{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T20:40:07Z","timestamp":1788986407786,"version":"build-2803163510"},"reference-count":43,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surgical Infections"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The Bologna guideline outlines three small bowel obstruction (SBO) management pathways. It remains unclear how pathway selection influences post-operative infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A multi-national, prospective, observational, audit of SBO management (November 1, 2023\u2013May 31, 2024) captured demographics, care, and outcomes. Patients were grouped by pathway (successful non-operative management [NOM], NOM followed by surgery [NOM-T], direct to surgery [DTS]). Intergroup comparisons by chi-square or Fisher exact test, significance for p &lt;\u20090.05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 1,737 patients were assessed across 21 countries (850 NOM, 379 NOM-T, 508 DTS). Operative cohorts demonstrated similar age (NOM-T 65.2 \u00b1 17.3 vs. DTS 65.5 \u00b1 18.4 y; p = 0.834) and gender (NOM-T 53.6% vs. DTS, 52% female; p = 0.688). Comorbidities were more frequent in patients undergoing NOM-T (77.8%) versus DTS (69.7%; p &lt;\u20090.001). DTS demonstrated more intestinal ischemia (NOM-T 22.8% vs. DTS 33%; p = 0.002). Time to OR was longer in NOM-T (43.8\u2009\u00b1\u200930.6 vs. DTS 12.4\u2009\u00b1\u200915.2 h; p &lt;\u20090.001). Hospital length of stay (LOS) (NOM-T 12.4\u2009\u00b1\u200915.2 vs. DTS 7.7\u2009\u00b1\u20098.0 d; p &lt; 0.001) and LOS (NOM-T 10.1\u2009\u00b1\u200910.4 vs. DTS 6.6\u2009\u00b1\u20099.1 d; p &lt; 0.001) were longer in NOM-T. Superficial wound dehiscence (3.9%) and fascial dehiscence (2.6%) were uncommon. Overall surgical site infection (SSI) incidence was similar (NOM-T 8.7% vs. DTS 7.7%; p = 0.578). Deep SSI overall frequency was low (3.9%) but increased in NOM-T (5.5%) versus DTS (2.8%, p = 0.035).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>An NOM trial before operation for adhesive SBO seems to increase deep SSI risk and likely reflects time to OR as well as hospital and surgeon factors\u2014elements that merit specific evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10962964251380382","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T16:22:44Z","timestamp":1758126164000},"page":"59-67","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Initial Adhesive Small Bowel Obstruction Management Pathway Drives Infectious Complication Occurrence"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8570-8598","authenticated-orcid":false,"given":"Christopher","family":"McLaughlin","sequence":"first","affiliation":[{"name":"Perelman School of Medicine, Division of Trauma, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lewis J.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, Division of Trauma, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isidro","family":"Martinez-Casas","sequence":"additional","affiliation":[{"name":"Unidad de Cirug\u00eda de Urgencias y Trauma del Hospital Universitario Virgen del Rocio, Sevilla, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahin","family":"Mohseni","sequence":"additional","affiliation":[{"name":"School of Medical Sciences, Orebro University, Orebro, Sweden."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Cimino","sequence":"additional","affiliation":[{"name":"Department of Emergency Surgery, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayato","family":"Kurihara","sequence":"additional","affiliation":[{"name":"Department of Emergency Surgery, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Institute for Applied Health Research, University of Birmingham, Birmingham, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary Alan","family":"Bass","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, Division of Trauma, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA."},{"name":"Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-023-00509-4"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2023.06.003"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-018-0185-2"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-022-02045-3"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znaf055"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0000000000001269"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2019.262"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-021-06061-z"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-022-00376-4"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-022-02427-9"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znaf080"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S336023"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2020.441"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02724-0"},{"key":"e_1_3_2_16_2","first-page":"1","article-title":"Immunology of aging: The birth of inflammaging","volume":"18","author":"Fulop T","year":"2021","unstructured":"Fulop T, , Larbi A, , Pawelec G, et al. 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