SynthesisEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025
Surgical management of injuries to the abdomen in patients with multiple and/or severe trauma- a systematic review and clinical practice guideline update.
Synthesis in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Laparoscopy as the initial approach for hemodynamically stable abdominal stab wounds requiring exploration: a South African single-center experience.Surgical endoscopy · 2026Article
- [Visceral surgery in mass casualty incidents due to disasters, crises and war].Chirurgie (Heidelberg, Germany) · 2026Review
- Macrophages on demand: How tissue trauma shapes their role.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Review
- Emergency Laparoscopy for Complex and Trauma Cases: Feasibility and Outcomes in Experienced Surgical Teams.Cureus · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeOur aim was to update evidence-based and consensus-based recommendations for the surgical management of abdominal injuries in patients with multiple and/or severe injuries based on current evidence. This guideline topic is part of the 2022 update of the German Guideline on the Treatment of Patients with Multiple and/or Severe Injuries.
methodsMEDLINE and Embase were systematically searched to May 2021. Further literature reports were obtained from clinical experts. Randomised controlled trials, prospective cohort studies, cross-sectional studies and comparative registry studies were included if they compared interventions for the surgical management of abdominal injuries in patients with multiple and/or severe injuries. We considered patient-relevant clinical outcomes such as mortality, length of stay, and diagnostic test accuracy. Risk of bias was assessed using NICE 2012 checklists. The evidence was synthesised narratively, and expert consensus was used to develop recommendations and determine their strength.
resultsThree studies were identified. The topics of these studies were nonoperative management in haemodynamically stable patients with isolated blunt hepatic (n = 1) or splenic injuries (n = 1) and selective angioembolisation (n = 1). None of the recommendations were modified, one new recommendation was developed, and one was deleted based on the updated evidence and expert consensus. All recommendations achieved strong consensus.
conclusionThe following recommendations are made. All but one of the previous guideline recommendations were confirmed. The recommendation to perform diagnostic peritoneal lavage in exceptional cases was completely deleted. An additional recommendation was made and states that the performance of a diagnostic laparoscopy can be considered in haemodynamically stable patients with penetrating trauma when there is therapeutic uncertainty.
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