The assurance of patient safety in emergency general surgery remains challenging due to the patients’ high-risk underlying conditions and the wide variability in emergency surgical care provided around the globe. The authors of this article convened as an expert panel on patient safety in surgery at the 8^thInternational Conference of the World Society of Emergency Surgery (WSES) in Edinburgh, Scotland, on September 7–10, 2021. This review article represents the proceedings from the expert panel discussions at the WSES congress and was designed to provide an international perspective on optimizing teamwork and non-technical skills in emergency general surgery.

On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.

Patients with intra-abdominal sepsis suffer from significant mortality and morbidity. The main pillars of treatment for intra-abdominal infections are (1) source control and (2) early delivery of antibiotics. Antibiotic therapy should be started as soon as possible. However, the duration of antibiotics remains a matter of debate. Prolonged antibiotic delivery can lead to increased microbial resistance and the development of nosocomial infections. There has been much research on biomarkers and their ability to aid the decision on when to stop antibiotics. Some of these biomarkers include interleukins, C-reactive protein (CRP) and procalcitonin (PCT). PCT’s value as a biomarker has been a focus area of research in recent years. Most studies use either a cut-off value of 0.50 ng/mL or an >80% reduction in PCT levels to determine when to stop antibiotics. This paper performs a literature review and provides a synthesized up-to-date global overview on the value of PCT in managing intra-abdominal infections.

Acute appendicitis remains one of the most common surgical emergencies, with a lifetime incidence of approximately 7–8% in the USA and Europe. Despite the widespread adoption of the laparoscopic approach and advances made in perioperative care, post-operative infections—particularly intra-abdominal abscesses—continue to pose a substantial clinical challenge, with an overall probability that ranges from 5 to 15%. Nowadays, it is essential not only to improve patient outcomes by reducing these complications but also to promote responsible antibiotic use. This review provides an in-depth examination of post-appendectomy infections in adults, synthesizing research from the past decade. It explores the various risks involved, including those related to the patient, the disease itself, and the surgical techniques employed. There is particular emphasis on the impact of surgical approach, closure methods, timing of surgery, and intraoperative decisions such as drain placement, peritoneal lavage, and routine bacterial cultures. Part of the discussion is about emerging data regarding the use of antiseptic solutions and specimen retrieval techniques. Additionally, the review examines current approaches to managing postoperative intra-abdominal abscesses. It assesses when antibiotics are necessary, evaluates image-guided percutaneous drainage, and considers laparoscopic re-intervention as a possible solution. While recent studies offer valuable insights, the heterogeneity of available evidence highlights the pressing need for high-quality, standardized research. Ultimately, a deeper understanding of infection pathways and preventative strategies is vital—not only for reducing morbidity and hospital readmissions, but also for safeguarding the long-term efficacy of antibiotics and delivering safer, more effective surgical care.

Emergency General Surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and non-traumatic acute conditions during the same admission in the hospital by general emergency surgeons and other specialists. It is the most diffused surgical discipline in the world. To live and grow strong EGS necessitates three fundamental parts: emergency and elective continuous surgical practice, evidence generation through clinical registries and data accrual, and indications and guidelines production: the LIFE TRIAD.