Browsing by Author "Soreide, Kjetil"

Now showing 1 - 5 of 5
  • Thumbnail Image
    ItemOpen Access
    Follow-up strategies for patients with splenic trauma managed non-operatively: the 2022 World Society of Emergency Surgery consensus document
    (2022-10-12) Podda, Mauro; De Simone, Belinda; Ceresoli, Marco; Virdis, Francesco; Favi, Francesco; Wiik Larsen, Johannes; Coccolini, Federico; Sartelli, Massimo; Pararas, Nikolaos; Beka, Solomon G.; Bonavina, Luigi; Bova, Raffaele; Pisanu, Adolfo; Abu-Zidan, Fikri; Balogh, Zsolt; Chiara, Osvaldo; Wani, Imtiaz; Stahel, Philip; Di Saverio, Salomone; Scalea, Thomas; Soreide, Kjetil; Sakakushev, Boris; Amico, Francesco; Martino, Costanza; Hecker, Andreas; de’Angelis, Nicola; Chirica, Mircea; Galante, Joseph; Kirkpatrick, Andrew; Pikoulis, Emmanouil; Kluger, Yoram; Bensard, Denis; Ansaloni, Luca; Fraga, Gustavo; Civil, Ian; Tebala, Giovanni D.; Di Carlo, Isidoro; Cui, Yunfeng; Coimbra, Raul; Agnoletti, Vanni; Sall, Ibrahima; Tan, Edward; Picetti, Edoardo; Litvin, Andrey; Damaskos, Dimitrios; Inaba, Kenji; Leung, Jeffrey; Maier, Ronald; Biffl, Walt; Leppaniemi, Ari; Moore, Ernest; Gurusamy, Kurinchi; Catena, Fausto
    Abstract Background In 2017, the World Society of Emergency Surgery published its guidelines for the management of adult and pediatric patients with splenic trauma. Several issues regarding the follow-up of patients with splenic injuries treated with NOM remained unsolved. Methods Using a modified Delphi method, we sought to explore ongoing areas of controversy in the NOM of splenic trauma and reach a consensus among a group of 48 international experts from five continents (Africa, Europe, Asia, Oceania, America) concerning optimal follow-up strategies in patients with splenic injuries treated with NOM. Results Consensus was reached on eleven clinical research questions and 28 recommendations with an agreement rate ≥ 80%. Mobilization after 24 h in low-grade splenic trauma patients (WSES Class I, AAST Grades I–II) was suggested, while in patients with high-grade splenic injuries (WSES Classes II–III, AAST Grades III–V), if no other contraindications to early mobilization exist, safe mobilization of the patient when three successive hemoglobins 8 h apart after the first are within 10% of each other was considered safe according to the panel. The panel suggests adult patients to be admitted to hospital for 1 day (for low-grade splenic injuries—WSES Class I, AAST Grades I–II) to 3 days (for high-grade splenic injuries—WSES Classes II–III, AAST Grades III–V), with those with high-grade injuries requiring admission to a monitored setting. In the absence of specific complications, the panel suggests DVT and VTE prophylaxis with LMWH to be started within 48–72 h from hospital admission. The panel suggests splenic artery embolization (SAE) as the first-line intervention in patients with hemodynamic stability and arterial blush on CT scan, irrespective of injury grade. Regarding patients with WSES Class II blunt splenic injuries (AAST Grade III) without contrast extravasation, a low threshold for SAE has been suggested in the presence of risk factors for NOM failure. The panel also suggested angiography and eventual SAE in all hemodynamically stable adult patients with WSES Class III injuries (AAST Grades IV–V), even in the absence of CT blush, especially when concomitant surgery that requires change of position is needed. Follow-up imaging with contrast-enhanced ultrasound/CT scan in 48–72 h post-admission of trauma in splenic injuries WSES Class II (AAST Grade III) or higher treated with NOM was considered the best strategy for timely detection of vascular complications. Conclusion This consensus document could help guide future prospective studies aiming at validating the suggested strategies through the implementation of prospective trauma databases and the subsequent production of internationally endorsed guidelines on the issue.
  • Thumbnail Image
    ItemOpen Access
    Management of intra-abdominal infections: recommendations by the WSES 2016 consensus conference
    (2017-05-04) Sartelli, Massimo; Catena, Fausto; Abu-Zidan, Fikri M; Ansaloni, Luca; Biffl, Walter L; Boermeester, Marja A; Ceresoli, Marco; Chiara, Osvaldo; Coccolini, Federico; De Waele, Jan J; Di Saverio, Salomone; Eckmann, Christian; Fraga, Gustavo P; Giannella, Maddalena; Girardis, Massimo; Griffiths, Ewen A; Kashuk, Jeffry; Kirkpatrick, Andrew W; Khokha, Vladimir; Kluger, Yoram; Labricciosa, Francesco M; Leppaniemi, Ari; Maier, Ronald V; May, Addison K; Malangoni, Mark; Martin-Loeches, Ignacio; Mazuski, John; Montravers, Philippe; Peitzman, Andrew; Pereira, Bruno M; Reis, Tarcisio; Sakakushev, Boris; Sganga, Gabriele; Soreide, Kjetil; Sugrue, Michael; Ulrych, Jan; Vincent, Jean-Louis; Viale, Pierluigi; Moore, Ernest E
    Abstract This paper reports on the consensus conference on the management of intra-abdominal infections (IAIs) which was held on July 23, 2016, in Dublin, Ireland, as a part of the annual World Society of Emergency Surgery (WSES) meeting. This document covers all aspects of the management of IAIs. The Grading of Recommendations Assessment, Development and Evaluation recommendation is used, and this document represents the executive summary of the consensus conference findings.
  • Thumbnail Image
    ItemOpen Access
    Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines
    (2023-07-21) Coccolini, Federico; Sartelli, Massimo; Sawyer, Robert; Rasa, Kemal; Viaggi, Bruno; Abu-Zidan, Fikri; Soreide, Kjetil; Hardcastle, Timothy; Gupta, Deepak; Bendinelli, Cino; Ceresoli, Marco; Shelat, Vishal G.; Broek, Richard t.; Baiocchi, Gian L.; Moore, Ernest E.; Sall, Ibrahima; Podda, Mauro; Bonavina, Luigi; Kryvoruchko, Igor A.; Stahel, Philip; Inaba, Kenji; Montravers, Philippe; Sakakushev, Boris; Sganga, Gabriele; Ballestracci, Paolo; Malbrain, Manu L. N. G.; Vincent, Jean-Louis; Pikoulis, Manos; Beka, Solomon G.; Doklestic, Krstina; Chiarugi, Massimo; Falcone, Marco; Bignami, Elena; Reva, Viktor; Demetrashvili, Zaza; Di Saverio, Salomone; Tolonen, Matti; Navsaria, Pradeep; Bala, Miklosh; Balogh, Zsolt; Litvin, Andrey; Hecker, Andreas; Wani, Imtiaz; Fette, Andreas; De Simone, Belinda; Ivatury, Rao; Picetti, Edoardo; Khokha, Vladimir; Tan, Edward; Ball, Chad; Tascini, Carlo; Cui, Yunfeng; Coimbra, Raul; Kelly, Michael; Martino, Costanza; Agnoletti, Vanni; Boermeester, Marja A.; De’Angelis, Nicola; Chirica, Mircea; Biffl, Walt L.; Ansaloni, Luca; Kluger, Yoram; Catena, Fausto; Kirkpatrick, Andrew W.
    Abstract Intra-abdominal infections (IAI) are among the most common global healthcare challenges and they are usually precipitated by disruption to the gastrointestinal (GI) tract. Their successful management typically requires intensive resource utilization, and despite the best therapies, morbidity and mortality remain high. One of the main issues required to appropriately treat IAI that differs from the other etiologies of sepsis is the frequent requirement to provide physical source control. Fortunately, dramatic advances have been made in this aspect of treatment. Historically, source control was left to surgeons only. With new technologies non-surgical less invasive interventional procedures have been introduced. Alternatively, in addition to formal surgery open abdomen techniques have long been proposed as aiding source control in severe intra-abdominal sepsis. It is ironic that while a lack or even delay regarding source control clearly associates with death, it is a concept that remains poorly described. For example, no conclusive definition of source control technique or even adequacy has been universally accepted. Practically, source control involves a complex definition encompassing several factors including the causative event, source of infection bacteria, local bacterial flora, patient condition, and his/her eventual comorbidities. With greater understanding of the systemic pathobiology of sepsis and the profound implications of the human microbiome, adequate source control is no longer only a surgical issue but one that requires a multidisciplinary, multimodality approach. Thus, while any breach in the GI tract must be controlled, source control should also attempt to control the generation and propagation of the systemic biomediators and dysbiotic influences on the microbiome that perpetuate multi-system organ failure and death. Given these increased complexities, the present paper represents the current opinions and recommendations for future research of the World Society of Emergency Surgery, of the Global Alliance for Infections in Surgery of Surgical Infection Society Europe and Surgical Infection Society America regarding the concepts and operational adequacy of source control in intra-abdominal infections.
  • Thumbnail Image
    ItemOpen Access
    Splenic trauma: WSES classification and guidelines for adult and pediatric patients
    (2017-08-18) Coccolini, Federico; Montori, Giulia; Catena, Fausto; Kluger, Yoram; Biffl, Walter; Moore, Ernest E; Reva, Viktor; Bing, Camilla; Bala, Miklosh; Fugazzola, Paola; Bahouth, Hany; Marzi, Ingo; Velmahos, George; Ivatury, Rao; Soreide, Kjetil; Horer, Tal; ten Broek, Richard; Pereira, Bruno M; Fraga, Gustavo P; Inaba, Kenji; Kashuk, Joseph; Parry, Neil; Masiakos, Peter T; Mylonas, Konstantinos S; Kirkpatrick, Andrew; Abu-Zidan, Fikri; Gomes, Carlos A; Benatti, Simone V; Naidoo, Noel; Salvetti, Francesco; Maccatrozzo, Stefano; Agnoletti, Vanni; Gamberini, Emiliano; Solaini, Leonardo; Costanzo, Antonio; Celotti, Andrea; Tomasoni, Matteo; Khokha, Vladimir; Arvieux, Catherine; Napolitano, Lena; Handolin, Lauri; Pisano, Michele; Magnone, Stefano; Spain, David A; de Moya, Marc; Davis, Kimberly A; De Angelis, Nicola; Leppaniemi, Ari; Ferrada, Paula; Latifi, Rifat; Navarro, David C; Otomo, Yashuiro; Coimbra, Raul; Maier, Ronald V; Moore, Frederick; Rizoli, Sandro; Sakakushev, Boris; Galante, Joseph M; Chiara, Osvaldo; Cimbanassi, Stefania; Mefire, Alain C; Weber, Dieter; Ceresoli, Marco; Peitzman, Andrew B; Wehlie, Liban; Sartelli, Massimo; Di Saverio, Salomone; Ansaloni, Luca
    Abstract Spleen injuries are among the most frequent trauma-related injuries. At present, they are classified according to the anatomy of the injury. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic derangement, and the associated injuries. The management of splenic trauma patients aims to restore the homeostasis and the normal physiopathology especially considering the modern tools for bleeding management. Thus, the management of splenic trauma should be ultimately multidisciplinary and based on the physiology of the patient, the anatomy of the injury, and the associated lesions. Lastly, as the management of adults and children must be different, children should always be treated in dedicated pediatric trauma centers. In fact, the vast majority of pediatric patients with blunt splenic trauma can be managed non-operatively. This paper presents the World Society of Emergency Surgery (WSES) classification of splenic trauma and the management guidelines.
  • Thumbnail Image
    ItemOpen Access
    The LIFE TRIAD of emergency general surgery
    (2022-07-25) Coccolini, Federico; Sartelli, Massimo; Kluger, Yoram; Osipov, Aleksei; Cui, Yunfeng; Beka, Solomon G.; Kirkpatrick, Andrew; Sall, Ibrahima; Moore, Ernest E.; Biffl, Walter L.; Litvin, Andrey; Pisano, Michele; Magnone, Stefano; Picetti, Edoardo; de Angelis, Nicola; Stahel, Philip; Ansaloni, Luca; Tan, Edward; Abu-Zidan, Fikri; Ceresoli, Marco; Hecker, Andreas; Chiara, Osvaldo; Sganga, Gabriele; Khokha, Vladimir; di Saverio, Salomone; Sakakushev, Boris; Campanelli, Giampiero; Fraga, Gustavo; Wani, Imtiaz; Broek, Richard t.; Cicuttin, Enrico; Cremonini, Camilla; Tartaglia, Dario; Soreide, Kjetil; Galante, Joseph; de Moya, Marc; Koike, Kaoru; De Simone, Belinda; Balogh, Zsolt; Amico, Francesco; Shelat, Vishal; Pikoulis, Emmanouil; Di Carlo, Isidoro; Bonavina, Luigi; Leppaniemi, Ari; Marzi, Ingo; Ivatury, Rao; Khan, Jim; Maier, Ronald V.; Hardcastle, Timothy C.; Isik, Arda; Podda, Mauro; Tolonen, Matti; Rasa, Kemal; Navsaria, Pradeep H.; Demetrashvili, Zaza; Tarasconi, Antonio; Carcoforo, Paolo; Sibilla, Maria G.; Baiocchi, Gian L.; Pararas, Nikolaos; Weber, Dieter; Chiarugi, Massimo; Catena, Fausto
    Abstract Emergency General Surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and non-traumatic acute conditions during the same admission in the hospital by general emergency surgeons and other specialists. It is the most diffused surgical discipline in the world. To live and grow strong EGS necessitates three fundamental parts: emergency and elective continuous surgical practice, evidence generation through clinical registries and data accrual, and indications and guidelines production: the LIFE TRIAD.