Background: Open abdomen (OA) treatment in patients with peritonitis is increasing worldwide. Various temporary abdominal closure devices are being used. This study included patients with complicated diffuse secondary peritonitis, OA, and vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM). The aim of this study was to describe mortality and major morbidity in terms of delayed primary fascial closure (DPFC) and enteroatmospheric fistula rates. Methods: This was a single academic center retrospective study of consecutive patients with diffuse peritonitis, OA, and VAWCM between years 2008-2016. Descriptive and univariate analyses were performed. Results: Forty-one patients were identified and analyzed. Median age was 59 years, preoperative septic shock was diagnosed in 54 % (n=22), and 59 % (n=24) had a postoperative peritonitis. Mortality was 29 % (n=12) and in to the ICU were admitted 76 % (n=31) of patients. The median duration of OA was seven days with a median of two dressing changes. DPFC rate among survivors was 92 % (n=33) and EAF[spacing acute]s developed in 7 % (n=3). In a subgroup analysis patients with OA in the primary laparotomy for peritonitis (n=27) were compared to patients with OA in the subsequent laparotomies (n=14). There were no significant differences between groups. Conclusions: VAWCM in patients with complicated secondary diffuse peritonitis and OA yields excellent results in terms of delayed primary fascial closure rate and a low number of enteroatmospheric fistulae. It seems to be safe to close the abdomen at the index laparotomy, if possible, even if there is a risk for a need of OA later. Level of evidence: Observational study, level III (C) 2017 Lippincott Williams & Wilkins, Inc.
from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2nP6LJb
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Publication date: Available online 7 July 2018 Source: The Journal of Emergency Medicine Author(s): Audrey Uong, Ariel Brandwein, Colin C...
-
Oral Candida colonization in xerostomic post‐radiotherapy head and neck cancer patients 16h ... Oral Candida colonization in xerostomic post...
-
Abstract Malignant brain tumors are rapidly progressive and often fatal owing to resistance to therapies and based on their complex biolog...
-
Abstract Background Bone flap resorption (BFR) is the most prevalent complication resulting in autologous cranioplasty failure, but no c...
-
Injury from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/1ULgTKC
-
Abstract Objectives Tumor invasion into blood and/or lymphatic vessels, perineural invasion, and histopathological grading are evaluated...
-
Objectives: Pantoprazole is frequently administered to critically ill patients for prophylaxis against gastrointestinal bleeding. However, ...
-
Abstract Non-tumoral portal vein thrombosis (PVT) remains a highly relevant topic in the field of hepatology and liver transplantation wit...
-
Abstract Many methods exist for generating keyframe summaries of videos. However, relatively few methods consider on-line summarisation, w...
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου