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Article
Skin Only or Silo Closure in the Critically Ill Patient with an Open Abdomen
The American Journal of Surgery
  • Lorraine N. Tremblay
  • David V. Feliciano
  • Julie Schmidt
  • Raymond A. Cava
  • Kathryn M. Tchorz, Wright State University
  • Walter L. Ingram
  • Jeffrey P. Salomone
  • Jeffrey M. Nicholas
  • Grace S. Rozycki
Document Type
Article
Publication Date
12-1-2001
Abstract
Background: The morbidity and mortality of various open abdominal techniques remains unclear. Methods: A retrospective review was made of all trauma or general surgery patients who underwent an open abdominal closure from January 1997 to December 2000, at a large urban acute care hospital. Data are mean ± SD. Results: From 1997 to 2000, 181 patients (aged 39.8 ± 16.5 years) had an open abdomen for abdominal infection, planned reexploration, abdominal compartment syndrome, inability to reapproximate fascia, or as part of a “damage control” procedure. Twenty-three patients went on to develop an abdominal compartment syndrome. Gastrointestinal fistulas occurred in 26 patients, and 9 patients had a dehiscence. The overall mortality was 44.7%. Of the survivors, 52% went on to fascial closure, requiring 1 to 7 additional abdominal operations. Conclusions: The morbidity of the open abdomen varies with the particular indication. Gastrointestinal fistulas are the most common acute complication and an abdominal wall hernia, the most common chronic complication.
Comments

This article was presented at the 53rd Annual Meeting of the Southwestern Surgical Congress, Cancun, Mexico, April 29-May 2, 2001.

DOI
10.1016/S0002-9610(01)00805-4
Citation Information
Lorraine N. Tremblay, David V. Feliciano, Julie Schmidt, Raymond A. Cava, et al.. "Skin Only or Silo Closure in the Critically Ill Patient with an Open Abdomen" The American Journal of Surgery Vol. 182 Iss. 6 (2001) p. 670 - 675 ISSN: 0002-9610
Available at: http://works.bepress.com/kathryn_tchorz/21/