Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines.

Abdominal Antibiotic Emergency Infections Mortality Source control Stewardship Surgery Trauma

Journal

World journal of emergency surgery : WJES
ISSN: 1749-7922
Titre abrégé: World J Emerg Surg
Pays: England
ID NLM: 101266603

Informations de publication

Date de publication:
21 07 2023
Historique:
received: 30 10 2022
accepted: 30 06 2023
medline: 24 7 2023
pubmed: 22 7 2023
entrez: 21 7 2023
Statut: epublish

Résumé

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.

Identifiants

pubmed: 37480129
doi: 10.1186/s13017-023-00509-4
pii: 10.1186/s13017-023-00509-4
pmc: PMC10362628
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

41

Informations de copyright

© 2023. The Author(s).

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Auteurs

Federico Coccolini (F)

General, Emergency and Trauma Surgery Dept., Pisa University Hospital, Via Paradisia, 56124, Pisa, Italy. federico.coccolini@gmail.com.

Massimo Sartelli (M)

General Surgery Dept., Macerata Hospital, Macerata, Italy.

Robert Sawyer (R)

Department of Surgery, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA.

Kemal Rasa (K)

Anadolu Medical Center, Kocaeli, Turkey.

Bruno Viaggi (B)

ICU Dept., Careggi University Hospital, Florence, Italy.

Fikri Abu-Zidan (F)

Department of Surgery, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.

Kjetil Soreide (K)

Department of Gastrointestinal Surgery, Stavanger University Hospital, University of Bergen, Bergen, Norway.

Timothy Hardcastle (T)

Dept. of Health - KwaZulu-Natal, Surgery, University of KwaZulu-Natal and Inkosi Albert Luthuli Central Hospital, Durban, South Africa.

Deepak Gupta (D)

All India Institute of Medical Sciences, New Delhi, India.

Cino Bendinelli (C)

Department of Surgery, John Hunter Hospital, Newcastle, Australia.

Marco Ceresoli (M)

General Surgery Dept., Monza University Hospital, Monza, Italy.

Vishal G Shelat (VG)

Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore.

Richard Ten Broek (RT)

Department of Surgery, Radboud University Medical Center, Njmegen, The Netherlands.

Gian Luca Baiocchi (GL)

General Surgery Dept., Brescia University Hospital, Brescia, Italy.

Ernest E Moore (EE)

Surgery Dept., Denver Trauma Centre, Denver, CO, USA.

Ibrahima Sall (I)

Département de Chirurgie, Hôpital Principal de Dakar, Hôpital d'Instruction des Armées, Dakar, Senegal.

Mauro Podda (M)

Department of Surgical Science, University of Cagliari, Cagliari, Italy.

Luigi Bonavina (L)

General Surgery, San Donato Hospital, Milan, Italy.

Igor A Kryvoruchko (IA)

Department of Surgery No. 2, Kharkiv National Medical University, Kharkiv, Ukraine.

Philip Stahel (P)

Department of Surgery, East Carolina University, Brody School of Medicine, Greenville, NC, USA.

Kenji Inaba (K)

LAC+USC Medical Center, Los Angeles, CA, USA.

Philippe Montravers (P)

Département d'Anesthésie-Réanimation CHU Bichat Claude Bernard, Paris, France.

Boris Sakakushev (B)

Research Institute of Medical, University Plovdiv/University Hospital St. George, Plovdiv, Bulgaria.

Gabriele Sganga (G)

Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Paolo Ballestracci (P)

General, Emergency and Trauma Surgery Dept., Pisa University Hospital, Via Paradisia, 56124, Pisa, Italy.

Manu L N G Malbrain (MLNG)

First Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland.

Jean-Louis Vincent (JL)

Dept. of Intensive Care, Erasme Univ Hospital, Brussels, Belgium.

Manos Pikoulis (M)

General Surgery, Hospital, National and Kapodistrian University of Athens (NKUA), Athens, Greece.

Solomon Gurmu Beka (SG)

University of Otago, Otago, New Zealand.

Krstina Doklestic (K)

Clinic of Emergency Surgery, University Clinical Center of Serbia, Belgrade, Serbia.

Massimo Chiarugi (M)

General, Emergency and Trauma Surgery Dept., Pisa University Hospital, Via Paradisia, 56124, Pisa, Italy.

Marco Falcone (M)

Infectious Disease Dept., Pisa University Hospital, Pisa, Italy.

Elena Bignami (E)

Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Parma, Italy.

Viktor Reva (V)

Department of War Surgery, Kirov Military Medical Academy, Saint-Petersburg, Russia.

Zaza Demetrashvili (Z)

Surgery Department, Tbilisi State Medical University, Tbilisi, Georgia.

Salomone Di Saverio (S)

General Surgery Dept, San Benedetto del Tronto Hospital, San Benedetto del Tronto, Italy.

Matti Tolonen (M)

Emergency Surgery, Meilahti Tower Hospital, Helsinki, Finland.

Pradeep Navsaria (P)

Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.

Miklosh Bala (M)

Trauma and Acute Care Surgery Unit, Hadassah - Hebrew University Medical Center, Jerusalem, Israel.

Zsolt Balogh (Z)

Department of Traumatology, John Hunter Hospital and University of Newcastle, Newcastle, NSW, Australia.

Andrey Litvin (A)

Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kaliningrad, Russia.

Andreas Hecker (A)

University Hospital of Giessen, Giessen, Germany.

Imtiaz Wani (I)

Government Gousia Hospital, Srinagar, Kashmir, India.

Andreas Fette (A)

PS-SS, Weissach im Tal, Germany.

Belinda De Simone (B)

Department of Emergency Surgery, Centre Hospitalier Intercommunal de Villeneuve-Saint-Georges, Villeneuve-Saint-Georges, France.

Rao Ivatury (R)

Virginia Commonwealth University, Richmond, VA, USA.

Edoardo Picetti (E)

ICU Dept., Parma University Hospital, Parma, Italy.

Vladimir Khokha (V)

General Surgery Dept., Mozir Hospital, Mozir, Belarus.

Edward Tan (E)

Emergency Department, Radboud University Medical Center, Njmegen, The Netherlands.

Chad Ball (C)

Trauma and Acute Care Surgery, Foothills Medical Center, Calgary, AB, Canada.

Carlo Tascini (C)

Infectious Disease Dept., Udine University Hospital, Udine, Italy.

Yunfeng Cui (Y)

Tianjin Nankai Hospital, Tianjin Medical University, Tianjin, China.

Raul Coimbra (R)

Riverside University Health System Medical Center, Riverside, CA, USA.
Loma Linda University School of Medicine, Loma Linda, CA, USA.

Michael Kelly (M)

Department of General Surgery, Albury Hospital, Albury, Australia.

Costanza Martino (C)

ICU Dept., Bufalini Hospital, Cesena, Italy.

Vanni Agnoletti (V)

ICU Dept., Bufalini Hospital, Cesena, Italy.

Marja A Boermeester (MA)

Surgery Dept., Amsterdam University, Amsterdam, The Netherlands.

Nicola De'Angelis (N)

Service de Chirurgie Digestive et Hépato-Bilio-Pancréatique, Hôpital Henri Mondor, Université Paris Est, Créteil, France.

Mircea Chirica (M)

Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.

Walt L Biffl (WL)

Trauma and Emergency Surgery, Scripss Memorial Hospital, La Jolla, CA, USA.

Luca Ansaloni (L)

General Surgery, Pavia University Hospital, Pavia, Italy.

Yoram Kluger (Y)

General Surgery, Rambam Medical Centre, Haifa, Israel.

Fausto Catena (F)

General, Emergency and Trauma Surgery Dept, Bufalini Hospital, Cesena, Italy.

Andrew W Kirkpatrick (AW)

General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB, Canada.

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