a multicenter observational study underwent in 68 medical institutions worldwide during a six-month study period (October 2012-March 2013). The study included patients older than 18 years undergoing surgery or interventional drainage to address complicated intra-abdominal infections (IAIs). 1898 patients with a mean age of 51.6 years (range 18-99) were enrolled in the study. 777 patients (41%) were women and 1,121 (59%) were men. Among these patients, 1,645 (86.7%) were affected by community-acquired IAIs while the remaining 253 (13.3%) suffered from healthcare-associated infections. Intraperitoneal specimens were collected from 1,190 (62.7%) of the enrolled patients. 827 patients (43.6%) were affected by generalized peritonitis while 1071 (56.4%) suffered from localized peritonitis or abscesses. The overall mortality rate was 10.5% (199/1898). According to stepwise multivariate analysis (PR = 0.005 and PE = 0.001), several criteria were found to be independent variables predictive of mortality, including patient age (OR = 1.1; 95%CI = 1.0-1.1; p
Published: 2014

35. Complicated intra-abdominal infections in a worldwide context: an observational prospective study (CIAOW Study)

Author: Ashraf Abbas, Cristian Tranà, Offir Ben-Ishay, Sanjay Gupta, Kenneth Y.Y. Kok, Kuo Ching Yuan, Khalid Al Khalifa, Kaoru Koike, Alberto Tavares, Tomohisa Shoko, Zsolt J. Balogh, Maurice Zida, Gian Luca Baiocchi, Alain Chichom Mefire, Sanoop K. Zachariah, Rafael Díaz-Nieto, Mark A. Malangoni, Rita Barnabé, Walter L. Biffl, Abdul Rashid K. Adesunkanmi, Ari Leppäniemi, Goran Augustin, Luca Ansaloni, Boris Sakakushev, Noel Naidoo, Federico Coccolini, Wataru Ishii, Rajeev Sharma, Nereo Vettoretto, Miroslav P. Peev, Carlos A. Ordoñez, Miklosh Bala, Suk-Kyung Hong, Ashok K. Attri, Massimo Sartelli, Ferdinando Agresta, Yoshiro Kobe, Koray Das, Norio Sato, Carlos Augusto Gomes, Ricardo Alessandro Teixeira Gonsaga, Tamer El Zalabany, Cino Bendinelli, Helmut Alfredo Segovia Lohse, Alfredo Verni, Ahmed O. Hamedelneel, Takayuki Irahara, Adamu Ahmed, Gregorio Tugnoli, Yoram Kluger, Damien Massalou, Julien Jarry, Matej Skrovina, Jae Gil Lee, Ernest E. Moore, Yunfeng Cui, Elia Poiasina, Varut Lohsiriwat, Raul Coimbra, Sanjay Marwah, Vladimir Khokha, Jakub Kenig, Wagih Ghnnam, Juan Sanjuan, Ihor Gerych, Kiyoshi Murata, Gianluca Guercioni, Victor Y. Kong, George C. Velmahos, Fausto Catena, Salomone Di Saverio, Boonying Siribumrungwong, Elio Jovine, Gerson Alves Pereira Júnior, [Sartelli,M] Department of Surgery, Macerata Hospital, Macerata, Italy. [Catena,F] Emergency Surgery, Maggiore Parma Hospital, Parma, Italy. [Ansaloni,L, Poiasina,E, Coccolini,F] Department of General Surgery, Ospedali Riuniti, Bergamo, Italy. [Moore,E, Biffl,W] Department of Surgery, Denver Health Medical Center, Denver, CO, USA. [Malangoni,M] American Board of Surgery, Philadelphia, PA, USA. [Velmahos,G, Peev,MP] Harvard Medical School, Division of Trauma, Emergency Surgery and Surgical Critical Care Massachusetts General Hospital, Boston, MA, USA. [Coimbra,R] Department of Surgery, UC San Diego Health System, San Diego, CA, USA. [Koike,K, Sato,N] Department of Primary Care & Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. [Leppaniemi,A] Department of Abdominal Surgery, University Hospital Meilahti, Helsinki, Finland. [Balogh,Z, Bendinelli,C] Department of Surgery, University of Newcastle, Newcastle, NSW, Australia. [Gupta,S, Attri,AK, Sharma,R] Department of Surgery, Govt Medical College and Hospital, Chandigarh, India. [Kluger,Y, Ben-Ishay,O] Department of General Surgery, Rambam Health Care Campus, Haifa, Israel. [Agresta,F] Department of Surgery, Adria Hospital, Adria, Italy. [Saverio,S di, Tugnoli,G] Trauma Surgery Unit, Maggiore Hospital, Bologna, Italy. [Jovine,E, Barnabé,R] Department of Surgery, Maggiore Hospital, Bologna, Italy. [Ordonez,C, Sanjuán,J] Department of Surgery, Universidad del Valle, Fundación Valle del Lili, Cali, Colombia. [Gomes,A] Department of Surgery, Monte Sinai Hospital, Juiz de Fora, Brazil. [Pereira Junior,GA] Emergency Unit, Department of Surgery, Ribeirão Preto, Brazil . [Yuan,K-CH] Department of Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan. [Bala,M] Department of General Surgery, Hadassah Medical Center, Jerusalem, Israel. [Cui,Y] Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China. [Marwah,S] Department of Surgery, Pt BDS Post-graduate Institute of Medical Sciences, Rohtak, India. [Zachariah,S] Department of Surgery, MOSC medical college, Cochin, India. [Sakakushev,B] First Clinic of General Surgery, University Hospital /UMBAL/ St George Plovdiv, Plovdiv, Bulgaria. [Sakakushev,B] General Surgery Clinic, Medical University/University Hospital St.George, Plovdiv, Bulgaria. [Kong,V] Department of Surgery, Edendale Hospital, Pietermaritzburg, Republic of South Africa. [Ahmed,A] Department of Surgery, Ahmadu Bello University Teaching Hospital Zaria, Kaduna, Nigeria. [Abbas,A] Department of Surgery, Mansoura University Hospital, Mansoura, Egypt . [Teixeira Gonsaga,RA] Department of Surgery, Faculdades Integradas Padre Albino, Catanduva, Brazil. [Guercioni,G] Department of Surgery, Mazzoni Hospital, Ascoli Piceno, Italy. [Vettoretto,N] Department of Surgery, Mellini Hospital, Chiari (BS), Italy. [Díaz Nieto,R] Department of General and Digestive Surgery, Hospital Universitario Virgen de la Victoria, Málaga, Spain. [Massalou,D] Department of General Surgery and Surgical Oncology, Université de Nice Sophia-Antipolis, Universitary Hospital of Nice, France. [Skrovina,M] Department of Surgery, Hospital and Oncological Centre, Novy Jicin, Czech Republic. [Gerych,I] Department of General Surgery, Lviv Emergency Hospital, Lviv, Ukraine. [Agustin,G] Department of Surgery, University Hospital Center Zagreb, Zagreb, Croatia. [Kenig,J] 3rd Department of General Surger Jagiellonian Univeristy, Narutowicz Hospital, Krakow, Poland. [Khokha,V] Department of Surgery, Mozyr City Hospital, Mozyr, Belarus. [Tranà,C] Department of Surgery, Ancona University, Ancona, Italy. [Yen Kok,KY] Department of Surgery, Ripas Hospital, Bandar Seri Begawan, Brunei. [Mefire,ACH] Clinical Sciences, Regional Hospitals Limbe and Buea, Limbe, Cameroon. [Lee,JG] Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. [Hong,S-K] Division of Trauma and Surgical Critical Care, Department of Surgery, University of Ulsan, Seoul, Republic of Korea . [Segovia Lohse,HA] II Cátedra de Clínica Quirúrgica, Hospital de Clínicas, Asunción, Paraguay. [Ghnnam,W] Department of Surgery, Khamis Mushayt General Hospital, Khamis Mushayt, Saudi Arabia. [Verni,A] Department of Surgery, Cutral Co Clinic, Neuquen, Argentina. [Lohsiriwat,W] Department of Surgery, Faculty of Medicine Siriraj Hospital, Bangkok, Thailand. [Siribumrungwong,B] Department of Surgery, Thammasat University Hospital, Pathumthani, Thailand. [Tavares,A] Department of Surgery, Hospital Regional de Alta Especialidad del Bajio, León, México. [Baiocchi,G] Department of Clinical and Experimental Sciences, Brescia University, Brescia, Italy. [Das,K] General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey. [Jarry,J] Visceral Surgery, Military Hospital Desgenettes, Lyon, France. [Zida,M] Visceral Surgery, Teaching Hospital Yalgado Ouedraogo, Ouagadougou, Burkina Faso. [Murata,K] Department of Acute and Critical care medicine, Tokyo Medical and Dental University, Tokyo, Japan. [Shoko,T] The Shock Trauma and Emergency Medical Center, Matsudo City Hospital, Chiba, Japan. [Irahara,T] Emergency and Critical Care Center of Nippon Medical School, Tama-Nagayama Hospital, Tokyo, Japan. [Hamedelneel,AO] Department of Surgery, Our Lady of Lourdes Hospital, Drogheda, Ireland. [Naidoo,N] Department of Surgery, Port Shepstone Hospital, Port Shepstone, South Africa. [Kayode Adesunkanmi,AR] Department of Surgery, College of Health Sciences, Obafemi Awolowo University Hospital, Ile-Ife, Nigeria. [Kobe,Y] Department of Emergency and Critical Care Medicine, Chiba University Hospital, Chiba, Japan. [El Zalabany,T, and Khalifa,K Al] Department of Surgery, Bahrain Defence Force Hospital, Manama, Bahrain. [Ishii,W] Department of Emergency Medicine, Kyoto Second Red Cross Hospital, Kyoto, Japan.
Subjects: Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Drainage [Medical Subject Headings], Pediatrics, medicine.medical_specialty, Infecciones Intraabdominales, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Digestive System Surgical Procedures [Medical Subject Headings], Infección Hospitalaria, Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection [Medical Subject Headings], MEDLINE, Peritonitis, Context (language use), Absceso Abdominal, Phenomena and Processes::Microbiological Phenomena::Drug Resistance, Microbial [Medical Subject Headings], Review, 030230 surgery, Enfermedad Crítica, Diseases::Bacterial Infections and Mycoses::Infection::Suppuration::Abscess::Abdominal Abscess [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Reoperation [Medical Subject Headings], 03 medical and health sciences, 0302 clinical medicine, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], Medicine, intra-abdominal infections, Prospective cohort study, Diseases::Bacterial Infections and Mycoses::Infection::Sepsis [Medical Subject Headings], Estudio Multicéntrico, Publication Characteristics::Study Characteristics::Multicenter Study [Medical Subject Headings], Diseases::Bacterial Infections and Mycoses::Infection::Intraabdominal Infections [Medical Subject Headings], business.industry, Adulto, Mortality rate, Abdominal Infection, Mean age, Farmacoresistencia microbiana, medicine.disease, 3. Good health, Humanos, Procedimientos Quirúrgicos del Sistema Digestivo, 030220 oncology & carcinogenesis, Emergency Medicine, DOENÇAS INFECCIOSAS, Observational study, Surgery, Drenaje, Diseases::Digestive System Diseases::Peritoneal Diseases::Peritonitis [Medical Subject Headings], business, Reoperación, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Critical Illness [Medical Subject Headings]
Abstract: Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The World Society of Emergency Surgery (WSES) has designed the CIAOW study in order to describe the clinical, microbiological, and management-related profiles of both community- and healthcare-acquired complicated intra-abdominal infections in a worldwide context. The CIAOW study (Complicated Intra-Abdominal infection Observational Worldwide Study) is a multicenter observational study currently underway in 57 medical institutions worldwide. The study includes patients undergoing surgery or interventional drainage to address complicated intra-abdominal infections. This preliminary report includes all data from almost the first two months of the six-month study period. Patients who met inclusion criteria with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 702 patients with a mean age of 49.2 years (range 18–98) were enrolled in the study. 272 patients (38.7%) were women and 430 (62.3%) were men. Among these patients, 615 (87.6%) were affected by community-acquired IAIs while the remaining 87 (12.4%) suffered from healthcare-associated infections. Generalized peritonitis was observed in 304 patients (43.3%), whereas localized peritonitis or abscesses was registered in 398 (57.7%) patients. The overall mortality rate was 10.1% (71/702). The final results of the CIAOW Study will be published following the conclusion of the study period in March 2013.
Published: 2013
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36. Management of intra-abdominal infections: recommendations by the WSES 2016 consensus conference.

Author: Sartelli M, Catena F, Abu-Zidan FM, Ansaloni L, Biffl WL, Boermeester MA, Ceresoli M, Chiara O, Coccolini F, De Waele JJ, Di Saverio S, Eckmann C, Fraga GP, Giannella M, Girardis M, Griffiths EA, Kashuk J, Kirkpatrick AW, Khokha V, Kluger Y, Labricciosa FM, Leppaniemi A, Maier RV, May AK, Malangoni M, Martin-Loeches I, Mazuski J, Montravers P, Peitzman A, Pereira BM, Reis T, Sakakushev B, Sganga G, Soreide K, Sugrue M, Ulrych J, Vincent JL, Viale P, and Moore EE
Subjects: Abdominal Pain etiology, Anti-Bacterial Agents therapeutic use, Appendectomy methods, Cholecystectomy, Laparoscopic methods, Decision Support Techniques, Diverticulitis surgery, Humans, Intra-Abdominal Hypertension etiology, Intra-Abdominal Hypertension prevention & control, Intraabdominal Infections complications, Laparoscopy methods, Laparoscopy statistics & numerical data, Organ Dysfunction Scores, Tomography, X-Ray Computed methods, Treatment Outcome, Ultrasonography methods, Guidelines as Topic, Intraabdominal Infections surgery
Abstract: This paper reports on the consensus conference on the management of intra-abdominal infections (IAIs) which was held on July 23, 2016, in Dublin, Ireland, as a part of the annual World Society of Emergency Surgery (WSES) meeting. This document covers all aspects of the management of IAIs. The Grading of Recommendations Assessment, Development and Evaluation recommendation is used, and this document represents the executive summary of the consensus conference findings.
Published: 2017
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37. Complicated intra-abdominal infections worldwide: the definitive data of the CIAOW Study.

Author: Sartelli M, Catena F, Ansaloni L, Coccolini F, Corbella D, Moore EE, Malangoni M, Velmahos G, Coimbra R, Koike K, Leppaniemi A, Biffl W, Balogh Z, Bendinelli C, Gupta S, Kluger Y, Agresta F, Di Saverio S, Tugnoli G, Jovine E, Ordonez CA, Whelan JF, Fraga GP, Gomes CA, Pereira GA, Yuan KC, Bala M, Peev MP, Ben-Ishay O, Cui Y, Marwah S, Zachariah S, Wani I, Rangarajan M, Sakakushev B, Kong V, Ahmed A, Abbas A, Gonsaga RA, Guercioni G, Vettoretto N, Poiasina E, Díaz-Nieto R, Massalou D, Skrovina M, Gerych I, Augustin G, Kenig J, Khokha V, Tranà C, Kok KY, Mefire AC, Lee JG, Hong SK, Lohse HA, Ghnnam W, Verni A, Lohsiriwat V, Siribumrungwong B, El Zalabany T, Tavares A, Baiocchi G, Das K, Jarry J, Zida M, Sato N, Murata K, Shoko T, Irahara T, Hamedelneel AO, Naidoo N, Adesunkanmi AR, Kobe Y, Ishii W, Oka K, Izawa Y, Hamid H, Khan I, Attri A, Sharma R, Sanjuan J, Badiel M, and Barnabé R
Abstract: The CIAOW study (Complicated intra-abdominal infections worldwide observational study) is a multicenter observational study underwent in 68 medical institutions worldwide during a six-month study period (October 2012-March 2013). The study included patients older than 18 years undergoing surgery or interventional drainage to address complicated intra-abdominal infections (IAIs). 1898 patients with a mean age of 51.6 years (range 18-99) were enrolled in the study. 777 patients (41%) were women and 1,121 (59%) were men. Among these patients, 1,645 (86.7%) were affected by community-acquired IAIs while the remaining 253 (13.3%) suffered from healthcare-associated infections. Intraperitoneal specimens were collected from 1,190 (62.7%) of the enrolled patients. 827 patients (43.6%) were affected by generalized peritonitis while 1071 (56.4%) suffered from localized peritonitis or abscesses. The overall mortality rate was 10.5% (199/1898). According to stepwise multivariate analysis (PR = 0.005 and PE = 0.001), several criteria were found to be independent variables predictive of mortality, including patient age (OR = 1.1; 95%CI = 1.0-1.1; p < 0.0001), the presence of small bowel perforation (OR = 2.8; 95%CI = 1.5-5.3; p < 0.0001), a delayed initial intervention (a delay exceeding 24 hours) (OR = 1.8; 95%CI = 1.5-3.7; p < 0.0001), ICU admission (OR = 5.9; 95%CI = 3.6-9.5; p < 0.0001) and patient immunosuppression (OR = 3.8; 95%CI = 2.1-6.7; p < 0.0001).
Published: 2014
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38. Current concept of abdominal sepsis: WSES position paper.

Author: Sartelli M, Catena F, Di Saverio S, Ansaloni L, Malangoni M, Moore EE, Moore FA, Ivatury R, Coimbra R, Leppaniemi A, Biffl W, Kluger Y, Fraga GP, Ordonez CA, Marwah S, Gerych I, Lee JG, Tranà C, Coccolini F, Corradetti F, and Kirkby-Bott J
Abstract: Although sepsis is a systemic process, the pathophysiological cascade of events may vary from region to region.Abdominal sepsis represents the host's systemic inflammatory response to bacterial peritonitis.It is associated with significant morbidity and mortality rates, and is the second most common cause of sepsis-related mortality in the intensive care unit.The review focuses on sepsis in the specific setting of severe peritonitis.
Published: 2014
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39. 2013 WSES guidelines for management of intra-abdominal infections.

Author: Sartelli M, Viale P, Catena F, Ansaloni L, Moore E, Malangoni M, Moore FA, Velmahos G, Coimbra R, Ivatury R, Peitzman A, Koike K, Leppaniemi A, Biffl W, Burlew CC, Balogh ZJ, Boffard K, Bendinelli C, Gupta S, Kluger Y, Agresta F, Di Saverio S, Wani I, Escalona A, Ordonez C, Fraga GP, Junior GA, Bala M, Cui Y, Marwah S, Sakakushev B, Kong V, Naidoo N, Ahmed A, Abbas A, Guercioni G, Vettoretto N, Díaz-Nieto R, Gerych I, Tranà C, Faro MP, Yuan KC, Kok KY, Mefire AC, Lee JG, Hong SK, Ghnnam W, Siribumrungwong B, Sato N, Murata K, Irahara T, Coccolini F, Segovia Lohse HA, Verni A, and Shoko T
Abstract: Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high.The 2013 update of the World Society of Emergency Surgery (WSES) guidelines for the management of intra-abdominal infections contains evidence-based recommendations for management of patients with intra-abdominal infections.
Published: 2013
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40. Complicated intra-abdominal infections in a worldwide context: an observational prospective study (CIAOW Study).

Author: Sartelli M, Catena F, Ansaloni L, Moore E, Malangoni M, Velmahos G, Coimbra R, Koike K, Leppaniemi A, Biffl W, Balogh Z, Bendinelli C, Gupta S, Kluger Y, Agresta F, Di Saverio S, Tugnoli G, Jovine E, Ordonez C, Gomes CA, Junior GA, Yuan KC, Bala M, Peev MP, Cui Y, Marwah S, Zachariah S, Sakakushev B, Kong V, Ahmed A, Abbas A, Gonsaga RA, Guercioni G, Vettoretto N, Poiasina E, Ben-Ishay O, Díaz-Nieto R, Massalou D, Skrovina M, Gerych I, Augustin G, Kenig J, Khokha V, Tranà C, Kok KY, Mefire AC, Lee JG, Hong SK, Segovia Lohse HA, Ghnnam W, Verni A, Lohsiriwat V, Siribumrungwong B, Tavares A, Baiocchi G, Das K, Jarry J, Zida M, Sato N, Murata K, Shoko T, Irahara T, Hamedelneel AO, Naidoo N, Adesunkanmi AR, Kobe Y, Attri A, Sharma R, Coccolini F, El Zalabany T, Khalifa KA, Sanjuan J, Barnabé R, and Ishii W
Abstract: Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The World Society of Emergency Surgery (WSES) has designed the CIAOW study in order to describe the clinical, microbiological, and management-related profiles of both community- and healthcare-acquired complicated intra-abdominal infections in a worldwide context. The CIAOW study (Complicated Intra-Abdominal infection Observational Worldwide Study) is a multicenter observational study currently underway in 57 medical institutions worldwide. The study includes patients undergoing surgery or interventional drainage to address complicated intra-abdominal infections. This preliminary report includes all data from almost the first two months of the six-month study period. Patients who met inclusion criteria with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 702 patients with a mean age of 49.2 years (range 18-98) were enrolled in the study. 272 patients (38.7%) were women and 430 (62.3%) were men. Among these patients, 615 (87.6%) were affected by community-acquired IAIs while the remaining 87 (12.4%) suffered from healthcare-associated infections. Generalized peritonitis was observed in 304 patients (43.3%), whereas localized peritonitis or abscesses was registered in 398 (57.7%) patients.The overall mortality rate was 10.1% (71/702). The final results of the CIAOW Study will be published following the conclusion of the study period in March 2013.
Published: 2013
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41. Scholarly activity.

Author: Wallack MK, Reilly L, Whalen T, Columbani P, Malangoni M, O'Leary P, Van Way C, and Simpson P
Subjects: Curriculum, Female, Humans, Internship and Residency, Male, Program Evaluation, Total Quality Management, Clinical Competence, Education, Medical, Graduate organization & administration, Faculty, Medical organization & administration, General Surgery education, Physician Executives organization & administration
Published: 2009
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42. Admitting service influences the outcomes of patients with small bowel obstruction.

Author: Malangoni MA, Times ML, Kozik D, and Merlino JI
Subjects: Adult, Aged, Humans, Length of Stay, Middle Aged, Retrospective Studies, Tomography, X-Ray Computed, Treatment Outcome, Intestinal Obstruction surgery, Patient Admission
Abstract: Background: Small bowel obstruction (SBO) is a common problem that often requires operation. We tested the hypotheses that patients admitted to a surgical service have improved outcomes and that these outcomes are related to early operation., Methods: Retrospective review of 281 patients with 336 episodes of SBO between 1992 and 1998 was performed. Parametric and nonparametric analysis was used as appropriate., Results: There were 222 admissions to a surgical service and 114 admissions to a medical service. Patient characteristics were similar between groups. Eighty-seven percent of patients had a previous abdominal or pelvic operation. There were 211 patients (217 admissions) who required operation. Operated patients admitted to the surgical service had a shorter preoperative (2.7 vs 6.3 days, P <.01) and overall length of stay (LOS) (17.9 vs 22.8 days, P <.0001). There was no difference in time to resumption of diet between groups. The number of previous admissions or operations did not affect the need for operative intervention. Unoperated patients admitted to a medical service had a shorter time to resumption of diet (3.1 vs 4.3 days) and LOS (4.8 vs 7.2 days, both P <.05) than the surgical service group. Operative mortality was 3.4%. The likelihood of developing a complication was related to the occurrence of an enterotomy (n = 21, odds ratio = 2.69; 95% confidence interval [CI]: 1.1-6.7, P =.014) or the need for bowel resection (odds ratio = 1.97; 95% CI: 1.2-3.5, P =.02). The occurrence of a complication resulted in a 46% increase in LOS (P <.0001). Patients operated on within 24 hours of admission had a decreased LOS (P <.05) and mortality, with no difference in the occurrence of postoperative complications., Conclusions: Patients with SBO who require operation benefit from a shorter time to operation and reduced LOS when admitted to a surgical service. Early operation is associated with a reduction in mortality, and avoidance of enterotomy decreases the risk of complications.
Published: 2001
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43. Necrotizing soft tissue infections: are we making any progress?

Author: Malangoni MA
Subjects: Humans, Soft Tissue Infections mortality, Necrosis, Soft Tissue Infections diagnosis, Soft Tissue Infections therapy
Abstract: Background: Necrotizing soft tissue infections are a group of diseases with significant associated mortality. A wide spectrum of bacteria can be involved, and diagnosis can be difficult., Methods: Review of pertinent literature of the diagnosis and therapy of necrotizing soft-tissue infection., Results: Mortality and other adverse outcomes are directly related to advanced age, the presence of organ system failure, lactic acidemia, the percentage of body surface area involved with infection, and delays in operative management. Patients usually die early from the consequences of septic shock, whereas late mortality is related to multiple organ failure., Conclusion: Early recognition and treatment can lower mortality from necrotizing soft tissue infection. Prompt operative debridement, broad-spectrum antimicrobials, and physiologic support are important components of treatment.
Published: 2001
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44. Prospective randomized trials affect the outcomes of intraabdominal infection.

Author: Merlino JI, Malangoni MA, Smith CM, and Lange RL
Subjects: Abdominal Abscess drug therapy, Adolescent, Adult, Age Factors, Appendicitis drug therapy, Female, Humans, Infections pathology, Length of Stay, Male, Middle Aged, Patient Selection, Peritonitis drug therapy, Prospective Studies, Randomized Controlled Trials as Topic, Risk Factors, Severity of Illness Index, Treatment Outcome, Abdomen, Anti-Bacterial Agents therapeutic use, Infections drug therapy
Abstract: Objective: To compare the characteristics and outcomes of patients with intraabdominal infections enrolled in prospective randomized trials (PRTs) with those of a cohort of patients not enrolled in a trial., Summary Background Data: Prospective randomized trials are the gold standard for the evaluation of new treatments. Patients are screened using rigorous eligibility criteria and sometimes are excluded from PRTs because of associated medical conditions or more severe illness. However, the effect that the exclusion of these patients has on the applicability of clinical trial outcomes has not been defined., Methods: One hundred sixty-eight adults with intraabdominal infection were treated at a single institution during 7 years. Fifty-three patients were enrolled in four PRTs comparing various antibiotic regimens for treatment; 115 were not enrolled. Patient characteristics and outcomes of these two groups were compared., Results: Patients with infections from appendicitis (n = 68) had a low severity of illness and similar outcomes in both groups. These patients and those for whom a concurrent PRT was unavailable were excluded from subsequent analysis. Eighty-eight patients (42 PRT, 46 not enrolled) with serious infection remained for analysis. Patients enrolled in PRTs were younger, had less severe illness, had a decreased length of stay, a lower incidence of antibiotic resistance, and less frequent extraabdominal infections than those not enrolled in a trial. Patients enrolled in PRTs were more likely to be cured and were less likely to die. Logistic regression analysis demonstrated that cure was associated with a lower initial severity of illness, absence of antibiotic resistance, and participation in a PRT., Conclusions: Patients with intraabdominal infection enrolled in PRTs have an increased likelihood of cure and survival. This is due in part to a lower incidence of antibiotic resistance, which may reflect improved drug selection. Patients not enrolled in PRTs are at greater risk for treatment failure and death because of concomitant illness. Outcomes from PRTs may not be applicable to all patients with intraabdominal infections.
Published: 2001
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45. The "Airmedical F.A.S.T." for trauma patients--the initial report of a novel application for sonography.

Author: Polk JD, Fallon WF Jr, Kovach B, Mancuso C, Stephens M, and Malangoni MA
Subjects: Adolescent, Adult, Aged, Aged, 80 and over, Child, False Negative Reactions, False Positive Reactions, Feasibility Studies, Humans, Middle Aged, Sensitivity and Specificity, Ultrasonography, Abdominal Injuries diagnostic imaging, Air Ambulances, Hemoperitoneum diagnostic imaging
Abstract: Background: While established as an initial screening tool for the evaluation of injured patients at the trauma center, sonographic evaluation of the patient in the prehospital setting remains untested. The purpose of this study was to determine the feasibility of this procedure during prehospital helicopter transport., Methods: Two qualified flight surgeons performed all imaging studies. Confirmatory endpoints were documented for all images obtained in flight., Results: For this preliminary study, 100 patients are presented; 84 studies were analyzed; 16 were excluded due to patient weight (8), hemodynamic instability (6), or problems with machine calibration (2). Sensitivity was 81.3%; specificity was 100%. The positive predictive value was 100%; the negative predictive value was 95.7%. The accuracy was 96.4%., Conclusion: Sonographic studies obtained during air-medical transport are of similar quality and consistency as those obtained in the emergency department. The ability to detect hemoperitoneum in the field may challenge traditional algorithms for prehospital care as a result.
Published: 2001

46. Profile. Mark A. Malangoni, M.D. Interview by Vicki Glaser.

Author: Malangoni MA
Subjects: Humans, Societies, Medical organization & administration, Surgical Wound Infection
Published: 2001
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47. Penetrating esophageal injuries: multicenter study of the American Association for the Surgery of Trauma.

Author: Asensio JA, Chahwan S, Forno W, MacKersie R, Wall M, Lake J, Minard G, Kirton O, Nagy K, Karmy-Jones R, Brundage S, Hoyt D, Winchell R, Kralovich K, Shapiro M, Falcone R, McGuire E, Ivatury R, Stoner M, Yelon J, Ledgerwood A, Luchette F, Schwab CW, Frankel H, Chang B, Coscia R, Maull K, Wang D, Hirsch E, Cue J, Schmacht D, Dunn E, Miller F, Powell M, Sherck J, Enderson B, Rue L 3rd, Warren R, Rodriquez J, West M, Weireter L, Britt LD, Dries D, Dunham CM, Malangoni M, Fallon W, Simon R, Bell R, Hanpeter D, Gambaro E, Ceballos J, Torcal J, Alo K, Ramicone E, and Chan L
Subjects: Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Length of Stay, Logistic Models, Male, Middle Aged, Neck Injuries mortality, Retrospective Studies, Risk Factors, Wounds, Gunshot mortality, Wounds, Stab mortality, Esophagus injuries, Wounds, Penetrating mortality
Abstract: Objective: The purpose of this study was to define the period of time after which delays in management incurred by investigations cause increased morbidity and mortality. The outcome study is intended to correlate time with death from esophageal causes, overall complications, esophageal related complications, and surgical intensive care unit length of stay., Methods: This was a retrospective multicenter study involving 34 trauma centers in the United States, under the auspices of the American Association for the Surgery of Trauma Multi-institutional Trials Committee over a span of 10.5 years. Patients surviving to reach the operating room (OR) were divided into two groups: those that underwent diagnostic studies to identify their injuries (preoperative evaluation group) and those that went immediately to the OR (no preoperative evaluation group). Statistical methods included Fisher's exact test, Student's T test, and logistic regression analysis., Results: The study involved 405 patients: 355 male patients (86.5%) and 50 female patients (13.5%). The mean Revised Trauma Score was 6.3, the mean Injury Severity Score was 28, and the mean time interval to the OR was 6.5 hours. There were associated injuries in 356 patients (88%), and an overall complication rate of 53.5%. Overall mortality was 78 of 405 (19%). Three hundred forty-six patients survived to reach the OR: 171 in the preoperative evaluation group and 175 in the no preoperative evaluation group. No statistically significant differences were noted in the two groups in the following parameters: number of patients, age, Injury Severity Score, admission blood pressure, anatomic location of injury (cervical or thoracic), surgical management (primary repair, resection and anastomosis, resection and diversion, flaps), number of associated injuries, and mortality. Average length of time to the OR was 13 hours in the preoperative evaluation group versus 1 hour in the no preoperative evaluation group (p < 0.001). Overall complications occurred in 134 in the preoperative evaluation group versus 87 in the no preoperative evaluation group (p < 0.001), and 74 (41%) esophageal related complications occurred in the preoperative evaluation group versus 32 (19%) in the no preoperative evaluation group (p = 0.003). Mean surgical intensive care unit length of stay was 11 days in the preoperative evaluation group versus 7 days in the no preoperative evaluation group (p = 0.012). Logistic regression analysis identified as independent risk factors for the development of esophageal related complications included time delays in preoperative evaluation (odds ratio, 3.13), American Association for the Surgery of Trauma Organ Injury Scale grade >2 (odds ratio, 2.62), and resection and diversion (odds ratio, 4.47)., Conclusion: Esophageal injuries carry a high morbidity and mortality. Increased esophageal related morbidity occurs with the diagnostic workup and its inherent delay in operative repair of these injuries. For centers practicing selective management of penetrating neck injuries and transmediastinal gunshot wounds, rapid diagnosis and definitive repair should be made a high priority.
Published: 2001
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48. Providence: Surgical Infection Society 2000.

Author: Malangoni MA
Subjects: Education, Medical, Humans, Organizational Objectives, Research, Societies, Medical organization & administration, Societies, Medical trends, Surgical Wound Infection
Published: 2000
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49. Emergency department discharge of patients with a negative cranial computed tomography scan after minimal head injury.

Author: Livingston DH, Lavery RF, Passannante MR, Skurnick JH, Baker S, Fabian TC, Fry DE, and Malangoni MA
Subjects: Adolescent, Adult, Emergency Treatment, Female, Glasgow Coma Scale, Head Injuries, Closed therapy, Humans, Length of Stay, Male, Middle Aged, New Jersey, Patient Discharge, Prospective Studies, Radiography, Emergency Service, Hospital, Head Injuries, Closed diagnostic imaging
Abstract: Objective: To determine the negative predictive value of cranial computed tomography (CT) scanning in a prospective series of patients and whether hospital admission for observation is mandatory after a negative diagnostic evaluation after minimal head injury (MHI)., Summary Background Data: Hospital admission for observation is a current standard of practice for patients who have sustained MHI, despite having undergone diagnostic studies that exclude the presence of an intracranial injury. The reasons for this practice are multifactorial and include the perceived false-negative rate of all standard diagnostic tests, the belief that admission will allow prompt diagnosis of occult injuries, and medicolegal considerations about the risk of early discharge., Methods: In a prospective, multiinstitutional study during a 22-month period at four level I trauma centers, all patients with MHI were evaluated using the following protocol: a standardized physical and neurologic examination in the emergency department, cranial CT scanning, and then admission for observation. MHI was defined as either a documented loss of consciousness or evidence of posttraumatic amnesia and an emergency department Glasgow Coma Scale score of 14 or 15. Outcomes were measured at 20 hours and at discharge and included clinical deterioration, need for craniotomy, and death., Results: Two thousand one hundred fifty-two consecutive patients fulfilled the study protocol. The CT was interpreted as negative for intracranial injury in 1,788, positive in 217, and equivocal in 119. Five patients with CT scans initially interpreted as negative required intervention. There was one craniotomy in a patient whose CT scan was initially interpreted as negative. This patient had facial fractures that required surgical intervention and elevation of depressed intracranial fracture fragments. The negative predictive power of a cranial CT scan based on the preliminary reading of the CT scan and defined by the subsequent need for neurosurgical intervention in the population fully satisfying the protocol was 99.70%., Conclusions: Patients with a cranial CT scan, obtained on a helical CT scanner, that shows no intracerebral injury and who do not have other body system injuries or a persistence of any neurologic finding can be safely discharged from the emergency department without a period of either inpatient or outpatient observation. Implementation of this practice could result in a potential decrease of more than 500,000 hospital admissions annually.
Published: 2000
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50. A time to remember.

Author: Malangoni MA
Subjects: History, 20th Century, Humans, Iran, Prisoners history, United States, Volunteers history, General Surgery history
Published: 2000
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