World Journal Of Emergency Surgery Research Articles

Interpretation of acute abdomen in the immunocompromised patients: WSES/SIS-E/WSIS/AAST/GAIS guideline

World Society of Emergency Surgery (WSES), in conjunction with Surgical Infection Society Europe (SIS-E), World Surgical Infection Society (WSIS), American Association for the Surgery of Trauma (AAST), and Global Alliance for Infection in Surgery (GAIS) developed guideline about the management of acute abdomen in immunocompromised patients, which was published in the World Journal of Emergency Surgery (WJES) on August 9, 2021. The guidelines elaborate on the definition, classification, diagnosis and treatment of immunocompromised patients. In addition, based on evidence-based medicine, it provides guidance and suggestion on the management of specific acute abdominal infections in immunocompromised patients, common acute abdominal infections in transplanted patients, patients with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS), as well as perioperative steroid management. An interpretation of the guideline was performed to accomplish a better understanding the current status and recommendations for the management of acute abdominal conditions in immunocompromised patients, and to make forward suggestions on its limitations.

A guide to caesarean wound healing

A guide to caesarean wound healing

Diverticular Disease of the Colon

Summary Introduction In the past decade, approaches to understanding epidemiology and treating diverticular disease have changed significantly. Many of the principles used earlier have lost their relevance at the moment. In the near future, we can expect an increase in cases of the disease, given the general population aging. Moreover, the number of surgical operations performed on diverticulosis increases annually. The number of complications are worsening the prognosis for a given disease increasing the risk of death results. The aim of the study A detailed scientific review is presented on the topic “Diverticular Colon Disease”. The paper primarily uses the guidelines of World Journal of Emergency Surgery (2016), as well as Guidelines of the American Association of Gastroenterologists and Clinical guidelines for the diagnosis and treatment of adult patients with diverticular colon disease developed by the expert committee of the All–Russian Public Organization “Association of Coloproctologists of Russia”. The work gives the definition of a diverticulum, diverticulosis, and diverticulitis of the colon. The issues of prevalence and frequency of occurrence of this pathology in various age and ethnic groups in developed and developing countries are reflected. The modern views on the etiology and pathogenesis of the disease are disclosed, taking into account the views of modern scholars and international guidelines. Finally, the work analyses case report on the complicated diverticular disease. Material and Methods The search for sources was performed in the PUBMED, PUBMED Central, Google Scholar and E–Library databases by keywords: colon diverticulosis, diverticulitis, as well as their Russian counterparts. The selection of sources was mainly limited to 2000–2020. Authors declare that the research was conducted according to the principles of the World Medical Association Declaration of Helsinki “Ethical Principles for Medical Research Involving Human Subjects. Informed consent was not received due to the nature of the study. Results and Conclusion In the past decade, approaches to understanding epidemiology and treating diverticular disease has changed. Many of the principles used earlier have lost their relevance at the moment. At the same time, a careful study of the etiological factors, pathophysiological mechanisms and cause–effect relationships in the development of this pathology is required. Improving diagnostic methods, early prevention and new approaches to treatment can reduce the risk of death in this disease.

Emergency repair of complicated abdominal wall hernias: WSES guidelines.

In July 2013, the World Society of Emergency Surgery (WSES) held the first Consensus Conference on emergency repair of abdominal wall hernias in adult patients with the intention of producing evidence-based guidelines to assist surgeons in the management of complicated abdominal wall hernias. Guidelines were updated in 2017 in keeping with varying clinical practice: benefits resulting from the increased use of biological prosthesis in the emergency setting were highlighted, as previously published in the World Journal of Emergency Surgery. This executive summary is intended to consolidate knowledge on the emergency management of complicated hernias by providing the broad readership with a practical and concise version of the original guidelines. This executive manuscript summarizes the WSES guidelines reporting on the emergency management of complicated abdominal wall hernias; statements are highlighted focusing the readers' attention on the main concepts presented in the original guidelines. Emergency repair of complicated abdominal hernias remains one of the most common and challenging surgical emergencies worldwide. WSES aims to provide an essential version of the evidence-based guidelines focusing on the timing of intervention, laparoscopic approach, surgical repair following the Centers for Disease Control and Prevention (CDC) wound classification, antimicrobial prophylaxis and anesthesia in the emergency setting.

CHRONIC COUGH CAUSING AN UNEXPECTED COMPLICATION

SESSION TITLE: Medical Student/Resident Signs and Symptoms of Chest Diseases SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/09/2018 01:15 PM - 02:15 PM INTRODUCTION: Cough is a physiologic defense mechanism to protect airways from foreign material and secretions. It’s one of the most common symptoms responsible of outpatient clinic evaluation and consists of approximately 30 million of visits annually in United States. Can be classified upon the duration on acute (less than 3 weeks), subacute (3 to 8 weeks) and chronic (more than 8 weeks). Sustained cough can be associated with multiple complications including cardiovascular, gastrointestinal, genitourinary, musculoskeletal, ophthalmologic, psychosocial, respiratory and skin complications. The most frequent documented is rib fractures. Other less reported complications include muscle rupture and pneumothorax CASE PRESENTATION: A 72yo woman G3P3A0 with morbid obesity, hypertension, fibromyalgia, diabetes mellitus type 2 and sleep apnea on Bipap with no toxic habits who presents with a chief complaint of dry cough and progressive shortness of breath of approximately 1 year evolution, with multiple visit to primary physician as well as emergency room without improvement of symptoms and treated with antibiotic therapy for pneumonic process. She continued with cough not responsive to medical management developing a tearing abdominal pain that radiate to the back and upper chest associated ecchymosis, worsening of dyspnea, early satiety, left breast pain and an episode of syncope. She denied fever, sputum, or recent trauma. Chest Xray performed on multiple occasions without evidence of abnormality. Chest CT with contrast showed a diaphragmatic rupture with displacement of small and large bowel into left side thoracic cavity causing left pulmonary collapse. Thoracic surgery was performed with placement of intestine on abdominal cavity, correction of diaphragmatic rupture and chest tube placement for pneumothorax. After procedure patient reported resolution of dyspnea. DISCUSSION: Diaphragm is an inspiratory muscle, which contracts during expiratory phase. Valsalva maneuver results in lack coordination of different muscles of expiration, the muscle of the abdominal wall contracts pushing the diaphragm upward whereas the ribs are pushed inward and downward causing diaphragmatic rupture. This complication is caused by thoracic injury in 7% and by thracoabdominal injury in 22% of cases. Herniation of bowel loops into the chest can be a consequence of diaphragmatic rupture, which impairs ventilation and oxygen delivery. The true incidence of abdominal organ herniation due to diaphragmatic rupture is unknown since many cases likely go undiagnosed. Diaphragmatic rupture has an overall mortality rate of 25% as reported by the National Trauma Data Bank. CONCLUSIONS: Due to an increase rate of herniation and strangulation of abdominal organs secondary to diaphragmatic rupture, which can be life threatening and surgical procedure is life saving; physician should be aware of the uncommon complication of cough. Reference #1: Hillenbrand A, Henne-Bruns, D. Cough induced rib fracture, rupture of the diaphragm and abdominal herniation. World Journal of Emergency Surgery 2006, 1:34 DISCLOSURES: No relevant relationships by Aixa Dones Rodriguez, source=Web Response No relevant relationships by Marlene Farinacci Vilaro, source=Web Response No relevant relationships by Ricardo Fernandez, source=Web Response No relevant relationships by Luis Gerena Montano, source=Web Response No relevant relationships by Hernan Gonzalez Monroig, source=Web Response No relevant relationships by Modesto Gonzalez-del Rosario, source=Web Response

Correction to: Vacuum-Assisted Wound Closure with Mesh-Mediated Fascial Traction Achieves Better Outcomes than Vacuum-Assisted Wound Closure Alone: A Comparative Study.

In the original article the credit line for the reuse of Fig.1 from an article published in the open access journal, World Journal of Emergency Surgery is missing.

World Journal of Emergency Surgery reviewer acknowledgement 2015

Contributing reviewersThe editors of World Journal of Emergency Surgery would like to thank all our reviewers who have contributed to the journal in volume 10 (2015).

World Society of Emergency Surgery-indication of globalism and renaissance through the 2015 biennial assembly.

The World Society of Emergency Surgery (WSES) was established in 2007. The objectives set forth by the society, as enumerated in the mission statement, is: “The overall goals include the promotion of the specialty of emergency surgery as part of the emerging discipline of acute care surgery via academic exchange in an effort to further training and education as well as translational research in the specialty’. The first WSES international assembly took place in Sardinia, Italy in 2011 and the second in Bergamo, Italy, in 2013. The 3rd international congress of WSES was held in Jerusalem, Israel, 5–8 July, 2015. As this was the first meeting outside of Italy, it represented an important worldwide extension of the society, with over 23 countries being represented by over 150 attendees. A pre- congress educational course on IAI (intra-abdominal infections) preceded the academic gathering, attended by 20 residents in training who enthusiastically participated and successfully completed the course. The residents were provided with a certificate of attendance by the WSES IAI course directors. An important and carefully planned objective of the meeting involved presentation of evidence based guidelines for common clinical challenges such as acute appendicitis, acute cholecystitis, and acute diverticulitis. These guidelines were reached after a detailed and methodical process with involvement of many contributing physicians and institutions and summaries of the suggested guidelines were presented for the approval of the assembly. The resultant guidelines from this process will be submitted for publication in the forthcoming issues of the World Journal of Emergency Surgery. Systematic reviews of the literature were presented in plenary sessions on a multitude of topics covering the entire spectrum of Emergency Surgery, A two and half day academic meeting followed the course and included 35 position lectures and 8 WSES guidelines reports. Eighty one clinical and research based abstracts were submitted from worldwide academic institutions, and 68 were presented in parallel sessions. Seven outstanding abstracts were chosen by the scientific committee and were presented in a plenary session. The assembly than nominated the three best abstract (1rd -3rd places) using an electronic voting system. The first authors of these abstracts were respected with a certificate signed by the congress chairmen. Besides discussions of the surgical approach to a many clinical challenges, state of the art strategies dealing with virtually all areas of surgical emergencies were comprehensively discussed. Thought-provoking case discussions presented during the meeting provided a great opportunity to share extensive knowledge and personal experiences from esteemed colleagues worldwide. Being a young society, the excitement generated by the meeting in Jerusalem reflected the dedication of its members to the specialty and generated new interest by a broader group of young surgeons and trainees. While the 2015 WSES meeting was termed “The Last of the Mohicans? - the General Surgeon of 2015?”, the keen support of many young surgeons suggests that indeed there is much enthusiasm and hope for the future of the specialty of Emergency Surgery. The executive board voted to host the next meeting, in 2017, in Brazil. We look forward to seeing everyone there as the congress moves to the American continent for the first time. Please join us at the new WSES web site (www.wses.org.uk) and in all the society activities (WSES registries, multi-center trails, courses and meetings). Your membership in the society is important.

Reviewer acknowledgement

Contributing reviewersThe World Journal of Emergency Surgery—which received its first Impact Factor in 2013—is extremely grateful for the time, hard work and support of its highly-qualified peer reviewers. The editors of World Journal of Emergency Surgery and BioMed Central would like to show our appreciation by thanking the following people for their assistance reviewing manuscripts for the journal in 2013.

Second WSES convention, WJES impact factor, and emergency surgery worldwide

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

Reviewer Acknowledgement 2012

Contributing reviewersThe Editors of World Journal of Emergency Surgery would like to thank all our reviewers who have contributed to the journal in Volume 7 (2012).

World Trauma Congress: when dreams come true

World Trauma Congress: when dreams come true

Molecular mechanisms and management of traumatic brain injury – missing the link?

We read with great interest the recent review article by Veenith et al. published in the World Journal of Emergency Surgery [1]. In this paper, the authors provide an overview on the epidemiology and pathophysiology of traumatic brain injury (TBI), and present an update on TBI-induced apoptosis, intracranial gene regulation and pharmacological approaches to ameliorate secondary brain injury. The authors are to be congratulated for outlining this important and constantly evolving topic of global importance. Unfortunately, our initial excitement about this paper, which promised to disclose the link between molecular pathology and new treatment concepts for TBI [1], was not justified. We believe that important pathways in the pathophysiology of TBI and resulting therapeutic concepts were not addressed in the review article. We would therefore like to comment on the missing aspects in the article by Veenith and colleagues [1], in order to provide a more balanced and comprehensive perspective on the topic. Beyond a doubt, a detailed description of the molecular neuropathology of TBI represents a challenging task, which is difficult to describe in just a few paragraphs. However, the authors could have expanded their article to include some of what we consider key pathways in the cellular and molecular pathophysiology of TBI (Figure ​(Figure1).1). For example, the role of neurotoxic proteases, nitric oxide and phospholipases released by damaged tissue, the impact on blood-brain-barrier breakdown by recruited and local inflammatory cells, and the activation of the innate immune system, e.g. the complement system, as a crucial mediator of posttraumatic neuroinflammation, are not mentioned or discussed in the paper. The section devoted to apoptosis provides the reader with some basic textbook information and definitions, but may have benefited from an additional update on the current literature in the field of neuronal apoptosis in TBI. Similarly, the paragraph on gene regulation appears to represent a random selection of candidate genes without a rationale being provided on how alterations in gene regulation may relate to the pathophysiology of TBI. Several references cited refer to studies related to cardiovascular disease, rather than head injury. Most importantly, this section of the manuscript fails to stress the clinical relevance of pathological alterations in gene expression. Figure 1 Simplified schematic of the complex neuroinflammatory response following traumatic brain injury. Check-marks indicate the areas discussed in the review article by Veenith and colleagues [1], while the red boxes designate pathophysiological pathways of ... Finally, as a minor comment, the authors should pay more attention to accuracy in the citation of the pertinent literature. For example, reference #10 is claimed to support a statement on interleukins and cerebral edema, when in fact the citation refers to a publication on programmed cell death in nematodes. Several other examples of inadequate reference to the literature could be mentioned. Finally, the title chosen by the authors appears problematic. The authors claim to provide the link between molecular mechanisms and therapeutic concepts in TBI. Unfortunately, the review article fails to provide a bridge between the two entities. In addition, many of the current therapeutic approaches and promising new strategies in search of the pharmacological golden bullet are missing [2]. While alterations in gene expression may be an interesting finding and promising target for future scientific approaches, we are still far from bringing the gene therapy concept from bench to bedside for an acute traumatic disorder such as TBI. In summary, we realize that providing an encompassing and scientifically accurate review on the topic represents a virtually impossible task. We are therefore grateful for the review by Veenith et al. [1] and we hope to contribute to the authors' search of the link between molecular pathophysiology and new therapeutic concepts in TBI by the identification of additional pathways of interest (Fig. ​(Fig.11).

WJES: how to review a clinical paper

Editorial World Journal of Emergency Surgery (WJES) was started to encompass all aspects of clinical and basic research studies related to emergency surgery and its allied subjects. Emergency surgery is a multidisciplinary super-specialty involving all surgical specialties and all emergency medicine specialties. Emergency surgery is divided into traumatic and non-traumatic emergency surgery. WJES accepts the following types of articles: research, case reports, reviews, book reviews, commentaries, letters to the editor, methodology articles, and study protocol.

Emergency surgery, acute care surgery and the boulevard of broken dreams

The scenario sounds familiar. Last night I returned home very late after a full day of emergency surgeries. While I was having my usual cold dinner in front of the television with my entire family asleep, I received disturbing news; a famous Italian actor had undergone emergency surgery in Honduras. the actor had been participating in a reality show and experienced severe back pain. For this reason, he was treated for one week with a NSAID. Suddenly, he developed acute abdominal pain and was taken to the nearest hospital. The diagnosis was acute appendicitis and he underwent immediate laparotomy via a Mc Burney incision. Unfortunately, the surgeons were mistaken. The problem was a large perforated duodenal ulcer and the actor then underwent a midline incisioThe patient was subsequently transferred to a Miami acute care hospital. The story is always the same; we can call it emergency surgery, acute care surgery, or Samantha, but the key point is that we do not have a widespread set of minimum standards for emergency surgery. Such standards are just as important as those of ATLS. We need to develop guidelines regarding organizational models to address diseases requiring urgent surgical intervention. This is an integral component in the mission of the World Journal of Emergency Surgery and of the World Society of Emergency Surgery. We must be uniformly prepared all around the world, similar to the uniform emergency protocols for airplanes and airports. If we fail to meet this objective, we will continue to witness preventable complications and deaths affecting both the famous and the non-famous alike. This is a dream, but it needn't be a broken one. In 2010 we will have the 1st World Congress of WSES. If we can successfully develop solid guidelines for surgeons from all around the world we will have accomplished a small yet important humanitarian mission. These guidelines would be freely available on the WJES web site and surgeons all around the world could reference them. You can call it emergency surgery or acute care surgery, but not the Boulevard of Broken Dreams.

In Memoriam: Michael E. DeBakey, M.D.

Telemedicine and e-HealthVol. 14, No. 6 IN MEMORIAMIn Memoriam: Michael E. DeBakey, M.D.Ronald C. Merrell and Charles R. DoarnRonald C. MerrellSearch for more papers by this author and Charles R. DoarnSearch for more papers by this authorPublished Online:26 Aug 2008https://doi.org/10.1089/tmj.2008.8500AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail "In Memoriam: Michael E. DeBakey, M.D.." , 14(6), pp. 503–504FiguresReferencesRelatedDetailsCited bySurgical Telementoring in Knowledge Translation—Clinical Outcomes and Educational Benefits30 October 2012 | Surgical Innovation, Vol. 20, No. 3Enhancing trauma education worldwide through telemedicine22 August 2012 | World Journal of Emergency Surgery, Vol. 7, No. S1Clinical and Educational Benefits of Surgical Telementoring4 April 2012Overcoming Distance: Video-Conferencing as a Clinical and Educational Tool Among Surgeons22 April 2009 | World Journal of Surgery, Vol. 33, No. 7 Volume 14Issue 6Aug 2008 InformationCopyright 2008, Mary Ann Liebert, Inc.To cite this article:Ronald C. Merrell and Charles R. Doarn.In Memoriam: Michael E. DeBakey, M.D..Telemedicine and e-Health.Aug 2008.503-504.http://doi.org/10.1089/tmj.2008.8500Published in Volume: 14 Issue 6: August 26, 2008PDF download

Felix Battistella, UC Davis Chief of Trauma and Emergency Surgery, Editorial Board member of World Journal of Emergency Surgery, dies at 48, January 22 2008

Felix D. Battistella, Professor and Chief of Trauma and Emergency Surgery at UC Davis Medical Center, died from cancer on January 22 at his home. He was 48.

World Journal of Emergency Surgery (WJES), World Society of Emergency Surgery (WSES) and the role of emergency surgery in the world

It has been more than a year since we founded WJES and with great satisfaction we have ascertained how great the interest in this topic is throughout the world in a polyspecialist environment, from ocular surgeons to neurosurgeons to the trauma surgeons who are clearly the protagonists. As you know we have developed a questionnaire to find out how emergency surgery is organized throughout the world. We have found that there are fundamentally two models, present at the same time and sometime in the same country: On the one hand there are the emergency surgery departments that burden themselves with almost all of the surgical emergencies that come into the hospital (40% of interviewed surgeons) (excluding hyperspecialist environments) and on the other hand there are hospitals without an emergency surgery department in which surgical emergencies are subdivided among the various general and specialized surgeons. In some hospitals there are trauma teams (30% of interviewed surgeons) but in others none at all. Therefore even if worldwide the situation in emergency surgery is so heterogeneous, the work of the various surgeons seems more or less similar regardless of whatever name it goes by, be it emergency surgery, acute care surgery, etc. 80% of interviewed surgeons answer that it would be better to have a more precise understanding of pathologies that they might encounter. We asked also in our survey a definition of emergency surgery: the answers were based on a time criterion (surgery less than 3–12 hours), on a place criterion (patients that come from emergency department) or on a disease criterion (surgery for trauma). Obviously it is difficult to define emergency surgery but we think that a possible definition can be: polispecialistic surgery performed for trauma injuries or for non traumatic acute diseases during the same admission in the hospital. In these last few years we've gone on a world tour to specialist conferences on emergency surgery along with conferences in other specialties, always with an eye toward emergency, in Europe, the USA and the rest of the world. We also attended world conferences in which we ascertained just how important cultural exchange is on a planetary scale. The natural consequence of these experiences is to begin considering to found the WSES (World Society of Emergency Surgery). This doesn't mean yet another scientific society designed to give visibility to certain people or to compete with other societies or associations with an annual Congress. It is intended to be an instrument. The objective is to put together all the world experts on emergency surgery every three years in one room for three days (Friday, Saturday, and Sunday). There would be selected lectures and free papers in the same room with a lot of space for discussion. Also lectures and free papers would be developed as articles for wide publication online at the beginning of the convention on the WJES. In the end we would put together a video of the conference and make it available on the WJES website. Every three years the WSES would develop a randomized multicenter study on a theme of general interest as well as guidelines on major themes. At least this much is clear: we wish to organize the first convention in 2009. Happy New Year!

World Journal of Emergency Surgery: "it has been a spectacular beginning"

Three months have passed since the WJES was launched. [1] In these few months, we have received a substantial amount of feed-back: 70 papers have been submitted and 10 invited reviews were published. The popularity of the topic has aided the growth and effectiveness of the journal. Now, it is the time to change; the journal is growing and it has stronger shoulders. [2] As you know, publishing in WJES has been free of charge, but starting June 24, the journal will introduce the usual Biomed fee. WJES articles will become financially self-sufficient through article-processing charges [APCs]. Authors are asked to pay GBP 750, if their research is accepted for publication. However, authors from resource-poor countries, who are unable to pay the APC for their manuscript, can apply to the Editors-in-Chief to have the APC waived. Other authors, who belong to BioMed Central member organizations, will have the APC covered in full or part by their membership. No charge is made for articles that are rejected after peer review. [2] Open Access publishing provides instant and universal availability of published work to any potential reader, worldwide, completely free of subscriptions, passwords, and charges. Furthermore, authors retain copyright of their work, facilitating its dissemination. Open Access publishing is made possible by article-processing charges assessed on the front end to authors, their institutions, or their funding agencies [3]. With this system, these article-processing charges will pay for three things: first, the electronic submission process, facilitating an efficient and thorough peer review; second, the publication costs involved in providing the article freely and universally in various formats online; and, third, the processes required for the article's inclusion in PubMed and its archiving in PubMed Central, e-Depot, Potsdam and INIST. There is no remuneration of any kind provided to the Editors-in-Chief, to any members of the Editorial Board, or to peer reviewers, as these positions work voluntarily. [4-6] The benefits from such Open Access will reward readers, with unrestricted access to information; to authors, through the widest possible dissemination of their work; and to science and society in general, by increasing the availability of information and scientific advancement. We believe World Journal of Emergency Surgery will benefit clinical care and aid scientific research, and we hope you will support this progress by submitting your next research article to this open access journal.

DIAGNOSING ACUTE COMPARTMENT SYNDROME

Compartment syndrome has been defined as “a condition in which increased pressure within a limited space compromises the circulation and function of the tissues within that space”.1 It is most commonly seen after injuries to the leg2-5 and forearm6-8 but may also occur in the arm,9 thigh,10 foot,11-13 buttock,14 hand15 and abdomen.16 It typically follows traumatic injury, but may also occur after ischaemic reperfusion injuries,17 burns,18 prolonged limb compression after drug overdose19 or poor positioning during surgery.20-24 Furthermore, subclinical compartment syndromes may explain the occurrence of a variety of postoperative disabilities which have been identified after the treatment of fractures of long bones using intramedullary nails.25 Approximately 40% of all acute compartment syndromes occur after fractures of the tibial shaft26 with an incidence in the range of 1% to 10%.26-30 A further 23% of compartment syndromes are caused by soft-tissue injuries with no fracture and fractures of the forearm account for 18%.26 Acute compartment syndrome is seen more commonly in younger patients, under 35 years of age31 and therefore leads to loss of function and long-term productivity in patients who would otherwise contribute to the country’s workforce for up to 40 years.