Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper
Abstract Background Rib fractures are one of the most common traumatic injuries and may result in significant morbidity and mortality. Despite growing evidence, technological advances and increasing acceptance, surgical stabilization of rib fractures (SSRF) remains not uniformly considered in trauma...
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2024-10-01
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| Series: | World Journal of Emergency Surgery |
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| Online Access: | https://doi.org/10.1186/s13017-024-00559-2 |
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| author | Giacomo Sermonesi Riccardo Bertelli Fredric M. Pieracci Zsolt J. Balogh Raul Coimbra Joseph M. Galante Andreas Hecker Dieter Weber Zachary M. Bauman Susan Kartiko Bhavik Patel SarahAnn S. Whitbeck Thomas W. White Kevin N. Harrell Daniele Perrina Alessia Rampini Brian Tian Francesco Amico Solomon G. Beka Luigi Bonavina Marco Ceresoli Lorenzo Cobianchi Federico Coccolini Yunfeng Cui Francesca Dal Mas Belinda De Simone Isidoro Di Carlo Salomone Di Saverio Agron Dogjani Andreas Fette Gustavo P. Fraga Carlos Augusto Gomes Jim S. Khan Andrew W. Kirkpatrick Vitor F. Kruger Ari Leppäniemi Andrey Litvin Andrea Mingoli David Costa Navarro Eliseo Passera Michele Pisano Mauro Podda Emanuele Russo Boris Sakakushev Domenico Santonastaso Massimo Sartelli Vishal G. Shelat Edward Tan Imtiaz Wani Fikri M. Abu-Zidan Walter L. Biffl Ian Civil Rifat Latifi Ingo Marzi Edoardo Picetti Manos Pikoulis Vanni Agnoletti Francesca Bravi Carlo Vallicelli Luca Ansaloni Ernest E. Moore Fausto Catena |
| author_facet | Giacomo Sermonesi Riccardo Bertelli Fredric M. Pieracci Zsolt J. Balogh Raul Coimbra Joseph M. Galante Andreas Hecker Dieter Weber Zachary M. Bauman Susan Kartiko Bhavik Patel SarahAnn S. Whitbeck Thomas W. White Kevin N. Harrell Daniele Perrina Alessia Rampini Brian Tian Francesco Amico Solomon G. Beka Luigi Bonavina Marco Ceresoli Lorenzo Cobianchi Federico Coccolini Yunfeng Cui Francesca Dal Mas Belinda De Simone Isidoro Di Carlo Salomone Di Saverio Agron Dogjani Andreas Fette Gustavo P. Fraga Carlos Augusto Gomes Jim S. Khan Andrew W. Kirkpatrick Vitor F. Kruger Ari Leppäniemi Andrey Litvin Andrea Mingoli David Costa Navarro Eliseo Passera Michele Pisano Mauro Podda Emanuele Russo Boris Sakakushev Domenico Santonastaso Massimo Sartelli Vishal G. Shelat Edward Tan Imtiaz Wani Fikri M. Abu-Zidan Walter L. Biffl Ian Civil Rifat Latifi Ingo Marzi Edoardo Picetti Manos Pikoulis Vanni Agnoletti Francesca Bravi Carlo Vallicelli Luca Ansaloni Ernest E. Moore Fausto Catena |
| author_sort | Giacomo Sermonesi |
| collection | DOAJ |
| description | Abstract Background Rib fractures are one of the most common traumatic injuries and may result in significant morbidity and mortality. Despite growing evidence, technological advances and increasing acceptance, surgical stabilization of rib fractures (SSRF) remains not uniformly considered in trauma centers. Indications, contraindications, appropriate timing, surgical approaches and utilized implants are part of an ongoing debate. The present position paper, which is endorsed by the World Society of Emergency Surgery (WSES), and supported by the Chest Wall Injury Society, aims to provide a review of the literature investigating the use of SSRF in rib fracture management to develop graded position statements, providing an updated guide and reference for SSRF. Methods This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of experts then critically revised the manuscript and discussed it in detail, to develop a consensus on the position statements. Results A total of 287 studies (systematic reviews, randomized clinical trial, prospective and retrospective comparative studies, case series, original articles) have been selected from an initial pool of 9928 studies. Thirty-nine graded position statements were put forward to address eight crucial aspects of SSRF: surgical indications, contraindications, optimal timing of surgery, preoperative imaging evaluation, rib fracture sites for surgical fixation, management of concurrent thoracic injuries, surgical approach, stabilization methods and material selection. Conclusion This consensus document addresses the key focus questions on surgical treatment of rib fractures. The expert recommendations clarify current evidences on SSRF indications, timing, operative planning, approaches and techniques, with the aim to guide clinicians in optimizing the management of rib fractures, to improve patient outcomes and direct future research. |
| format | Article |
| id | doaj-art-ab27c29fa0fe454cb5512281972ddd3d |
| institution | Kabale University |
| issn | 1749-7922 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Emergency Surgery |
| spelling | doaj-art-ab27c29fa0fe454cb5512281972ddd3d2025-02-02T12:13:43ZengBMCWorld Journal of Emergency Surgery1749-79222024-10-0119113510.1186/s13017-024-00559-2Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paperGiacomo Sermonesi0Riccardo Bertelli1Fredric M. Pieracci2Zsolt J. Balogh3Raul Coimbra4Joseph M. Galante5Andreas Hecker6Dieter Weber7Zachary M. Bauman8Susan Kartiko9Bhavik Patel10SarahAnn S. Whitbeck11Thomas W. White12Kevin N. Harrell13Daniele Perrina14Alessia Rampini15Brian Tian16Francesco Amico17Solomon G. Beka18Luigi Bonavina19Marco Ceresoli20Lorenzo Cobianchi21Federico Coccolini22Yunfeng Cui23Francesca Dal Mas24Belinda De Simone25Isidoro Di Carlo26Salomone Di Saverio27Agron Dogjani28Andreas Fette29Gustavo P. Fraga30Carlos Augusto Gomes31Jim S. Khan32Andrew W. Kirkpatrick33Vitor F. Kruger34Ari Leppäniemi35Andrey Litvin36Andrea Mingoli37David Costa Navarro38Eliseo Passera39Michele Pisano40Mauro Podda41Emanuele Russo42Boris Sakakushev43Domenico Santonastaso44Massimo Sartelli45Vishal G. Shelat46Edward Tan47Imtiaz Wani48Fikri M. Abu-Zidan49Walter L. Biffl50Ian Civil51Rifat Latifi52Ingo Marzi53Edoardo Picetti54Manos Pikoulis55Vanni Agnoletti56Francesca Bravi57Carlo Vallicelli58Luca Ansaloni59Ernest E. Moore60Fausto Catena61Department of General and Emergency Surgery, Anesthesia and Intensive Care Unit, Maurizio Bufalini HospitalDepartment of General and Emergency Surgery, Anesthesia and Intensive Care Unit, Maurizio Bufalini HospitalDepartment of Surgery, University of Colorado School of MedicineDepartment of Traumatology, John Hunter Hospital and University of NewcastleComparative Effectiveness and Clinical Outcomes Research Center, Riverside University Health System Medical CenterDivision of Trauma and Acute Care Surgery, Department of Surgery, University of California DavisEmergency Medicine Department of General and Thoracic Surgery, University Hospital of GiessenDepartment of Trauma Surgery, Royal Perth HospitalDepartment of Surgery, University of Nebraska Medical CenterDepartment of Surgery, George Washington University School of Medicine and Health SciencesDivision of Trauma, Gold Coast University HospitalChest Wall Injury SocietyIntermountain Medical CenterDepartment of Surgery, University of Tennessee College of Medicine ChattanoogaDepartment of General and Emergency Surgery, Anesthesia and Intensive Care Unit, Maurizio Bufalini HospitalDepartment of General and Emergency Surgery, Anesthesia and Intensive Care Unit, Maurizio Bufalini HospitalDepartment of General Surgery, Singapore General HospitalDiscipline of Surgery, School of Medicine and Public HealthEthiopian Air Force HospitalDepartment of Surgery, IRCCS Policlinico San Donato, University of MilanoGeneral and Emergency Surgery Department, School of Medicine and Surgery, Milano-Bicocca UniversityDepartment of Surgery, Fondazione IRCCS Policlinico San Matteo, University of PaviaDepartment of General, Emergency and Trauma Surgery, Pisa University HospitalDepartment of Surgery, Tianjin Nankai Hospital, Nankai Clinical School of Medicine, Tianjin Medical UniversityCollegium Medicum, University of Social SciencesDepartment of Minimally Invasive Emergency and General Surgery, Infermi HospitalDepartment of Surgical Sciences and Advanced Technologies, General Surgery Cannizzaro Hospital, University of CataniaGeneral Surgery Department Hospital of San Benedetto del TrontoDepartment of General Surgery, University of Medicine of TiranaPediatric Surgery, Children’s Care Center, SRH Klinikum SuhlDivision of Trauma Surgery, School of Medical Sciences, University of CampinasFaculdade de Medicina, SUPREMA, Hospital Universitario Terezinha de Jesus de Juiz de ForaDepartment of Colorectal Surgery, Portsmouth Hospitals University NHS TrustDepartments of Surgery and Critical Care Medicine, Foothills Medical Centre, University of CalgaryDivision of Trauma Surgery, School of Medical Sciences, University of CampinasAbdominal Center, Helsinki University Hospital and University of HelsinkiDepartment of Surgical Diseases No. 3, University Clinic, Gomel State Medical UniversityPoliclinico Umberto I University Hospital, Sapienza University of RomeColorectal Surgery Unit, Trauma Care Committee, Alicante General University HospitalDepartments of Surgery, ASST Papa Giovanni XXIIIDepartments of Surgery, ASST Papa Giovanni XXIIIDepartment of Surgical Science, Emergency Surgery Unit, University of CagliariDepartment of General and Emergency Surgery, Anesthesia and Intensive Care Unit, Maurizio Bufalini HospitalGeneral Surgery Department, Medical University, University Hospital St GeorgeDepartment of General and Emergency Surgery, Anesthesia and Intensive Care Unit, Maurizio Bufalini HospitalDepartment of Surgery, Macerata HospitalDepartment of General Surgery, Tan Tock Seng HospitalDepartment of Surgery, Radboud University Medical CenterGovernment Gousia HospitalDepartment of Surgery, College of Medicine and Health Sciences, United Arab Emirates UniversityDivision of Trauma/Acute Care Surgery, Scripps Clinic Medical GroupFaculty of Medical and Health Sciences, University of AucklandDepartment of Surgery, Westchester Medical Center, New York Medical CollegeDepartment of Trauma Surgery and Orthopedics, University Hospital Goethe University FrankfurtDepartment of Anesthesia and Intensive Care, Parma University Hospital3rd Department of Surgery, Attikon General Hospital, National and Kapodistrian University of Athens (NKUA)Department of General and Emergency Surgery, Anesthesia and Intensive Care Unit, Maurizio Bufalini HospitalHealthcare Administration, Santa Maria Delle Croci HospitalDepartment of General and Emergency Surgery, Anesthesia and Intensive Care Unit, Maurizio Bufalini HospitalDepartment of Surgery, Fondazione IRCCS Policlinico San Matteo, University of PaviaDepartment of Surgery, University of Colorado School of MedicineDepartment of General and Emergency Surgery, Anesthesia and Intensive Care Unit, Maurizio Bufalini HospitalAbstract Background Rib fractures are one of the most common traumatic injuries and may result in significant morbidity and mortality. Despite growing evidence, technological advances and increasing acceptance, surgical stabilization of rib fractures (SSRF) remains not uniformly considered in trauma centers. Indications, contraindications, appropriate timing, surgical approaches and utilized implants are part of an ongoing debate. The present position paper, which is endorsed by the World Society of Emergency Surgery (WSES), and supported by the Chest Wall Injury Society, aims to provide a review of the literature investigating the use of SSRF in rib fracture management to develop graded position statements, providing an updated guide and reference for SSRF. Methods This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of experts then critically revised the manuscript and discussed it in detail, to develop a consensus on the position statements. Results A total of 287 studies (systematic reviews, randomized clinical trial, prospective and retrospective comparative studies, case series, original articles) have been selected from an initial pool of 9928 studies. Thirty-nine graded position statements were put forward to address eight crucial aspects of SSRF: surgical indications, contraindications, optimal timing of surgery, preoperative imaging evaluation, rib fracture sites for surgical fixation, management of concurrent thoracic injuries, surgical approach, stabilization methods and material selection. Conclusion This consensus document addresses the key focus questions on surgical treatment of rib fractures. The expert recommendations clarify current evidences on SSRF indications, timing, operative planning, approaches and techniques, with the aim to guide clinicians in optimizing the management of rib fractures, to improve patient outcomes and direct future research.https://doi.org/10.1186/s13017-024-00559-2Rib fracturesSurgical stabilization of rib fractures (SSRF)Flail chestMultiple rib fracturesThoracic/chest trauma injuryRib fixation |
| spellingShingle | Giacomo Sermonesi Riccardo Bertelli Fredric M. Pieracci Zsolt J. Balogh Raul Coimbra Joseph M. Galante Andreas Hecker Dieter Weber Zachary M. Bauman Susan Kartiko Bhavik Patel SarahAnn S. Whitbeck Thomas W. White Kevin N. Harrell Daniele Perrina Alessia Rampini Brian Tian Francesco Amico Solomon G. Beka Luigi Bonavina Marco Ceresoli Lorenzo Cobianchi Federico Coccolini Yunfeng Cui Francesca Dal Mas Belinda De Simone Isidoro Di Carlo Salomone Di Saverio Agron Dogjani Andreas Fette Gustavo P. Fraga Carlos Augusto Gomes Jim S. Khan Andrew W. Kirkpatrick Vitor F. Kruger Ari Leppäniemi Andrey Litvin Andrea Mingoli David Costa Navarro Eliseo Passera Michele Pisano Mauro Podda Emanuele Russo Boris Sakakushev Domenico Santonastaso Massimo Sartelli Vishal G. Shelat Edward Tan Imtiaz Wani Fikri M. Abu-Zidan Walter L. Biffl Ian Civil Rifat Latifi Ingo Marzi Edoardo Picetti Manos Pikoulis Vanni Agnoletti Francesca Bravi Carlo Vallicelli Luca Ansaloni Ernest E. Moore Fausto Catena Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper World Journal of Emergency Surgery Rib fractures Surgical stabilization of rib fractures (SSRF) Flail chest Multiple rib fractures Thoracic/chest trauma injury Rib fixation |
| title | Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper |
| title_full | Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper |
| title_fullStr | Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper |
| title_full_unstemmed | Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper |
| title_short | Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper |
| title_sort | surgical stabilization of rib fractures ssrf the wses and cwis position paper |
| topic | Rib fractures Surgical stabilization of rib fractures (SSRF) Flail chest Multiple rib fractures Thoracic/chest trauma injury Rib fixation |
| url | https://doi.org/10.1186/s13017-024-00559-2 |
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