2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias

Emergency repair of complicated abdominal wall hernias may be associated with worsen outcome and a significant rate of postoperative complications. There is no consensus on management of complicated abdominal hernias. The main matter of debate is about the use of mesh in case of intestinal resection and the type of mesh to be used. Wound infection is the most common complication encountered and represents an immense burden especially in the presence of a mesh. The recurrence rate is an important topic that influences the final outcome. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013 with the aim to define recommendations for emergency repair of abdominal wall hernias in adults. This document represents the executive summary of the consensus conference approved by a WSES expert panel. In 2016, the guidelines have been revised and updated according to the most recent available literature.Peer reviewe

WSES guidelines for emergency repair of complicated abdominal wall hernias

Emergency repair of complicated abdominal hernias is associated with poor prognosis and a high rate of post-operative complications. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013, during the 2nd Congress of the World Society of Emergency Surgery with the goal of defining recommendations for emergency repair of abdominal wall hernias in adults. This document represents the executive summary of the consensus conference approved by a WSES expert panel

Complicated intra-abdominal infections worldwide : the definitive data of the CIAOW Study

Peer reviewe

WSES guidelines for emergency repair of complicated abdominal wall hernias

Peer reviewe

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

2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias

textabstractEmergency repair of complicated abdominal wall hernias may be associated with worsen outcome and a significant rate of postoperative complications. There is no consensus on management of complicated abdominal hernias. The main matter of debate is about the use of mesh in case of intestinal resection and the type of mesh to be used. Wound inf

Management and Outcomes Following Surgery for Gastrointestinal Typhoid: An International, Prospective, Multicentre Cohort Study

Background: Gastrointestinal perforation is the most serious complication of typhoid fever, with a high disease burden in low-income countries. Reliable, prospective, contemporary surgical outcome data are scarce in these settings. This study aimed to investigate surgical outcomes following surgery for intestinal typhoid. Methods: Two multicentre, international prospective cohort studies of consecutive patients undergoing surgery for gastrointestinal typhoid perforation were conducted. Outcomes were measured at 30 days and included mortality, surgical site infection, organ space infection and reintervention rate. Multilevel logistic regression models were used to adjust for clinically plausible explanatory variables. Effect estimates are expressed as odds ratios (ORs) alongside their corresponding 95% confidence intervals. Results: A total of 88 patients across the GlobalSurg 1 and GlobalSurg 2 studies were included, from 11 countries. Children comprised 38.6% (34/88) of included patients. Most patients (87/88) had intestinal perforation. The 30-day mortality rate was 9.1% (8/88), which was higher in children (14.7 vs. 5.6%). Surgical site infection was common, at 67.0% (59/88). Organ site infection was common, with 10.2% of patients affected. An ASA grade of III and above was a strong predictor of 30-day post-operative mortality, at the univariable level and following adjustment for explanatory variables (OR 15.82, 95% CI 1.53–163.57, p = 0.021). Conclusions: With high mortality and complication rates, outcomes from surgery for intestinal typhoid remain poor. Future studies in this area should focus on sustainable interventions which can reduce perioperative morbidity. At a policy level, improving these outcomes will require both surgical and public health system advances