MANAGEMENT AND OUTCOMES OF TRAUMA PATIENTS TREATED WITH OPEN ABDOMEN IN A TERTIARY HOSPITAL IN BRAZIL

Global Wound Care Congress

September 12-13, 2016 San Antonio, USA

Carlos Menegozzo, Adilson Costa Rodrigues, Pedro Henrique Ferreira Alves and Edivaldo Masazo Utiyama

Sao Paulo University School of Medicine, Brazil

Posters & Accepted Abstracts: J Nurs Care

Abstract :

Severely injured patients often require damage control surgery and open abdomen. The Lethal Triad is a frequent and is associated with worse prognosis. Therefore, morbidity and mortality are high. We analyze data in a one-year period, and discuss factors associated with poor outcome and fascial closure. Patients admitted who underwent damage control surgery and open abdomen were enrolled. Patients (27) underwent damage control with open abdomen during one year. Most of them were male (85%) and the mean age was 31 years. Seventeen (63%) were involved in a blunt trauma and motor vehicle accidents were the most common mechanism (53%). Of the penetrating trauma cases, gunshot wound (60%) was more frequent than knife injuries. Mean ISS was 27. Mean lactate and base excess at admission were 66 and -9.7, respectively. Mean fibrinogen and INR were 149 and 1.9, respectively. Average of ICU days and in-hospital length of stay were 17 and 29 days, respectively. Sixteen patients (60%) successfully underwent primary fascial closure, eight of them in the first reoperation. Two patients had skin closure only. Twenty-four (89%) patients sustained 56 different complications, the most common being renal insufficiency, followed by intestinal fistulae, wound infection and intrabdominal abscess. Thirteen patients (48%) died, four of them (30%) during the first 48h. Damage control surgery is mostly employed in severe physically stressed patients. They are often acidotic, coagulopathic and hypothermic on admission, and demonstrate a high ISS. Mortality and morbidity are both high. Primary fascial closure is difficult, but feasible.

Biography :

Email: carlosmenegozzo@gmail.com