These data support the scheduling of appendectomies for the earliest, yet most suitable time for the surgeon and for proper hospital resource utilization and expenditure, which is usually in the morning. Several studies have addressed the optimal time for surgical intervention in acute cholecystitis [5] and diverticulitis [6]. Pakula et al. recently showed that delaying surgery in patients diagnosed

with necrotizing fasciitis did not increase the risk of mortality [7]. Chao et al. [8] echoed Pakuals’ observation indicating that timing of surgery (within 12 hours of admission) didn’t impact outcome of patients admitted for Vibrio- vulnifics- related necrotizing fasciitis. Korkut et al. [9] on the GANT61 nmr contrary claim that the interval from the onset of clinical symptoms to the initial surgical intervention seems to be the most important prognostic factor with a significant impact on outcome of patients with Fournier’s

gangrene. The objective of the management of acute surgical diseases is to save lives by controlling bleeding or contamination, or by improving organ perfusion. This objective obligates the need for strong commitment and effective mechanisms for prioritizing patient management according to physiological and clinical parameters. Resource availability along patient physiological and clinical parameters in the acute care arena justifies the www.selleckchem.com/mTOR.html development of triage tools and agreed criteria for proper timing of emergency operations. Most studies on timing of surgery have investigated delays in operations. This may reflect problems of resource availability, and indicate a need for all parties involved in surgical emergencies, both caregivers and their employers, to commit to high quality of care. Convenience for caregivers or administrators should not override patient safety. Investigations of the influence on patient outcomes of surgical delays due to constraints of resource utilization, must consider the availability of operating theaters at any given time. Despite the widespread adoption of acute care surgery as a specialty

among other surgical professions, the implementation, standardization and development of this discipline vary considerably among Telomerase medical centers [10]. The World Society for Emergency Surgery (WSES) conducted an international Rabusertib price expert opinion panel (TACS). Members of this panel were asked to fill a questionnaire that included information on their acute care service in regard to operating room availability for emergency cases, as well as hospital case load (Table 1). Of the 88 WSES expert panel members receiving the survey, 43 (48.6%) responded. Of the respondents, 79% indicated that a dedicated acute care surgery service operates in their hospital and 71.9% activate a dedicated operating theater (1–3, 72.9%).