The management of intra-abdominal infections from a global perspective : 2017 WSES guidelines for management of intra-abdominal infections

Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in the emergency departments worldwide. The cornerstones of effective treatment of IAIs are early recognition, adequate source control, and appropriate antimicrobial therapy. Prompt resuscitation of patients with ongoing sepsis is of utmost important. In hospitals worldwide, non-acceptance of, or lack of access to, accessible evidence-based practices and guidelines result in overall poorer outcome of patients suffering IAIs. The aim of this paper is to promote global standards of care in IAIs and update the 2013 WSES guidelines for management of intra-abdominal infections.Peer reviewe

Antimicrobials : a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.Peer reviewe

Determination of quality of life of patients with morbid obesity with simultaneous analysis of three questionnaires - SF-36, GIQLI and QUALITY OF LIFE INDEX QUESTIONNAIRE

Nowadays a great number of different questionnaires and forms for to assessment of quality of life (QL) of patients, including patients with morbid obesity, have been developed and used. To estimate the QL, we used three questionnaires: SF-36, GIQLI and the original one assessing the quality of life index (QLI), developed by us specifically for patients with morbid obesity. The main group consisted of 26 patients with morbid obesity, the av. age of which was 36,7 ± 0,3 years, the av. weight - 125,1 ± 24,5 kg (from 93 to 160 kg) and the av. BMI - 42,8 ± 8,1 kg/m 2. The control group consisted of 26 healthy persons without any comorbidities and morbid obesity. All indicators in all groups are higher than in healthy persons (the difference is statistically significant (р £ 0,05). From these data it follows that, as in the case of SF-36 questionnaire, there are significant differences between the two groups in all blocks of questions indicating a lower level of QL in patients with morbid obesity compared with healthy. Similar results were obtained in the analysis of QLI. Analysis of the three questionnaires revealed that all demonstrated a significant difference between the QL in patients with morbid obesity from that of healthy persons. These figures differ both in total points and in individual clusters of questions. A study of the correlation between BMI and levels of QL showed that, according to the GIQLI questionnaire has not represented. According to the questionnaire SF-36 there is inverse dependence between indicators of physical well-being and body weight of the patient. The same relationship exists in the QLI questionnaire in the block of disease-specific questions

Comparative evaluation of tissue reaction to the implantation of conventional polypropylene meshes end with autofibroblasts

One of the possible ways to solve the problem of improving the integration of polypropylene prostheses in the tissue of the patient in the treatment of hernias of the abdominal wall is the application, making and use of composite polypropylene mesh with a coating of own fibroblasts. In the experiment on the basis of morphometric analysis a comprehensive assessment of the effectiveness of the use of covering of «heavyweight» and «lightweight» polypropylene meshes by autofibroblasts has been conducted. The use of composite mesh, consisting of the «heavyweight» or «lightweight» polypropylene mesh and autofibroblasts in all cases, allows to speak about the more pronounced proliferative process compared with the group, using only the polypropylene mesh. The ability to create a composite polypropylene mesh with fixed autofibroblasts on the basis of «lightweight» and «heavyweight» composite polypropylene meshes has been proved

The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections

Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in the emergency departments worldwide. The cornerstones of effective treatment of IAIs are early recognition, adequate source control, and appropriate antimicrobial therapy. Prompt resuscitation of patients with ongoing sepsis is of utmost important. In hospitals worldwide, non-acceptance of, or lack of access to, accessible evidence-based practices and guidelines result in overall poorer outcome of patients suffering IAIs. The aim of this paper is to promote global standards of care in IAIs and update the 2013 WSES guidelines for management of intra-abdominal infections

Erratum: Antimicrobials: A global alliance for optimizing their rational use in intra-abdominal infections (AGORA). [World J Emerg Surg. 11, (2016) (33)] DOI: 10.1186/s13017-016-0089-y

The original article [1] contains an error whereby a co-author, Boris Sakakushev has their family name spelt incorrectly as 'Sakakhushev'. The authors would therefore like it known that the correct spelling of the family name is 'Sakakushev'.Scopu

Antimicrobials: A global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs

A Global Declaration on Appropriate Use of Antimicrobial Agents across the Surgical Pathway

This declaration, signed by an interdisciplinary task force of 234 experts from 83 different countries with different backgrounds, highlights the threat posed by antimicrobial resistance and the need for appropriate use of antibiotic agents and antifungal agents in hospitals worldwide especially focusing on surgical infections. As such, it is our intent to raise awareness among healthcare workers and improve antimicrobial prescribing. To facilitate its dissemination, the declaration was translated in different languages