Management of intra-abdominal infections: recommendations by the WSES 2016 consensus conference
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Management of intra-abdominal infections: recommendations by the WSES 2016 consensus conference Massimo Sartelli1*, Fausto Catena2, Fikri M. Abu-Zidan3, Luca Ansaloni4, Walter L. Biffl5, Marja A. Boermeester6, Marco Ceresoli3, Osvaldo Chiara7, Federico Coccolini3, Jan J. De Waele8, Salomone Di Saverio9, Christian Eckmann10, Gustavo P. Fraga11, Maddalena Giannella12, Massimo Girardis13, Ewen A. Griffiths14, Jeffry Kashuk15, Andrew W. Kirkpatrick16, Vladimir Khokha17, Yoram Kluger18, Francesco M. Labricciosa19, Ari Leppaniemi20, Ronald V. Maier21, Addison K. May22, Mark Malangoni23, Ignacio Martin-Loeches24, John Mazuski25, Philippe Montravers26, Andrew Peitzman27, Bruno M. Pereira11, Tarcisio Reis28, Boris Sakakushev29, Gabriele Sganga30, Kjetil Soreide31, Michael Sugrue32, Jan Ulrych33, Jean-Louis Vincent34, Pierluigi Viale12 and Ernest E. Moore35
Abstract This paper reports on the consensus conference on the management of intra-abdominal infections (IAIs) which was held on July 23, 2016, in Dublin, Ireland, as a part of the annual World Society of Emergency Surgery (WSES) meeting. This document covers all aspects of the management of IAIs. The Grading of Recommendations Assessment, Development and Evaluation recommendation is used, and this document represents the executive summary of the consensus conference findings. Keywords: Intra-abdominal infections, Sepsis, Peritonitis, Antibiotics
Background Intra-abdominal infections (IAIs) are an important cause of morbidity and mortality [1]. Early clinical diagnosis, adequate source control to stop ongoing contamination, appropriate antimicrobial therapy dictated by patient and infection risk factors, and prompt resuscitation in critically ill patients are the cornerstones in the management of IAIs. However, several critical controversies can be debated in the management of these patients. Application of management principles to the individual patient is crucial to optimize outcome. In order to clarify these major controversies in the management of IAI, many of the world’s leading experts met in Dublin, Ireland, on July 23, 2016, for a specialist multidisciplinary consensus conference under the auspices of the World Society of Emergency Surgery (WSES) and with the support of the World Society of Abdominal Compartment * Correspondence: [email protected] 1 Department of Surgery, Macerata Hospital, Macerata, Italy Full list of author information is available at the end of the article
Syndrome (WSACS). This document represents the executive summary of this consensus conference.
Methodology In constituting the expert panel, the WSES committee invited many of the world’s leading experts in the management of IAIs. It was a multidisciplinary expert panel including general and specialist surgeons, emergency and acute care surgeons, infectious disease specialists, and intensivists. The expert panel reviewed the scientific evidence and composed statements which addressed a set of predefined questions. The statements were formulated and graded acc
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