American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Clinical Updates

ACS Strengthens Its Emergency General Surgery Guidelines for Appendicitis Treatment during COVID-19

The ACS COVID-19 Guidelines for Triage of Emergency General Surgery Patients has updated the Appendicitis, Uncomplicated section to include the following:

"There is high-quality evidence that most patients with appendicitis can be managed with antibiotics instead of appendectomy (69 percent overall avoid appendectomy by 90 days, 75 percent of those without appendicolith and 59 percent of those with appendicolith). Based on the surgeon's judgment, patient preferences and local resources (e.g., hospital staff, bed and PPE supply availability), antibiotics are an acceptable first-line treatment, with appendectomy offered for those with worsening or recurrent symptoms. Length of time in the hospital setting was similar between treatments, but nearly half of patients receiving antibiotics were not admitted to the hospital. Antibiotics resulted in more 90-day emergency room visits and hospitalizations. Antibiotics were associated with a higher risk of complications in those with an appendicolith." Access the complete Emergency General Surgery guidelines.

Intimate Partner Violence Increases by 15 Million Cases Worldwide Every Three Months of Quarantine

An Update from the ACS Oral and Maxillofacial Surgery Advisory Council

COVID-19 pandemic restrictive measures, such as financial struggles, closure of schools and childcare facilities, and reduced access to shelters, have increased the incidence of intimate partner violence (IPV). IPV is defined as physical, sexual or psychological harm by a current or former partner or spouse. Prior to the pandemic, one in four women and one in 10 men experienced IPV, and 6.9 percent of women and 1.6 percent of men required medical care for IPV-related injuries. Studies have shown that 40–80 percent of victims experience facial injuries. Estimates from the United Nations Population Fund predict IPV incidence will increase by 15 million cases worldwide every three months of quarantine. With the second wave of COVID-19 cases occurring, it is essential to recognize and detect IPV through facial injuries.

For more resources about IPV and to read the ACS Statement on Intimate Partner Violence, visit the Intimate Partner Violence section.