Evidence map›Paper›PMID 42720903›Full record

ArticleUpdates in surgery2026

Damage control surgery and open abdomen in Hinchey III-IV acute diverticulitis: current practice from a nationwide Italian survey.

Alessio Giordano, Manuela Mastronardi, Andrea Mingoli, Hayato Kurihara, Eugenio Cucinotta, Mauro Zago, Massimo Chiarugi, Roberto Cirocchi, Paolo Prosperi, Alan Biloslavo and 2 more

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Article in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Alessio Giordano *Department of Emergency and Acceptance, Emergency Surgery Unit, Careggi University Hospital, Florence, Italy.
Manuela Mastronardi *Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149, Trieste, TS, Italy. MANUELA.MASTRONARDI@units.it.ORCID http://orcid.org/0000-0003-3525-3692
Andrea MingoliDepartment of Surgery, Sapienza University of Rome, Rome, Italy.
Hayato KuriharaDepartment of Emergency Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Eugenio CucinottaDepartment of Human Pathology of the Adult and Evolutive Age "Gaetano Barresi," Section of General Surgery, University of Messina, Messina, Italy.
Mauro ZagoGeneral Surgery Department, Lecco Hospital, Lecco, Italy.
Massimo ChiarugiEmergency and General Surgery Unit, New Santa Chiara University Hospital, University of Pisa, Pisa, Italy.
Roberto CirocchiDepartment of Medicine and Surgery, University of Perugia, Perugia, Italy.
Paolo ProsperiDepartment of Emergency and Acceptance, Emergency Surgery Unit, Careggi University Hospital, Florence, Italy.
Alan BiloslavoDepartment of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149, Trieste, TS, Italy.
Gianluca CostaDepartment of Life Sciences, Health and Health Professions, Link Campus University, Rome, Italy.
DCS Collaborative group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDamage control surgery (DCS) with staged reconstruction may offer an alternative to Hartmann's procedure in selected unstable patients with generalized peritonitis from acute diverticulitis, but its adoption in routine practice is uncertain.

methodsA nationwide web-based survey explored management of Hinchey III-IV acute diverticulitis, institutional use of open abdomen, and knowledge and application of DCS. Categorical data were summarized as n (%). The survey was endorsed by Italian Society of Emergency and Trauma Surgery (SICUT).

resultsAmong 175 respondents, 71.4% reported using Hartmann's procedure in at least half of severe cases, whereas 37.7% used primary anastomosis in at least one-quarter. Open abdomen was available in 82.3% of institutions. Awareness of DCS was reported by 148/174 (85.1%), and 116/168 (69.0%) had used it for severe diverticulitis; however, only 33/147 (22.4%) used a clinical score. Hemodynamic instability (83.1%), severe peritoneal contamination (73.2%), and the opportunity for delayed anastomosis (64.1%) were the main indications. Respondents with greater emergency surgery commitment more often reported primary anastomosis (48.1% vs. 20.9%; P < 0.001), open abdomen availability (93.5% vs. 64.2%; P < 0.001), and previous DCS use (75.5% vs. 58.1%; P = 0.024).

conclusionDCS is familiar to and has been used by most respondents, but selection and implementation remain heterogeneous and rarely score-based. Standardized criteria, shared terminology, and prospective outcome evaluation are needed.

Indexed as

Acute diverticulitisDamage control surgeryHartmann's procedureOpen abdomenPeritonitisSurvey

Identifiers

PMID42720903

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