In the last three decades, Clostridium difficile infection (CDI) has increased in incidence and severity in many countries worldwide. The increase in CDI incidence has been particularly apparent among surgical patients. Therefore, prevention of CDI and optimization of management in the surgical patient are paramount. An international multidisciplinary panel of experts from the World Society of Emergency Surgery (WSES) updated its guidelines for management of CDI in surgical patients according to the most recent available literature. The update includes recent changes introduced in the management of this infection.

• MeSH
• Anti-Bacterial Agents therapeutic use   MeSH
• Antimicrobial Stewardship MeSH
• Clostridioides difficile pathogenicity   MeSH
• Fecal Microbiota Transplantation methods   trends   MeSH
• Incidence MeSH
• Clostridium Infections diagnosis   therapy   MeSH
• Infection Control methods   trends   MeSH
• Humans MeSH
• Postoperative Complications therapy   MeSH
• Enterocolitis, Pseudomembranous etiology   prevention & control   MeSH
• Risk Factors MeSH
• Guidelines as Topic MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

Background: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. Methods: This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. Results: A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. Conclusions: The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.

• MeSH
• Acute Disease therapy   MeSH
• Appendectomy adverse effects   methods   standards   MeSH
• Appendicitis surgery   MeSH
• Length of Stay statistics & numerical data   MeSH
• Adult MeSH
• Hospitalization statistics & numerical data   MeSH
• Laparoscopy methods   statistics & numerical data   MeSH
• Humans MeSH
• Logistic Models MeSH
• Tomography, X-Ray Computed methods   MeSH
• Prospective Studies MeSH
• Chi-Square Distribution MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Observational Study MeSH

The Global Alliance for Infections in Surgery appreciates the great effort of the task force who derived and validated the Sepsis-3 definitions and considers the new definitions an important step forward in the evolution of our understanding of sepsis. Nevertheless, more than a year after their publication, we have a few concerns regarding the use of the Sepsis-3 definitions.

• MeSH
• Arterial Pressure MeSH
• Glasgow Coma Scale MeSH
• Consensus MeSH
• Humans MeSH
• Sensitivity and Specificity MeSH
• Sepsis classification   mortality   MeSH
• Data Accuracy * MeSH
• Severity of Illness Index * MeSH
• Organ Dysfunction Scores MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH