IROA: International Register of Open Abdomen, preliminary results

Federico Coccolini, Giulia Montori, Marco Ceresoli, Fausto Catena, Rao Ivatury, Michael Sugrue, Massimo Sartelli, Paola Fugazzola, Davide Corbella, Francesco Salvetti, Ionut Negoi, Monica Zese, Savino Occhionorelli, Stefano Maccatrozzo, Sergei Shlyapnikov, Christian Galatioto, Massimo Chiarugi, Zaza Demetrashvili, Daniele Dondossola, Yovcho YovtchevOrestis Ioannidis, Giuseppe Novelli, Mirco Nacoti, Desmond Khor, Kenji Inaba, Demetrios Demetriades, Torsten Kaussen, Asri Che Jusoh, Wagih Ghannam, Boris Sakakushev, Ohad Guetta, Agron Dogjani, Stefano Costa, Sandeep Singh, Dimitrios Damaskos, Arda Isik, Kuo Ching Yuan, Francesco Trotta, Stefano Rausei, Aleix Martinez-Perez, Giovanni Bellanova, Vinicius Cordeiro Fonseca, Fernando Hernández, Athanasios Marinis, Wellington Fernandes, Martha Quiodettis, Miklosh Bala, Andras Vereczkei, Rafael L. Curado, Gustavo Pereira Fraga, Bruno M. Pereira, Mahir Gachabayov, Guillermo Perez Chagerben, Miguel Leon Arellano, Sefa Ozyazici, Gianluca Costa, Tugan Tezcaner, Luca Ansaloni

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: No definitive data about open abdomen (OA) epidemiology and outcomes exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) promoted the International Register of Open Abdomen (IROA). Methods: A prospective observational cohort study including patients with an OA treatment. Data were recorded on a web platform (Clinical Registers®) through a dedicated website: www.clinicalregisters.org. Results: Four hundred two patients enrolled. Adult patients: 369 patients; Mean age: 57.39±18.37; 56% male; Mean BMI: 36±5.6. OA indication: Peritonitis (48.7%), Trauma (20.5%), Vascular Emergencies/Hemorrhage (9.4%), Ischemia (9.1%), Pancreatitis (4.2%),Post-operative abdominal-compartment-syndrome (3.9%), Others (4.2%). The most adopted Temporary-abdominal-closure systems were the commercial negative pressure ones (44.2%). During OA 38% of patients had complications; among them 10.5% had fistula. Definitive closure: 82.8%; Mortality during treatment: 17.2%. Mean duration of OA: 5.39(±4.83) days; Mean number of dressing changes: 0.88(±0.88). After-closure complications: (49.5%) and Mortality: (9%). No significant associations among TACT, indications, mortality, complications and fistula. A linear correlationexists between days of OA and complications (Pearson linear correlation = 0.326 p<0.0001) and with the fistula development (Pearson = 0.146 p= 0.016). Pediatric patients: 33 patients. Mean age: 5.91±(3.68) years; 60% male. Mortality: 3.4%; Complications: 44.8%; Fistula: 3.4%. Mean duration of OA: 3.22(±3.09) days. Conclusion: Temporary abdominal closure is reliable and safe. The different techniques account for different results according to the different indications. In peritonitis commercial negative pressure temporary closure seems to improve results. In trauma skin-closure and Bogotà-bag seem to improve results. Trial registration: ClinicalTrials.gov NCT02382770

Original languageEnglish
Article number10
JournalWorld Journal of Emergency Surgery
Volume12
Issue number1
DOIs
Publication statusPublished - Feb 21 2017
Externally publishedYes

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Keywords

  • Barker
  • Bogotà bag
  • Commercial
  • Compartment
  • IROA
  • Ischemia
  • Negative pressure
  • Non-commercial
  • Open abdomen
  • Peritonitis
  • Register
  • Skin
  • Trauma
  • Vascular emergencies
  • Witmann

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine

Cite this

Coccolini, F., Montori, G., Ceresoli, M., Catena, F., Ivatury, R., Sugrue, M., Sartelli, M., Fugazzola, P., Corbella, D., Salvetti, F., Negoi, I., Zese, M., Occhionorelli, S., Maccatrozzo, S., Shlyapnikov, S., Galatioto, C., Chiarugi, M., Demetrashvili, Z., Dondossola, D., ... Ansaloni, L. (2017). IROA: International Register of Open Abdomen, preliminary results. World Journal of Emergency Surgery, 12(1), [10]. https://doi.org/10.1186/s13017-017-0123-8