ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy

ICU Management: General Management in the Elderly in ICU

The elderly population continues to grow worldwide. Furthermore, studies suggest that seniors nowadays tend to be more active in everyday life. Therefore, the burden of geriatric (poly-) trauma patients who are in need of intensive care and the consequential costs are expected to rise over the years to come. In contrast to younger (poly-) traumatized patients, the geriatric patient often sustains severe injuries from low energy trauma as a fall from standing height. The outcome in elderly patients may worsen due to preexisting conditions and frailty. These comorbidities lead to an increased need for intensive care after suffering a trauma. The impact of ethical aspects of intensive care treatment itself and the therapeutic options in the elderly are not to be underestimated and complicate the decision-making as well

Subcoracoid acromioclavicular joint dislocation (Rockwood type VI) sustained in motorcycle crash: A case report

We present the case of a young male who sustained a rare acromioclavicular joint (ACJ) injury during a road traffic accident. A left-sided ACJ injury was identified on plain radiographs fourteen days following a motorcycling accident during which significant distracting injuries were sustained. Owing to persistent shoulder pain during awake tertiary surveillance, repeat shoulder plain radiographs were obtained, along with re-examination of the patient's index computed tomography (CT) shoulder imaging, indicating a grade VI left-sided acromioclavicular subluxation.The patient underwent operative management of the above injury at three weeks, with initial examination under anesthetic revealing a stiff shoulder joint significantly limited external rotation requiring extensive release of fibrosis. The left ACJ was reduced under anesthesia, being temporarily secured with Kirschner wire insertion. A Synthes locking distal tibial “L” plate was contoured and applied across the AC joint, and secured with locking screws. Intensive post-operative physiotherapy resulted in an significantly improved post-operative range of motion in the patient's left shoulder.Acromioclavicular joint injuries, commonly shortened to ACJ injuries, are most regularly traumatic in etiology, ranging in severity from mild sprain to complete joint disruption.ACJ injuries are classified according to the position of the clavicle with respect to the acromion and coracoid. The above case highlights the requirement for comprehensive tertiary surveillance of trauma patients both pre and postextubation, in order to identify such injuries that may require prompt surgical management in order to restore range of motion and function in affected joints

ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings.

Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy

ECLAPTE: Effective Closure of LAParoTomy in Emergency—2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

Abstract Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy