Underlying disease determines the risk of an open abdomen treatment, final closure, however, is determined by the surgical abdominal history.
Introduction: Temporary abdominal closure is frequently used in several situations such as abbreviated surgery in damage control situations or when closing is impossible due to organ distention or increased abdominal pressure. The ultimate goal is to eventually close the fascia; however, little is k...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 47; no. 1; pp. 113 - 121 |
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| Autores principales: | , , , , , |
| Formato: | algorithm research tables/charts Journal Article |
| Publicado: |
Springer Nature
2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=148426343&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 148426343 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: 2021 vid: 47 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 148426343 148426343 148426343 10.1007/s00068-019-01205-2 148426343 ppf: 113 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Underlying disease determines the risk of an open abdomen treatment, final closure, however, is determined by the surgical abdominal history. aug: au: Karhof, Steffi Haverkort, Mark Simmermacher, Rogier Hietbrink, Falco Leenen, Luke van Wessem, Karlijn affil: Department of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands sug: subj: Open Abdomen Techniques Abdomen Surgery Disease Wound Healing Fascia Human Retrospective Design Laparotomy Univariate Statistics Multivariate Analysis Male Female Sex Factors Acidosis Postoperative Complications Male Female ab: Introduction: Temporary abdominal closure is frequently used in several situations such as abbreviated surgery in damage control situations or when closing is impossible due to organ distention or increased abdominal pressure. The ultimate goal is to eventually close the fascia; however, little is known about factors predicting abdominal closure. The purpose of this study was to identify characteristics associated with the need for open abdomen as well as indicating the possibility of delayed fascial closure after a period of open abdominal treatment. Methods: A retrospective review of all patients that underwent midline laparotomy between January 2008 and December 2012 was performed. Both factors predicting open abdominal treatment and possibility to close the fascia afterwards were identified and analyzed by univariate and multivariate analyses. Results: 775 laparotomies in 525 patients (60% male) were included. 109 patients (21%) had an open abdomen with a mortality rate of 27%. Male gender and acidosis were associated with open abdominal treatment. In 54%, the open abdomen could be closed by delayed fascial closure. The number of laparotomies both before and during temporary abdominal treatment was associated with failure of closure. Conclusion: In this study, male sex and physiological derangement, reflected by acidosis, were independent predictors of open abdominal treatment. Furthermore, the success of delayed fascial closure depends on number of abdominal surgical procedures. Moreover, based on our experiences, we suggest to change modalities early on, to prevent multiple fruitless attempts to close the abdomen. pubtype: Academic Journal doctype: algorithm research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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