Publication date: Available online 24 September 2018
Source: Injury
Author(s): Federico Coccolini, Marco Ceresoli, Yoram Kluger, Andrew Kirkpatrick, Giulia Montori, Fracensco Salvetti, Paola Fugazzola, Matteo Tomasoni, Massimo Sartelli, Luca Ansaloni, Fausto Catena, Ionut Negoi, Monica Zese, Savino Occhionorelli, Sergei Shlyapnikov, Christian Galatioto, Massimo Chiarugi, Zaza Demetrashvili, Daniele Dondossola, Orestis Ioannidis
ABSTRACT
Introduction
No definitive data describing associations between cases of Open Abdomen (OA) and Entero-atmospheric fistulae (EAF) exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) thus analyzed the International Register of Open Abdomen (IROA) to assess this question.
Material and Methods
A prospective analysis of adult patients enrolled in the IROA.
Results
Among 649 adult patients with OA 58 (8.9%) developed EAF. Indications for OA were peritonitis (51.2%) and traumatic-injury (16.8%). The most frequently utilized temporary abdominal closure techniques were Commercial-NPWT (46.8%) and Bogotà-bag (21.9%). Mean OA days were 7.9 ± 18.22. Overall mortality rate was 29.7%, with EAF having no impact on mortality. Multivariate analysis associated cancer (p = 0.018), days of OA (p = 0.003) and time to provision-of-nutrition (p = 0.016) with EAF occurrence.
Conclusion
Entero-atmospheric fistulas are influenced by the duration of open abdomen treatment and by the nutritional status of the patient. Peritonitis, intestinal anastomosis, negative pressure and oral or enteral nutrition were not risk factors for EAF during OA treatment.
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