Abstract

BackgroundIn 2007, before founding the World Society of Emer-gency Surgery (WSES), we developed a questionnaire toinvestigate how emergency surgery was organized andimplemented as a practice throughout the world. Wediscovered two fundamental models, which were some-times present simultaneously in the same country [1].One model was characterized by hospitals with desig-nated emergency surgery departments and the other fea-tured hospitals without an emergency surgery departmentin which surgical emergencies were subdivided amongvarious general and specialized surgeons. Similarly, somehospitals had designated trauma teams while others hadno such designated units.However, despite the heterogeneous complexity of emer-gency surgery in a worldwide context, the work of sur-geons around the globe appears remarkably similarregardless of the name attributed to the facility in whichthey practice, be it emergency surgery, acute care surgery,or another generic title.Although it is difficult to succinctly define emergencysurgery, which includes a broad spectrum of procedures,a universal definition could be poly-specialized surgeryperformed for traumatic and non-traumatic acute dis-eases. We have considered non traumatic emergencysurgery as non CNS life-threatening diseases requiringurgent operative intervention (within 24 hr) with the ex-ception of those requiring total cardiac bypass.There is a significant difference between traumatic andnon-traumatic acute diseases. The dispersion of traumaprograms sponsored by the American College of Sur-geons has resulted in the near-uniform management oftrauma patients around the world. By contrast, the man-agement of patients with non-traumatic acute diseases(intra-abdominal infections, bowel occlusion, etc.) re-mains poorly standardized and varies dramatically be-tween treatment centers. Standards for the managementof non-traumatic acute diseases are just as important asthose of ATLS.Practitioners of emergency surgery worldwide must de-velop standardized guidelines to streamline protocol anddesignate organizational models used to address acute dis-eases requiring urgent surgical intervention; this ambi-tious effort is the primary objective of the World Societyof Emergency Surgery (WSES) and its publication affiliatethe World Journal of Emergency Surgery (WJES).In recent years, the WSES has focused on non-traumaticacute diseases, proposing standardized protocol guidelinesand prospective studies shared worldwide.In 2011, WSES published the first set of universalguidelines for the management of intra-abdominal infec-tions in the WJES [2]. This article was an executive sum-mary of the final recommendations approved by theconsensus conference held in Bologna, Italy, in July of2010 during the first WSES convention. These guide-lines were recently updated following a multidisciplinarycollaboration of international contributors [3].In 2011, the WSES also presented guidelines for themanagement of obstructive cancer of the left colon [4]as well as guidelines for the diagnosis and managementof adhesive small bowel obstruction [5], both publishedin the WJES. These guidelines represent a summary ofthe final recommendations approved by the consensusconference of the first WSES convention held in Bolognain 2010.In an effort to promote global sharing on the topic ofmanagement of intra-abdominal infections and to garnerinternational support and input, the WSES also conductedtwo prospective observational studies.The CIAO Study (“Complicated Intra-Abdominal in-fection Observational” Study) was a multicenter investi-gation performed in 68 medical institutions throughoutEurope over the course of a 6-month observationalperiod (January-June 2012) [6].Given the success of the CIAO Study, WSES designed

Highlights

  • In 2007, before founding the World Society of Emergency Surgery (WSES), we developed a questionnaire to investigate how emergency surgery was organized and implemented as a practice throughout the world

  • Practitioners of emergency surgery worldwide must develop standardized guidelines to streamline protocol and designate organizational models used to address acute diseases requiring urgent surgical intervention; this ambitious effort is the primary objective of the World Society of Emergency Surgery (WSES) and its publication affiliate the World Journal of Emergency Surgery (WJES)

  • In 2011, WSES published the first set of universal guidelines for the management of intra-abdominal infections in the WJES [2]

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Summary

Introduction

In 2007, before founding the World Society of Emergency Surgery (WSES), we developed a questionnaire to investigate how emergency surgery was organized and implemented as a practice throughout the world. The management of patients with non-traumatic acute diseases (intra-abdominal infections, bowel occlusion, etc.) remains poorly standardized and varies dramatically between treatment centers.

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