Articles

Abdominopelvic trauma: from anatomical to anatomo-physiological classification

Abdominopelvic trauma has been for decades classified with the AAST-OIS (American Association for the Surgery of Trauma—Organ Injury Scale) classification. It has represented a milestone. At present, the medic...

Authors: Federico Coccolini, Fausto Catena, Yoram Kluger, Massimo Sartelli, Gianluca Baiocchi, Luca Ansaloni and Ernest Eugene Moore

Effect of resuscitative endovascular balloon occlusion of the aorta in hemodynamically unstable patients with multiple severe torso trauma: a retrospective study

Although resuscitative endovascular balloon occlusion of the aorta (REBOA) may be effective in trauma management, its effect in patients with severe multiple torso trauma remains unclear.

Authors: Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka and Sadaki Inokuchi

Small bowel obstruction in the elderly: a plea for comprehensive acute geriatric care

Small bowel obstruction is one of the most frequent emergencies in general surgery, commonly affecting elderly patients. Morbidity and mortality from small bowel obstruction in elderly is high. Significant pro...

Authors: Ekin Ozturk, Marianne van Iersel, Martijn MWJ Stommel, Yvonne Schoon, Richard RPG ten Broek and Harry van Goor

Diagnostic point-of-care ultrasound (POCUS) for gastrointestinal pathology: state of the art from basics to advanced

The use of point-of-care ultrasound (POCUS) by non-radiologists has dramatically increased. POCUS is completely different from the routine radiological studies. POCUS is a Physiological, On spot, extension of ...

Authors: Fikri M Abu-Zidan and Arif Alper Cevik

A tribute to Ernest E. “Gene” Moore

Authors: Jeffry Kashuk, Walter Biffl, Yoram Kluger, Luca Ansaloni and Fausto Catena

Risk factors for mortality in the late amputation of necrotizing fasciitis: a retrospective study

Necrotizing fasciitis (NF) is a rapidly progressive infectious disease that primarily involves the fascia and subcutaneous tissue. If not promptly treated, it can lead to morbidity as well as mortality. It can...

Authors: Chia-Peng Chang, Cheng-Ting Hsiao, Chun-Nan Lin and Wen-Chih Fann

Resuscitative endovascular balloon occlusion of the aorta deployed by acute care surgeons in patients with morbidly adherent placenta: a feasible solution for two lives in peril

Morbidly adherent placenta (MAP), which includes accreta, increta, and percreta, is a condition characterized by the invasion of the uterine wall by placental tissue. The condition is associated with higher od...

Authors: Ramiro Manzano-Nunez, Maria F. Escobar-Vidarte, Claudia P. Orlas, Juan P. Herrera-Escobar, Samuel M. Galvagno, Juan J. Melendez, Natalia Padilla, Justin C. McCarty, Albaro J. Nieto and Carlos A. Ordoñez

Impact of initial temporary abdominal closure in damage control surgery: a retrospective analysis

Damage control surgery has revolutionized trauma surgery. Use of damage control surgery allows for resuscitation and reversal of coagulopathy at the risk of loss of abdominal domain and intra-abdominal complic...

Authors: Parker Hu, Rindi Uhlich, Frank Gleason, Jeffrey Kerby and Patrick Bosarge

Flexible versus rigid endoscopy in the management of esophageal foreign body impaction: systematic review and meta-analysis

Foreign body (FB) impaction accounts for 4% of emergency endoscopies in clinical practice. Flexible endoscopy (FE) is recommended as the first-line therapeutic option because it can be performed under sedation...

Authors: Davide Ferrari, Alberto Aiolfi, Gianluca Bonitta, Carlo Galdino Riva, Emanuele Rausa, Stefano Siboni, Francesco Toti and Luigi Bonavina

A combination of SOFA score and biomarkers gives a better prediction of septic AKI and in-hospital mortality in critically ill surgical patients: a pilot study

Sepsis is a syndrome characterized by a constellation of clinical manifestations and a significantly high mortality rate in the surgical intensive care unit (ICU). It is frequently complicated by acute kidney ...

Authors: Chao-Wei Lee, Hao-wei Kou, Hong-Shiue Chou, Hsu-huan Chou, Song-Fong Huang, Chih-Hsiang Chang, Chun-Hsing Wu, Ming-Chin Yu and Hsin-I Tsai

Implementation and adoption of advanced care planning in the elderly trauma patient

Geriatric trauma has high morbidity and mortality, often requiring extensive hospital stays and interventions. The number of geriatric trauma patients is also increasing significantly and accounts for a large ...

Authors: K. Verhoeff, P. Glen, A. Taheri, B. Min, B. Tsang, V. Fawcett and S. Widder

The long-term outcomes of early abdominal wall reconstruction by bilateral anterior rectus abdominis sheath turnover flap method in critically ill patients requiring open abdomen

In a previous study, we reported the usefulness of early abdominal wall reconstruction using bilateral anterior rectus abdominis sheath turnover flap method (turnover flap method) in open abdomen (OA) patients...

Authors: Masatoku Arai, Shiei Kim, Hiromoto Ishii, Jun Hagiwara, Shigeki Kushimoto and Hiroyuki Yokota

Introduction of a mass burn casualty triage system in a hospital during a powder explosion disaster: a retrospective cohort study

The triage system used during an actual mass burn casualty (MBC) incident is a major focus of concern. This study introduces a MBC triage system that was used by a burn center during an actual MBC incident fol...

Authors: Chip-Jin Ng, Shih-Hao You, I-Lin Wu, Yi-Ming Weng, Chung-Hsien Chaou, Cheng-Yu Chien and Chen-June Seak

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

Despite evidence supporting the effectiveness of best practices of infection prevention and management, many surgeons worldwide fail to implement them. Evidence-based practices tend to be underused in routine ...

Authors: Massimo Sartelli, Yoram Kluger, Luca Ansaloni, Federico Coccolini, Gian Luca Baiocchi, Timothy C. Hardcastle, Ernest E. Moore, Addison K. May, Kamal M. F. Itani, Donald E. Fry, Marja A. Boermeester, Xavier Guirao, Lena Napolitano, Robert G. Sawyer, Kemal Rasa, Fikri M. Abu-Zidan…

2017 WSES guidelines on colon and rectal cancer emergencies: obstruction and perforation

Obstruction and perforation due to colorectal cancer represent challenging matters in terms of diagnosis, life-saving strategies, obstruction resolution and oncologic challenge. The aims of the current paper a...

Authors: Michele Pisano, Luigi Zorcolo, Cecilia Merli, Stefania Cimbanassi, Elia Poiasina, Marco Ceresoli, Ferdinando Agresta, Niccolò Allievi, Giovanni Bellanova, Federico Coccolini, Claudio Coy, Paola Fugazzola, Carlos Augusto Martinez, Giulia Montori, Ciro Paolillo, Thiago Josè Penachim…

The abdominal wall hernia in cirrhotic patients: a historical challenge

The incidence rate of abdominal wall hernia is 20–40% in cirrhotic patients. A surgical approach was originally performed only if complication signs and symptoms occurred. Several recent studies have demonstra...

Authors: Giuseppe Salamone, Leo Licari, Giovanni Guercio, Sofia Campanella, Nicolò Falco, Gregorio Scerrino, Sebastiano Bonventre, Girolamo Geraci, Gianfranco Cocorullo and Gaspare Gulotta

Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery: a brief radiological commentary

The aim of this letter is to report some deeper explanations regarding the role of imaging in acute mesenteric ischemia.

Authors: Maria Antonietta Mazzei

Correlation between modified LEMON score and intubation difficulty in adult trauma patients undergoing emergency surgery

Prediction of difficult airway is critical in the airway management of trauma patients. A LEMON method which consists of following assessments; Look-Evaluate-Mallampati-Obstruction-Neck mobility is a fast and eas...

Authors: Sung-Mi Ji, Eun-Jin Moon, Tae-Jun Kim, Jae-Woo Yi, Hyungseok Seo and Bong-Jae Lee

Acute care and emergency general surgery in patients with chronic liver disease: how can we optimize perioperative care? A review of the literature

The increasing prevalence of advanced cirrhosis among operative candidates poses a major challenge for the acute care surgeon. The severity of hepatic dysfunction, degree of portal hypertension, emergency of s...

Authors: Michael S. Bleszynski, Alexsander K. Bressan, Emilie Joos, S. Morad Hameed and Chad G. Ball

Ischemic colitis caused increased early and delayed mortality

Ischemic colitis remains a challenge for the surgeon, both in its diagnosis and treatment. Data from a single tertiary center, of patients diagnosed with ischemic colitis, was collected. An attempt was made to...

Authors: Hayim Gilshtein, Kenan Hallon and Yoram Kluger

Blunt cerebrovascular injury in elderly fall patients: are we screening enough?

Blunt cerebrovascular injuries (BCVI) are generally associated with high-energy injury mechanisms. Less is known regarding lower-energy injuries in elderly patients. We sought to determine the incidence of BCV...

Authors: Vincent P. Anto, Joshua B. Brown, Andrew B. Peitzman, Brian S. Zuckerbraun, Matthew D. Neal, Gregory Watson, Raquel Forsythe, Timothy R. Billiar and Jason L. Sperry

ICEAGE (Incidence of Complications following Emergency Abdominal surgery: Get Exercising): study protocol of a pragmatic, multicentre, randomised controlled trial testing physiotherapy for the prevention of complications and improved physical recovery after emergency abdominal surgery

Postoperative complications and delayed physical recovery are significant problems following emergency abdominal surgery. Physiotherapy aims to aid recovery and prevent complications in the acute phase after s...

Authors: Ianthe Boden, Kate Sullivan, Claire Hackett, Brooke Winzer, Rebecca Lane, Melissa McKinnon and Iain Robertson

Should ambulatory appendectomy become the standard treatment for acute appendicitis?

Appendectomy is increasingly performed as a ‘short stay’ or ‘ambulatory’ procedure, yet there is no consensus for selection of patients with acute appendicitis for ambulatory surgery (AS). We aimed to compare ...

Authors: Benoit Gignoux, Marie-Cecile Blanchet, Thomas Lanz, Alexandre Vulliez, Mo Saffarini, Hugo Bothorel, Maud Robert and Vincent Frering

Emergency surgeons’ perceptions and attitudes towards antibiotic prescribing and resistance: a worldwide cross-sectional survey

Antibiotic resistance (AMR) is a growing public health problem worldwide, in part related to inadequate antibiotic use. A better knowledge of physicians’ motivations, attitudes and practice about AMR and presc...

Authors: Francesco M. Labricciosa, Massimo Sartelli, Sofia Correia, Lilian M. Abbo, Milton Severo, Luca Ansaloni, Federico Coccolini, Carlos Alves, Renato Bessa Melo, Gian Luca Baiocchi, José-Artur Paiva, Fausto Catena and Ana Azevedo

Closed Or Open after Source Control Laparotomy for Severe Complicated Intra-Abdominal Sepsis (the COOL trial): study protocol for a randomized controlled trial

Severe complicated intra-abdominal sepsis (SCIAS) has an increasing incidence with mortality rates over 80% in some settings. Mortality typically results from disruption of the gastrointestinal tract, progress...

Authors: Andrew W. Kirkpatrick, Federico Coccolini, Luca Ansaloni, Derek J. Roberts, Matti Tolonen, Jessica L. McKee, Ari Leppaniemi, Peter Faris, Christopher J. Doig, Fausto Catena, Timothy Fabian, Craig N. Jenne, Osvaldo Chiara, Paul Kubes, Braden Manns, Yoram Kluger…

A contemporary case series of Fournier’s gangrene at a Swiss tertiary care center—can scoring systems accurately predict mortality and morbidity?

Fournier’s gangrene (FG) is a life-threatening infection of the genital, perineal, and perianal regions with a morbidity range between 3 and 67%. Our aim is to report our experience in treatment of FG and to a...

Authors: C. Wetterauer, J. Ebbing, A. Halla, R. Kuehl, S. Erb, A. Egli, D. J. Schaefer and H. H. Seifert

Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group

Adhesive small bowel obstruction (ASBO) is a common surgical emergency, causing high morbidity and even some mortality. The adhesions causing such bowel obstructions are typically the footprints of previous ab...

Authors: Richard P. G. ten Broek, Pepijn Krielen, Salomone Di Saverio, Federico Coccolini, Walter L. Biffl, Luca Ansaloni, George C. Velmahos, Massimo Sartelli, Gustavo P. Fraga, Michael D. Kelly, Frederick A. Moore, Andrew B. Peitzman, Ari Leppaniemi, Ernest E. Moore, Johannes Jeekel, Yoram Kluger…

Clinical prediction score for superficial surgical site infection after appendectomy in adults with complicated appendicitis

Superficial surgical site infection (SSI) is common after appendectomy. This study aims to determine a clinical prediction score for SSI after appendectomy in complicated appendicitis.

Authors: Pinit Noorit, Boonying Siribumrungwong and Ammarin Thakkinstian

Stump appendicitis: a retrospective review of 3130 consecutive appendectomy cases

Stump appendicitis is inflammation of remnant appendix tissue due to incomplete removal of the appendix. Due to appendectomy history, stump appendicitis diagnosis is usually delay and that can cause increase m...

Authors: Enis Dikicier, Fatih Altintoprak, Kayhan Ozdemir, Kemal Gundogdu, Mustafa Yener Uzunoglu, Guner Cakmak, Feyyaz Onuray and Recai Capoglu

Development of a reconditioning program for elderly abdominal surgery patients: the Elder-friendly Approaches to the Surgical Environment–BEdside reconditioning for Functional ImprovemenTs (EASE-BE FIT) pilot study

Elderly individuals who are hospitalized due to emergency abdominal surgery spend over 80% of their recovery time in bed, resulting in early and rapid muscle loss. As these elderly individuals have a lower phy...

Authors: Alyssa McComb, Lindsey M. Warkentin, Margaret L. McNeely and Rachel G. Khadaroo

The complications associated with Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)

Non-compressible torso hemorrhage (NCTH) remains a significant cause of morbidity and mortality in the field of trauma and emergency medicine. In recent times, there has been a resurgence in the adoption of Re...

Authors: Marcelo A. F. Ribeiro Junior, Celia Y. D. Feng, Alexander T. M. Nguyen, Vinicius C. Rodrigues, Giovana E. K. Bechara, Raíssa Reis de-Moura and Megan Brenner

Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The ...

Authors: Massimo Sartelli, Gian L. Baiocchi, Salomone Di Saverio, Francesco Ferrara, Francesco M. Labricciosa, Luca Ansaloni, Federico Coccolini, Deepak Vijayan, Ashraf Abbas, Hariscine K. Abongwa, John Agboola, Adamu Ahmed, Lali Akhmeteli, Nezih Akkapulu, Seckin Akkucuk, Fatih Altintoprak…

Differentiation in an inclusive trauma system: allocation of lower extremity fractures

Implementation of an inclusive trauma system leads to reduced mortality rates, specifically in polytrauma patients. Field triage is essential in this mortality reduction. Triage systems are developed to identi...

Authors: F. S. Würdemann, D. P. J. Smeeing, S. Ferree, F. Nawijn, E. J. M. M. Verleisdonk, L. P. H. Leenen, R. M. Houwert and F. Hietbrink

Getting the invite list right: a discussion of sepsis severity scoring systems in severe complicated intra-abdominal sepsis and randomized trial inclusion criteria

Severe complicated intra-abdominal sepsis (SCIAS) is a worldwide challenge with increasing incidence. Open abdomen management with enhanced clearance of fluid and biomediators from the peritoneum is a potentia...

Authors: Matti Tolonen, Federico Coccolini, Luca Ansaloni, Massimo Sartelli, Derek J. Roberts, Jessica L. McKee, Ari Leppaniemi, Christopher J. Doig, Fausto Catena, Timothy Fabian, Craig N. Jenne, Osvaldo Chiara, Paul Kubes, Yoram Kluger, Gustavo P. Fraga, Bruno M. Pereira…

Treating patients in a trauma room equipped with computed tomography and patients’ mortality: a non-controlled comparison study

To improve acute trauma care workflow, the number of trauma centers equipped with a computed tomography (CT) machine in the trauma resuscitation room has increased. The effect of the presence of a CT machine i...

Authors: Shintaro Furugori, Makoto Kato, Takeru Abe, Masayuki Iwashita and Naoto Morimura

What is the treatment of tracheal lesions associated with traditional thyroidectomy? Case report and systematic review

The aim of this study is to review the literature focusing on various treatments based on time of tracheal injury and on different surgeons’ personal experience.

Authors: Nicola Tartaglia, Roberta Iadarola, Alessandra Di Lascia, Pasquale Cianci, Alberto Fersini and Antonio Ambrosi

Addition of lactic acid levels improves the accuracy of quick sequential organ failure assessment in predicting mortality in surgical patients with complicated intra-abdominal infections: a retrospective study

The quick sequential organ failure assessment (qSOFA) alone has a poor sensitivity for predicting mortality in patients with complicated intra-abdominal infections, and plasma lactate levels have been shown to...

Authors: Yun Tae Jung, Jiyeon Jeon, Jung Yun Park, Myung Jun Kim, Seung Hwan Lee and Jae Gil Lee

WSES worldwide emergency general surgery formation and evaluation project

Optimal management of emergency surgical patients represents one of the major health challenges worldwide. Emergency general surgery (EGS) was identified as multidisciplinary surgery performed for traumatic an...

Authors: Federico Coccolini, Yoram Kluger, Luca Ansaloni, Ernest E. Moore, Raul Coimbra, Gustavo P. Fraga, Andrew Kirkpatrick, Andrew Peitzman, Ron Maier, Gianluca Baiocchi, Vanni Agnoletti, Emiliano Gamberini, Ari Leppaniemi, Rao Ivatury, Michael Sugrue, Massimo Sartelli…

New Trauma and Injury Severity Score (TRISS) adjustments for survival prediction

The objective of this study is to propose three new adjustments to the Trauma and Injury Severity Score (TRISS) equation and compare their performances with the original TRISS as well as this index with coeffi...

Authors: Cristiane de Alencar Domingues, Raul Coimbra, Renato Sérgio Poggetti, Lilia de Souza Nogueira and Regina Marcia Cardoso de Sousa

Evaluation of capillary leakage after vasopressin resuscitation in a hemorrhagic shock model

Hemorrhagic shock (HS) is a major threat to patients with trauma and spontaneous bleeding. The aim of the study was to investigate early effects of vasopressin on metabolic and hemodynamic parameters and endot...

Authors: Roberto Bini, Osvaldo Chiara, Stefania Cimbanassi, Giorgio Olivero, Antonella Trombetta and Paolo Cotogni

Nonoperative management of appendiceal phlegmon or abscess in children less than 3 years of age

In children less than 3 years of age, there is little experience in the nonoperative management of appendiceal phlegmon or abscess (APA), especially in APA with an appendicolith. The purposes of this study wer...

Authors: Hailan Zhang, Yuzuo Bai and Weilin Wang

Advanced gallbladder inflammation is a risk factor for gallbladder perforation in patients with acute cholecystitis

Acute perforated cholecystitis (APC) is probably the most severe benign gallbladder pathology with high rates of morbidity and mortality. The cause of APC has not been fully understood. We postulated that APC ...

Authors: Stefan Jansen, Maciej Stodolski, Hubert Zirngibl, Daniel Gödde and Peter C. Ambe

Circulation first – the time has come to question the sequencing of care in the ABCs of trauma; an American Association for the Surgery of Trauma multicenter trial

The traditional sequence of trauma care: Airway, Breathing, Circulation (ABC) has been practiced for many years. It became the standard of care despite the lack of scientific evidence. We hypothesized that pat...

Authors: Paula Ferrada, Rachael A. Callcut, David J. Skarupa, Therese M. Duane, Alberto Garcia, Kenji Inaba, Desmond Khor, Vincent Anto, Jason Sperry, David Turay, Rachel M. Nygaard, Martin A. Schreiber, Toby Enniss, Michelle McNutt, Herb Phelan, Kira Smith…

The open abdomen in trauma and non-trauma patients: WSES guidelines

Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physio...

Authors: Federico Coccolini, Derek Roberts, Luca Ansaloni, Rao Ivatury, Emiliano Gamberini, Yoram Kluger, Ernest E. Moore, Raul Coimbra, Andrew W. Kirkpatrick, Bruno M. Pereira, Giulia Montori, Marco Ceresoli, Fikri M. Abu-Zidan, Massimo Sartelli, George Velmahos, Gustavo Pereira Fraga…

Raising concerns about the Sepsis-3 definitions

The Global Alliance for Infections in Surgery appreciates the great effort of the task force who derived and validated the Sepsis-3 definitions and considers the new definitions an important step forward in th...

Authors: Massimo Sartelli, Yoram Kluger, Luca Ansaloni, Timothy C. Hardcastle, Jordi Rello, Richard R. Watkins, Matteo Bassetti, Eleni Giamarellou, Federico Coccolini, Fikri M. Abu-Zidan, Abdulrashid K. Adesunkanmi, Goran Augustin, Gian L. Baiocchi, Miklosh Bala, Oussema Baraket, Marcelo A. Beltran…

2017 WSES guidelines for the management of iatrogenic colonoscopy perforation

Iatrogenic colonoscopy perforation (ICP) is a severe complication that can occur during both diagnostic and therapeutic procedures. Although 45–60% of ICPs are diagnosed by the endoscopist while performing the...

Authors: Nicola de’Angelis, Salomone Di Saverio, Osvaldo Chiara, Massimo Sartelli, Aleix Martínez-Pérez, Franca Patrizi, Dieter G. Weber, Luca Ansaloni, Walter Biffl, Offir Ben-Ishay, Miklosh Bala, Francesco Brunetti, Federica Gaiani, Solafah Abdalla, Aurelien Amiot, Hany Bahouth…

Is case triaging a useful tool for emergency surgeries? A review of 106 trauma surgery cases at a level 1 trauma center in South Africa

The optimal timing for emergency surgical interventions and implementation of protocols for trauma surgery is insufficient in the literature. The Groote Schuur emergency surgery triage (GSEST) system, based on...

Authors: Sharfuddin Chowdhury, Andrew John Nicol, Mahammed Riyaad Moydien, Pradeep Harkison Navsaria and Luis Felipe Montoya-Pelaez

Pattern and nature of Neyshabur train explosion blast injuries

Explosions are classified as both man-made and complex accidents. Explosive events can cause serious damage to people, property, and the environment. This study aimed to investigate the pattern and nature of d...

Authors: Katayoun Jahangiri, Hasan Ghodsi, Ali Khodadadizadeh and Sadegh Yousef Nezhad

Casualties of peace: an analysis of casualties admitted to the intensive care unit during the negotiation of the comprehensive Colombian process of peace

After 52 years of war in 2012, the Colombian government began the negotiation of a process of peace, and by November 2012, a truce was agreed. We sought to analyze casualties who were admitted to the intensive...

Authors: Carlos A. Ordoñez, Ramiro Manzano-Nunez, Maria Paula Naranjo, Esteban Foianini, Cecibel Cevallos, Maria Alejandra Londoño, Alvaro I. Sanchez Ortiz, Alberto F. García and Ernest E. Moore

Establishing position papers by the WSES

A position paper (PP) should establish a unified voice in areas where controversy occurs based upon multiple practices and/or therapeutic choices. Typically, a position paper should elucidate the knowledge gap...

Authors: Miklosh Bala, Jeffry Kashuk, Ernest E. Moore, Fausto Catena, Ari Leppaniemi, Luca Ansaloni, Walter Biffl, Federico Coccolini, Andrew Peitzman, Massimo Sartelli, Michael Sugrue, Gustavo P. Fraga, Salomone Di Saverio and Yoram Kluger