Browsing by Author "Kirkpatrick, Andrew W"

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    Open Access
    It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey
    (2022-03-17) Sartelli, Massimo; Labricciosa, Francesco M; Coccolini, Federico; Coimbra, Raul; Abu-Zidan, Fikri M; Ansaloni, Luca; Al-Hasan, Majdi N; Ansari, Shamshul; Barie, Philip S; Caínzos, Miguel A; Ceresoli, Marco; Chiarugi, Massimo; Claridge, Jeffrey A; Cicuttin, Enrico; Dellinger, Evan P; Fry, Donald E; Guirao, Xavier; Hardcastle, Timothy C; Hecker, Andreas; Leppäniemi, Ari K; Litvin, Andrey; Marwah, Sanjay; Maseda, Emilio; Mazuski, John E; Memish, Ziad A; Kirkpatrick, Andrew W; Pagani, Leonardo; Podda, Mauro; Rasa, Huseyin K; Sakakushev, Boris E; Sawyer, Robert G; Tumietto, Fabio; Xiao, Yonghong; Aboubreeg, Wedad F; Adamou, Harissou; Akhmeteli, Lali; Akin, Emrah; Alberio, Maria G; Alconchel, Felipe; Magagi, Ibrahim A; Araúz, Ana B; Argenio, Giulio; Atanasov, Boyko C; Atici, Semra D; Awad, Selmy S; Baili, Efstratia; Bains, Lovenish; Bala, Miklosh; Baraket, Oussama; Baral, Suman; Belskii, Vladislav A; Benboubker, Moussa; Ben-Ishay, Offir; Bordoni, Pierpaolo; Boumédiène, Abdalia; Brisinda, Giuseppe; Cavazzuti, Laura; Chandy, Sujith J; Chiarello, Maria M; Cillara, Nicola; Clarizia, Guglielmo; Cocuz, Maria-Elena; Cocuz, Iuliu G; Conti, Luigi; Coppola, Raffaella; Cui, Yunfeng; Czepiel, Jacek; D’Acapito, Fabrizio; Damaskos, Dimitrios; Das, Koray; De Simone, Belinda; Delibegovic, Samir; Demetrashvili, Zaza; Detanac, Dzemail S; Dhingra, Sameer; Di Bella, Stefano; Dimitrov, Evgeni N; Dogjani, Agron; D’Oria, Mario; Dumitru, Irina M; Elmangory, Mutasim M; Enciu, Octavian; Fantoni, Massimo; Filipescu, Daniela; Fleres, Francesco; Foghetti, Domitilla; Fransvea, Pietro; Gachabayov, Mahir; Galeiras, Rita; Gattuso, Gianni; Ghannam, Wagih M; Ghisetti, Valeria; Giraudo, Giorgio; Gonfa, Kebebe B; Gonullu, Emre; Hamad, Yousif T E Y; Hecker, Matthias; Isik, Arda; Ismail, Nizar; Ismail, Azzain; Jain, Sumita A; Kanj, Souha S; Kapoor, Garima; Karaiskos, Ilias; Kavalakat, Alfie J; Kenig, Jakub; Khamis, Faryal; Khokha, Vladimir; Kiguba, Ronald; Kim, Jae I; Kobe, Yoshiro; Kok, Kenneth Y Y; Kovacevic, Bojan M; Kryvoruchko, Igor A; Kuriyama, Akira; Landaluce-Olavarria, Aitor; Lasithiotakis, Konstantinos; Lohsiriwat, Varut; Lostoridis, Eftychios; Luppi, Davide; Vega, Gustavo M M; Maegele, Marc; Marinis, Athanasios; Martines, Gennaro; Martínez-Pérez, Aleix; Massalou, Damien; Mesina, Cristian; Metan, Gökhan; Miranda-Novales, María G; Mishra, Shyam K; Mohamed, Mohaned I H; Mohamedahmed, Ali Y Y; Mora-Guzmán, Ismael; Mulita, Francesk; Musina, Ana-Maria; Navsaria, Pradeep H; Negoi, Ionut; Nita, Gabriela E; O’Connor, Donal B; Ordoñez, Carlos A; Pantalone, Desiré; Panyko, Arpád; Papadopoulos, Aristeidis; Pararas, Nikolaos; Pata, Francesco; Patel, Tapan; Pellino, Gianluca; Perra, Teresa; Perrone, Gennaro; Pesce, Antonio; Pintar, Tadeja; Popivanov, Georgi I; Porcu, Alberto; Quiodettis, Martha A; Rahim, Razrim; Mitul, Ashrarur R; Reichert, Martin; Rems, Miran; Campbell, Glendee Y R; Rocha-Pereira, Nuno; Rodrigues, Gabriel; Villamil, Gustavo E R; Rossi, Stefano; Sall, Ibrahima; Kafil, Hossein S; Sasia, Diego; Seni, Jeremiah; Seretis, Charalampos; Serradilla-Martín, Mario; Shelat, Vishal G; Siribumrungwong, Boonying; Slavchev, Mihail; Solaini, Leonardo; Tan, Boun K; Tarasconi, Antonio; Tartaglia, Dario; Toma, Elena A; Tomadze, Gia; Toro, Adriana; Tovani-Palone, Marcos R; van Goor, Harry; Vasilescu, Alin; Vereczkei, Andras; Veroux, Massimiliano; Weckmann, Sergio A; Widmer, Lukas W; Yahya, AliIbrahim; Zachariah, Sanoop K; Zakaria, Andee D; Zubareva, Nadezhda; Zuidema, Wietse P; Di Carlo, Isidoro; Cortese, Francesco; Baiocchi, Gian L; Maier, Ronald V; Catena, Fausto
    Background The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants’ perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened.
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    Open Access
    Outcomes of selective nonoperative management of civilian abdominal gunshot wounds: a systematic review and meta-analysis
    (BioMed Central, 2018-11-27) Al Rawahi, Aziza N; Al Hinai, Fatma A; Boyd, Jamie M; Doig, Christopher J; Ball, Chad G; Velmahos, George C; Kirkpatrick, Andrew W; Navsaria, Pradeep H; Roberts, Derek J
    Abstract Background Although mandatory laparotomy has been standard of care for patients with abdominal gunshot wounds (GSWs) for decades, this approach is associated with non-therapeutic operations, morbidity, and long hospital stays. This systematic review and meta-analysis sought to summarize outcomes of selective nonoperative management (SNOM) of civilian abdominal GSWs. Methods We searched electronic databases (March 1966–April 1, 2017) and reference lists of articles included in the systematic review for studies reporting outcomes of SNOM of civilian abdominal GSWs. We meta-analyzed the associated risks of SNOM-related failure (defined as laparotomy during hospital admission), mortality, and morbidity across included studies using DerSimonian and Laird random-effects models. Between-study heterogeneity was assessed by calculating I2 statistics and conducting tests of homogeneity. Results Of 7155 citations identified, we included 41 studies [n = 22,847 patients with abdominal GSWs, of whom 6777 (29.7%) underwent SNOM]. The pooled risk of failure of SNOM in hemodynamically stable patients without a reduced level of consciousness or signs of peritonitis was 7.0% [95% confidence interval (CI) = 3.9–10.1%; I2 = 92.6%, homogeneity p < 0.001] while the pooled mortality associated with use of SNOM in this patient population was 0.4% (95% CI = 0.2–0.6%; I2 = 0%, homogeneity p > 0.99). In patients who failed SNOM, the pooled estimate of the risk of therapeutic laparotomy was 68.0% (95% CI = 58.3–77.7%; I2 = 91.5%; homogeneity p < 0.001). Risks of failure of SNOM were lowest in studies that evaluated patients with right thoracoabdomen (3.4%; 95% CI = 0–7.0%; I2 = 0%; homogeneity p = 0.45), flank (7.0%; 95% CI = 3.9–10.1%), and back (3.1%; 95% CI = 0–6.5%) GSWs and highest in those that evaluated patients with anterior abdomen (13.2%; 95% CI = 6.3–20.1%) GSWs. In patients who underwent mandatory abdominopelvic computed tomography (CT), the pooled risk of failure was 4.1% versus 8.3% in those who underwent selective CT (p = 0.08). The overall sample-size-weighted mean hospital length of stay among patients who underwent SNOM was 6 days versus 10 days if they failed SNOM or developed an in-hospital complication. Conclusions SNOM of abdominal GSWs is safe when conducted in hemodynamically stable patients without a reduced level of consciousness or signs of peritonitis. Failure of SNOM may be lower in patients with GSWs to the back, flank, or right thoracoabdomen and be decreased by mandatory use of abdominopelvic CT scans.