Dr Francesco Amico
Surgery Lecturer
School of Medicine and Public Health
- Email:francesco.amico@newcastle.edu.au
- Phone:(02) 4921 5000
Career Summary
Biography
Dr Amico's career as a health professional commenced following his overseas graduation as a medical doctor. He continuously worked to expand the breadth and depth of his knowledge in the discipline of surgery. Dr Amico always had an interest in trauma and acute care.
Dr Amico worked on his research fellowship on multiple surgical projects, conducted through the University of Melbourne in 2012. He practiced overseas as a specialist general surgeon after completing his specialist training. Dr Amico completed a clinical fellowship at John Hunter Hospital, where he gained vast experience caring for injured patients.
Since 2021 Dr Amico was appointed as a lecturer at the University of Newcastle and works as a General and Trauma Surgeon at John Hunter Hospital, New Lambton Heights, Australia.
Qualifications
- Master an Bachelor Degree in Medicine and Surgery, The Insubria University, Italy
Keywords
- Acute General Surgery
- Complex Hernia
- General Surgery
- Physiological response to trauma
- Polytrauma
- Post injury critical care
- Postinjury Multiple Organ Failure
- Postinjury immunology/inflammation
- Trauma Care
- Traumatology
Languages
- English (Fluent)
- Italian (Mother)
- French (Fluent)
Fields of Research
Code | Description | Percentage |
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320226 | Surgery | 40 |
420702 | Exercise physiology | 60 |
Professional Experience
UON Appointment
Title | Organisation / Department |
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Surgery Lecturer | University of Newcastle School of Medicine and Public Health Australia |
Academic appointment
Dates | Title | Organisation / Department |
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1/1/2018 - 30/9/2020 | Cojoint Surgery Lecturer | School of Medicine and Public Health | University of Newcastle Australia |
1/10/2017 - 31/1/2021 | Postgraduate Fellow | Hunter New England Area Health Service John Hunter Hospital Australia |
Membership
Dates | Title | Organisation / Department |
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4/10/2022 - 4/12/2023 |
Core Committee Member The ITIM Education Committee provides strategic advice to the ITIM Executive Committee on system-wide education requirements and opportunities. It provides oversight of the education functions of ITIM. The key focus is in promoting and providing direction to collaborative trauma education in NSW. |
NSW Agency for Clinical Innovation (ACI) Institute of Trauma and Injury Management Education Committee |
1/10/2021 - |
Board of Directors The aim of society is to promote training and continuing medical education in emergency surgery and trauma surgery. |
World Society of Emergency Surgery Italy |
1/1/2021 - |
Member Mission: Optimizing the operative and non-operative care of the patient with chest wall injury. |
Chest Wall Injury Society United States |
1/1/2019 - |
Member The promotion of abdominal wall surgery, the study of anatomic, physiologic and therapeutic problems related to the pathology of the abdominal wall, the creation of associated groups which will promote research and teaching in this field, and the development of interdisciplinary relations. |
European Hernia Society Spain |
1/1/2017 - |
Member The Australian and New Zealand Association for the Surgery of Trauma is a surgical society open to surgical trainees and Fellows of the Royal Australasian College of Surgeons (or equivalent). |
Australia New Zealand Association for the Surgery of Trauma Australia |
Professional appointment
Dates | Title | Organisation / Department |
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1/2/2021 - | General and Trauma Surgeon | Hunter New England Health John Hunter Hospital Australia |
Awards
Award
Year | Award |
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2021 |
Association between blood donor demographics and post-injury Multiple Organ Failure after Politrauma School of Medicine and Public Health | University of Newcastle |
Member
Year | Award |
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2018 |
Management of grade 3 splenic injury without blush World Society of Emergency Surgery |
Invitations
Contributor
Year | Title / Rationale |
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2022 | Frontiers of Emergency General Surgery |
2022 |
Anatomically Based Surgical Exposure for Trauma PROGRAM OBJECTIVES • Apply knowledge of key anatomical exposures for the care of acutely injured surgical patients. • Demonstrate technical ability to expose important structures that may require acute surgical intervention to save life or limb. • Perform anatomic exposures independently. |
Speaker
Year | Title / Rationale |
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2019 |
Direct admissions from resuscitation to operating room The NSW Institute of Trauma and Injury Management (ITIM) is an institute within the Agency for Clinical Innovation (ACI). It is the body responsible for overseeing, coordinating and supporting the NSW trauma system. |
2019 |
Over Achiever, a severe multitrauma case study The conference is hosted by Hunter New England Health professionals to support networking, sharing of initiatives and innovations in critical practice and learnings experienced locally, and from a NSW or interstate perspective. Around 200 delegates from around Australia attend the conference, which targets the educational needs of multidisciplinary staff within the health care industry with a focus on Critical Care, including Trauma, Emergency, Intensive Care, High Dependency, Disaster and Retrievals, in both the adult and paediatric population. |
2019 |
Management of grade III blunt splenic injury The WSES is a society that brings together surgeons and other physicians in emergency and trauma surgery from all parts of the world to share the latest research.
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Teaching
Code | Course | Role | Duration |
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SURG6002 |
Surgical Sciences 2 College of Health, Medicine and Wellbeing, University of Newcastle This course will give the student a comprehensive and critical understanding of the pathophysiology, aetiology, outcomes and management of surgical disease. This course is a compulsory course in the Master of Traumatology Surgical Specialisation. |
Lecturer, Master of Traumatology | 1/10/2017 - 31/12/2025 |
SURG6001 |
Surgical Sciences 1 College of Health, Medicine and Wellbeing, University of Newcastle This course will give the student a comprehensive and critical understanding of the pathophysiology, aetiology, outcomes and management of surgical disease. This course is a compulsory course in the Master of Traumatology Surgical Specialisation. |
Lecturer, Master of Traumatology | 1/9/2020 - 31/12/2025 |
Publications
For publications that are currently unpublished or in-press, details are shown in italics.
Chapter (1 outputs)
Year | Citation | Altmetrics | Link | ||
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2023 |
Phillips A, Loh EJ, Amico F, 'Enterocutaneous and Enteroatmospheric Fistulae', Textbook of Emergency General Surgery: Traumatic and Non-traumatic Surgical Emergencies 1337-1350 (2023) Enteroatmospheric and enterocutaneous fistulae are uncommon and extremely morbid conditions. Their aetiology is multifactorial and can be spontaneous as well as iatrogenic. Their ... [more] Enteroatmospheric and enterocutaneous fistulae are uncommon and extremely morbid conditions. Their aetiology is multifactorial and can be spontaneous as well as iatrogenic. Their classification relies on the anatomical aspects that invariably correlate with the fistula output, which in turn determines the degree of morbidity to the patient. The key diagnostic aspects revolve around determining the anatomy of the disease, which can be done through basic and advanced imaging techniques depending on the underlying disease responsible for the fistula. Investigations need to be tailored in the context of an ad hoc treatment plan encompassing best timing for surgical intervention. Closure of those defects represents a challenge to the treating team, which relies on a multidisciplinary approach with multifaceted goals including optimization of nutritional status, wound and skin care and sepsis and fistula output control. Non-surgical options like glue and fibrin sealant together with additional novel methods are also available as part of the modern approach to this challenging disease.
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Journal article (42 outputs)
Year | Citation | Altmetrics | Link | ||||||||
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2023 |
Tian BWCA, Vigutto G, Tan E, van Goor H, Bendinelli C, Abu-Zidan F, et al., 'WSES consensus guidelines on sigmoid volvulus management', World Journal of Emergency Surgery, 18 (2023) [C1] Sigmoid volvulus is a common surgical emergency, especially in elderly patients. Patients can present with a wide range of clinical states: from asymptomatic, to frank peritonitis... [more] Sigmoid volvulus is a common surgical emergency, especially in elderly patients. Patients can present with a wide range of clinical states: from asymptomatic, to frank peritonitis secondary to colonic perforation. These patients generally need urgent treatment, be it endoscopic decompression of the colon or an upfront colectomy. The World Society of Emergency Surgery united a worldwide group of international experts to review the current evidence and propose a consensus guidelines on the management of sigmoid volvulus.
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2023 |
Frassini S, Cobianchi L, Fugazzola P, Biffl WL, Coccolini F, Damaskos D, et al., 'ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings.', World J Emerg Surg, 18 42 (2023) [C1]
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2023 |
Cobianchi L, Piccolo D, Dal Mas F, Agnoletti V, Ansaloni L, Balch J, et al., 'Correction: Surgeons perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey (World Journal of Emergency Surgery, (2023), 18, 1, (1), 10.1186/s13017-022-00467-3)', World Journal of Emergency Surgery, 18 (2023) Following publication of the original article [1], in Pub-Med the author name Daniele Bissacco under Team Dynamics Study Group has not been tagged and now it has been rectified.... [more] Following publication of the original article [1], in Pub-Med the author name Daniele Bissacco under Team Dynamics Study Group has not been tagged and now it has been rectified.
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2023 |
Sermonesi G, Tian BWCA, Vallicelli C, Abu-Zidan FM, Damaskos D, Kelly MD, et al., 'Cesena guidelines: WSES consensus statement on laparoscopic-first approach to general surgery emergencies and abdominal trauma', World Journal of Emergency Surgery, 18 (2023) [C1] Background: Laparoscopy is widely adopted across nearly all surgical subspecialties in the elective setting. Initially finding indication in minor abdominal emergencies, it has gr... [more] Background: Laparoscopy is widely adopted across nearly all surgical subspecialties in the elective setting. Initially finding indication in minor abdominal emergencies, it has gradually become the standard approach in the majority of elective general surgery procedures. Despite many technological advances and increasing acceptance, the laparoscopic approach remains underutilized in emergency general surgery and in abdominal trauma. Emergency laparotomy continues to carry a high morbidity and mortality. In recent years, there has been a growing interest from emergency and trauma surgeons in adopting minimally invasive surgery approaches in the acute surgical setting. The present position paper, supported by the World Society of Emergency Surgery (WSES), aims to provide a review of the literature to reach a consensus on the indications and benefits of a laparoscopic-first approach in patients requiring emergency abdominal surgery for general surgery emergencies or abdominal trauma. Methods: This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of 54 experts then critically revised the manuscript and discussed it in detail, to develop a consensus on a position statement. Results: A total of 323 studies (systematic review and meta-analysis, randomized clinical trial, retrospective comparative cohort studies, case series) have been selected from an initial pool of 7409 studies. Evidence demonstrates several benefits of the laparoscopic approach in stable patients undergoing emergency abdominal surgery for general surgical emergencies or abdominal trauma. The selection of a stable patient seems to be of paramount importance for a safe adoption of a laparoscopic approach. In hemodynamically stable patients, the laparoscopic approach was found to be safe, feasible and effective as a therapeutic tool or helpful to identify further management steps and needs, resulting in improved outcomes, regardless of conversion. Appropriate patient selection, surgeon experience and rigorous minimally invasive surgical training, remain crucial factors to increase the adoption of laparoscopy in emergency general surgery and abdominal trauma. Conclusions: The WSES expert panel suggests laparoscopy as the first approach for stable patients undergoing emergency abdominal surgery for general surgery emergencies and abdominal trauma.
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2023 |
Ceresoli M, Braga M, Zanini N, Abu-Zidan FM, Parini D, Langer T, et al., 'Enhanced perioperative care in emergency general surgery: the WSES position paper.', World J Emerg Surg, 18 47 (2023) [C1]
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2023 |
Cobianchi L, Piccolo D, Dal Mas F, Agnoletti V, Ansaloni L, Balch J, et al., 'Surgeons perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey', World Journal of Emergency Surgery, 18 (2023) [C1] Background: Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analyt... [more] Background: Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons¿ knowledge and perception of using AI-based tools in clinical decision-making processes. Methods: An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society¿s website and Twitter profile. Results: 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons¿ preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion: The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI.
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2023 |
Cobianchi L, Dal Mas F, Agnoletti V, Ansaloni L, Biffl W, Butturini G, et al., 'Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey', World Journal of Emergency Surgery, 18 (2023) [C1] Background: Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in ... [more] Background: Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons. Methods: Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society¿s website, and shared on the society¿s Twitter profile. Results: A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involving the patient. Several barriers to effectively partnering with the patient in the decision-making process were identified, such as the lack of time and the need to concentrate on making medical teams work smoothly. Discussion: Our investigation underlines how only a minority of trauma and emergency surgeons understand SDM, and perhaps, the value of SDM is not fully accepted in trauma and emergency situations. The inclusion of SDM practices in clinical guidelines may represent the most feasible and advocated solutions.
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2023 |
Amico F, Efird JT, Briggs GD, Lott NJ, King KL, Hirani R, Balogh ZJ, 'Association between Blood Donor Demographics and Post-injury Multiple Organ Failure after Polytrauma', Annals of Surgery, 277 E170-E174 (2023) [C1] Objective: To test the hypothesis that blood donor demographics are associated with transfused polytrauma patients' post-injury multiple organ failure (MOF) status. Summary o... [more] Objective: To test the hypothesis that blood donor demographics are associated with transfused polytrauma patients' post-injury multiple organ failure (MOF) status. Summary of Background Data: Traumatic shock and MOF are preventable causes of death and post-traumatic hemorrhage is a frequent indication for transfusion. The role of blood donor demographics on transfusion recipients is not well known. Methods: A log-linear analysis accounting for the correlated structure of the data based on our prospective MOF database was utilized. Tests for trend and interaction were computed using a likelihood ratio procedure. Results: A total of 229 critically injured transfused trauma patients were included, with 68% of them being males and a mean age of 45 years. On average 10 units of blood components were transfused per patient. A total of 4379 units of blood components were donated by donors aged 46 years on average, 74% of whom were males. Blood components used were red blood cells (47%), cryoprecipitate (29%), fresh frozen plasma (24%), and platelets (less than 1%). Donor-recipient sex mismatched red blood cells transfusions were more likely to be associated with MOF (P = 0.0012); fresh frozen plasma and cryoprecipitate recipients were more likely to experience MOF when transfused with a male (vs female) component (P = 0.0014 and <0.0001, respectively). Donor age was not significantly associated with MOF for all blood components. Conclusions: Blood components donor sex, but not age, may be an important factor associated with post-injury MOF. Further validation of our findings will help guide future risk mitigation strategies specific to blood donor demographics.
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2023 |
Tian BWCA, Stahel PF, Picetti E, Campanelli G, Di Saverio S, Moore E, et al., 'Assessing and managing frailty in emergency laparotomy: a WSES position paper.', World journal of emergency surgery : WJES, 18 38 (2023) [C1]
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2022 |
Smyth L, Bendinelli C, Lee N, Reeds MG, Loh EJ, Amico F, et al., 'WSES guidelines on blunt and penetrating bowel injury: diagnosis, investigations, and treatment.', World J Emerg Surg, 17 13 (2022) [C1]
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2022 |
García IC, Villalba JS, Iovino D, Franchi C, Iori V, Pettinato G, et al., 'Liver Trauma: Until When We Have to Delay Surgery? A Review.', Life (Basel), 12 (2022) [C1]
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2022 |
Cobianchi L, Dal Mas F, Massaro M, Biffl W, Catena F, Coccolini F, et al., 'Diversity and ethics in trauma and acute care surgery teams: results from an international survey', World Journal of Emergency Surgery, 17 (2022) [C1] Background: Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance ... [more] Background: Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods: The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results: Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions: Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence: Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance.
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2022 |
Podda M, De Simone B, Ceresoli M, Virdis F, Favi F, Larsen JW, et al., 'Follow-up strategies for patients with splenic trauma managed non-operatively: the 2022 World Society of Emergency Surgery consensus document', WORLD JOURNAL OF EMERGENCY SURGERY, 17 (2022) [C1]
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2022 |
'The management of peri-operative anaemia in patients undergoing major abdominal surgery in Australia and New Zealand: a prospective cohort study', Medical Journal of Australia, 217 487-493 (2022) [C1]
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2022 |
De Simone B, Chouillard E, Ramos AC, Donatelli G, Pintar T, Gupta R, et al., 'Operative management of acute abdomen after bariatric surgery in the emergency setting: the OBA guidelines', WORLD JOURNAL OF EMERGENCY SURGERY, 17 (2022) [C1]
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2021 |
Ietto G, Amico F, Pettinato G, Iori V, Carcano G, 'Laparoscopy in emergency: Why not? advantages of laparoscopy in major emergency: A review', Life, 11 (2021) [C1] A laparoscopic approach is suggested with the highest grade of recommendation for acute cholecystitis, perforated gastroduodenal ulcers, acute appendicitis, gynaecological disorde... [more] A laparoscopic approach is suggested with the highest grade of recommendation for acute cholecystitis, perforated gastroduodenal ulcers, acute appendicitis, gynaecological disorders, and non-specific abdominal pain (NSAP). To date, the main qualities of laparoscopy for these acute surgical scenarios are clearly stated: quicker surgery, faster recovery and shorter hospital stay. For the remaining surgical emergencies, as well as for abdominal trauma, the role of laparoscopy is still a matter of debate. Patients might benefit from a laparoscopic approach only if performed by experienced teams and surgeons which guarantee a high standard of care. More precisely, laparoscopy can limit damage to the tissue and could be effective for the reduction of the overall amount of cell debris, which is a result of the intensity with which the immune system reacts to the injury and the following symptomatology. In fact, these fragments act as damage-associated molecular patterns (DAMPs). DAMPs, as well as pathogen associated molecular patterns (PAMPs), are recognised by both surface and intracellular receptors of the immune cells and activate the cascade which, in critically ill surgical patients, is responsible for a deranged response. This may result in the development of progressive and multiple organ dysfunctions, manifesting with acute respiratory distress syndrome (ARDS), coagulopathy, liver dysfunction and renal failure. In conclusion, none of the emergency surgical scenarios preclude laparoscopy, provided that the surgical tactic could ensure sufficient cleaning of the abdomen in addition to resolving the initial tissue damage caused by the ¿trauma¿.
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2021 |
Ietto G, Guzzetti L, Baglieri CS, Raveglia V, Zani E, Benedetti F, et al., 'Predictive Models for the Functional Recovery of Transplanted Kidney', Transplantation Proceedings, 53 2873-2878 (2021) [C1] Background: Renal transplantation is the gold standard treatment for end-stage renal disease, however, in 20% of cases, the graft develops a delayed graft function (DGF) that is a... [more] Background: Renal transplantation is the gold standard treatment for end-stage renal disease, however, in 20% of cases, the graft develops a delayed graft function (DGF) that is associated with both early and late worsening of the outcome. The aim of this study was to examine and validate in a population of transplanted patients the appropriateness of the predictive score systems of DGF available to identify patients who might take advantage of a tailored immunosuppressive therapy. Materials and Methods: We conducted a systematic review of the literature to identify articles concerning scoring systems predicting DGF to identify those applicable to the study population and subsequently comparing their appropriateness for defining the most accurate one. Results: From an analysis of the scientific literature, we found 7 scoring systems predicting DGF. Of these, 3 can be calculated for the study population. We enrolled 247 renal transplants in the study. DGF was recorded in 41 cases (15.95%). The Irish score recognized 25 of 41 cases (60.98%), the Jeldres score 41 of 41 cases (100%), and the Chapal score only 7 of 41 (17.07%). Although the Irish score did not identify all cases of DGF, the analysis of data revealed that it is the most accurate, with area under the receiver operating characteristic almost overlapping. Conclusions: The study resulted in some interesting and promising conclusions about the predictability of DGF, defining the Irish score as the most reliable. This result can be considered the fundamental requirement to develop a custom therapeutic algorithm to be applied to all recipients with higher probability of developing DGF.
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2021 |
Cobianchi L, Dal Mas F, Massaro M, Fugazzola P, Coccolini F, Kluger Y, et al., 'Team dynamics in emergency surgery teams: results from a first international survey', World Journal of Emergency Surgery, 16 (2021) [C1] Background: Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with n... [more] Background: Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma¿s causes or the patient¿s personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes. Methods: An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the software R, and reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results: Findings highlight how several surgeons are still unsure about the meaning and potential of knowledge translation and its mechanisms. Tools like training, clinical guidelines, and non-technical skills are recognized and used in clinical practice. Others, like patients¿ and stakeholders¿ engagement, are hardly implemented, despite their increasing importance in the modern healthcare scenario. Several difficulties in working as a team are described, including the lack of time, communication, training, trust, and ego. Discussion: Scientific societies should take the lead in offering training and support about the abovementioned topics. Dedicated educational initiatives, practical cases and experiences, workshops and symposia may allow mitigating the difficulties highlighted by the survey¿s participants, boosting the performance of emergency teams. Additional investigation of the survey results and its characteristics may lead to more further specific suggestions and potential solutions.
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2021 |
Ietto G, Zani E, Benedetti F, Parise C, Iori V, Masci F, et al., 'Indocyanine Green Angiography for Quality Assessment of the Kidney During Transplantation: An Outcome Predictor Prospective Study', Transplantation Proceedings, 53 1892-1896 (2021) [C1] Background: Microvascular damage is the main cause of delayed graft function (DGF) after kidney transplant. Assessing its extent may be helpful in predicting DGF to achieve better... [more] Background: Microvascular damage is the main cause of delayed graft function (DGF) after kidney transplant. Assessing its extent may be helpful in predicting DGF to achieve better postoperative management, especially in terms of an immunosuppressive regimen. Our aim was to explore the capability of intraoperative indocyanine green (ICG) angiography to examine the microvasculature of the kidney. Methods: We conducted a prospective cohort study on 37 kidney transplant recipients in a high-volume kidney transplant center. During surgery, after graft implant, an ICG angiography was performed through a high-definition Storz camera system (Karl Storz GmbH, Tuttlingen, Germany) with successive quantitative assessment of fluorescence using Icy bioimage analysis. Results: All transplanted kidneys that showed immediate recovery of their function had a fluorescent intensity =49.953 with a mean of 96.930 ± 21. The fluorescence intensity for kidneys that showed a delayed recovery of their function never exceeded 55.648, and the mean was 37.718 ± 13. The difference between the 2 groups was statistically significant with a P value < .001. The only kidney that never recovered showed a fluorescence intensity consistently <25.220, the lowest detected. Conclusions: This study demonstrates that intraoperative ICG angiography may be used to assess the microvasculature of the graft. A statistically significant difference in terms of fluorescent intensity can be highlighted between kidneys that immediately recover their function and those with delayed recovery. Further larger studies are needed to confirm the capability of the technique to predict DGF to optimize the transplanted patients¿ management.
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2020 |
Coccolini F, Gubbiotti F, Ceresoli M, Tartaglia D, Fugazzola P, Ansaloni L, et al., 'Open Abdomen and Fluid Instillation in the Septic Abdomen: Results from the IROA Study', World Journal of Surgery, 44 4032-4040 (2020) [C1] Background: Open abdomen (OA) is a surgical option that can be used in patients with severe peritonitis. Few evidences exist to recommend the use of intraperitoneal fluid instilla... [more] Background: Open abdomen (OA) is a surgical option that can be used in patients with severe peritonitis. Few evidences exist to recommend the use of intraperitoneal fluid instillation associated with OA in managing septic abdomen. Materials and methods: A prospective analysis of adult patients enrolled in the International Register of Open Abdomen (trial registration: NCT02382770) was performed. Results: A total of 387 patients were enrolled in two groups: 84 with peritoneal fluid instillation (FI) and 303 without (NFI). The groups were homogeneous for baseline characteristics. Overall complications were 92.9% in FI and 86.3% in NFI (p = 0.106). Complications during OA were 72.6% in FI and 59.9% in NFI (p = 0.034). Complications after definitive closure were 70.8% in FI and 61.1% in NFI (p = 0.133). Entero-atmospheric fistula was 13.1% in FI and 12% in NFI (p = 0.828). Fascial closure was 78.6% in FI and 63.7% in NFI (p = 0.02). Analysis of FI in negative pressure wound therapy (NPWT) showed: Overall morbidity in NPWT was 94% and in non-NPWT 91.2% (p = 0.622) and morbidity during OA was 68% and 79.4% (p = 0.25), respectively. Definitive fascial closure in NPWT was 87.8% and 96.8% in non-NPWT (p = 0.173). Overall mortality was 40% in NPWT and 29.4% in non-NPWT (p = 0.32) and morality during OA period was 18% and 8.8% (p = 0.238), respectively. Conclusion: We found intraperitoneal fluid instillation during open abdomen in peritonitic patients to increase the complication rate during the open abdomen period, with no impact on mortality, entero-atmospheric fistula rate and opening time. Fascial closure rate is increased by instillation. Fluid instillation is feasible even when associated with nonnegative pressure temporary abdominal closure techniques.
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2020 |
Amico F, Anning R, Bendinelli C, Balogh ZJ, 'Grade III blunt splenic injury without contrast extravasation-World Society of Emergency Surgery Nijmegen consensus practice', WORLD JOURNAL OF EMERGENCY SURGERY, 15 (2020) [C1]
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2020 |
De Simone B, Birindelli A, Ansaloni L, Sartelli M, Coccolini F, Di Saverio S, et al., 'Emergency repair of complicated abdominal wall hernias: WSES guidelines', HERNIA, 24 359-368 (2020) [C1]
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2019 |
Bishop B, Hannah N, Doyle A, Amico F, Hockey B, Moore D, et al., 'A prospective study of the incidence of drug-induced liver injury by the modern volatile anaesthetics sevoflurane and desflurane', Alimentary Pharmacology and Therapeutics, 49 940-951 (2019) Background: Volatile anaesthetics are known to cause drug-induced liver injury, a hepatotoxic reaction characterised by antibodies to trifluoroacetylated lipid and protein adducts... [more] Background: Volatile anaesthetics are known to cause drug-induced liver injury, a hepatotoxic reaction characterised by antibodies to trifluoroacetylated lipid and protein adducts and cytochrome p450 2E1. The incidence of volatile anaesthetic drug-induced liver injury from older agents has been described, but modern agents have not been prospectively studied. Aim: To determine prospectively the incidence of volatile anaesthetic drug-induced liver injury from sevoflurane and desflurane. Methods: Adult surgical patients with a predicted post-operative stay of at least 4¿days were recruited. If volatile anaesthetic was administered, liver biochemistry was performed regularly. Medications, observations and other investigations were documented. Patients with abnormal liver biochemistry were classified as likely volatile anaesthetic drug-induced liver injury or not based on clinical assessment, Roussel Uclaf Causality Assessment Method score, and the absence of other likely pathology. Some patients were also tested for antibodies to both trifluoroacetylated lipid and protein adducts, and cytochrome p450 2E1. Results: A total of 209 patients were recruited, of which 121 were included for analysis. Post-operative liver biochemistry was abnormal in 62 patients (51.2%); further classified as not volatile anaesthetic drug-induced liver injury in 47 cases (38.8%), and likely volatile anaesthetic-drug induced liver injury in 15 cases (12.4%). Of the likely volatile anaesthetic drug-induced liver injury patients, only one had severe disease with alanine transaminase greater than five times the upper limit of normal, while four cases had moderate disease with alanine transaminase greater than three times the upper limit of normal. Thus, the incidence of clinically significant volatile anaesthetic drug-induced liver injury was 4.1%. No risk factors were identified. Conclusions: Volatile anaesthetic drug-induced liver injury from modern agents seems to be as common (4.1%) as previously reported with older agents (3%), and may identify patients at risk of severe acute liver injury with subsequent re-exposure.
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2019 |
Amico F, Briggs G, Balogh ZJ, 'Transfused trauma patients have better outcomes when transfused with blood components from young donors', Medical Hypotheses, 122 141-146 (2019) [C1] The physiology of tissue healing and aging share common pathways. Both patient age and tissue healing are crucial factors predicting outcomes in trauma patients. The presented hyp... [more] The physiology of tissue healing and aging share common pathways. Both patient age and tissue healing are crucial factors predicting outcomes in trauma patients. The presented hypothesis focuses on the concept that transfused trauma patients have better outcomes when transfused with blood components from young donors. The age of the donor of a blood transfusion could affect recovery following a major traumatic insult and help avoid postinjury immune paralysis and its associated complications. The frequent transfusion of blood components to the severely injured trauma patient provides an opportunity for the recipient to benefit from the potentially favourable effect of blood originating from young donors. Different types of evidence support the presented hypothesis including work on soluble circulating factors, research on animal parabiontic models and epidemiological studies. Theories on the role of transfusion of cells, on bone marrow and on senolytics also represent grounds to elaborate pathways to test this hypothesis. The precise molecular mechanism underlying this hypothesis is uncertain. A beneficial effect on trauma patients following transfusion of blood could be due to a positive effect of blood donated from younger donors or instead to the lack of a negative effect possibly occurring when transfusing blood from older donors. Either way, identifying this mechanism would provide a powerful tool enhance long and short term recovery after trauma.
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2017 |
Iovino D, Ietto G, Soldini G, Calussi M, Parise C, Zani E, et al., 'Page Kidney phenomenon following kidney transplant, secondary to acute postsurgical sub capsular hematoma compression: A case report', Transplantation Reports, 2 15-18 (2017) Page kidney is one of secondary arterial hypertension forms and it is due to external compression of renal parenchyma. Hematomas, masses or fluid collection, that lead to activati... [more] Page kidney is one of secondary arterial hypertension forms and it is due to external compression of renal parenchyma. Hematomas, masses or fluid collection, that lead to activation of the renin-angiotensin-aldosterone system, resulting in systemic hypertension and then renal failure are the main causes. Nowadays higher necessity of kidney transplants led to more frequent use of marginal grafts, exposed to major risk of primary non function, delayed graft function or acute post-surgical complications such as capsular detachment and following hematoma. Page effect must be suspected when we notice serum creatinine increase, diuresis contraction and arterial hypertension. Doppler ultrasound (DUS) could allow diagnosis but CT scan may detect even very small hematomas that require urgent surgical drainage in order to obtain rapid recovery of renal function. We present the case of a 61-year-old man, with end-stage renal failure secondary to focal glomerulosclerosis, who underwent kidney transplantation from a deceased heart beating expanded criteria donor in October 2015. On postoperative day thirteen we observed a rapid and severe increase of serum creatinine, and for this reason patient underwent surgery for hematoma evacuation. During the immediate postoperative time we observed a rapid decrease of serum creatinine until stabilization in post-operative day four.
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2016 |
letto G, Amico F, Soldini G, Chiappa C, Franchin M, lovino D, et al., 'Real-time Intraoperative Fluorescent Lymphography: A New Technique for Lymphatic Sparing Surgery', TRANSPLANTATION PROCEEDINGS, 48 3073-3078 (2016) [C1]
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2016 |
Ferrari CC, Rausei S, Amico F, Boni L, Chiang F-Y, Wu C-W, et al., 'Recurrent laryngeal nerve injury in thyroid surgery: Clinical pathways and resources consumption', HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, 38 1657-1665 (2016)
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Grants and Funding
Summary
Number of grants | 3 |
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Total funding | $57,395 |
Click on a grant title below to expand the full details for that specific grant.
20211 grants / $2,500
CHMW Support Scheme$2,500
Funding body: College Health, Medicine and Wellbeing - The University of Newcastle (Australia)
Funding body | College Health, Medicine and Wellbeing - The University of Newcastle (Australia) |
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Project Team | Francesco Amico |
Scheme | CHMW Support Scheme |
Role | Lead |
Funding Start | 2021 |
Funding Finish | 2022 |
GNo | |
Type Of Funding | Other Public Sector - Local |
Category | 2OPL |
UON | N |
20141 grants / $30,895
Establishment of a Control Network from Remote for Patients with a Complex Vascular Access$30,895
Funding body: Fondazione Comunitaria del Varesotto
Funding body | Fondazione Comunitaria del Varesotto |
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Project Team | Amico F, Tozzi M, Franchin M, Ietto G, Carcano G, Castelli P |
Scheme | Granted on 5th session/2014. |
Role | Investigator |
Funding Start | 2014 |
Funding Finish | 2014 |
GNo | |
Type Of Funding | C3600 - International Philanthropy |
Category | 3600 |
UON | N |
20131 grants / $24,000
Linkage Directed Sequencing of Colorectal Cancer Coding Regions: A Pilot Study Based on Exome Sequencing Approach Re-Examining Families Previously Involved in a Genome Wide Linkage Study. $24,000
Funding body: Melbourne Health Research Funding Program
Funding body | Melbourne Health Research Funding Program |
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Project Team | Macrae F, Hannan G, Ross J, Amico F. |
Scheme | Melbourne Health Research Funding Program |
Role | Investigator |
Funding Start | 2013 |
Funding Finish | 2014 |
GNo | |
Type Of Funding | C1600 - Aust Competitive - StateTerritory Govt |
Category | 1600 |
UON | N |
Dr Francesco Amico
Position
Surgery Lecturer
Division of Surgery
School of Medicine and Public Health
College of Health, Medicine and Wellbeing
Contact Details
francesco.amico@newcastle.edu.au | |
Phone | (02) 4921 5000 |
Link | Research Networks |
Office
Location | John Hunter Hospital , |
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