Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines
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, morbidit...
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-07-01
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| Series: | World Journal of Emergency Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13017-023-00509-4 |
| _version_ | 1797774320297050112 |
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| author | Federico Coccolini Massimo Sartelli Robert Sawyer Kemal Rasa Bruno Viaggi Fikri Abu-Zidan Kjetil Soreide Timothy Hardcastle Deepak Gupta Cino Bendinelli Marco Ceresoli Vishal G. Shelat Richard ten Broek Gian Luca Baiocchi Ernest E. Moore Ibrahima Sall Mauro Podda Luigi Bonavina Igor A. Kryvoruchko Philip Stahel Kenji Inaba Philippe Montravers Boris Sakakushev Gabriele Sganga Paolo Ballestracci Manu L. N. G. Malbrain Jean-Louis Vincent Manos Pikoulis Solomon Gurmu Beka Krstina Doklestic Massimo Chiarugi Marco Falcone Elena Bignami Viktor Reva Zaza Demetrashvili Salomone Di Saverio Matti Tolonen Pradeep Navsaria Miklosh Bala Zsolt Balogh Andrey Litvin Andreas Hecker Imtiaz Wani Andreas Fette Belinda De Simone Rao Ivatury Edoardo Picetti Vladimir Khokha Edward Tan Chad Ball Carlo Tascini Yunfeng Cui Raul Coimbra Michael Kelly Costanza Martino Vanni Agnoletti Marja A. Boermeester Nicola De’Angelis Mircea Chirica Walt L. Biffl Luca Ansaloni Yoram Kluger Fausto Catena Andrew W. Kirkpatrick |
| author_facet | Federico Coccolini Massimo Sartelli Robert Sawyer Kemal Rasa Bruno Viaggi Fikri Abu-Zidan Kjetil Soreide Timothy Hardcastle Deepak Gupta Cino Bendinelli Marco Ceresoli Vishal G. Shelat Richard ten Broek Gian Luca Baiocchi Ernest E. Moore Ibrahima Sall Mauro Podda Luigi Bonavina Igor A. Kryvoruchko Philip Stahel Kenji Inaba Philippe Montravers Boris Sakakushev Gabriele Sganga Paolo Ballestracci Manu L. N. G. Malbrain Jean-Louis Vincent Manos Pikoulis Solomon Gurmu Beka Krstina Doklestic Massimo Chiarugi Marco Falcone Elena Bignami Viktor Reva Zaza Demetrashvili Salomone Di Saverio Matti Tolonen Pradeep Navsaria Miklosh Bala Zsolt Balogh Andrey Litvin Andreas Hecker Imtiaz Wani Andreas Fette Belinda De Simone Rao Ivatury Edoardo Picetti Vladimir Khokha Edward Tan Chad Ball Carlo Tascini Yunfeng Cui Raul Coimbra Michael Kelly Costanza Martino Vanni Agnoletti Marja A. Boermeester Nicola De’Angelis Mircea Chirica Walt L. Biffl Luca Ansaloni Yoram Kluger Fausto Catena Andrew W. Kirkpatrick |
| author_sort | Federico Coccolini |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-12T22:19:20Z |
| format | Article |
| id | doaj.art-f177b05f381d47b6a2e813490da368c6 |
| institution | Directory Open Access Journal |
| issn | 1749-7922 |
| language | English |
| last_indexed | 2024-03-12T22:19:20Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Emergency Surgery |
| spelling | doaj.art-f177b05f381d47b6a2e813490da368c62023-07-23T11:09:47ZengBMCWorld Journal of Emergency Surgery1749-79222023-07-0118112110.1186/s13017-023-00509-4Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelinesFederico Coccolini0Massimo Sartelli1Robert Sawyer2Kemal Rasa3Bruno Viaggi4Fikri Abu-Zidan5Kjetil Soreide6Timothy Hardcastle7Deepak Gupta8Cino Bendinelli9Marco Ceresoli10Vishal G. Shelat11Richard ten Broek12Gian Luca Baiocchi13Ernest E. Moore14Ibrahima Sall15Mauro Podda16Luigi Bonavina17Igor A. Kryvoruchko18Philip Stahel19Kenji Inaba20Philippe Montravers21Boris Sakakushev22Gabriele Sganga23Paolo Ballestracci24Manu L. N. G. Malbrain25Jean-Louis Vincent26Manos Pikoulis27Solomon Gurmu Beka28Krstina Doklestic29Massimo Chiarugi30Marco Falcone31Elena Bignami32Viktor Reva33Zaza Demetrashvili34Salomone Di Saverio35Matti Tolonen36Pradeep Navsaria37Miklosh Bala38Zsolt Balogh39Andrey Litvin40Andreas Hecker41Imtiaz Wani42Andreas Fette43Belinda De Simone44Rao Ivatury45Edoardo Picetti46Vladimir Khokha47Edward Tan48Chad Ball49Carlo Tascini50Yunfeng Cui51Raul Coimbra52Michael Kelly53Costanza Martino54Vanni Agnoletti55Marja A. Boermeester56Nicola De’Angelis57Mircea Chirica58Walt L. Biffl59Luca Ansaloni60Yoram Kluger61Fausto Catena62Andrew W. Kirkpatrick63General, Emergency and Trauma Surgery Dept., Pisa University HospitalGeneral Surgery Dept., Macerata HospitalDepartment of Surgery, Western Michigan University Homer Stryker MD School of MedicineAnadolu Medical CenterICU Dept., Careggi University HospitalDepartment of Surgery, College of Medicine and Health Sciences, United Arab Emirates UniversityDepartment of Gastrointestinal Surgery, Stavanger University Hospital, University of BergenDept. of Health – KwaZulu-Natal, Surgery, University of KwaZulu-Natal and Inkosi Albert Luthuli Central HospitalAll India Institute of Medical SciencesDepartment of Surgery, John Hunter HospitalGeneral Surgery Dept., Monza University HospitalDepartment of General Surgery, Tan Tock Seng HospitalDepartment of Surgery, Radboud University Medical CenterGeneral Surgery Dept., Brescia University HospitalSurgery Dept., Denver Trauma CentreDépartement de Chirurgie, Hôpital Principal de Dakar, Hôpital d’Instruction des ArméesDepartment of Surgical Science, University of CagliariGeneral Surgery, San Donato HospitalDepartment of Surgery No. 2, Kharkiv National Medical UniversityDepartment of Surgery, East Carolina University, Brody School of MedicineLAC+USC Medical CenterDépartement d’Anesthésie-Réanimation CHU Bichat Claude BernardResearch Institute of Medical, University Plovdiv/University Hospital St. GeorgeFondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro CuoreGeneral, Emergency and Trauma Surgery Dept., Pisa University HospitalFirst Department of Anaesthesiology and Intensive Therapy, Medical University of LublinDept. of Intensive Care, Erasme Univ HospitalGeneral Surgery, Hospital, National and Kapodistrian University of Athens (NKUA)University of OtagoClinic of Emergency Surgery, University Clinical Center of SerbiaGeneral, Emergency and Trauma Surgery Dept., Pisa University HospitalInfectious Disease Dept., Pisa University HospitalAnesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of ParmaDepartment of War Surgery, Kirov Military Medical AcademySurgery Department, Tbilisi State Medical UniversityGeneral Surgery Dept, San Benedetto del Tronto HospitalEmergency Surgery, Meilahti Tower HospitalGroote Schuur Hospital and University of Cape TownTrauma and Acute Care Surgery Unit, Hadassah - Hebrew University Medical CenterDepartment of Traumatology, John Hunter Hospital and University of NewcastleDepartment of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical HospitalUniversity Hospital of GiessenGovernment Gousia HospitalPS-SSDepartment of Emergency Surgery, Centre Hospitalier Intercommunal de Villeneuve-Saint-GeorgesVirginia Commonwealth UniversityICU Dept., Parma University HospitalGeneral Surgery Dept., Mozir HospitalEmergency Department, Radboud University Medical CenterTrauma and Acute Care Surgery, Foothills Medical CenterInfectious Disease Dept., Udine University HospitalTianjin Nankai Hospital, Tianjin Medical UniversityRiverside University Health System Medical CenterDepartment of General Surgery, Albury HospitalICU Dept., Bufalini HospitalICU Dept., Bufalini HospitalSurgery Dept., Amsterdam UniversityService de Chirurgie Digestive et Hépato-Bilio-Pancréatique, Hôpital Henri Mondor, Université Paris EstCentre Hospitalier Universitaire Grenoble AlpesTrauma and Emergency Surgery, Scripss Memorial HospitalGeneral Surgery, Pavia University HospitalGeneral Surgery, Rambam Medical CentreGeneral, Emergency and Trauma Surgery Dept, Bufalini HospitalGeneral, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical CentreAbstract 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.https://doi.org/10.1186/s13017-023-00509-4Source controlEmergencyInfectionsAbdominalSurgeryTrauma |
| spellingShingle | Federico Coccolini Massimo Sartelli Robert Sawyer Kemal Rasa Bruno Viaggi Fikri Abu-Zidan Kjetil Soreide Timothy Hardcastle Deepak Gupta Cino Bendinelli Marco Ceresoli Vishal G. Shelat Richard ten Broek Gian Luca Baiocchi Ernest E. Moore Ibrahima Sall Mauro Podda Luigi Bonavina Igor A. Kryvoruchko Philip Stahel Kenji Inaba Philippe Montravers Boris Sakakushev Gabriele Sganga Paolo Ballestracci Manu L. N. G. Malbrain Jean-Louis Vincent Manos Pikoulis Solomon Gurmu Beka Krstina Doklestic Massimo Chiarugi Marco Falcone Elena Bignami Viktor Reva Zaza Demetrashvili Salomone Di Saverio Matti Tolonen Pradeep Navsaria Miklosh Bala Zsolt Balogh Andrey Litvin Andreas Hecker Imtiaz Wani Andreas Fette Belinda De Simone Rao Ivatury Edoardo Picetti Vladimir Khokha Edward Tan Chad Ball Carlo Tascini Yunfeng Cui Raul Coimbra Michael Kelly Costanza Martino Vanni Agnoletti Marja A. Boermeester Nicola De’Angelis Mircea Chirica Walt L. Biffl Luca Ansaloni Yoram Kluger Fausto Catena Andrew W. Kirkpatrick Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines World Journal of Emergency Surgery Source control Emergency Infections Abdominal Surgery Trauma |
| title | Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines |
| title_full | Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines |
| title_fullStr | Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines |
| title_full_unstemmed | Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines |
| title_short | Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines |
| title_sort | source control in emergency general surgery wses gais sis e sis a guidelines |
| topic | Source control Emergency Infections Abdominal Surgery Trauma |
| url | https://doi.org/10.1186/s13017-023-00509-4 |
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