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1.  Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study) 
Sartelli, Massimo | Abu-Zidan, Fikri M. | Catena, Fausto | Griffiths, Ewen A. | Di Saverio, Salomone | Coimbra, Raul | Ordoñez, Carlos A. | Leppaniemi, Ari | Fraga, Gustavo P. | Coccolini, Federico | Agresta, Ferdinando | Abbas, Asrhaf | Abdel Kader, Saleh | Agboola, John | Amhed, Adamu | Ajibade, Adesina | Akkucuk, Seckin | Alharthi, Bandar | Anyfantakis, Dimitrios | Augustin, Goran | Baiocchi, Gianluca | Bala, Miklosh | Baraket, Oussama | Bayrak, Savas | Bellanova, Giovanni | Beltràn, Marcelo A. | Bini, Roberto | Boal, Matthew | Borodach, Andrey V. | Bouliaris, Konstantinos | Branger, Frederic | Brunelli, Daniele | Catani, Marco | Che Jusoh, Asri | Chichom-Mefire, Alain | Cocorullo, Gianfranco | Colak, Elif | Costa, David | Costa, Silvia | Cui, Yunfeng | Curca, Geanina Loredana | Curry, Terry | Das, Koray | Delibegovic, Samir | Demetrashvili, Zaza | Di Carlo, Isidoro | Drozdova, Nadezda | El Zalabany, Tamer | Enani, Mushira Abdulaziz | Faro, Mario | Gachabayov, Mahir | Giménez Maurel, Teresa | Gkiokas, Georgios | Gomes, Carlos Augusto | Gonsaga, Ricardo Alessandro Teixeira | Guercioni, Gianluca | Guner, Ali | Gupta, Sanjay | Gutierrez, Sandra | Hutan, Martin | Ioannidis, Orestis | Isik, Arda | Izawa, Yoshimitsu | Jain, Sumita A. | Jokubauskas, Mantas | Karamarkovic, Aleksandar | Kauhanen, Saila | Kaushik, Robin | Kenig, Jakub | Khokha, Vladimir | Kim, Jae Il | Kong, Victor | Koshy, Renol | Krasniqi, Avidyl | Kshirsagar, Ashok | Kuliesius, Zygimantas | Lasithiotakis, Konstantinos | Leão, Pedro | Lee, Jae Gil | Leon, Miguel | Lizarazu Pérez, Aintzane | Lohsiriwat, Varut | López-Tomassetti Fernandez, Eudaldo | Lostoridis, Eftychios | Mn, Raghuveer | Major, Piotr | Marinis, Athanasios | Marrelli, Daniele | Martinez-Perez, Aleix | Marwah, Sanjay | McFarlane, Michael | Melo, Renato Bessa | Mesina, Cristian | Michalopoulos, Nick | Moldovanu, Radu | Mouaqit, Ouadii | Munyika, Akutu | Negoi, Ionut | Nikolopoulos, Ioannis | Nita, Gabriela Elisa | Olaoye, Iyiade | Omari, Abdelkarim | Ossa, Paola Rodríguez | Ozkan, Zeynep | Padmakumar, Ramakrishnapillai | Pata, Francesco | Pereira Junior, Gerson Alves | Pereira, Jorge | Pintar, Tadeja | Pouggouras, Konstantinos | Prabhu, Vinod | Rausei, Stefano | Rems, Miran | Rios-Cruz, Daniel | Sakakushev, Boris | Sánchez de Molina, Maria Luisa | Seretis, Charampolos | Shelat, Vishal | Simões, Romeo Lages | Sinibaldi, Giovanni | Skrovina, Matej | Smirnov, Dmitry | Spyropoulos, Charalampos | Tepp, Jaan | Tezcaner, Tugan | Tolonen, Matti | Torba, Myftar | Ulrych, Jan | Uzunoglu, Mustafa Yener | van Dellen, David | van Ramshorst, Gabrielle H. | Vasquez, Giorgio | Venara, Aurélien | Vereczkei, Andras | Vettoretto, Nereo | Vlad, Nutu | Yadav, Sanjay Kumar | Yilmaz, Tonguç Utku | Yuan, Kuo-Ching | Zachariah, Sanoop Koshy | Zida, Maurice | Zilinskas, Justas | Ansaloni, Luca
Background
To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression.
Methods
The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18–99) were enrolled in the WISS study.
Results
Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p < 0.0001). The multivariate logistic regression model was highly significant (p < 0.0001, R2 = 0.54) and showed that all these factors were independent in predicting mortality of sepsis. Receiver Operator Curve has shown that the WSES Severity Sepsis Score had an excellent prediction for mortality. A score above 5.5 was the best predictor of mortality having a sensitivity of 89.2 %, a specificity of 83.5 % and a positive likelihood ratio of 5.4.
Conclusions
WSES Sepsis Severity Score for patients with complicated Intra-abdominal infections can be used on global level. It has shown high sensitivity, specificity, and likelihood ratio that may help us in making clinical decisions.
doi:10.1186/s13017-015-0055-0
PMCID: PMC4681030  PMID: 26677396
Intra-abdominal; Infections; Sepsis; Septic shock
2.  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.
doi:10.1186/1749-7922-8-50
PMCID: PMC4176144  PMID: 24289453
3.  A multicenter randomized controlled trial evaluating the effect of small stitches on the incidence of incisional hernia in midline incisions 
BMC Surgery  2011;11:20.
Background
The median laparotomy is frequently used by abdominal surgeons to gain rapid and wide access to the abdominal cavity with minimal damage to nerves, vascular structures and muscles of the abdominal wall. However, incisional hernia remains the most common complication after median laparotomy, with reported incidences varying between 2-20%. Recent clinical and experimental data showed a continuous suture technique with many small tissue bites in the aponeurosis only, is possibly more effective in the prevention of incisional hernia when compared to the common used large bite technique or mass closure.
Methods/Design
The STITCH trial is a double-blinded multicenter randomized controlled trial designed to compare a standardized large bite technique with a standardized small bites technique. The main objective is to compare both suture techniques for incidence of incisional hernia after one year. Secondary outcomes will include postoperative complications, direct costs, indirect costs and quality of life.
A total of 576 patients will be randomized between a standardized small bites or large bites technique. At least 10 departments of general surgery and two departments of oncological gynaecology will participate in this trial. Both techniques have a standardized amount of stitches per cm wound length and suture length wound length ratio's are calculated in each patient. Follow up will be at 1 month for wound infection and 1 year for incisional hernia. Ultrasound examinations will be performed at both time points to measure the distance between the rectus muscles (at 3 points) and to objectify presence or absence of incisional hernia. Patients, investigators and radiologists will be blinded during follow up, although the surgeon can not be blinded during the surgical procedure.
Conclusion
The STITCH trial will provide level 1b evidence to support the preference for either a continuous suture technique with many small tissue bites in the aponeurosis only or for the commonly used large bites technique.
Trial registration
Clinicaltrials.gov NCT01132209
doi:10.1186/1471-2482-11-20
PMCID: PMC3182877  PMID: 21871072

Results 1-3 (3)