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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...

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Autores principales: Hsu, Yu-Pao, Wong, Yon-Cheong, Fu, Chih-Yuan, Wang, Shang-Yu, Liao, Chien-Hung, Yang, Chun-Hsiang Ou, Yuan, Kuo-Ching
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
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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.
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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
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