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World Journal of Emergency Surgery: WJES

Parker Hu, Rindi Uhlich, Frank Gleason, Jeffrey Kerby, Patrick Bosarge
Background: 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 complications. Temporary abdominal closure is possible with multiple techniques, the choice of which may affect ability to achieve primary fascial closure and further complication. Methods: A retrospective analysis of all trauma patients requiring damage control laparotomy upon admission to an ACS-verified level one trauma center from 2011 to 2016 was performed...
2018: World Journal of Emergency Surgery: WJES
Davide Ferrari, Alberto Aiolfi, Gianluca Bonitta, Carlo Galdino Riva, Emanuele Rausa, Stefano Siboni, Francesco Toti, Luigi Bonavina
Background: 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, is cost-effective, and is well tolerated. Rigid endoscopy (RE) under general anesthesia is less used but may be advantageous in some circumstances. The aim of the study was to compare the efficacy and safety of FE and RE in esophageal FB removal. Methods: PubMed, MEDLINE, Embase, and Cochrane databases were consulted matching the terms "Rigid endoscopy AND Flexible endoscopy AND foreign bod*"...
2018: World Journal of Emergency Surgery: WJES
Chao-Wei Lee, Hao-Wei Kou, Hong-Shiue Chou, Hsu-Huan Chou, Song-Fong Huang, Chih-Hsiang Chang, Chun-Hsing Wu, Ming-Chin Yu, Hsin-I Tsai
Background: 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 injury (AKI), which, in turn, increases the risk of mortality. Therefore, it is of paramount importance to identify those septic patients at risk for the development of AKI and mortality. The objective of this pilot study was to evaluate several different biomarkers, including NGAL, calprotectin, KIM-1, cystatin C, and GDF-15, along with SOFA scores, in predicting the development of septic AKI and associated in-hospital mortality in critically ill surgical patients...
2018: World Journal of Emergency Surgery: WJES
K Verhoeff, P Glen, A Taheri, B Min, B Tsang, V Fawcett, S Widder
Background: 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 proportion of trauma care. Specific geriatric trauma protocols exist to improve care for this complex patient population, who often have various comorbidities, pre-existing medications, and extensive injury within a trauma perspective. These guidelines for geriatric trauma care often suggest early advanced care planning (ACP) discussions and documentation to guide patient and family-centered care...
2018: World Journal of Emergency Surgery: WJES
Masatoku Arai, Shiei Kim, Hiromoto Ishii, Jun Hagiwara, Shigeki Kushimoto, Hiroyuki Yokota
Background: 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 in whom early primary fascial closure was difficult to achieve. However, the long-term outcomes have not been elucidated. In the present study, we aimed to evaluate the procedure, particularly in terms of ventral hernia, pain, and daily activities. Methods: Between 2001 and 2013, 15 consecutive patients requiring OA after emergency laparotomy and in whom turnover flap method was applied were retrospectively identified...
2018: World Journal of Emergency Surgery: WJES
Chip-Jin Ng, Shih-Hao You, I-Lin Wu, Yi-Ming Weng, Chung-Hsien Chaou, Cheng-Yu Chien, Chen-June Seak
Background: 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 following a powder explosion in New Taipei City, Taiwan. Methods: This study retrospectively analyzed data from patients who were sent to the study hospital during a MBC incident. The patient list was retrieved from a national online management system...
2018: World Journal of Emergency Surgery: WJES
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, Abdulrashid K Adesunkanmi, Boyko Atanasov, Goran Augustin, Miklosh Bala, Miguel A Cainzos, Alain Chichom-Mefire, Francesco Cortese, Dimitris Damaskos, Samir Delibegovic, Zaza Demetrashvili, Belinda De Simone, Therese M Duane, Wagih Ghnnam, George Gkiokas, Carlos A Gomes, Andreas Hecker, Aleksandar Karamarkovic, Jakub Kenig, Vladimir Khokha, Victor Kong, Arda Isik, Ari Leppäniemi, Andrey Litvin, Eftychios Lostoridis, Gustavo M Machain, Sanjay Marwah, Michael McFarlane, Cristian Mesina, Ionut Negoi, Iyiade Olaoye, Tadeja Pintar, Guntars Pupelis, Miran Rems, Ines Rubio-Perez, Boris Sakakushev, Helmut Segovia-Lohse, Boonying Siribumrungwong, Peep Talving, Jan Ulrych, András G Vereczkei, Francesco M Labricciosa, Fausto Catena
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 practice. Surgeons with knowledge in surgical infections should provide feedback to prescribers and integrate best practices among surgeons and implement changes within their team. Identifying a local opinion leader to serve as a champion within the surgical department may be important. The "surgeon champion" can integrate best clinical practices of infection prevention and management, drive behavior change in their colleagues, and interact with both infection control teams in promoting antimicrobial stewardship...
2018: World Journal of Emergency Surgery: WJES
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, Bruno Pereira, Tarcisio Reis, Angelo Restivo, Joao Rezende-Neto, Massimo Sartelli, Massimo Valentino, Fikri M Abu-Zidan, Itamar Ashkenazi, Miklosh Bala, Osvaldo Chiara, Nicola De' Angelis, Simona Deidda, Belinda De Simone, Salomone Di Saverio, Elena Finotti, Inaba Kenji, Ernest Moore, Steven Wexner, Walter Biffl, Raul Coimbra, Angelo Guttadauro, Ari Leppäniemi, Ron Maier, Stefano Magnone, Alain Chicom Mefire, Andrew Peitzmann, Boris Sakakushev, Michael Sugrue, Pierluigi Viale, Dieter Weber, Jeffry Kashuk, Gustavo P Fraga, Ioran Kluger, Fausto Catena, Luca Ansaloni
ᅟ: 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 are to update the previous WSES guidelines for the management of large bowel perforation and obstructive left colon carcinoma (OLCC) and to develop new guidelines on obstructive right colon carcinoma (ORCC). Methods: The literature was extensively queried for focused publication until December 2017...
2018: World Journal of Emergency Surgery: WJES
Maria Antonietta Mazzei
The aim of this letter is to report some deeper explanations regarding the role of imaging in acute mesenteric ischemia. The correlation between some computed tomography findings and the cause of ischemia as well as other main factors that could condition the computed tomography appearance of this critical issue is also discussed.
2018: World Journal of Emergency Surgery: WJES
Giuseppe Salamone, Leo Licari, Giovanni Guercio, Sofia Campanella, Nicolò Falco, Gregorio Scerrino, Sebastiano Bonventre, Girolamo Geraci, Gianfranco Cocorullo, Gaspare Gulotta
Background: 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 demonstrated the usefulness of elective surgery. During recent decades, the indications for surgical timing have changed. Methods: Cirrhotic patients with abdominal hernia who underwent surgical operation for abdominal wall hernia repair at the Policlinico "Paolo Giaccone" at Palermo University Hospital between January 2010 and September 2016 were identified in a prospective database, and the data collected were retrospectively reviewed; patients' medical and surgical records were collected from charts and surgical and intensive care unit (ICU) registries...
2018: World Journal of Emergency Surgery: WJES
Sung-Mi Ji, Eun-Jin Moon, Tae-Jun Kim, Jae-Woo Yi, Hyungseok Seo, Bong-Jae Lee
Background: 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 easy technique to evaluate patients' airways in the emergency situation. And a modified LEMON method, which excludes the Mallampati classification from the original LEMON score, also can be used clinically. We investigated the relationship between modified LEMON score and intubation difficulty score in adult trauma patients undergoing emergency surgery...
2018: World Journal of Emergency Surgery: WJES
Michael S Bleszynski, Alexsander K Bressan, Emilie Joos, S Morad Hameed, Chad G Ball
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 surgery, and severity of patients' comorbidities constitute predictors of postoperative mortality. Comprehensive history taking, physical examination, and thorough review of laboratory and imaging examinations typically elucidate clinical evidence of hepatic dysfunction, portal hypertension, and/or their complications...
2018: World Journal of Emergency Surgery: WJES
Hayim Gilshtein, Kenan Hallon, Yoram Kluger
Background: 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 delineate the patients requiring surgical intervention. Methods: A retrospective study was undertaken in patients diagnosed with ischemic colitis admitted to Rambam Health Care Campus between 2011 and 2016. The primary outcome was defined as mortality...
2018: World Journal of Emergency Surgery: WJES
Vincent P Anto, Joshua B Brown, Andrew B Peitzman, Brian S Zuckerbraun, Matthew D Neal, Gregory Watson, Raquel Forsythe, Timothy R Billiar, Jason L Sperry
Background: 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 BCVI and characterize current BCVI screening practices and associated complications in elderly ground-level fall patients (EGLF, ≥ 65 years). We hypothesized that BCVI in EGLF patients would be clinically significant and screening would be less common. Methods: A retrospective study was performed utilizing the National Trauma Data Bank (NTDB, 2007-2014) and single institutional data...
2018: World Journal of Emergency Surgery: WJES
Ianthe Boden, Kate Sullivan, Claire Hackett, Brooke Winzer, Rebecca Lane, Melissa McKinnon, Iain Robertson
Background: 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 surgery and is commonplace in most first-world hospitals. Despite ubiquitous service provision, no well-designed, adequately powered, parallel-group, randomised controlled trial has investigated the effect of physiotherapy on the incidence of respiratory complications, paralytic ileus, rate of physical recovery, ongoing need for formal sub-acute rehabilitation, hospital length of stay, health-related quality of life, and mortality following emergency abdominal surgery...
2018: World Journal of Emergency Surgery: WJES
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, Ana Azevedo
Background: 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 prescribing should enable the design and implementation of effective antibiotic stewardship programs (ASPs). The objective of the study was to assess attitudes and perceptions concerning AMR and use of antibiotics among surgeons who regularly perform emergency or trauma surgery...
2018: World Journal of Emergency Surgery: WJES
Benoit Gignoux, Marie-Cecile Blanchet, Thomas Lanz, Alexandre Vulliez, Mo Saffarini, Hugo Bothorel, Maud Robert, Vincent Frering
Background: 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 characteristics and outcomes of complicated and uncomplicated appendectomies performed in ambulatory vs. conventional settings, and to determine factors associated with unexpected re-consultations and re-hospitalizations. Methods: The authors reviewed a consecutive series of 185 laparoscopic appendectomies...
2018: World Journal of Emergency Surgery: WJES
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, Gustavo P Fraga, Bruno M Pereira, Jose J Diaz, Michael Sugrue, Ernest E Moore, Jianan Ren, Chad G Ball, Raul Coimbra, Zsolt J Balogh, Fikri M Abu-Zidan, Elijah Dixon, Walter Biffl, Anthony MacLean, Ian Ball, John Drover, Paul B McBeth, Juan G Posadas-Calleja, Neil G Parry, Salomone Di Saverio, Carlos A Ordonez, Jimmy Xiao, Massimo Sartelli
Background: 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, progressive and self-perpetuating bio-mediator generation, systemic inflammation, and multiple organ failure. Principles of treatment include early antibiotic administration and operative source control. A further therapeutic option may be open abdomen (OA) management with active negative peritoneal pressure therapy (ANPPT) to remove inflammatory ascites and ameliorate the systemic damage from SCIAS...
2018: World Journal of Emergency Surgery: WJES
C Wetterauer, J Ebbing, A Halla, R Kuehl, S Erb, A Egli, D J Schaefer, H H Seifert
Background: 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 assess whether three different scoring systems can accurately predict mortality and morbidity in FG patients. Methods: All patients that were treated for FG at the Department of Urology of the University Hospital Basel between June 2012 and March 2017 were included and assessed retrospectively by chart review...
2018: World Journal of Emergency Surgery: WJES
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, Michael Sugrue, Zsolt J Balogh, Cino Bendinelli, Ian Civil, Raul Coimbra, Mark De Moya, Paula Ferrada, Kenji Inaba, Rao Ivatury, Rifat Latifi, Jeffry L Kashuk, Andrew W Kirkpatrick, Ron Maier, Sandro Rizoli, Boris Sakakushev, Thomas Scalea, Kjetil Søreide, Dieter Weber, Imtiaz Wani, Fikri M Abu-Zidan, Nicola De'Angelis, Frank Piscioneri, Joseph M Galante, Fausto Catena, Harry van Goor
Background: 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 abdominal surgical procedures. The present paper presents a revised version of the Bologna guidelines to evidence-based diagnosis and treatment of ASBO. The working group has added paragraphs on prevention of ASBO and special patient groups. Methods: The guideline was written under the auspices of the World Society of Emergency Surgery by the ASBO working group...
2018: World Journal of Emergency Surgery: WJES
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