Analysis for Patient Survival after Open Abdomen for Torso Trauma and the Impact of Achieving Primary Fascial Closure: A Single-Center Experience /692/699/578 /692/308/409 article

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

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Article number6213
JournalScientific Reports
Volume8
Issue number1
DOIs
Publication statusPublished - Dec 1 2018

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Torso
Survival Analysis
Abdomen
Fascia
Wounds and Injuries
Organ Dysfunction Scores
Negative-Pressure Wound Therapy
Physiological Stress
Injury Severity Score
Laparotomy
Shock
Patient Care
Odds Ratio
Observation
Urine
Confidence Intervals
Hemorrhage
Survival

ASJC Scopus subject areas

  • General

Cite this

Analysis for Patient Survival after Open Abdomen for Torso Trauma and the Impact of Achieving Primary Fascial Closure : A Single-Center Experience /692/699/578 /692/308/409 article. / Hsu, Yu Pao; Wong, Yon Cheong; Fu, Chih Yuan; Wang, Shang Yu; Liao, Chien Hung; Yang, Chun Hsiang Ou; Yuan, Kuo Ching.

In: Scientific Reports, Vol. 8, No. 1, 6213, 01.12.2018.

Research output: Contribution to journalArticle

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