WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections

Massimo Sartelli¹, Federico Coccolini², Yoram Kluger³, Ervis Agastra⁴, Fikri M Abu-Zidan⁵, Ashraf El Sayed Abbas⁶, Luca Ansaloni⁷, Abdulrashid Kayode Adesunkanmi⁸, Goran Augustin⁹, Miklosh Bala¹⁰, Oussama Baraket¹¹, Walter L Biffl¹², Marco Ceresoli¹³, Elisabetta Cerutti¹⁴, Osvaldo Chiara¹⁵, Enrico Cicuttin², Massimo Chiarugi², Raul Coimbra¹⁶, Daniela Corsi¹⁷, Francesco Cortese¹⁸, Yunfeng Cui¹⁹, Dimitris Damaskos²⁰, Nicola de'Angelis^{21

22}, Samir Delibegovic²³, Zaza Demetrashvili²⁴, Belinda De Simone²⁵, Stijn W de Jonge²⁶, Stefano Di Bella²⁷, Salomone Di Saverio²⁸, Therese M Duane²⁹, Paola Fugazzola⁷, Joseph M Galante³⁰, Wagih Ghnnam³¹, George Gkiokas³², Carlos Augusto Gomes³³, Ewen A Griffiths³⁴, Timothy C Hardcastle³⁵, Andreas Hecker³⁶, Torsten Herzog³⁷, Aleksandar Karamarkovic³⁸, Vladimir Khokha³⁹, Peter K Kim⁴⁰, Jae Il Kim⁴¹, Andrew W Kirkpatrick⁴², Victor Kong⁴³, Renol M Koshy⁴⁴, Kenji Inaba⁴⁵, Arda Isik⁴⁶, Rao Ivatury⁴⁷, Francesco M Labricciosa⁴⁸, Yeong Yeh Lee⁴⁹, Ari Leppäniemi⁵⁰, Andrey Litvin⁵¹, Davide Luppi⁵², Ronald V Maier⁵³, Athanasios Marinis⁵⁴, Sanjay Marwah⁵⁵, Cristian Mesina⁵⁶, Ernest E Moore⁵⁷, Frederick A Moore⁵⁸, Ionut Negoi⁵⁹, Iyiade Olaoye⁶⁰, Carlos A Ordoñez^{61

62}, Mouaqit Ouadii⁶³, Andrew B Peitzman⁶⁴, Gennaro Perrone⁶⁵, Tadeja Pintar⁶⁶, Giuseppe Pipitone⁶⁷, Mauro Podda⁶⁸, Kemal Raşa⁶⁹, Julival Ribeiro⁷⁰, Gabriel Rodrigues⁷¹, Ines Rubio-Perez⁷², Ibrahima Sall⁷³, Norio Sato⁷⁴, Robert G Sawyer⁷⁵, Vishal G Shelat⁷⁶, Michael Sugrue⁷⁷, Antonio Tarasconi⁶⁵, Matti Tolonen⁵⁰, Bruno Viaggi⁷⁸, Andrea Celotti⁷⁹, Claudio Casella⁸⁰, Leonardo Pagani⁸¹, Sameer Dhingra⁸², Gian Luca Baiocchi^{79

80}, Fausto Catena⁸³

Affiliations

¹ Department of Surgery, Macerata Hospital, Macerata, Italy. massimosartelli@gmail.com.
² Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy.
³ Department of General Surgery, Rambam Health Care Campus, Haifa, Israel.
⁴ General Surgery Department, Regional Hospital of Durres, Durres, Albania.
⁵ Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
⁶ Department of General and Emergency Surgery Faculty of Medicine, Mansoura University Hospital, Mansoura, Egypt.
⁷ Department of Surgery, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
⁸ Department of Surgery, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
⁹ Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.
¹⁰ Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
¹¹ Department of General Surgery Bizerte Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
¹² Division of Trauma/Acute Care Surgery, Scripps Clinic Medical Group, La Jolla, CA, USA.
¹³ Emergency and General Surgery Department, University of Milan-Bicocca, Milan, Italy.
¹⁴ Anesthesia and Transplant Surgical Intensive Care Unit, Ospedali Riuniti, Ancona, Italy.
¹⁵ Department of Pathophysiology, ASST Niguarda Ca'Granda Hospital, University of Milano, Milan, Italy.
¹⁶ Riverside University Health System, CECORC Research Center, Loma Linda University, Loma Linda, USA.
¹⁷ General Direction, Area Vasta 3, ASUR Marche, Macerata, Italy.
¹⁸ Emergency Surgery Unit, San Filippo Neri's Hospital, Rome, Italy.
¹⁹ Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China.
²⁰ Department of Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
²¹ Minimally Invasive and Robotic Digestive Surgery Unit, Regional General Hospital F. Miulli, Bari, Italy.
²² Université Paris Est, UPEC, Creteil, France.
²³ Department of Surgery, University Clinical Center of Tuzla, Tuzla, Bosnia and Herzegovina.
²⁴ Department General Surgery, Kipshidze Central University Hospital, Tbilisi, Georgia.
²⁵ Department of General, Digestive and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal De Poissy/St Germain en Laye, Poissy, France.
²⁶ Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.
²⁷ Clinical Department of Medical, Surgical and Health Sciences, Trieste University, Trieste, Italy.
²⁸ Department of General Surgery, "Madonna del Soccorso" San Benedetto del Tronto Hospital, San Benedetto del Tronto, Italy.
²⁹ Department of Surgery, Texas Health Resources, Ft Worth, TX, USA.
³⁰ Division of Trauma and Acute Care Surgery, Department of Surgery, University of California Davis, Sacramento, CA, USA.
³¹ Department of General Surgery, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt.
³² Second Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
³³ Department of Surgery, Hospital Universitário Terezinha de Jesus, Faculdade de Ciências Médicas E da Saúde de Juiz de Fora, Juiz de Fora, Brazil.
³⁴ Department of Upper GI Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
³⁵ Trauma Service, Inkosi Albert Luthuli Central Hospital and Department of Surgery, Nelson R Mandela School of Clinical Medicine, Durban, South Africa.
³⁶ Department of General and Thoracic Surgery, University Hospital Giessen, Giessen, Germany.
³⁷ Department of Surgery, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany.
³⁸ Surgical Clinic "Nikola Spasic", Faculty of Medicine University of Belgrade, Belgrade, Serbia.
³⁹ Department of Emergency Surgery, City Hospital, Mozyr, Belarus.
⁴⁰ Department of Surgery, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
⁴¹ Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea.
⁴² General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB, Canada.
⁴³ Department of Surgery, Edendale Hospital, Pietermaritzburg, South Africa.
⁴⁴ Department of General Surgery, University Hospital of Coventry and Warwickshire, Coventry, UK.
⁴⁵ Division of Trauma and Surgical Critical Care, Department of Surgery, University of Southern California, Los Angeles, CA, USA.
⁴⁶ Department of General Surgery, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey.
⁴⁷ Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
⁴⁸ Global Alliance for Infections in Surgery, Macerata, Italy.
⁴⁹ School of Medical Sciences, Universitiy Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
⁵⁰ Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
⁵¹ Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kaliningrad, Russia.
⁵² Department of General and Emergency Surgery, ASMN, Reggio Emilia, Italy.
⁵³ Department of Surgery, University of Washington, Seattle, WA, USA.
⁵⁴ First Department of Surgery, Tzaneion General Hospital, Piraeus, Greece.
⁵⁵ Department of Surgery, Post-Graduate Institute of Medical Sciences, Rohtak, India.
⁵⁶ Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Romania.
⁵⁷ Ernest E Moore Shock Trauma Center at Denver Health, Denver, USA.
⁵⁸ Department of Surgery, Division of Acute Care Surgery, and Center for Sepsis and Critical Illness Research, University of Florida College of Medicine, Gainesville, FL, USA.
⁵⁹ Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania.
⁶⁰ Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
⁶¹ Division of Trauma and Acute Care Surgery, Fundacion Valle del Lili, Cali, Colombia.
⁶² Department of Surgery, Universidad del Valle, Cali, Colombia.
⁶³ Department of Surgery, Hassan II University Hospital, Medical School of Fez, Sidi Mohamed Benabdellah University, Fez, Morocco.
⁶⁴ Department of Surgery, University of Pittsburgh School of Medicine, UPMC-Presbyterian, Pittsburgh, USA.
⁶⁵ Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy.
⁶⁶ Department of Surgery, UMC Ljubljana, Ljubljana, Slovenia.
⁶⁷ Department of Internal Medicine, Division of Infectious Disease, ARNAS Civico-Di Cristina Hospital, Palermo, Italy.
⁶⁸ Department of General and Emergency Surgery, Cagliari University Hospital, Cagliari, Italy.
⁶⁹ Department of Surgery, Anadolu Medical Center, Kocaeli, Turkey.
⁷⁰ Infection Control, Hospital de Base, Brasília, DF, Brazil.
⁷¹ Department of General Surgery, Kasturba Medical College and Hospital, Manipal Academy of Higher Education, Manipal, India.
⁷² General Surgery Department, Colorectal Surgery Unit, La Paz University Hospital, Madrid, Spain.
⁷³ General Surgery Department, Military Teaching Hospital, Dakar, Senegal.
⁷⁴ Department of Aeromedical Services for Emergency and Trauma Care, Ehime University Graduate School of Medicine, Ehime, Japan.
⁷⁵ Department of Surgery, Western Michigan University School of Medicine, Kalamazoo, MI, USA.
⁷⁶ Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
⁷⁷ Donegal Clinical Research Academy Emergency Surgery Outcome Project, Letterkenny University Hospital, Donegal, Ireland.
⁷⁸ Department of Anesthesiology, Neuro Intensive Care Unit, Florence Careggi University Hospital, Florence, Italy.
⁷⁹ Department of Surgery, AAST Cremona, Cremona, Italy.
⁸⁰ Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
⁸¹ Department of Infectious Diseases, Bolzano Hospital, Bolzano, Italy.
⁸² Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur, Bihar, India.
⁸³ Department of Surgery, "Bufalini" Hospital, Cesena, Italy.

PMID: 35033131
PMCID: PMC8761341
DOI: 10.1186/s13017-022-00406-2

Review

WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections

Massimo Sartelli et al. World J Emerg Surg. 2022.

. 2022 Jan 15;17(1):3.

doi: 10.1186/s13017-022-00406-2.

Authors

Affiliations

¹ Department of Surgery, Macerata Hospital, Macerata, Italy. massimosartelli@gmail.com.
² Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy.
³ Department of General Surgery, Rambam Health Care Campus, Haifa, Israel.
⁴ General Surgery Department, Regional Hospital of Durres, Durres, Albania.
⁵ Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
⁶ Department of General and Emergency Surgery Faculty of Medicine, Mansoura University Hospital, Mansoura, Egypt.
⁷ Department of Surgery, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
⁸ Department of Surgery, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
⁹ Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.
¹⁰ Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
¹¹ Department of General Surgery Bizerte Hospital, Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.
¹² Division of Trauma/Acute Care Surgery, Scripps Clinic Medical Group, La Jolla, CA, USA.
¹³ Emergency and General Surgery Department, University of Milan-Bicocca, Milan, Italy.
¹⁴ Anesthesia and Transplant Surgical Intensive Care Unit, Ospedali Riuniti, Ancona, Italy.
¹⁵ Department of Pathophysiology, ASST Niguarda Ca'Granda Hospital, University of Milano, Milan, Italy.
¹⁶ Riverside University Health System, CECORC Research Center, Loma Linda University, Loma Linda, USA.
¹⁷ General Direction, Area Vasta 3, ASUR Marche, Macerata, Italy.
¹⁸ Emergency Surgery Unit, San Filippo Neri's Hospital, Rome, Italy.
¹⁹ Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China.
²⁰ Department of Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
²¹ Minimally Invasive and Robotic Digestive Surgery Unit, Regional General Hospital F. Miulli, Bari, Italy.
²² Université Paris Est, UPEC, Creteil, France.
²³ Department of Surgery, University Clinical Center of Tuzla, Tuzla, Bosnia and Herzegovina.
²⁴ Department General Surgery, Kipshidze Central University Hospital, Tbilisi, Georgia.
²⁵ Department of General, Digestive and Metabolic Minimally Invasive Surgery, Centre Hospitalier Intercommunal De Poissy/St Germain en Laye, Poissy, France.
²⁶ Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.
²⁷ Clinical Department of Medical, Surgical and Health Sciences, Trieste University, Trieste, Italy.
²⁸ Department of General Surgery, "Madonna del Soccorso" San Benedetto del Tronto Hospital, San Benedetto del Tronto, Italy.
²⁹ Department of Surgery, Texas Health Resources, Ft Worth, TX, USA.
³⁰ Division of Trauma and Acute Care Surgery, Department of Surgery, University of California Davis, Sacramento, CA, USA.
³¹ Department of General Surgery, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt.
³² Second Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
³³ Department of Surgery, Hospital Universitário Terezinha de Jesus, Faculdade de Ciências Médicas E da Saúde de Juiz de Fora, Juiz de Fora, Brazil.
³⁴ Department of Upper GI Surgery, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
³⁵ Trauma Service, Inkosi Albert Luthuli Central Hospital and Department of Surgery, Nelson R Mandela School of Clinical Medicine, Durban, South Africa.
³⁶ Department of General and Thoracic Surgery, University Hospital Giessen, Giessen, Germany.
³⁷ Department of Surgery, St. Josef Hospital, Ruhr University Bochum, Bochum, Germany.
³⁸ Surgical Clinic "Nikola Spasic", Faculty of Medicine University of Belgrade, Belgrade, Serbia.
³⁹ Department of Emergency Surgery, City Hospital, Mozyr, Belarus.
⁴⁰ Department of Surgery, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
⁴¹ Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea.
⁴² General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB, Canada.
⁴³ Department of Surgery, Edendale Hospital, Pietermaritzburg, South Africa.
⁴⁴ Department of General Surgery, University Hospital of Coventry and Warwickshire, Coventry, UK.
⁴⁵ Division of Trauma and Surgical Critical Care, Department of Surgery, University of Southern California, Los Angeles, CA, USA.
⁴⁶ Department of General Surgery, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey.
⁴⁷ Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
⁴⁸ Global Alliance for Infections in Surgery, Macerata, Italy.
⁴⁹ School of Medical Sciences, Universitiy Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
⁵⁰ Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
⁵¹ Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kaliningrad, Russia.
⁵² Department of General and Emergency Surgery, ASMN, Reggio Emilia, Italy.
⁵³ Department of Surgery, University of Washington, Seattle, WA, USA.
⁵⁴ First Department of Surgery, Tzaneion General Hospital, Piraeus, Greece.
⁵⁵ Department of Surgery, Post-Graduate Institute of Medical Sciences, Rohtak, India.
⁵⁶ Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Romania.
⁵⁷ Ernest E Moore Shock Trauma Center at Denver Health, Denver, USA.
⁵⁸ Department of Surgery, Division of Acute Care Surgery, and Center for Sepsis and Critical Illness Research, University of Florida College of Medicine, Gainesville, FL, USA.
⁵⁹ Department of Surgery, Emergency Hospital of Bucharest, Bucharest, Romania.
⁶⁰ Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
⁶¹ Division of Trauma and Acute Care Surgery, Fundacion Valle del Lili, Cali, Colombia.
⁶² Department of Surgery, Universidad del Valle, Cali, Colombia.
⁶³ Department of Surgery, Hassan II University Hospital, Medical School of Fez, Sidi Mohamed Benabdellah University, Fez, Morocco.
⁶⁴ Department of Surgery, University of Pittsburgh School of Medicine, UPMC-Presbyterian, Pittsburgh, USA.
⁶⁵ Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy.
⁶⁶ Department of Surgery, UMC Ljubljana, Ljubljana, Slovenia.
⁶⁷ Department of Internal Medicine, Division of Infectious Disease, ARNAS Civico-Di Cristina Hospital, Palermo, Italy.
⁶⁸ Department of General and Emergency Surgery, Cagliari University Hospital, Cagliari, Italy.
⁶⁹ Department of Surgery, Anadolu Medical Center, Kocaeli, Turkey.
⁷⁰ Infection Control, Hospital de Base, Brasília, DF, Brazil.
⁷¹ Department of General Surgery, Kasturba Medical College and Hospital, Manipal Academy of Higher Education, Manipal, India.
⁷² General Surgery Department, Colorectal Surgery Unit, La Paz University Hospital, Madrid, Spain.
⁷³ General Surgery Department, Military Teaching Hospital, Dakar, Senegal.
⁷⁴ Department of Aeromedical Services for Emergency and Trauma Care, Ehime University Graduate School of Medicine, Ehime, Japan.
⁷⁵ Department of Surgery, Western Michigan University School of Medicine, Kalamazoo, MI, USA.
⁷⁶ Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
⁷⁷ Donegal Clinical Research Academy Emergency Surgery Outcome Project, Letterkenny University Hospital, Donegal, Ireland.
⁷⁸ Department of Anesthesiology, Neuro Intensive Care Unit, Florence Careggi University Hospital, Florence, Italy.
⁷⁹ Department of Surgery, AAST Cremona, Cremona, Italy.
⁸⁰ Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
⁸¹ Department of Infectious Diseases, Bolzano Hospital, Bolzano, Italy.
⁸² Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur, Bihar, India.
⁸³ Department of Surgery, "Bufalini" Hospital, Cesena, Italy.

PMID: 35033131
PMCID: PMC8761341
DOI: 10.1186/s13017-022-00406-2

Abstract

Skin and soft-tissue infections (SSTIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections.Together, the World Society of Emergency Surgery, the Global Alliance for Infections in Surgery, the Surgical Infection Society-Europe, The World Surgical Infection Society, and the American Association for the Surgery of Trauma have jointly completed an international multi-society document to promote global standards of care in SSTIs guiding clinicians by describing reasonable approaches to the management of SSTIs.An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting evidence was shared by an international task force with different clinical backgrounds.

Keywords: Necrotizing infections; Necrotizing soft-tissue infections; Skin and soft-tissue infections.

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Conflict of interest statement

The authors declare that they have no competing interests.

References

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WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections

Affiliations

WSES/GAIS/WSIS/SIS-E/AAST global clinical pathways for patients with skin and soft tissue infections

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources