Cargando…
Analysis for Patient Survival after Open Abdomen for Torso Trauma and the Impact of Achieving Primary Fascial Closure: A Single-Center Experience
Open abdomen indicates the abdominal fascia is unclosed to abbreviate surgery and to reduce physiological stress. However, complications and difficulties in patient care are often encountered after operation. During May 2008 to March 2013, we performed a prospective protocol-directed observation stu...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5906612/ https://www.ncbi.nlm.nih.gov/pubmed/29670226 http://dx.doi.org/10.1038/s41598-018-24482-0 |
_version_ | 1783315408418242560 |
---|---|
author | Hsu, Yu-Pao Wong, Yon-Cheong Fu, Chih-Yuan Wang, Shang-Yu Liao, Chien-Hung Yang, Chun-Hsiang Ou Yuan, Kuo-Ching |
author_facet | Hsu, Yu-Pao Wong, Yon-Cheong Fu, Chih-Yuan Wang, Shang-Yu Liao, Chien-Hung Yang, Chun-Hsiang Ou Yuan, Kuo-Ching |
author_sort | Hsu, Yu-Pao |
collection | PubMed |
description | Open abdomen indicates the abdominal fascia is unclosed to abbreviate surgery and to reduce physiological stress. However, complications and difficulties in patient care are often encountered after operation. During May 2008 to March 2013, we performed a prospective protocol-directed observation study regarding open abdomen use in trauma patients. Bogota bag is the temporary abdomen closure initially but negative pressure dressing is used later. A goal-directed ICU care is applied and primary fascial closure is the primary endpoint. There were 242 patients received laparotomy after torso trauma and 84 (34.7%) had open abdomen. Twenty patients soon died within one day and were excluded. Among the included 64 patients, there were 49 (76.6%) males and the mean Injury Severity Score was 31.7. Uncontrolled bleeding was the major indication for open abdomen (64.1%) and the average duration of open abdomen was about 4.2 ± 2.2 days. After treatment, 53(82.8%) had primary fascia closure, which is significant for patient survival (odds ratio 21.6; 95% confidence interval: 3.27–142, p = 0.0014). Factors related to failed primary fascia closure are profound shock during operation, high Sequential Organ Failure Assessment Score in ICU and inadequate urine amount at first 48 hours admission. |
format | Online Article Text |
id | pubmed-5906612 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-59066122018-04-30 Analysis for Patient Survival after Open Abdomen for Torso Trauma and the Impact of Achieving Primary Fascial Closure: A Single-Center Experience Hsu, Yu-Pao Wong, Yon-Cheong Fu, Chih-Yuan Wang, Shang-Yu Liao, Chien-Hung Yang, Chun-Hsiang Ou Yuan, Kuo-Ching Sci Rep Article Open abdomen indicates the abdominal fascia is unclosed to abbreviate surgery and to reduce physiological stress. However, complications and difficulties in patient care are often encountered after operation. During May 2008 to March 2013, we performed a prospective protocol-directed observation study regarding open abdomen use in trauma patients. Bogota bag is the temporary abdomen closure initially but negative pressure dressing is used later. A goal-directed ICU care is applied and primary fascial closure is the primary endpoint. There were 242 patients received laparotomy after torso trauma and 84 (34.7%) had open abdomen. Twenty patients soon died within one day and were excluded. Among the included 64 patients, there were 49 (76.6%) males and the mean Injury Severity Score was 31.7. Uncontrolled bleeding was the major indication for open abdomen (64.1%) and the average duration of open abdomen was about 4.2 ± 2.2 days. After treatment, 53(82.8%) had primary fascia closure, which is significant for patient survival (odds ratio 21.6; 95% confidence interval: 3.27–142, p = 0.0014). Factors related to failed primary fascia closure are profound shock during operation, high Sequential Organ Failure Assessment Score in ICU and inadequate urine amount at first 48 hours admission. Nature Publishing Group UK 2018-04-18 /pmc/articles/PMC5906612/ /pubmed/29670226 http://dx.doi.org/10.1038/s41598-018-24482-0 Text en © The Author(s) 2018 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Hsu, Yu-Pao Wong, Yon-Cheong Fu, Chih-Yuan Wang, Shang-Yu Liao, Chien-Hung Yang, Chun-Hsiang Ou Yuan, Kuo-Ching Analysis for Patient Survival after Open Abdomen for Torso Trauma and the Impact of Achieving Primary Fascial Closure: A Single-Center Experience |
title | Analysis for Patient Survival after Open Abdomen for Torso Trauma and the Impact of Achieving Primary Fascial Closure: A Single-Center Experience |
title_full | Analysis for Patient Survival after Open Abdomen for Torso Trauma and the Impact of Achieving Primary Fascial Closure: A Single-Center Experience |
title_fullStr | Analysis for Patient Survival after Open Abdomen for Torso Trauma and the Impact of Achieving Primary Fascial Closure: A Single-Center Experience |
title_full_unstemmed | Analysis for Patient Survival after Open Abdomen for Torso Trauma and the Impact of Achieving Primary Fascial Closure: A Single-Center Experience |
title_short | Analysis for Patient Survival after Open Abdomen for Torso Trauma and the Impact of Achieving Primary Fascial Closure: A Single-Center Experience |
title_sort | analysis for patient survival after open abdomen for torso trauma and the impact of achieving primary fascial closure: a single-center experience |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5906612/ https://www.ncbi.nlm.nih.gov/pubmed/29670226 http://dx.doi.org/10.1038/s41598-018-24482-0 |
work_keys_str_mv | AT hsuyupao analysisforpatientsurvivalafteropenabdomenfortorsotraumaandtheimpactofachievingprimaryfascialclosureasinglecenterexperience AT wongyoncheong analysisforpatientsurvivalafteropenabdomenfortorsotraumaandtheimpactofachievingprimaryfascialclosureasinglecenterexperience AT fuchihyuan analysisforpatientsurvivalafteropenabdomenfortorsotraumaandtheimpactofachievingprimaryfascialclosureasinglecenterexperience AT wangshangyu analysisforpatientsurvivalafteropenabdomenfortorsotraumaandtheimpactofachievingprimaryfascialclosureasinglecenterexperience AT liaochienhung analysisforpatientsurvivalafteropenabdomenfortorsotraumaandtheimpactofachievingprimaryfascialclosureasinglecenterexperience AT yangchunhsiangou analysisforpatientsurvivalafteropenabdomenfortorsotraumaandtheimpactofachievingprimaryfascialclosureasinglecenterexperience AT yuankuoching analysisforpatientsurvivalafteropenabdomenfortorsotraumaandtheimpactofachievingprimaryfascialclosureasinglecenterexperience |