Defects in surgical care for patients with abdominal sepsis
https://doi.org/10.18705/3034-7270-2025-1-4-49-58
Abstract
Abdominal sepsis remains one of the leading causes of mortality in emergency surgery worldwide. The persistently high fatality rate is largely associated with diagnostic errors, organizational shortcomings, and inadequate management of surgical care. To identify the most frequent errors in providing surgical care to patients with abdominal sepsis and to improve a preventive checklist aimed at reducing these defects. A retrospective expert analysis of 502 medical records of patients diagnosed with abdominal sepsis who died in surgical departments of the Republic of Tatarstan between 2018 and 2022 was conducted. Statistical evaluation was performed using Student’s t-test, Pearson’s chi-square, and Fisher’s exact test (p < 0.05). The analysis revealed recurrent deficiencies in medical documentation (28.9–37.8 %), organizational management (26.5–44.2 %), diagnostic accuracy (26.3–95.0 %), and therapeutic processes (up to 85.8 %). Based on the findings, an updated 47-item checklist titled “Control List for Preventing Defects in Surgical Care for Abdominal Sepsis” was developed and implemented. The revised tool improves standardization of clinical procedures and enhances the quality of surgical practice in patients with abdominal sepsis.
About the Authors
A. A. Anisimov
Kazan (Volga Region) Federal University ; Kazan State Medical University
Russian Federation
Russian Federation
Anisimov Andrei A. – Candidate of Medical Sciences, Assistant at Forensic Medicine Department ; Senior Lecturer at Department of Emergency Aid and Simulation Medicine at Institute of Fundamental Medicine and Biology
Kazan
R. A. Ibragimov
Kazan (Volga Region) Federal University
Russian Federation
Russian Federation
Ibragimov Rinat A. – Candidate of Medical Sciences, Senior Lecturer at Department of Emergency Aid and Simulation Medicine at Institute of Fundamental Medicine and Biology
Kazan
A. I. Andreev
Kazan (Volga Region) Federal University
Russian Federation
Russian Federation
Andreev Andrey I. – Candidate of Medical Sciences, Senior Lecturer at Department of Emergency Aid and Simulation Medicine at Institute of Fundamental Medicine and Biology
Kazan
A. Yu. Anisimov
Kazan (Volga Region) Federal University
Russian Federation
Russian Federation
Anisimov Andrey Yu. – Doctor of Medical Sciences, Professor, Head of the Department of Emergency Medicine and Simulation Medicine of the Center for Medicine and Pharmacy of the Graduate School of Medicine of the Institute of Fundamental Medicine and Biology, Honored Physician of the Russian Federation and the Republic of Tatarstan
Kazan
References
1. Abdominal surgical infection (classification, diagnostics, antimicrobial therapy) Russian national recommendations. Ed. by VS Saveliev, BR Gelfand. Moscow: OOO “Boroges Company”, 2011. 99 p. (In Russ.).
2. Sartelli M, Chichom-Mefire A, Labricciosa FM, et al. The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections. World J Emerg Surg. 2017;12:29. https://doi.org/10.1186/s13017-017-0141-6.
3. Hecker A, Reichert M, Reuß CJ, et al. Intra-abdominal sepsis: new definitions and current clinical standards. Langenbecks Arch Surg. 2019;404(3):257–271. https://doi.org/10.1007/s00423-019-01752-7.
4. Coccolini F, Sartelli M, Sawyer R, et al. Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines. World J Emerg Surg. 2023;18(1):41. https://doi.org/10.1186/s13017-023-00509-4.
5. Clements TW, Tolonen M, Ball CG, Kirkpatrick AW. Secondary Peritonitis and Intra-Abdominal Sepsis: An Increasingly Global Disease in Search of Better Systemic Therapies. Scand J Surg. 2021;110(2):139–149.
6. Bova R, Griggio G, Vallicelli C, et al. Source Control and Antibiotics in Intra-Abdominal Infections. Antibiotics. 2024;13(8):776. https://doi.org/10.3390/antibiotics13080776.
7. Coccolini F, Kirkpatrick AW, Cremonini C, Sartelli M. Source control in intra-abdominal infections: What you need to know. J Trauma Acute Care Surg. 2025. https://doi.org/10.1097/TA.0000000000004654.
8. Timerbulatov ShV, Timerbulatov MV, Gafarova AR, Timerbulatov VM. Evaluation of the effectiveness of the WHO surgical safety checklist. Surgical News. 2019;27(6):683–690. (In Russ.).
9. Sigua BV, Zemlyanoy VP, Filenko BP, et al. Scoring scale for determining treatment tactics in patients with adhesive small intestinal obstruction. Sklifosovsky Journal Emergency Medical Care. 2021;10(2):303–308. https://doi.org/10.23934/2223-9022-2021-10-2-303-308. (In Russ.).
10. Benyan AS, Korymasov EA, Chertukhina OB, et al. Surgical safety: effectiveness based on collective experience and problems of implementation (Literature review). Public health. 2023;3(3):44–56. https://doi.org/10.21045/2782-1676-2023-3-3-44-56. (In Russ.).
11. Wurdeman T, Staffa SJ, Barash D, et al. Surgical safety checklist use and post-caesarean sepsis in the lake zone of tanzania: results from safe surgery 2020. World J Surg. 2022;46(2):303–309. https://doi.org/10.1007/s00268-021-06338-3.
12. Anisimov AYu, Anisimov AA, Anisimov YuA. Effectiveness of safety control in surgical care for patients with abdominal sepsis. Russian Sklifosovsky Journal "Emergency Medical Care". 2025;14(3):547–557. https://doi.org/10.23934/2223-9022-2025-14-3-547-557. (In Russ.).
13. Rebrova OYu. Statisticheskiy analiz meditsinskikh dannykh. Primenenie paketa prikladnykh programm STATISTICA. Moscow: MediaSfera; 2006. (In Russ.).
14. Acute peritonitis. Clinical recommendations. Мoscow, 2017. (In Russ.).
15. Schuetz P, Albrich W, Mueller B. Procalcitonin for diagnosis of infection and guide to antibiotic decisions: past, present and future. BMC Med. 2011;9:107. https://doi.org/10.1186/1741-7015-9-107.
16. Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801–810. https://doi.org/10.1001/jama.2016.0287.
17. Carroll PJ, Gibson D, El-Faedy O, et al. Surgeon-performed ultrasound at the bedside for the detection of appendicitis and gallstones: systematic review and meta-analysis. Am J Surg. 2013;205(1):102–108. https://doi.org/10.1016/j.amjsurg.2012.02.017.
18. Laméris W, van Randen A, van Es HW, et al. Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study. BMJ. 2009;338:b2431. https://doi.org/10.1136/bmj.b2431.
19. Koo HS, Kim HC, Yang DM, et al. Does computed tomography have any additional value after sonography in patients with suspected acute appendicitis? J Ultrasound Med. 2013;32(8):1397–1403. https://doi.org/10.7863/ultra.32.8.1397.
20. Shah BR, Stewart J, Jeffrey RB, Olcott EW. Value of shortinterval computed tomography when sonography fails to visualize the appendix and shows otherwise normal findings. J Ultrasound Med. 2014;33(9):1589–1595. https://doi.org/10.7863/ultra.33.9.1589.
21. Hecker A, Schneck E, Röhrig R, et al. The impact of early surgical intervention in free intestinal perforation: a time-tointervention pilot study. World J Emerg Surg. 2015;10:54. https://doi.org/10.1186/s13017-015-0047-0.
22. Kirkpatrick AW, Roberts DJ, De Waele J, et al. Pediatric guidelines sub-committee for the world society of the abdominal compartment syndrome. intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the world society of the abdominal compartment syndrome. Intensive Care Med. 2013;39(7):1190–206. https://doi.org/10.1007/s00134-013-2906-z.
23. Anisimov AA, Dobrokvashin SV, Anisimov AYu, et al. Use of vacuum closure of laparotomy wound and negative pressure therapy in the treatment of patients with abdominal sepsis. Medical Bulletin of the Ministry of Internal Affairs. 2025;134(1):8– 12. https://doi.org/10.52341/20738080_2025_134_1_8. (In Russ.).
24. Dellinger RP, Levy MM, Rhodes A, et al. Surviving sepsis campaign guidelines committee including the pediatric subgroup. surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41(2):580–637. https://doi.org/10.1097/CCM.0b013e31827e83af.
25. Geerts W, Cook D, Selby R, Etchells E. Venous thromboembolism and its prevention in critical care. J Crit Care. 2002;17(2):95–104. https://doi.org/10.1053/jcrc.2002.33941.
26. Bloos F, Sachse S, Kortgen A, et al. Evaluation of a polymerase chain reaction assay for pathogen detection in septic patients under routine condition: an observational study. PloS One. 2012;7(9):e46003. https://doi.org/10.1371/journal.pone.0046003.
27. Gelfand B.R., Kirienko A.I., Shachatryan N.N. Abdominal Surgical Infection: Russian National Recommendations. 2nd edition, revised and supplemented. Moscow: “Medical Information Agency”, 2018. 168 p. (In Russ.).
Review
For citations:
Anisimov A.A., Ibragimov R.A., Andreev A.I., Anisimov A.Yu. Defects in surgical care for patients with abdominal sepsis. Russian surgical journal. 2025;1(4):49-58. (In Russ.) https://doi.org/10.18705/3034-7270-2025-1-4-49-58
Views:
38
JATS XML
Email this article 