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1. Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Author

Gennaro Perrone, Mario Giuffrida, Fikri Abu-Zidan, Vitor F. Kruger, Marco Livrini, Gabriele Luciano Petracca, Giorgio Rossi, Antonio Tarasconi, Brian W. C. A. Tian, Elena Bonati, Ricardo Mentz, Federico N. Mazzini, Juan P. Campana, Elisabeth Gasser, Reinhold Kafka-Ritsch, Daniel M. Felsenreich, Christopher Dawoud, Stefan Riss, Carlos Augusto Gomes, Felipe Couto Gomes, Ricardo Alessandro Teixeira Gonzaga, Cassio Alfred Brattig Canton, Bruno Monteiro Pereira, Gustavo P. Fraga, Leticia Gonçalves Zem, Vinicius Cordeiro-Fonseca, Renato de Mesquita Tauil, Boyko Atanasov, Nikolay Belev, Nikola Kovachev, L. Juan José Meléndez, Ana Dimova, Stefan Dimov, Zdravko Zelić, Goran Augustin, Branko Bogdanić, Trpimir Morić, Elie Chouillard, Melinda Bajul, Belinda De Simone, Yves Panis, Francesco Esposito, Margherita Notarnicola, Lelde Lauka, Anna Fabbri, Hassen Hentati, Iskander Fnaiech, Venara Aurélien, Marie Bougard, Maxime Roulet, Zaza Demetrashvili, Irakli Pipia, Giorgi Merabishvili, Konstantinos Bouliaris, Georgios Koukoulis, Christos Doudakmanis, Sofia Xenaki, Emmanuel Chrysos, Stamatios Kokkinakis, Panteleimon Vassiliu, Nikolaos Michalopoulos, Ioannis Margaris, Aristotelis Kechagias, Konstantinos Avgerinos, Jevgeni Katunin, Eftychios Lostoridis, Eleni-Aikaterini Nagorni, Antonio Pujante, Francesk Mulita, Ioannis Maroulis, Michail Vailas, Athanasios Marinis, Ioannis Siannis, Eirini Bourbouteli, Dimitrios K. Manatakis, Nikolaos Tasis, Vasileios Acheimastos, Sotiropoulou Maria, Kapiris Stylianos, Harilaos Kuzeridis, Dimitrios Korkolis, Evangelos Fradelos, George Kavalieratos, Thalia Petropoulou, Andreas Polydorou, Ioannis Papacostantinou, Tania Triantafyllou, Despina Kimpizi, Dimitrios Theodorou, Konstantinos Toutouzas, Alexandros Chamzin, Maximos Frountzas, Dimitrios Schizas, Ioannis Karavokyros, Athanasios Syllaios, Alexandros Charalabopoulos, Maria Boura, Efstratia Baili, Orestis Ioannidis, Lydia Loutzidou, Elissavet Anestiadou, Ioannis Tsouknidas, Georgios Petrakis, Eleni Polenta, Lovenish Bains, Rahul Gupta, Sudhir K. Singh, Archana Khanduri, Miklosh Bala, Asaf Kedar, Marcello Pisano, Mauro Podda, Adolfo Pisanu, Gennaro Martines, Giuseppe Trigiante, Giuliano Lantone, Antonino Agrusa, Giuseppe Di Buono, Salvatore Buscemi, Massimiliano Veroux, Rossella Gioco, Gastone Veroux, Luigi Oragano, Sandro Zonta, Federico Lovisetto, Carlo V. Feo, Antonio Pesce, Nicolò Fabbri, Giulio Lantone, Fabio Marino, Fabrizio Perrone, Leonardo Vincenti, Vincenzo Papagni, Arcangelo Picciariello, Stefano Rossi, Biagio Picardi, Simone Rossi Del Monte, Diego Visconti, Giulia Osella, Luca Petruzzelli, Giusto Pignata, Jacopo Andreuccetti, Rossella D’Alessio, Massimo Buonfantino, Eleonora Guaitoli, Stefano Spinelli, Gianluca Matteo Sampietro, Carlo Corbellini, Leonardo Lorusso, Alice Frontali, Isabella Pezzoli, Alessandro Bonomi, Andrea Chierici, Christian Cotsoglou, Giuseppe Manca, Antonella Delvecchio, Nicola Musa, Massimiliano Casati, Laface Letizia, Emmanuele Abate, Giorgio Ercolani, Fabrizio D’Acapito, Leonardo Solaini, Gianluca Guercioni, Simone Cicconi, Diego Sasia, Felice Borghi, Giorgio Giraudo, Giuseppe Sena, Pasquale Castaldo, Eugenia Cardamone, Giuseppe Portale, Matteo Zuin, Ylenia Spolverato, Marialusia Esposito, Roberta Maria Isernia, Maria Di Salvo, Romina Manunza, Giuseppe Esposito, Marcello Agus, Emanuele Luigi Giuseppe Asti, Daniele Tiziano Bernardi, Tommaso Panici Tonucci, Davide Luppi, Massimiliano Casadei, Stefano Bonilauri, Angela Pezzolla, Annunziata Panebianco, Rita Laforgia, Maurizio De Luca, Monica Zese, Dario Parini, Elio Jovine, Giuseppina De Sario, Raffaele Lombardi, Giovanni Aprea, Giuseppe Palomba, Marianna Capuano, Giulio Argenio, Gianluca Orio, Mariano Fortunato Armellino, Marina Troian, Martina Guerra, Carlo Nagliati, Alan Biloslavo, Paola Germani, Giada Aizza, Igor Monsellato, Ali Chaouki Chahrour, Gabriele Anania, Cristina Bombardini, Francesco Bagolini, Gabriele Sganga, Pietro Fransvea, Valentina Bianchi, Paolo Boati, Francesco Ferrara, Francesco Palmieri, Pasquale Cianci, Domenico Gattulli, Enrico Restini, Nicola Cillara, Alessandro Cannavera, Gabriela Elisa Nita, Jlenia Sarnari, Francesco Roscio, Federico Clerici, Ildo Scandroglio, Stefano Berti, Alessandro Cadeo, Alice Filippelli, Luigi Conti, Carmine Grassi, Gaetano Maria Cattaneo, Marina Pighin, Davide Papis, Giovanni Gambino, Vanessa Bertino, Domenico Schifano, Daniela Prando, Luisella Fogato, Fabio Cavallo, Luca Ansaloni, Roberto Picheo, Nicholas Pontarolo, Norma Depalma, Marcello Spampinato, Stefano D’Ugo, Luca Lepre, Michela Giulii Capponi, Rossella Domenica Campa, Giuliano Sarro, Vincenza Paola Dinuzzi, Stefano Olmi, Matteo Uccelli, Davide Ferrari, Marco Inama, Gianluigi Moretto, Michele Fontana, Francesco Favi, Erika Picariello, Alessia Rampini, Andrea Barberis, Antonio Azzinnaro, Alba Oliva, Luigi Totaro, Ilaria Benzoni, Valerio Ranieri, Gabriella Teresa Capolupo, Filippo Carannante, Marco Caricato, Maurizio Ronconi, Silvia Casiraghi, Giovanni Casole, Desire Pantalone, Giovanni Alemanno, Maximilian Scheiterle, Marco Ceresoli, Marco Cereda, Chiara Fumagalli, Federico Zanzi, Stefano Bolzon, Enrico Guerra, Francesca Lecchi, Paola Cellerino, Antonella Ardito, Rosa Scaramuzzo, Andrea Balla, Pasquale Lepiane, Nicola Tartaglia, Antonio Ambrosi, Giovanna Pavone, Gian Marco Palini, Simone Veneroni, Gianluca Garulli, Claudio Ricci, Beatrice Torre, Iris Shari Russo, Matteo Rottoli, Marta Tanzanu, Angela Belvedere, Marco Milone, Michele Manigrasso, Giovanni Domenico De Palma, Micaela Piccoli, Gianmaria Casoni Pattacini, Stefano Magnone, Paolo Bertoli, Michele Pisano, Paolo Massucco, Marco Palisi, Andrea-Pierre Luzzi, Francesco Fleres, Guglielmo Clarizia, Alessandro Spolini, Yoshiro Kobe, Takayuki Toma, Fumihiko Shimamura, Robert Parker, Sinkeet Ranketi, Mercy Mitei, Saulius Svagzdys, Henrikas Pauzas, Justas Zilinskas, Tomas Poskus, Marius Kryzauskas, Matas Jakubauskas, Andee Dzulkarnaen Zakaria, Zaidi Zakaria, Michael Pak-Kai Wong, Asri Che Jusoh, Muhammad Nazreen Zakaria, Daniel Rios Cruz, Aurea Barbara Rodriguez Elizalde, Alejandro Bañon Reynaud, Edgard Efren Lozada Hernandez, Jose maria Victor Palomo Monroy, Diego Hinojosa-Ugarte, Martha Quiodettis, María Esther Du Bois, José Latorraca, Piotr Major, Michał Pędziwiatr, Magdalena Pisarska-Adamczyk, Maciej Walędziak, Andrzej Kwiatkowski, Łukasz Czyżykowski, Silvia Dantas da Costa, Bela Pereira, Ana Rita Oliveira Ferreira, Filipe Almeida, Ricardo Rocha, Carla Carneiro, Diego Pita Perez, João Carvas, Catarina Rocha, Cátia Ferreira, Rita Marques, Urânia Fernandes, Pedro Leao, André Goulart, Rita Gonçalves Pereira, Sara Daniela Direito Patrocínio, Nuno Gonçalo Gonçalves de Mendonça, Maria Isabel Cerqueira Manso, Henrique Manuel Cardoso Morais, Paulo Sebastião Cardoso, Valentin Calu, Adrian Miron, Elena Adelina Toma, Mahir Gachabayov, Abakar Abdullaev, Andrey Litvin, Taras Nechay, Alexander Tyagunov, Anvar Yuldashev, Alison Bradley, Michael Wilson, Arpád Panyko, Zuzana Látečková, Vladimír Lacko, Dusan Lesko, Marek Soltes, Jozef Radonak, Victor Turrado-Rodriguez, Roser Termes-Serra, Xavier Morales-Sevillano, Pierfrancesco Lapolla, Andrea Mingoli, Gioia Brachini, Maurizio Degiuli, Silvia Sofia, Rossella Reddavid, Andrea de Manzoni Garberini, Angelica Buffone, Eduardo Perea del Pozo, Daniel Aparicio-Sánchez, Sandra Dos Barbeito, Mercedes Estaire-Gómez, Rebeca Vitón-Herrero, Mª de los Ángeles Gil Olarte-Marquez, José Gil-Martínez, Felipe Alconchel, Tatiana Nicolás-López, Aida Cristina Rahy-Martin, María Pelloni, Raquel Bañolas-Suarez, Fernando Mendoza-Moreno, Francisca García-Moreno Nisa, Manuel Díez-Alonso, María Elisa Valle Rodas, María Carmona Agundez, María Inmaculada Pérez Andrés, Claudia Cristina Lopes Moreira, Aintzane Lizarazu Perez, Iñigo Augusto Ponce, Ana María González-Castillo, Estela Membrilla-Fernández, Silvia Salvans, Mario Serradilla-Martín, Pablo Sancho Pardo, Daniel Rivera-Alonso, Jana Dziakova, Jose Mugüerza Huguet, Naila Pagès Valle, Enrique Colás Ruiz, Cristina Rey Valcárcel, Cristina Ruiz Moreno, Yeniffer Tatiana Moreno Salazar, Juan Jesús Rubio García, Silvia Sevila Micó, Joaquín Ruiz López, Silvia Pérez Farré, Maite Santamaria Gomez, Nuria Mestres Petit, Alberto Titos-García, Jose Manuel Aranda-Narváez, Laura Romacho-López, Luis Sánchez-Guillén, Veronica Aranaz-Ostariz, Marina Bosch-Ramírez, Aleix Martínez-Pérez, Elías Martínez-López, Juan Carlos Sebastián-Tomás, Granada Jimenez-Riera, Javier Jimenez-Vega, Jose Aurelio Navas Cuellar, Andrea Campos-Serra, Anna Muñoz-Campaña, Raquel Gràcia-Roman, Javier Martínez Alegre, Francisca Lima Pinto, Sara Nuñez O’Sullivan, Francisco Blanco Antona, Beatriz Muñoz Jiménez, Jaime López-Sánchez, Zahira Gómez Carmona, Rocio Torres Fernández, Isabel Blesa Sierra, Laura Román García de León, Verónica Polaino Moreno, Eva Iglesias, Paola Lora Cumplido, Altea Arango Bravo, Ignacio Rey Simó, Carlota López Domínguez, Aloia Guerreiro Caamaño, Rafael Calleja Lozano, Manuel Durán Martínez, Álvaro Naranjo Torres, Javier Tomas Morales Bernaldo de Quiros, Gianluca Pellino, Miriam Moratal Cloquell, Elsa García Moller, Sami Jalal-Eldin, Ahmed K. Abdoun, Hytham K. S. Hamid, Varut Lohsiriwat, Aitsariya Mongkhonsupphawan, Oussama Baraket, Karim Ayed, Imed Abbassi, Ali Ben Ali, Houssem Ammar, Ali Kchaou, Ahmed Tlili, Imen Zribi, Elif Colak, Suleyman Polat, Zehra Alan Koylu, Ali Guner, Mehmet Arif Usta, Murat Emre Reis, Baris Mantoglu, Emre Gonullu, Emrah Akin, Fatih Altintoprak, Zulfu Bayhan, Necattin Firat, Arda Isik, Ufuk Memis, Mehmet Bayrak, Yasemin Altıntaş, Yasin Kara, Mehmet Abdussamet Bozkurt, Ali Kocataş, Koray Das, Ahmet Seker, Nazmi Ozer, Semra Demirli Atici, Korhan Tuncer, Tayfun Kaya, Zeynep Ozkan, Onur Ilhan, Ibrahim Agackiran, Mustafa Yener Uzunoglu, Eren Demirbas, Yuksel Altinel, Serhat Meric, Nadir Adnan Hacım, Derya Salim Uymaz, Nail Omarov, Emre Balık, Giovanni D. Tebala, Hany Khalil, Mridul Rana, Mansoor Khan, Charlotte Florence, Christie Swaminathan, Cosimo Alex Leo, Lampros Liasis, Josef Watfah, Ivan Trostchansky, Edward Delgado, Marcelo Pontillo, Rifat Latifi, Raul Coimbra, Sara Edwards, Ana Lopez, George Velmahos, Ander Dorken, Anthony Gebran, Amanda Palmer, Jeffrey Oury, James M. Bardes, Sirivan Suon Seng, Lauren S. Coffua, Asanthi Ratnasekera, Tanya Egodage, Karla Echeverria-Rosario, Isabella Armento, Lena M. Napolitano, Naveen F. Sangji, Mark Hemmila, Jacob A. Quick, Tyler R. Austin, Theodore S. Hyman, William Curtiss, Amanda McClure, Nicholas Cairl, Walter L. Biffl, Hung P. Truong, Kathryn Schaffer, Summer Reames, Filippo Banchini, Patrizio Capelli, Federico Coccolini, Massimo Sartelli, Francesca Bravi, Carlo Vallicelli, Vanni Agnoletti, Gian Luca Baiocchi, and Fausto Catena

Subjects
Hartmann’s procedure, Ostomy, Emergency surgery, Resection, Primary anastomosis, Left side, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann’s procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P

Published
2024
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2. Declaration on infection prevention and management in global surgery

Author

Massimo Sartelli, Federico Coccolini, Luca Ansaloni, Walter L. Biffl, David P. Blake, Marja A. Boermeester, Raul Coimbra, Heather L. Evans, Paula Ferrada, George Gkiokas, Marc G. Jeschke, Timothy Hardcastle, Chandler Hinson, Francesco M. Labricciosa, Sanjay Marwah, Antonio C. Marttos, Martha Quiodettis, Kemal Rasa, Jianan Ren, Ines Rubio-Perez, Robert Sawyer, Vishal Shelat, Jeffrey S. Upperman, and Fausto Catena

Subjects
Antibiotic therapy, Antimicrobial resistance, Education, Hospital-acquired infections, Infection prevention and control, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Surgeons in their daily practice are at the forefront in preventing and managing infections. However, among surgeons, appropriate measures of infection prevention and management are often disregarded. The lack of awareness of infection and prevention measures has marginalized surgeons from this battle. Together, the Global Alliance for Infections in Surgery (GAIS), the World Society of Emergency Surgery (WSES), the Surgical Infection Society (SIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), the American Association for the Surgery of Trauma (AAST), and the Panamerican Trauma Society (PTS) have jointly completed an international declaration, highlighting the threat posed by antimicrobial resistance globally and the need for preventing and managing infections appropriately across the surgical pathway. The authors representing these surgical societies call all surgeons around the world to participate in this global cause by pledging support for this declaration for maintaining the effectiveness of current and future antibiotics.

Published
2023
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4. Risk factors for the leakage of the repair of duodenal wounds: a secondary analysis of the Panamerican Trauma Society multicenter retrospective review

Author

Alberto García, Alvaro I. Sanchez, Paula Ferrada, Luke Wolfe, Juan Duchesne, Gustavo P. Fraga, Elizabeth Benjamin, Andre Campbell, Carlos Morales, Bruno M. Pereira, Marcelo Ribeiro, Martha Quiodettis, Gregory Peck, Juan C. Salamea, Vitor F. Kruger, Rao Ivatury, and Thomas Scalea

Subjects
Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Published
2023
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5. Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study

Author

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

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

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

Published
2019
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6. The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship—results from an international cross-sectional survey

Author

Massimo Sartelli, Francesco M. Labricciosa, Pamela Barbadoro, Leonardo Pagani, Luca Ansaloni, Adrian J. Brink, Jean Carlet, Ashish Khanna, Alain Chichom-Mefire, Federico Coccolini, Salomone Di Saverio, Addison K. May, Pierluigi Viale, Richard R. Watkins, Luigia Scudeller, Lilian M. Abbo, Fikri M. Abu-Zidan, Abdulrashid K. Adesunkanmi, Sara Al-Dahir, Majdi N. Al-Hasan, Halil Alis, Carlos Alves, André R. Araujo da Silva, Goran Augustin, Miklosh Bala, Philip S. Barie, Marcelo A. Beltrán, Aneel Bhangu, Belefquih Bouchra, Stephen M. Brecher, Miguel A. Caínzos, Adrian Camacho-Ortiz, Marco Catani, Sujith J. Chandy, Asri Che Jusoh, Jill R. Cherry-Bukowiec, Osvaldo Chiara, Elif Colak, Oliver A. Cornely, Yunfeng Cui, Zaza Demetrashvili, Belinda De Simone, Jan J. De Waele, Sameer Dhingra, Francesco Di Marzo, Agron Dogjani, Gereltuya Dorj, Laurent Dortet, Therese M. Duane, Mutasim M. Elmangory, Mushira A. Enani, Paula Ferrada, J. Esteban Foianini, Mahir Gachabayov, Chinmay Gandhi, Wagih Mommtaz Ghnnam, Helen Giamarellou, Georgios Gkiokas, Harumi Gomi, Tatjana Goranovic, Ewen A. Griffiths, Rosio I. Guerra Gronerth, Julio C. Haidamus Monteiro, Timothy C. Hardcastle, Andreas Hecker, Adrien M. Hodonou, Orestis Ioannidis, Arda Isik, Katia A. Iskandar, Hossein S. Kafil, Souha S. Kanj, Lewis J. Kaplan, Garima Kapoor, Aleksandar R. Karamarkovic, Jakub Kenig, Ivan Kerschaever, Faryal Khamis, Vladimir Khokha, Ronald Kiguba, Hong B. Kim, Wen-Chien Ko, Kaoru Koike, Iryna Kozlovska, Anand Kumar, Leonel Lagunes, Rifat Latifi, Jae G. Lee, Young R. Lee, Ari Leppäniemi, Yousheng Li, Stephen Y. Liang, Warren Lowman, Gustavo M. Machain, Marc Maegele, Piotr Major, Sydney Malama, Ramiro Manzano-Nunez, Athanasios Marinis, Isidro Martinez Casas, Sanjay Marwah, Emilio Maseda, Michael E. McFarlane, Ziad Memish, Dominik Mertz, Cristian Mesina, Shyam K. Mishra, Ernest E. Moore, Akutu Munyika, Eleftherios Mylonakis, Lena Napolitano, Ionut Negoi, Milica D. Nestorovic, David P. Nicolau, Abdelkarim H. Omari, Carlos A. Ordonez, José-Artur Paiva, Narayan D. Pant, Jose G. Parreira, Michal Pędziwiatr, Bruno M. Pereira, Alfredo Ponce-de-Leon, Garyphallia Poulakou, Jacobus Preller, Céline Pulcini, Guntars Pupelis, Martha Quiodettis, Timothy M. Rawson, Tarcisio Reis, Miran Rems, Sandro Rizoli, Jason Roberts, Nuno Rocha Pereira, Jesús Rodríguez-Baño, Boris Sakakushev, James Sanders, Natalia Santos, Norio Sato, Robert G. Sawyer, Sandro Scarpelini, Loredana Scoccia, Nusrat Shafiq, Vishalkumar Shelat, Costi D. Sifri, Boonying Siribumrungwong, Kjetil Søreide, Rodolfo Soto, Hamilton P. de Souza, Peep Talving, Ngo Tat Trung, Jeffrey M. Tessier, Mario Tumbarello, Jan Ulrych, Selman Uranues, Harry Van Goor, Andras Vereczkei, Florian Wagenlehner, Yonghong Xiao, Kuo-Ching Yuan, Agnes Wechsler-Fördös, Jean-Ralph Zahar, Tanya L. Zakrison, Brian Zuckerbraun, Wietse P. Zuidema, and Fausto Catena

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

Abstract Background Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. Methods A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. Results The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4–6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p

Published
2017
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7. A pandemic recap: lessons we have learned

Author

Ugo Boggi, Julival Ribeiro, Luigi Bonavina, Mauro Pistello, Fikri M. Abu-Zidan, Massimo Sartelli, Dieter G. Weber, Vladimir Khokha, Pietro Brambillasca, Dario Tartaglia, Yoram Kluger, Lorenzo Cobianchi, Damien Massalou, Cristian Mesina, Arda Isik, Alessandro Cucchetti, Mutasim M. Elmangory, Xavier Guirao, Salomone Di Saverio, Ibrahima Sall, Emmanouil Pikoulis, Aleksei V. Osipov, Krstina Doklestic, Mahir Gachabayov, Maria Grazia Sibilla, Charalampos Seretis, Fabio Tumietto, M Chirica, Paola Fugazzola, Isidoro Di Carlo, Gian Luca Baiocchi, Chad G. Ball, Yunfeng Cui, Lorenzo Ghiadoni, Timothy Craig Hardcastle, Massimo Fantoni, Boun Kim Tan, Bruno Turri, Edoardo Picetti, Federico Coccolini, Jacek Czepiel, Jae Il Kim, Evgeni Dimitrov, R. V. Maier, Camilla Cremonini, Ali I. Yahya, I. A. Kryvoruchko, Akira Kuriyama, Wagih Ghannam, Shamshul Ansari, Fernando Machado, Enrico Cicuttin, Sumita A Jain, Ronald Kiguba, Doron Kopelman, Martha Quiodettis, Michele Pisano, Marco Ceresoli, Harry van Goor, Garima Kapoor, Andrew W. Kirkpatrick, Mauro Podda, Angelo Gemignani, Boris Sakakushev, Souha S. Kanj, Ernest E. Moore, Samir Delibegovic, Cinzia Monti, Massimo Girardis, Matti Tolonen, Mushira Enani, Massimo Chiarugi, Carlos A. Ordoñez, Zaza Demetrashvili, Leonardo Pagani, Ziad A. Memish, Pradeep H. Navsaria, Paolo Malacarne, Nicola de’Angelis, Giandomenico Luigi Biancofiore, Fulvio Basolo, Goran Augustin, Junichi Matsumoto, Fausto Catena, Ari Leppäniemi, Gabriel Rodrigues, W.P. Zuidema, Raul Coimbra, Manu Malbrain, Emilio Maseda, Suman Baral, Demetrios Demetriades, M. Hecker, Davide Corbella, András Vereczkei, Sanjay Marwah, Francesco Forfori, Donal B. O’Connor, Carlo Palombo, Vishal G Shelat, Michelangelo Scaglione, Walter L. Biffl, Andrey Litvin, Majdi N. Al-Hasan, Sameer Dhingra, Miklosh Bala, Oussama Baraket, Carlos Augusto Gomez, Offir Ben-Ishay, Gabriele Materazzi, Paolo Carcoforo, Rita Galeiras, Belinda De Simone, Ionut Negoi, Mirco Nacoti, Luca Ansaloni, Bruno Viaggi, Jose J. Diaz, Alessandro Puzziello, Bruno Amato, Lostoridis Eftychios, Cino Bendinelli, Mario Testini, Andreas Hecker, Martin Reichert, Francesco Corradi, Korey Das, Gustavo M. Machain Vega, Evika Karamagioli, Rao R. Ivatury, HUS Abdominal Center, II kirurgian klinikka, Coccolini, F, Cicuttin, E, Cremonini, C, Tartaglia, D, Viaggi, B, Kuriyama, A, Picetti, E, Ball, C, Abu-Zidan, F, Ceresoli, M, Turri, B, Jain, S, Palombo, C, Guirao, X, Rodrigues, G, Gachabayov, M, Machado, F, Eftychios, L, Kanj, S, Di Carlo, I, Di Saverio, S, Khokha, V, Kirkpatrick, A, Massalou, D, Forfori, F, Corradi, F, Delibegovic, S, Machain Vega, G, Fantoni, M, Demetriades, D, Kapoor, G, Kluger, Y, Ansari, S, Maier, R, Leppaniemi, A, Hardcastle, T, Vereczkei, A, Karamagioli, E, Pikoulis, E, Pistello, M, Sakakushev, B, Navsaria, P, Galeiras, R, Yahya, A, Osipov, A, Dimitrov, E, Doklestic, K, Pisano, M, Malacarne, P, Carcoforo, P, Sibilla, M, Kryvoruchko, I, Bonavina, L, Kim, J, Shelat, V, Czepiel, J, Maseda, E, Marwah, S, Chirica, M, Biancofiore, G, Podda, M, Cobianchi, L, Ansaloni, L, Fugazzola, P, Seretis, C, Gomez, C, Tumietto, F, Malbrain, M, Reichert, M, Augustin, G, Amato, B, Puzziello, A, Hecker, A, Gemignani, A, Isik, A, Cucchetti, A, Nacoti, M, Kopelman, D, Mesina, C, Ghannam, W, Ben-Ishay, O, Dhingra, S, Coimbra, R, Moore, E, Cui, Y, Quiodettis, M, Bala, M, Testini, M, Diaz, J, Girardis, M, Biffl, W, Hecker, M, Sall, I, Boggi, U, Materazzi, G, Ghiadoni, L, Matsumoto, J, Zuidema, W, Ivatury, R, Enani, M, Litvin, A, Al-Hasan, M, Demetrashvili, Z, Baraket, O, Ordonez, C, Negoi, I, Kiguba, R, Memish, Z, Elmangory, M, Tolonen, M, Das, K, Ribeiro, J, O'Connor, D, Tan, B, Van Goor, H, Baral, S, De Simone, B, Corbella, D, Brambillasca, P, Scaglione, M, Basolo, F, De'Angelis, N, Bendinelli, C, Weber, D, Pagani, L, Monti, C, Baiocchi, G, Chiarugi, M, Catena, F, Sartelli, M, Surgery, Other Research, APH - Quality of Care, Department of Surgery, and Faculty of Health Sciences

Subjects
Biomedical Research, Pandemics / prevention & control, Delivery of Health Care / organization & administration, International Cooperation, Reflection, 030230 surgery, Global Health, Health Services Accessibility, COVID-19 / epidemiology, 0302 clinical medicine, White paper, Telemedicine / organization & administration, Multidisciplinary approach, Pandemic, Health care, Global health, 030212 general & internal medicine, Letter to the Editor, Health Policy, Politics, Medical emergencies. Critical care. Intensive care. First aid, COVID-19 / therapy, Public relations, Telemedicine, Primary Health Care / organization & administration, 3. Good health, Policy, International, Emergency Medicine, Thought, medicine.medical_specialty, COVID-19 Vaccines, RD1-811, Thoughts, Mass Vaccination, Mass Vaccination / organization & administration, NO, 03 medical and health sciences, medicine, Politic, Humans, Ethic, Healthcare Disparities, Biology, Pandemics, Health policy, LS7_4, Ethics, Pandemia, Primary Health Care, RC86-88.9, business.industry, Public health, COVID-19, Health Status Disparities, 3126 Surgery, anesthesiology, intensive care, radiology, Delivery of Health Care, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Surgery, business, COVID-19 / diagnosis
Abstract

Contains fulltext : 238976.pdf (Publisher’s version ) (Open Access) On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.

Published
2021

8. Open abdomen management for severe peritonitis in elderly. Results from the prospective International Register of Open Abdomen (IROA): Cohort study

Author

Stefano Rausei, Vincenzo Pappalardo, Marco Ceresoli, Fausto Catena, Massimo Sartelli, Massimo Chiarugi, Yoram Kluger, Andrew Kirkpatrick, Luca Ansaloni, Federico Coccolini, Giulia Montori, Fracensco Salvetti, Paola Fugazzola, Ionut Negoi, Monica Zese, Savino Occhionorelli, Sergei Shlyapnikov, Zaza Demetrashvili, Daniele Dondossola, Orestis Ioannidis, Giuseppe Novelli, Mirco Nacoti, Desmond Khor, Kenji Inaba, Demetrios Demetriades, Torsten Kaussen, Asri Che Jusoh, Wagih Ghannam, Boris Sakakushev, Ohad Guetta, Agron Dogjani, Stefano Costa, Sandeep Singh, Dimitrios Damaskos, Arda Isik, Kuo-Ching Yuan, Francesco Trotta, Aleix Martinez-Perez, Giovanni Bellanova, Vinicius Cordeiro Fonseca, Fernando Hernández, Athanasios Marinis, Wellington Fernandes, Martha Quiodettis, Miklosh Bala, Andras Vereczkei, Rafael Curado, Gustavo Pereira Fraga, Bruno M. Pereira, Mahir Gachabayov, Guillermo Perez Chagerben, Miguel Leon Arellano, Sefa Ozyazici, Gianluca Costa, Tugan Tezcaner, Matteo Porta, Yousheng Li, Faruk Karateke, Dimitrios Manatakis, Federico Mariani, Federico Lora, Ivan Sahderov, Boyko Atanasov, Sergio Zegarra, Luca Fattori, Rao Ivatury, Jimmy Xiao, Andrea Lippi, Mario Improta, Francesca Gubbiotti, Andrey Zharikov, Vincent Dubuisson, Michael Sugrue, Rausei, S, Pappalardo, V, Ceresoli, M, Catena, F, Sartelli, M, Chiarugi, M, Kluger, Y, Kirkpatrick, A, Ansaloni, L, Coccolini, F, Montori, G, Salvetti, F, Fugazzola, P, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Lippi, A, Improta, M, Gubbiotti, F, Zharikov, A, Dubuisson, V, and Sugrue, M

Subjects
Male, medicine.medical_specialty, Sepsi, Peritonitis, NO, Sepsis, 03 medical and health sciences, Elderly, Intra-abdominal infection, Open abdomen management, Source control, 0302 clinical medicine, Postoperative Complications, Abdomen, Medicine, Humans, Prospective Studies, Registries, Open abdomen, Aged, Aged, 80 and over, Univariate analysis, business.industry, Potential risk, Age Factors, Mean age, General Medicine, medicine.disease, Surgery, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Observational study, Female, business, Cohort study
Abstract

Background Analyzing the data of the International Register of Open Abdomen (IROA), the feasibility of open abdomen treatment has been demonstrated at every age. This new analysis on the IROA database investigates the risk factors for mortality in elderly patients treated with open abdomen for intra-abdominal infection. Methods Data were derived from the IROA, a prospective observational international cohort study that enrolled patients treated with open abdomen worldwide. A univariate analysis of potential risk factors was performed. Inclusion criteria were patients older than 65 years and treated with open abdomen for intra-abdominal infection. End point was overall mortality, calculated within 30 days after open abdomen management, after 1-month and 1-year follow-up. Results A total of 116 patients was analyzed with mean age of 76 ± 7 years. Definitive closure was achieved in 93 patients (93/116, 80.2%) for a mean open abdomen duration of 5.0 ± 5.0 days. Complicated patients were 101 (101/116, 87.1%) for a total of 201 complications. Overall, 62 out of 116 patients (53.4%) died: 23 patients (23/62, 37.1%) during open abdomen management, 29 patients (46.8%) within 30 days after abdominal closure, 9 patients (14.5%) after 1-month follow-up, and 1 patient (1.6%) after 1-year follow-up. Age did not affect mortality (75 ± 6 years in alive patients versus 77 ± 7 years in dead patients, p = 0.773). Definitive abdominal closure was the most important factor to prevent mortality. Conclusions This study confirmed that age alone cannot be considered a determinant for death, even in elderly patients managed with open abdomen for severe intra-abdominal infection.

Published
2020

9. Open Abdomen in Obese Patients: Pay Attention! New Evidences from IROA, the International Register of Open Abdomen

Author

Marco Ceresoli, Francesco Salvetti, Yoram Kluger, Marco Braga, Jacopo Viganò, Paola Fugazzola, Massimo Sartelli, Luca Ansaloni, Fausto Catena, Federico Coccolini, Ionut Negoi, Monica Zese, Savino Occhionorelli, Francesca Gubbiotti, Sergei Shlyapnikov, Christian Galatioto, Massimo Chiarugi, Zaza Demetrashvili, Daniele Dondossola, Orestis Ioannidis, Giuseppe Novelli, Mirco Nacoti, Desmond Khor, Kenji Inaba, Demetrios Demetriades, Torsten Kaussen, Asri Che Jusoh, Wagih Ghannam, Boris Sakakushev, Ohad Guetta, Agron Dogjani, Stefano Costa, Sandeep Singh, Dimitrios Damaskos, Arda Isik, Kuo-Ching Yuan, Francesco Trotta, Stefano Rausei, Aleix Martinez-Perez, Giovanni Bellanova, Vinicius Cordeiro Fonseca, Fernando Hernández, Athanasios Marinis, Wellington Fernandes, Martha Quiodettis, Miklosh Bala, Andras Vereczkei, Rafael Curado, Gustavo Pereira Fraga, Bruno M Pereira, Mahir Gachabayov, Guillermo Perez Chagerben, Miguel Leon Arellano, Sefa Ozyazici, Gianluca Costa, Tugan Tezcaner, Matteo Porta, Yousheng Li, Faruk Karateke, Dimitrios Manatakis, Federico Mariani, Federic Lora, Ivan Sahderov, Boyko Atanasov, Sergio Zegarra, Luca Fattori, Alice Nigro, Andrew Kirkpatrick, Anton Parfenov, Giulia Montori, Paolo Dionigi, Michael Sugrue, Vincent Dubuisson, Joel Noutakdie Tochie, Rao Ivatury, Ceresoli, M, Salvetti, F, Kluger, Y, Braga, M, Viganò, J, Fugazzola, P, Sartelli, M, Ansaloni, L, Catena, F, Coccolini, F, Negoi, I, Zese, M, Occhionorelli, S, Gubbiotti, F, Shlyapnikov, S, Galatioto, C, Chiarugi, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Che Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Cordeiro Fonseca, V, Hernández, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Pereira Fraga, G, M Pereira, B, Gachabayov, M, Perez Chagerben, G, Leon Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Nigro, A, Kirkpatrick, A, Parfenov, A, Montori, G, Dionigi, P, Sugrue, M, Dubuisson, V, Noutakdie Tochie, J, and Ivatury, R

Subjects
Adult, Male, medicine.medical_specialty, Abdominal compartment syndrome, Fistula, open abdomen, NO, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Acute care, Abdomen, Female, Humans, Intensive Care Units, Length of Stay, Middle Aged, Obesity, Registries, medicine, business.industry, Fascia, medicine.disease, Cardiac surgery, Surgery, medicine.anatomical_structure, Cardiothoracic surgery, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, business, Trauma surgery, Abdominal surgery
Abstract

Background: Open abdomen is the cornerstone of damage control strategies in acute care and trauma surgery. The role of BMI has not been well investigated. The aim of the study was to assess the role of BMI in determining outcomes after open abdomen. Methods: This is an analysis of patients recorded into the International Register of Open Abdomen; patients were classified in two groups according to BMI using a cutoff of 30 kg/m2. The primary outcome was in-hospital mortality; secondary outcomes were primary fascia closure rate, length of treatment, complication rate, entero-atmospheric fistula rate and length of ICU stay. Results: A total of 591 patients were enrolled from 57 centers, and obese patients were 127 (21.5%). There was no difference in mortality between the two groups; complications developed during the open treatment were higher in obese patients (63.8% vs. 53.4%, p = 0.038) while post-closure complications rate was similar. Obese patients had a significantly longer duration of the open treatment (9.1 ± 11.5 days vs. 6.3 ± 7.5 days; p = 0,002) and lower primary fascia closure rate (75.5% vs. 89.5%; p < 0,001). No differences in fistula rate were found. There was a linear correlation between the duration of open abdomen and the BMI (Pearson’s linear correlation coefficient = 0,201; p < 0,001). Conclusions: Open abdomen in obese patients seems to be safe as in non-obese patients with similar mortality; however, in obese patients the length of open abdomen is significantly higher with higher complication rate, longer ICU length of stay and lower primary fascia closure rate. Trial registration number: ClinicalTrials.gov, Identifier: NCT02382770.

Published
2019

10. Management of duodenal trauma: A retrospective review from the Panamerican Trauma Society

Author

Elizabeth Benjamin, Julieta Correa, Christopher A. Wybourn, Marcelo Ribeiro, Rao R. Ivatury, Alberto García, Thomas M. Scalea, Paula Ferrada, Luke Wolfe, Gustavo P Fraga, Martha Quiodettis, Andre Campbell, Gregory L Peck, Bruno M Pereira, Augustin Alvarez, Carlos Morales, Juan Duchesne, Juan C Salamea, and Victor F Kruger

Subjects
Adult, Male, medicine.medical_specialty, Duodenum, medicine.medical_treatment, Operative Time, Blood Loss, Surgical, Abdominal Injuries, Critical Care and Intensive Care Medicine, Sepsis, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Interquartile range, Risk Factors, Medicine, Humans, Blood Transfusion, Renal replacement therapy, Renal Insufficiency, Pancreas, Retrospective Studies, Univariate analysis, Trauma Severity Indices, Abbreviated Injury Scale, business.industry, 030208 emergency & critical care medicine, Retrospective cohort study, Length of Stay, medicine.disease, Surgery, Injury Severity Score, Female, Pancreatic injury, business
Abstract

Introduction The operative management of duodenal trauma remains controversial. Our hypothesis is that a simplified operative approach could lead to better outcomes. Methods We conducted an international multicenter study, involving 13 centers. We performed a retrospective review from January 2007 to December of 2016. Data on demographics, mechanism of trauma, blood loss, operative time, and associated injured organs were collected. Outcomes included postoperative intra-abdominal sepsis, leak, need for unplanned surgery, length of stay, renal failure, and mortality. We used the Research Electronic Data Capture tool to store the data. Poisson regression using a backward selection method was used to identify independent predictors of mortality. Results We collected data of 372 patients with duodenal injuries. Although the duodenal trauma was complex (median Injury Severity Score [ISS], 18 [interquartile range, 2-3]; Abbreviated Injury Scale, 3.5 [3-4]; American Association for the Surgery of Trauma grade, 3 [2-3]), primary repair alone was the most common type of operative management (80%, n = 299). Overall mortality was 24%. On univariate analysis, mortality was associated with male gender, lower admission systolic blood pressure, need for transfusion before operative repair, higher intraoperative blood loss, longer operative time, renal failure requiring renal replacement therapy, higher ISS, and associated pancreatic injury. Poisson regression showed higher ISS, associated pancreatic injury, postoperative renal failure requiring renal replacement therapy, the need for preoperative transfusion, and male gender remained significant predictors of mortality. Duodenal suture line leak was statistically significantly lower, and patients had primary repair over every American Association for the Surgery of Trauma grade of injury. Conclusions The need for transfusion prior to the operating room, associated pancreatic injuries, and postoperative renal failure are predictors of mortality for patients with duodenal injuries. Primary repair alone is a common and safe operative repair even for complex injuries when feasible. Level of evidence Therapeutic study, level IV.

Published
2018

11. Panamerican Trauma Society Basic Trauma Education Course Administration in Resource-limited Areas

Author

Gustavo M Machain, Francisco Mora, Michel B. Aboutanos, Martha Quiodettis, Jaime Fischer, Edgar B. Rodas, Juan C Salamea, Rao R. Ivatury, and Lina V Mata

Subjects
medicine.medical_specialty, business.industry, Emergency medicine, Medicine, Medical emergency, business, medicine.disease, Administration (government), Limited resources
Abstract

Introduction and objectives Injuries and noncommunicable diseases account for greater than 73% deaths and 76% disability adjusted life years (DALYs) in Latin America, where trauma care is challenging especially when resources are scarce. Education and training is a basic step in trauma systems development, which was shown to improve survival. Except for urban areas, trauma courses are unavailable and unaffordable in the Latin region. The aim of this study is to evaluate the feasibility of implementation of a basic trauma education course (BTC) for resource-limited areas adopted and promulgated by the Panamerican Trauma Society (PTS) since 2011. Materials and methods Basic trauma education course was administered in Paraguay, Medellin, Chile, and Panama during the PTS congresses (2011-2013). The two-day course was based on the patient's pathway system, addressing the management of the patient through various echelon of care from rural health centers to local provincial hospital and tertiary treatment facilities. It contained 20 hours of didactic lectures and hands on skill labs on basic trauma resuscitation, stabilization, and transport, as well as trauma system-oriented teaching (triage, EMS, kinematics, trauma registries). Panamerican Trauma Society international and national instructors administered the courses. Course logistics and coordination were carried out by international and local coordinators and by trauma league medical students. Pre and post (30 multiple-choice questions) tests were used to assess participants. Paired t-test was used to compare scores. Results Fifty-four students (rural physicians, EMS providers, students, nurses, and administrators) participated. Pre and posttest score comparison showed significant improvement 74% vs 85% respectively, p-value < 0.0001. Conclusion A tailored trauma course and evaluation can be feasible in educating local providers. The PTS can promulgate the application of BTCs that may serve as a model for continuing trauma care education in developing countries. Course follow-up evaluation is pending. How to cite this article Mata LV, Mora FE, Quiodettis M, Fischer J, Machain GM, Salamea JC, Rodas EB, Aboutanos MB. Panamerican Trauma Society Basic Trauma Education Course Administration in Resource-limited Areas. Panam J Trauma Crit Care Emerg Surg 2016;5(2):83-87.

Published
2016

12. The Global Alliance for Infections in Surgery : defining a model for antimicrobial stewardship-results from an international cross-sectional survey

Author

Federico Coccolini, Leonel Lagunes, André Ricardo Araujo da Silva, Massimo Sartelli, Sara Al-Dahir, Young R. Lee, Mario Tumbarello, Faryal Khamis, Natalia Santos, Jean Carlet, Fausto Catena, Agron Dogjani, Jan Ulrych, Isidro Martinez Casas, András Vereczkei, Salomone Di Saverio, Sydney Malama, Harry van Goor, Garima Kapoor, Hong Bin Kim, Norio Sato, Gustavo M. Machain, Chinmay Gandhi, Iryna Kozlovska, Ramiro Manzano-Nunez, Katia Iskandar, Fikri M. Abu-Zidan, Sujith J Chandy, Rosio Isabel Guerra Gronerth, Therese M. Duane, Lena M. Napolitano, Carlos A. Ordoñez, Yonghong Xiao, Michael McFarlane, Cristian Mesina, Sanjay Marwah, Goran Augustin, Tatjana Goranovic, Bruno M. Pereira, Ivan Kerschaever, Timothy Craig Hardcastle, Marcelo A. Beltrán, Stephen Y. Liang, Julio C. Haidamus Monteiro, Vishalkumar G Shelat, Kuo Ching Yuan, Sandro Scarpelini, Narayan Dutt Pant, Martha Quiodettis, Carlos Alves, Mutasim M. Elmangory, Céline Pulcini, Addison K. May, Guntars Pupelis, Selman Uranues, Pamela Barbadoro, Sandro Rizoli, Ernest E. Moore, Rifat Latifi, Ashish Khanna, Hossein Samadi Kafil, Richard R. Watkins, Boonying Siribumrungwong, Abdelkarim H. Omari, Agnes Wechsler-Fördös, Lewis J. Kaplan, Nusrat Shafiq, Jason A. Roberts, Warren Lowman, Laurent Dortet, Stephen M. Brecher, Luca Ansaloni, Rodolfo Soto, Tanya L. Zakrison, Sameer Dhingra, Jacobus Preller, Eleftherios Mylonakis, Wagih Ghnnam, Asri Che Jusoh, Pierluigi Viale, Costi D. Sifri, Miklosh Bala, José Gustavo Parreira, Alfredo Ponce-de-León, Jae G. Lee, Jakub Kenig, Kjetil Søreide, Halil Alis, Lilian M. Abbo, Mahir Gachabayov, Marco Catani, Ronald Kiguba, Jean-Ralph Zahar, Wietse P. Zuidema, Robert G. Sawyer, Loredana Scoccia, Nuno Pereira, Vladimir Khokha, Ionut Negoi, Aneel Bhangu, Michał Pędziwiatr, Helen Giamarellou, Garyphallia Poulakou, Shyam Kumar Mishra, Francesco Di Marzo, Jeffrey M. Tessier, Boris Sakakushev, Milica D. Nestorovic, Hamilton Petry de Souza, Tarcisio Reis, Yousheng Li, Dominik Mertz, Andreas Hecker, Ngo Tat Trung, Anand Kumar, Belefquih Bouchra, Leonardo Pagani, James M. Sanders, AA Munyika, Brian S. Zuckerbraun, Souha S. Kanj, Arda Isik, Luigia Scudeller, Adrien Hodonou, Philip S. Barie, Marc Maegele, Jill R. Cherry-Bukowiec, Peep Talving, Orestis Ioannidis, Miran Rems, Oliver A. Cornely, Harumi Gomi, Ewen A. Griffiths, Mushira Enani, Zaza Demetrashvili, Gereltuya Dorj, Piotr Major, Miguel Caínzos, Ari Leppäniemi, Jesús Rodríguez-Baño, Wen Chien Ko, Ziad A. Memish, Osvaldo Chiara, Elif Colak, José Artur Paiva, A R K Adesunkanmi, Timothy M. Rawson, Georgios Gkiokas, Paula Ferrada, Francesco M. Labricciosa, Alain Chichom-Mefire, Jan J. De Waele, Yunfeng Cui, Adrián Camacho-Ortiz, J. Esteban Foianini, Majdi N. Al-Hasan, Belinda De Simone, David P. Nicolau, Kaoru Koike, Athanasios Marinis, Florian M.E. Wagenlehner, Aleksandar Karamarkovic, Adrian Brink, Emilio Maseda, II kirurgian klinikka, Department of Surgery, Clinicum, HUS Abdominal Center, Surgery, Other Research, Università degli Studi di Macerata = University of Macerata (UNIMC), Università Politecnica delle Marche [Ancona] (UNIVPM), Central Hospital [Bolzano, Italy], Hospital Papa Giovanni XXIII (Hosp P Giovanni XXIII), Milpark Hospital (Milpark Hospital), Milpark Hospital, University of Cape Town, World Alliance against Antibiotics Resistance, Cleveland Clinic, Regional Hospital, Limbe, Rimini Infermi Hospital, Maggiore Hospital, Vanderbilt University Medical Center [Nashville], Vanderbilt University [Nashville], University of Bologna, Northeastern Ohio Medical University (NEOMED), Foundation IRCCS Policlinico San Matteo, University of Miami Leonard M. Miller School of Medicine (UMMSM), United Arab Emirates University (UAEU), Obafemi Awolowo University (OAU), Xavier University of Louisiana, University of South Carolina School of Medicine, Columbia, South Carolina, Training Hospital Istanbul, Hospital de São João [Porto], Centro de Investigação em Estudos da Criança (CIEC), Universidade do Minho, University Hospital Center Zagreb, Hadassah Hebrew University Medical Center [Jerusalem], Weill Cornell Medicine [New York], Universidad de La Serena (USERENA), Queens Elizabeth Hospital [Birmingham], Université Internationale de Casablanca (UIC), VA Boston Healthcare System, Boston University School of Medicine (BUSM), Boston University [Boston] (BU), Natbrainlab, Department of Forensic and Neurodevelopmental Sciences, Institute of psychiatry-King‘s College London, University Hospital of Cologne [Cologne], 4th Department of Internal Medicine, University of Athens Medical School [Athens], Center for Visual Information Technology [Hyderabad] (CVIT), International Institute of Information Technology, Hyderabad [Hyderabad] (IIIT-H), Chonnam National University [Gwangju], Shanghai Jiaotong University, University of Houston, Centro Hospitalar Universitário São João - Faculty of Medicine - University of Porto - Grupo de Infecção e Sepsis, Porto, Unité de biostatistiques, CHU Clermont-Ferrand, ATTIKON University General Hospital, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Duke University Marine Laboratory, University Hospital Virgen Macarena, Service de bactériologie, virologie, parasitologie et hygiène, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sartelli, M, Labricciosa, FM, Barbadoro, P, Pagani, L, Dorj, G, Catena, Fausto, Sartelli, Massimo, Labricciosa, Francesco M., Barbadoro, Pamela, Pagani, Leonardo, Ansaloni, Luca, Brink, Adrian J., Carlet, Jean, Khanna, Ashish, Chichom-Mefire, Alain, Coccolini, Federico, Di Saverio, Salomone, May, Addison K., Viale, Pierluigi, Watkins, Richard R., Scudeller, Luigia, Abbo, Lilian M., Abu-Zidan, Fikri M., Adesunkanmi, Abdulrashid K., Al-Dahir, Sara, Al-Hasan, Majdi N., Alis, Halil, Alves, Carlo, Araujo da Silva, André R., Augustin, Goran, Bala, Miklosh, Barie, Philip S., Beltrán, Marcelo A., Bhangu, Aneel, Bouchra, Belefquih, Brecher, Stephen M., Caínzos, Miguel A., Camacho-Ortiz, Adrian, Catani, Marco, Chandy, Sujith J., Jusoh, Asri Che, Cherry-Bukowiec, Jill R., Chiara, Osvaldo, Colak, Elif, Cornely, Oliver A., Cui, Yunfeng, Demetrashvili, Zaza, De Simone, Belinda, De Waele, Jan J., Dhingra, Sameer, Di Marzo, Francesco, Dogjani, Agron, Dorj, Gereltuya, Dortet, Laurent, Duane, Therese M., Elmangory, Mutasim M., Enani, Mushira A., Ferrada, Paula, Esteban Foianini, J., Gachabayov, Mahir, Gandhi, Chinmay, Ghnnam, Wagih Mommtaz, Giamarellou, Helen, Gkiokas, Georgio, Gomi, Harumi, Goranovic, Tatjana, Griffiths, Ewen A., Guerra Gronerth, Rosio I., Haidamus Monteiro, Julio C., Hardcastle, Timothy C., Hecker, Andrea, Hodonou, Adrien M., Ioannidis, Oresti, Isik, Arda, Iskandar, Katia A., Kafil, Hossein S., Kanj, Souha S., Kaplan, Lewis J., Kapoor, Garima, Karamarkovic, Aleksandar R., Kenig, Jakub, Kerschaever, Ivan, Khamis, Faryal, Khokha, Vladimir, Kiguba, Ronald, Kim, Hong B., Ko, Wen-Chien, Koike, Kaoru, Kozlovska, Iryna, Kumar, Anand, Lagunes, Leonel, Latifi, Rifat, Lee, Jae G., Lee, Young R., Leppäniemi, Ari, Li, Yousheng, Liang, Stephen Y., Lowman, Warren, Machain, Gustavo M., Maegele, Marc, Major, Piotr, Malama, Sydney, Manzano-Nunez, Ramiro, Marinis, Athanasio, Martinez Casas, Isidro, Marwah, Sanjay, Maseda, Emilio, McFarlane, Michael E., Memish, Ziad, Mertz, Dominik, Mesina, Cristian, Mishra, Shyam K., Moore, Ernest E., Munyika, Akutu, Mylonakis, Eleftherio, Napolitano, Lena, Negoi, Ionut, Nestorovic, Milica D., Nicolau, David P., Omari, Abdelkarim H., Ordonez, Carlos A., Paiva, José-Artur, Pant, Narayan D., Parreira, Jose G., Pedziwiatr, Michal, Pereira, Bruno M., Ponce-de-Leon, Alfredo, Poulakou, Garyphallia, Preller, Jacobu, Pulcini, Céline, Pupelis, Guntar, Quiodettis, Martha, Rawson, Timothy M., Reis, Tarcisio, Rems, Miran, Rizoli, Sandro, Roberts, Jason, Pereira, Nuno Rocha, Rodríguez-Baño, Jesú, Sakakushev, Bori, Sanders, Jame, Santos, Natalia, Sato, Norio, Sawyer, Robert G., Scarpelini, Sandro, Scoccia, Loredana, Shafiq, Nusrat, Shelat, Vishalkumar, Sifri, Costi D., Siribumrungwong, Boonying, Søreide, Kjetil, Soto, Rodolfo, de Souza, Hamilton P., Talving, Peep, Trung, Ngo Tat, Tessier, Jeffrey M., Tumbarello, Mario, Ulrych, Jan, Uranues, Selman, Van Goor, Harry, Vereczkei, Andra, Wagenlehner, Florian, Xiao, Yonghong, Yuan, Kuo-Ching, Wechsler-Fördös, Agne, Zahar, Jean-Ralph, Zakrison, Tanya L., Zuckerbraun, Brian, and Zuidema, Wietse P.

Subjects
0301 basic medicine, Cross-sectional study, Psychological intervention, Antibiotics, Antimicrobial stewardship, Infections, Surgery, Anti-Infective Agents, Antimicrobial Stewardship, Cross-Sectional Studies, Global Health, Humans, Intraabdominal Infections, Postoperative Complications, Surveys and Questionnaires, GUIDELINES, HEALTH-CARE EPIDEMIOLOGY, 0302 clinical medicine, Global health, Medicine and Health Sciences, PROGRAM, Infection control, Medicine, 030212 general & internal medicine, Response rate (survey), DISEASES SOCIETY, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 3. Good health, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], CIRURGIA, Emergency Medicine, Infection, Life Sciences & Biomedicine, medicine.medical_specialty, 030106 microbiology, lcsh:Surgery, MEDLINE, 03 medical and health sciences, Antibiotic resistance, AMERICA, Science & Technology, business.industry, Antibiotic, lcsh:RD1-811, lcsh:RC86-88.9, 3126 Surgery, anesthesiology, intensive care, radiology, HOSPITALS, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

Contains fulltext : 177987.pdf (Publisher’s version ) (Open Access) BACKGROUND: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. METHODS: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. RESULTS: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). CONCLUSION: The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal.

Published
2017

13. The

Author

Massimo, Sartelli, Francesco M, Labricciosa, Pamela, Barbadoro, Leonardo, Pagani, Luca, Ansaloni, Adrian J, Brink, Jean, Carlet, Ashish, Khanna, Alain, Chichom-Mefire, Federico, Coccolini, Salomone, Di Saverio, Addison K, May, Pierluigi, Viale, Richard R, Watkins, Luigia, Scudeller, Lilian M, Abbo, Fikri M, Abu-Zidan, Abdulrashid K, Adesunkanmi, Sara, Al-Dahir, Majdi N, Al-Hasan, Halil, Alis, Carlos, Alves, André R, Araujo da Silva, Goran, Augustin, Miklosh, Bala, Philip S, Barie, Marcelo A, Beltrán, Aneel, Bhangu, Belefquih, Bouchra, Stephen M, Brecher, Miguel A, Caínzos, Adrian, Camacho-Ortiz, Marco, Catani, Sujith J, Chandy, Asri Che, Jusoh, Jill R, Cherry-Bukowiec, Osvaldo, Chiara, Elif, Colak, Oliver A, Cornely, Yunfeng, Cui, Zaza, Demetrashvili, Belinda, De Simone, Jan J, De Waele, Sameer, Dhingra, Francesco, Di Marzo, Agron, Dogjani, Gereltuya, Dorj, Laurent, Dortet, Therese M, Duane, Mutasim M, Elmangory, Mushira A, Enani, Paula, Ferrada, J, Esteban Foianini, Mahir, Gachabayov, Chinmay, Gandhi, Wagih Mommtaz, Ghnnam, Helen, Giamarellou, Georgios, Gkiokas, Harumi, Gomi, Tatjana, Goranovic, Ewen A, Griffiths, Rosio I, Guerra Gronerth, Julio C, Haidamus Monteiro, Timothy C, Hardcastle, Andreas, Hecker, Adrien M, Hodonou, Orestis, Ioannidis, Arda, Isik, Katia A, Iskandar, Hossein S, Kafil, Souha S, Kanj, Lewis J, Kaplan, Garima, Kapoor, Aleksandar R, Karamarkovic, Jakub, Kenig, Ivan, Kerschaever, Faryal, Khamis, Vladimir, Khokha, Ronald, Kiguba, Hong B, Kim, Wen-Chien, Ko, Kaoru, Koike, Iryna, Kozlovska, Anand, Kumar, Leonel, Lagunes, Rifat, Latifi, Jae G, Lee, Young R, Lee, Ari, Leppäniemi, Yousheng, Li, Stephen Y, Liang, Warren, Lowman, Gustavo M, Machain, Marc, Maegele, Piotr, Major, Sydney, Malama, Ramiro, Manzano-Nunez, Athanasios, Marinis, Isidro, Martinez Casas, Sanjay, Marwah, Emilio, Maseda, Michael E, McFarlane, Ziad, Memish, Dominik, Mertz, Cristian, Mesina, Shyam K, Mishra, Ernest E, Moore, Akutu, Munyika, Eleftherios, Mylonakis, Lena, Napolitano, Ionut, Negoi, Milica D, Nestorovic, David P, Nicolau, Abdelkarim H, Omari, Carlos A, Ordonez, José-Artur, Paiva, Narayan D, Pant, Jose G, Parreira, Michal, Pędziwiatr, Bruno M, Pereira, Alfredo, Ponce-de-Leon, Garyphallia, Poulakou, Jacobus, Preller, Céline, Pulcini, Guntars, Pupelis, Martha, Quiodettis, Timothy M, Rawson, Tarcisio, Reis, Miran, Rems, Sandro, Rizoli, Jason, Roberts, Nuno Rocha, Pereira, Jesús, Rodríguez-Baño, Boris, Sakakushev, James, Sanders, Natalia, Santos, Norio, Sato, Robert G, Sawyer, Sandro, Scarpelini, Loredana, Scoccia, Nusrat, Shafiq, Vishalkumar, Shelat, Costi D, Sifri, Boonying, Siribumrungwong, Kjetil, Søreide, Rodolfo, Soto, Hamilton P, de Souza, Peep, Talving, Ngo Tat, Trung, Jeffrey M, Tessier, Mario, Tumbarello, Jan, Ulrych, Selman, Uranues, Harry, Van Goor, Andras, Vereczkei, Florian, Wagenlehner, Yonghong, Xiao, Kuo-Ching, Yuan, Agnes, Wechsler-Fördös, Jean-Ralph, Zahar, Tanya L, Zakrison, Brian, Zuckerbraun, Wietse P, Zuidema, and Fausto, Catena

Subjects
Antimicrobial Stewardship, Cross-Sectional Studies, Postoperative Complications, Anti-Infective Agents, Antibiotics, Surveys and Questionnaires, Humans, Intraabdominal Infections, Surgery, Global Health, Infections, Research Article
Abstract

Background Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. Methods A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. Results The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4–6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p

Published
2017

14. IROA: International Register of Open Abdomen, preliminary results

Author

Arda Isik, Luca Ansaloni, Tugan Tezcaner, Fausto Catena, Rao R. Ivatury, Federico Coccolini, András Vereczkei, Giulia Montori, Guillermo Perez Chagerben, Francesco Salvetti, Fernando Hernández, Sergei Shlyapnikov, Torsten Kaussen, Mahir Gachabayov, Kuo-Ching Yuan, Boris Sakakushev, Francesco Trotta, Martha Quiodettis, Paola Fugazzola, Zaza Demetrashvili, Rafael L. Curado, Stefano Rausei, Christian Galatioto, Marco Ceresoli, Athanasios Marinis, Ionut Negoi, Desmond Khor, Dimitrios Damaskos, Yovcho Yovtchev, Sefa Ozyazici, Giovanni Bellanova, Aleix Martínez-Pérez, Massimo Chiarugi, Monica Zese, Gianluca Costa, Giuseppe Novelli, Michael Sugrue, Davide Corbella, Miguel Leon Arellano, Gustavo Pereira Fraga, Ohad Guetta, Stefano Costa, Bruno M. Pereira, Demetrios Demetriades, Asri Che Jusoh, Savino Occhionorelli, Orestis Ioannidis, Daniele Dondossola, Wagih Ghannam, Miklosh Bala, Wellington Fernandes, Kenji Inaba, Vinicius Cordeiro Fonseca, Agron Dogjani, Sandeep Singh, Stefano Maccatrozzo, Massimo Sartelli, Mirco Nacoti, Coccolini, F, Montori, G, Ceresoli, M, Catena, F, Ivatury, R, Sugrue, M, Sartelli, M, Fugazzola, P, Corbella, D, Salvetti, F, Negoi, I, Zese, M, Occhionorelli, S, Maccatrozzo, S, Shlyapnikov, S, Galatioto, C, Chiarugi, M, Demetrashvili, Z, Dondossola, D, Yovtchev, Y, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, and Ansaloni, L

Subjects
Male, Internationality, Fistula, Kaplan-Meier Estimate, 030230 surgery, Barker, Cohort Studies, 0302 clinical medicine, Ischemia, Abdomen, Epidemiology, Prospective Studies, Registries, Bogotà bag, Commercial, Compartment, IROA, Negative pressure, Non-commercial, Open abdomen, Peritonitis, Register, Skin, Trauma, Vascular emergencies, Witmann, Child, Digestive System Surgical Procedures, Peritoniti, Abdominal Wound Closure Techniques, Middle Aged, Bogota bag, Vascular emergencie, Child, Preschool, 030220 oncology & carcinogenesis, Emergency Medicine, Female, Erratum, Cohort study, Adult, medicine.medical_specialty, NO, 03 medical and health sciences, Emergency surgery, medicine, Humans, Aged, Adult patients, business.industry, medicine.disease, Surgery, Wounds and Injuries, Pancreatitis, business
Abstract

Background: No definitive data about open abdomen (OA) epidemiology and outcomes exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) promoted the International Register of Open Abdomen (IROA). Methods: A prospective observational cohort study including patients with an OA treatment. Data were recorded on a web platform (Clinical Registers (R)) through a dedicated website: www.clinicalregisters.org. Results: Four hundred two patients enrolled. Adult patients: 369 patients; Mean age: 57.39 +/- 18.37; 56% male; Mean BMI: 36 +/- 5.6. OA indication: Peritonitis (48.7%), Trauma (20.5%), Vascular Emergencies/Hemorrhage (9.4%), Ischemia (9.1%), Pancreatitis (4.2%), Post-operative abdominal-compartment-syndrome (3.9%), Others (4.2%). The most adopted Temporary-abdominal-closure systems were the commercial negative pressure ones (44.2%). During OA 38% of patients had complications; among them 10.5% had fistula. Definitive closure: 82.8%; Mortality during treatment: 17.2%. Mean duration of OA: 5.39(+/- 4.83) days; Mean number of dressing changes: 0.88(+/- 0.88). After-closure complications: (49.5%) and Mortality: (9%). No significant associations among TACT, indications, mortality, complications and fistula. A linear correlationexists between days of OA and complications (Pearson linear correlation = 0.326 p

Published
2017

15. Pesadillas Trauma Abdominal: Solución FácilProblemas Complejos

Author

Saturnino Domínguez and Martha Quiodettis

Subjects
medicine.medical_specialty, business.industry, Fistula, Biliary fistula, Granulation tissue, Dehiscence, medicine.disease, Surgery, medicine.anatomical_structure, Parenteral nutrition, Suture (anatomy), medicine, Abdomen, business, Open abdomen
Abstract

RESUMEN Introducción Determinar la eficiencia del uso de parches de coloides en el control local de una fístula enteroatmosférica de alto gasto. Materiales y métodos Presentamos el caso de un paciente de 25 años que sufrió heridas múltiples por proyectil de arma de fuego en abdomen con lesiones de duodeno y colon. El paciente inicialmente se le realiza sutura primaria de las lesiones y presenta dehiscencia de suturas con peritonitis fecal y biliar con posterior fístula enteroatmosférica de alto gasto asociada a abdomen abierto que fue manejada con dispositivo de presión negativa, drenajes, lavados de cavidad abdominal y nutrición parenteral total (NPT), sin embargo luego de ocho semanas se evidencia un abdomen abierto grado IV sin mejoría significativa del gasto o el cierre de la fístula, con significativos problemas para el control local debido a que era imposible lograr sello o controlar las secreciones por lo cual se decide iniciar el uso de parches de coloide en reemplazo de la terapia con dispositivo a presión negativa como método para el control de la fístula. Resultados Después de 88 días con el uso de parches de coloides el paciente presenta epitelización del abdomen abierto con aumento en el tejido de granulación, corrección parcial del desequilibrio hidroelectrolítico y el estado nutricional mejorando de forma significativa, ya que se pudo iniciar nutrición enteral a través de asa de yeyuno. No se han presentado complicaciones asociadas a la utilización de los parches de coloides. Conclusión La utilización de parches de coloides como método alternativo ha demostrado ser una forma eficiente para el control local de la fístula enteroatmosférica, facilitando el manejo sin aumento en las complicaciones.

Published
2012

16. Erratum to: IROA: International Register of Open Abdomen, preliminary results

Author

Giuseppe Novelli, Fernando Hernández, Giovanni Bellanova, Massimo Chiarugi, Luca Ansaloni, Mahir Gachabayov, Asri Che Jusoh, Boris Sakakushev, Mirco Nacoti, Savino Occhionorelli, Francesco Salvetti, Giulia Montori, Gustavo Pereira Fraga, Zaza Demetrashvili, Guillermo Perez Chagerben, Gianluca Costa, Wagih Ghannam, Athanasios Marinis, Monica Zese, Davide Corbella, Rao R. Ivatury, Sefa Ozyazici, Federico Coccolini, Michael Sugrue, Vinicius Cordeiro Fonseca, Kuo-Ching Yuan, Wellington Fernandes, Orestis Ioannidis, Paola Fugazzola, Stefano Costa, Miklosh Bala, Ionut Negoi, Desmond Khor, Daniele Dondossola, Bruno M. Pereira, Yovcho Yovtchev, Rafael L. Curado, Arda Isik, Sandeep Singh, Sergei Shlyapnikov, Stefano Rausei, Dimitrios Damaskos, Stefano Maccatrozzo, Aleix Martínez-Pérez, Miguel Leon Arellano, Massimo Sartelli, Ohad Guetta, Christian Galatioto, Demetrios Demetriades, Marco Ceresoli, Kenji Inaba, Agron Dogjani, Tugan Tezcaner, Fausto Catena, András Vereczkei, Torsten Kaussen, Francesco Trotta, and Martha Quiodettis

Subjects
MEDLINE, Peritonitis, 030230 surgery, Trauma, Barker, 03 medical and health sciences, 0302 clinical medicine, Ischemia, Medicine, Open abdomen, Skin, Compartment, business.industry, Commercial, Published Erratum, Bogotà bag, Vascular emergencies, Register, medicine.disease, Negative pressure, IROA, Register (music), Non-commercial, Emergency Medicine, Surgery, Medical emergency, business, Research Article, Witmann
Abstract

Background No definitive data about open abdomen (OA) epidemiology and outcomes exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) promoted the International Register of Open Abdomen (IROA). Methods A prospective observational cohort study including patients with an OA treatment. Data were recorded on a web platform (Clinical Registers®) through a dedicated website: www.clinicalregisters.org. Results Four hundred two patients enrolled. Adult patients: 369 patients; Mean age: 57.39±18.37; 56% male; Mean BMI: 36±5.6. OA indication: Peritonitis (48.7%), Trauma (20.5%), Vascular Emergencies/Hemorrhage (9.4%), Ischemia (9.1%), Pancreatitis (4.2%),Post-operative abdominal-compartment-syndrome (3.9%), Others (4.2%). The most adopted Temporary-abdominal-closure systems were the commercial negative pressure ones (44.2%). During OA 38% of patients had complications; among them 10.5% had fistula. Definitive closure: 82.8%; Mortality during treatment: 17.2%. Mean duration of OA: 5.39(±4.83) days; Mean number of dressing changes: 0.88(±0.88). After-closure complications: (49.5%) and Mortality: (9%). No significant associations among TACT, indications, mortality, complications and fistula. A linear correlationexists between days of OA and complications (Pearson linear correlation = 0.326 p

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