WSES guidelines for management of Clostridium difficile infection in surgical patients

In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency Surgery (WSES) guidelines for management of CDI in surgical patients

WSES Guidelines for emergency repair of complicated abdominal wall hernia

46nonerestrictedMassimo Sartelli; Federico Coccolini; Gabrielle H van Ramshorst; Giampiero Campanelli; Vincenzo Mandalà; Luca Ansaloni; Ernest E Moore; Andrew Peitzman; George Velmahos; Fredrick Alan Moore; Ari Leppaniemi1; Clay Cothren Burlew; Walter Biffl; Kaoru Koike1; Yoram Kluger; Gustavo P Fraga; Carlos A Ordonez; Salomone Di Saverio; Ferdinando Agresta; Boris Sakakushev; Igor Gerych; Imtiaz Wani; Michael D Kelly; Carlos Augusto Gomes; Mario Paulo Faro; Korhan Taviloglu; Zaza Demetrashvili; Jae Gil Lee; Nereo Vettoretto; Gianluca Guercioni; Cristian Tranà; Yunfeng Cui; Kenneth YY Kok; Wagih M Ghnnam; Ashraf El-Sayed Abbas; Norio Sato; Sanjay Marwah; Muthukumaran Rangarajan; Offir Ben-Ishay; Abdul Rashid K Adesunkanmi; Helmut Alfredo Segovia Lohse; Jakub Kenig; Stefano Mandalà; Andrea Patrizi; Rodolfo Scibé; Fausto CatenaMassimo, Sartelli; Federico, Coccolini; van Ramshorst, Gabrielle H.; Campanelli, GIAMPIERO GIORGIO SALVATORE CIRO; Vincenzo, Mandalà; Luca, Ansaloni; Moore, Ernest E.; Andrew, Peitzman; George, Velmahos; Fredrick Alan Moore, ; Ari, Leppaniemi1; Clay Cothren Burlew, ; Walter, Biffl; Kaoru, Koike1; Yoram, Kluger; Fraga, Gustavo P.; Ordonez, Carlos A.; DI SAVERIO, Salomone; Ferdinando, Agresta; Boris, Sakakushev; Igor, Gerych; Imtiaz, Wani; Kelly, Michael D.; Carlos Augusto Gomes, ; Mario Paulo Faro, ; Korhan, Taviloglu; Zaza, Demetrashvili; Jae Gil Lee, ; Nereo, Vettoretto; Gianluca, Guercioni; Cristian, Tranà; Yunfeng, Cui; Kenneth YY Kok, ; Ghnnam, Wagih M.; Ashraf El Sayed Abbas, ; Norio, Sato; Sanjay, Marwah; Muthukumaran, Rangarajan; Offir Ben Ishay, ; Adesunkanmi, Abdul Rashid K.; Helmut Alfredo Segovia Lohse, ; Jakub, Kenig; Stefano, Mandalà; Andrea, Patrizi; Rodolfo, Scibé; Fausto, Caten

Changes in surgicaL behaviOrs dUring the CoviD-19 pandemic. The SICE CLOUD19 Study

BACKGROUND: The spread of the SARS-CoV2 virus, which causes COVID-19 disease, profoundly impacted the surgical community. Recommendations have been published to manage patients needing surgery during the COVID-19 pandemic. This survey, under the aegis of the Italian Society of Endoscopic Surgery, aims to analyze how Italian surgeons have changed their practice during the pandemic.METHODS: The authors designed an online survey that was circulated for completion to the Italian departments of general surgery registered in the Italian Ministry of Health database in December 2020. Questions were divided into three sections: hospital organization, screening policies, and safety profile of the surgical operation. The investigation periods were divided into the Italian pandemic phases I (March-May 2020), II (June-September 2020), and III (October-December 2020).RESULTS: Of 447 invited departments, 226 answered the survey. Most hospitals were treating both COVID-19-positive and -negative patients. The reduction in effective beds dedicated to surgical activity was significant, affecting 59% of the responding units. 12.4% of the respondents in phase I, 2.6% in phase II, and 7.7% in phase III reported that their surgical unit had been closed. 51.4%, 23.5%, and 47.8% of the respondents had at least one colleague reassigned to non-surgical COVID-19 activities during the three phases. There has been a reduction in elective (>200 procedures: 2.1%, 20.6% and 9.9% in the three phases, respectively) and emergency (<20 procedures: 43.3%, 27.1%, 36.5% in the three phases, respectively) surgical activity. The use of laparoscopy also had a setback in phase I (25.8% performed less than 20% of elective procedures through laparoscopy). 60.6% of the respondents used a smoke evacuation device during laparoscopy in phase I, 61.6% in phase II, and 64.2% in phase III. Almost all responders (82.8% vs. 93.2% vs. 92.7%) in each analyzed period did not modify or reduce the use of high-energy devices.CONCLUSION: This survey offers three faithful snapshots of how the surgical community has reacted to the COVID-19 pandemic during its three phases. The significant reduction in surgical activity indicates that better health policies and more evidence-based guidelines are needed to make up for lost time and surgery not performed during the pandemic