ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

Simone Frassini; Lorenzo Cobianchi; Paola Fugazzola; Walter L Biffl; Federico Coccolini; Dimitrios Damaskos; Ernest E Moore; Yoram Kluger; Marco Ceresoli; Raul Coimbra; Justin Davies; Andrew Kirkpatrick; Isidoro Di Carlo; Timothy C Hardcastle; Arda Isik; Massimo Chiarugi; Kurinchi Gurusamy; Ronald V Maier; Helmut A Segovia Lohse; Hans Jeekel; Marja A Boermeester; Fikri Abu-Zidan; Kenji Inaba; Dieter G Weber; Goran Augustin; Luigi Bonavina; George Velmahos; Massimo Sartelli; Salomone Di Saverio; Richard P G Ten Broek; Stefano Granieri; Francesca Dal Mas; Camilla Nikita Farè; Jacopo Peverada; Simone Zanghì; Jacopo Viganò; Matteo Tomasoni; Tommaso Dominioni; Enrico Cicuttin; Andreas Hecker; Giovanni D Tebala; Joseph M Galante; Imtiaz Wani; Vladimir Khokha; Michael Sugrue; Thomas M Scalea; Edward Tan; Mark A Malangoni; Nikolaos Pararas; Mauro Podda; Belinda De Simone; Rao Ivatury; Yunfeng Cui; Jeffry Kashuk; Andrew Peitzman; Fernando Kim; Emmanouil Pikoulis; Gabriele Sganga; Osvaldo Chiara; Michael D Kelly; Ingo Marzi; Edoardo Picetti; Vanni Agnoletti; Nicola De'Angelis; Giampiero Campanelli; Marc de Moya; Andrey Litvin; Aleix Martínez-Pérez; Ibrahima Sall; Sandro Rizoli; Gia Tomadze; Boris Sakakushev; Philip F Stahel; Ian Civil; Vishal Shelat; David Costa; Alain Chichom-Mefire; Rifat Latifi; Mircea Chirica; Francesco Amico; Amyn Pardhan; Vidya Seenarain; Nikitha Boyapati; Basil Hatz; Travis Ackermann; Sandun Abeyasundara; Linda Fenton; Frank Plani; Rohit Sarvepalli; Omid Rouhbakhshfar; Pamela Caleo; Victor Ho-Ching Yau; Kristenne Clement; Erasmia Christou; Ana María González Castillo; Preet K S Gosal; Sunder Balasubramaniam; Jeremy Hsu; Kamon Banphawatanarak; Michele Pisano; Toro Adriana; Altomare Michele; Stefano P B Cioffi; Andrea Spota; Fausto Catena; Luca Ansaloni

doi:10.1186/s13017-023-00511-w

ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

World J Emerg Surg. 2023 Jul 26;18(1):42. doi: 10.1186/s13017-023-00511-w.

Authors

Simone Frassini^{1

2}, Lorenzo Cobianchi^{3

4}, Paola Fugazzola⁴, Walter L Biffl⁵, Federico Coccolini⁶, Dimitrios Damaskos⁷, Ernest E Moore⁸, Yoram Kluger⁹, Marco Ceresoli¹⁰, Raul Coimbra¹¹, Justin Davies¹², Andrew Kirkpatrick¹³, Isidoro Di Carlo¹⁴, Timothy C Hardcastle^{15

16}, Arda Isik¹⁷, Massimo Chiarugi⁶, Kurinchi Gurusamy¹⁸, Ronald V Maier¹⁹, Helmut A Segovia Lohse²⁰, Hans Jeekel²¹, Marja A Boermeester²², Fikri Abu-Zidan²³, Kenji Inaba²⁴, Dieter G Weber²⁵, Goran Augustin²⁶, Luigi Bonavina²⁷, George Velmahos²⁸, Massimo Sartelli²⁹, Salomone Di Saverio³⁰, Richard P G Ten Broek³¹, Stefano Granieri³², Francesca Dal Mas³³, Camilla Nikita Farè^{3

4}, Jacopo Peverada^{3

4}, Simone Zanghì^{3

4}, Jacopo Viganò^{3

4}, Matteo Tomasoni⁴, Tommaso Dominioni⁴, Enrico Cicuttin⁴, Andreas Hecker³⁴, Giovanni D Tebala³⁵, Joseph M Galante³⁶, Imtiaz Wani³⁷, Vladimir Khokha³⁸, Michael Sugrue³⁹, Thomas M Scalea⁴⁰, Edward Tan³¹, Mark A Malangoni⁴¹, Nikolaos Pararas⁴², Mauro Podda⁴³, Belinda De Simone⁴⁴, Rao Ivatury⁴⁵, Yunfeng Cui⁴⁶, Jeffry Kashuk⁴⁷, Andrew Peitzman⁴⁸, Fernando Kim⁴⁹, Emmanouil Pikoulis⁵⁰, Gabriele Sganga⁵¹, Osvaldo Chiara⁵², Michael D Kelly⁵³, Ingo Marzi⁵⁴, Edoardo Picetti⁵⁵, Vanni Agnoletti⁵⁶, Nicola De'Angelis⁵⁷, Giampiero Campanelli⁵⁸, Marc de Moya⁵⁹, Andrey Litvin⁶⁰, Aleix Martínez-Pérez⁶¹, Ibrahima Sall⁶², Sandro Rizoli⁶³, Gia Tomadze⁶⁴, Boris Sakakushev⁶⁵, Philip F Stahel⁶⁶, Ian Civil⁶⁷, Vishal Shelat⁶⁸, David Costa⁶⁹, Alain Chichom-Mefire⁷⁰, Rifat Latifi⁷¹, Mircea Chirica⁷², Francesco Amico⁷³, Amyn Pardhan⁷⁴, Vidya Seenarain⁷⁵, Nikitha Boyapati⁷⁵, Basil Hatz⁷⁶, Travis Ackermann⁷⁷, Sandun Abeyasundara⁷⁸, Linda Fenton⁷⁹, Frank Plani⁸⁰, Rohit Sarvepalli²⁵, Omid Rouhbakhshfar²⁵, Pamela Caleo⁸¹, Victor Ho-Ching Yau⁸², Kristenne Clement⁸³, Erasmia Christou²⁵, Ana María González Castillo⁸⁴, Preet K S Gosal⁸⁵, Sunder Balasubramaniam⁸⁶, Jeremy Hsu⁸⁶, Kamon Banphawatanarak⁸⁷, Michele Pisano⁸⁸, Toro Adriana⁸⁹, Altomare Michele⁵², Stefano P B Cioffi⁵², Andrea Spota⁵², Fausto Catena⁹⁰, Luca Ansaloni^{3

4}

Affiliations

¹ University of Pavia, Corso Str. Nuova, 65, 27100, Pavia, Italy. [email protected].
² Unit of General Surgery I, Fondazione I.R.C.C.S. Policlinico San Matteo, Viale Camillo Golgi, 19, 27100, Pavia, Italy. [email protected].
³ University of Pavia, Corso Str. Nuova, 65, 27100, Pavia, Italy.
⁴ Unit of General Surgery I, Fondazione I.R.C.C.S. Policlinico San Matteo, Viale Camillo Golgi, 19, 27100, Pavia, Italy.
⁵ Department of Emergency and Trauma Surgery, Scripps Clinic Medical Group, La Jolla, CA, USA.
⁶ General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy.
⁷ General and Emergency Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
⁸ Ernest E Moore Shock Trauma Center at Denver Health, Denver, CO, USA.
⁹ Division of General Surgery, Rambam Health Care Campus, Haifa, Israel.
¹⁰ General Surgery, Monza University Hospital, Monza, Italy.
¹¹ Riverside University Health System Medical Center, Comparative Effectiveness and Clinical Outcomes Research Center - CECORC, Claremont, CA, USA.
¹² Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge, UK.
¹³ Departments of Surgery and Critical Care Medicine, University of Calgary, Calgary, Canada.
¹⁴ Department of Surgical Sciences and Advanced Technologies, General Surgery Unit, Cannizzaro Hospital, Catania, Italy.
¹⁵ Department of Surgical Sciences, Nelson R Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, 4001, South Africa.
¹⁶ Trauma and Burns Services, Inkosi Albert Luthuli Central Hospital, Mayville, 4058, South Africa.
¹⁷ Division of General Surgery, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey.
¹⁸ Division of Surgery and Interventional Science, Hampstead Campus, University College London, London, UK.
¹⁹ Department of Surgery, Harborview Medical Centre, University of Washington, Seattle, USA.
²⁰ II Cátedra de Clínica Quirúrgica, Hospital de Clínicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay.
²¹ Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands.
²² Department of Surgery, Amsterdam University Medical Center, University of Amsterdam, 1105AZ, Amsterdam, The Netherlands.
²³ The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE.
²⁴ Los Angeles County + USC Medical Center, 2051 Marengo Street, Room C5L100, Los Angeles, CA, 90033, USA.
²⁵ Department of General Surgery, Royal Perth Hospital, University of Western Australia, Perth, Australia.
²⁶ Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.
²⁷ Division of General Surgery, Department of Biomedical Science for Health, I.R.C.C.S. Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy.
²⁸ Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
²⁹ Department of Surgery, Macerata Hospital, Macerata, Italy.
³⁰ Unit of General Surgery, San Benedetto del Tronto Hospital, av5 Asur Marche, San Benedetto del Tronto, Italy.
³¹ Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
³² General Surgery Unit, ASST Vimercate, Via Santi Cosma E Damiano, 10, 20871, Vimercate, Italy.
³³ Department of Management, Università Ca' Foscari, Dorsoduro 3246, 30123, Venezia, Italy.
³⁴ Department of General and Thoracic Surgery, University Hospital of Giessen, Giessen, Germany.
³⁵ Department of Digestive and Emergency Surgery, S. Maria Hospital Trust, Terni, Italy.
³⁶ Trauma Department, University of California, Davis, Sacramento, CA, USA.
³⁷ Government Gousia Hospital, Srinagar, India.
³⁸ Department of Emergency Surgery, City Hospital, Mozyr, Belarus.
³⁹ Donegal Clinical Research Academy Emergency Surgery Outcome Project, Letterkenny University Hospital, Donegal, Ireland.
⁴⁰ Cowley Shock Trauma Center at the University of Maryland, Baltimore, MD, USA.
⁴¹ Department of Surgery, MetroHealth Medical Center Campus, Case Western Reserve University, Cleveland, OH, 44109, USA.
⁴² Third Department of Surgery, Attikon University Hospital, 15772, Athens, Greece.
⁴³ Department of Surgical Science, Cagliari State University, Cagliari, Italy.
⁴⁴ Department of Emergency Surgery, Centre Hospitalier Intercommunal de Villeneuve-Saint-Georges, Villeneuve-Saint-Georges, France.
⁴⁵ Virginia Commonwealth University, Richmond, VA, USA.
⁴⁶ Department of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical University, Tianjin, China.
⁴⁷ Department of Surgery, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
⁴⁸ Division of Trauma and General Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
⁴⁹ Denver Health Medical Center, University of Colorado Anschutz Medical Center, Aurora, CO, USA.
⁵⁰ Medical School, National and Kapodistrian University of Athens (NKUA), Athens, Greece.
⁵¹ Fondazione Policlinico Universitario A.Gemelli IRCCS, Università Cattolica, Rome, Italy.
⁵² Trauma Center and Emergency Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
⁵³ Department of General Surgery, Albury Hospital, Albury, Australia.
⁵⁴ Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt, Germany.
⁵⁵ Department of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy.
⁵⁶ Anesthesia and Intensive Care Unit, Ospedale M Bufalini, Cesena, Italy.
⁵⁷ Service de Chirurgie Digestive et Hépato-Bilio-Pancréatique, Hôpital Henri Mondor, Université Paris Est, Créteil, France.
⁵⁸ Division of General Surgery, I.R.C.C.S. Ospedale Galeazzi-Sant'Ambrogio, University of Insubria, Varese, Italy.
⁵⁹ Medical College of Wisconsin, Milwaukee, WI, USA.
⁶⁰ AI Medica Hospital Center / Immanuel Kant Baltic Federal University, Kaliningrad, Russia.
⁶¹ Faculty of Health Sciences, Valencian International University (VIU), Valencia, Spain.
⁶² Department of General Surgery, Military Teaching Hospital, Hôpital Principal Dakar, Dakar, Senegal.
⁶³ Hamad General Hospital, Doha, Qatar.
⁶⁴ Department of Surgery, Tbilisi State Medical University, Tbilisi, Georgia.
⁶⁵ RIMU/University Hospital St George, Plovdiv, Bulgaria.
⁶⁶ Department of Orthopedic Surgery and Neurosurgery, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO, USA.
⁶⁷ Trauma Service, Auckland City Hospital, Auckland, New Zealand.
⁶⁸ Tan Tock Seng Hospital, Singapore, Singapore.
⁶⁹ Department of General y Digestive Surgery, "Dr. Balmis" Alicante General University Hospital, Alicante, Spain.
⁷⁰ Faculty of Health Sciences, University of Buea, Buea, Cameroon.
⁷¹ College of Medicine, University of Arizona, Tucson, AZ, USA.
⁷² Service de Chirurgie Digestive, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.
⁷³ Department of Traumatology, John Hunter Hospital, University of Newcastle, Newcastle, NSW, Australia.
⁷⁴ Bunbury Hospital, Bunbury, WA, 6230, Australia.
⁷⁵ Acute Surgical Unit, Department of General Surgery, Fiona Stanley Hospital, Murdoch, WA, Australia.
⁷⁶ State Major Trauma Unit, Royal Perth Hospital, Wellington Street, Perth, Australia.
⁷⁷ General Surgery, Monash Medical Centre, Monash Health, Melbourne, VIC, Australia.
⁷⁸ Department of Colorectal Surgery, Logan Hospital, Meadowbrook, QLD, Australia.
⁷⁹ Maitland Private Hospital, East Maitland, Newcastle, NSW, Australia.
⁸⁰ Chris Hani Baragwanath Hospital, Soweto, South Africa.
⁸¹ Nambour Selangor Private Hospital, Sunshine Coast University Private Hospital, Birtinya, QLD, Australia.
⁸² Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
⁸³ Department of Surgery, Nepean Hospital, Penrith, NSW, 2751, Australia.
⁸⁴ Departamento de Cirugía, Universidad Autónoma de Barcelona, Barcelona, Spain.
⁸⁵ Department of General Surgery, Nepean Hospital, Sydney, NSW, Australia.
⁸⁶ Department of Trauma, Westmead Hospital, The University of Sydney, Sydney, NSW, Australia.
⁸⁷ Division of Trauma, Siriraj Hospital, Bangkok, Thailand.
⁸⁸ General and Emergency Surgery, ASST Papa Giovanni XXIII, Bergamo, Italy.
⁸⁹ General Surgery, Augusta Hospital, Augusta, Italy.
⁹⁰ Acute Care Surgery Unit, Department of Surgery and Trauma, Maurizio Bufalini Hospital, Cesena, Italy.

Abstract

Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy.

Keywords: Abdominal wall incision; Closure technique; Emergency; Incisional hernia; Laparotomy closure; Midline incision; Wound complications; Wound dehiscence.

Publication types

Review

MeSH terms

Abdominal Wound Closure Techniques* / adverse effects
Humans
Incisional Hernia* / etiology
Laparotomy / adverse effects
Reoperation / adverse effects
Suture Techniques / adverse effects