An experience in the management of the open abdomen in severely injured burn patients

Mark O. Hardin, James E. Mace, John D. Ritchie, Kevin K. Chung, Katharine W. Markell, Evan M. Renz, Steven Wolf, Lorne H. Blackbourne, Christopher E. White

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Few descriptions of temporary abdominal closure for planned relaparotomy have been reported in burned patients. The purpose of this study is to describe our experience and outcomes in the management of burned patients with an open abdomen. The authors performed a retrospective review of all admissions to our burn center from March 2003 to June 2008, identifying patients treated by laparotomy with temporary abdominal closure. The authors collected data on patient demographics, indication for laparotomy, methods of temporary and definitive abdominal closure, and outcomes. Of 2,104 patients admitted, 38 underwent a laparotomy with temporary abdominal closure. Their median TBSA was 55%, and the incidence of inhalation injury was 58%. Abdominal compartment syndrome was the most common indication for laparotomy (82%) followed by abdominal trauma (16%). The in-hospital mortality associated with an open abdomen was 68%. Temporary abdominal closure was performed most commonly using negative pressure wound therapy (90%). Fascial closure was performed in 21 patients but was associated with a 38% rate of failure requiring reexploration. Of 12 survivors, fascial closure was achieved in seven patients and five were managed with a planned ventral hernia. Burned patients who necessitate an open abdomen management strategy have a high morbidity and mortality. Fascial closure was associated with a high rate of failure but was successful in a select group of patients. Definitive abdominal closure with a planned ventral hernia was associated with no increased mortality and remains an option when "tension-free" fascial closure cannot be achieved. (J Burn Care Res 2012;33:491-496).

Original languageEnglish (US)
Pages (from-to)491-496
Number of pages6
JournalJournal of Burn Care and Research
Volume33
Issue number4
DOIs
StatePublished - Jul 1 2012
Externally publishedYes

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Abdomen
Laparotomy
Ventral Hernia
Intra-Abdominal Hypertension
Negative-Pressure Wound Therapy
Burn Units
Mortality
Wounds and Injuries
Hospital Mortality
Inhalation
Survivors
Demography
Morbidity
Incidence

ASJC Scopus subject areas

  • Emergency Medicine
  • Rehabilitation
  • Surgery

Cite this

Hardin, M. O., Mace, J. E., Ritchie, J. D., Chung, K. K., Markell, K. W., Renz, E. M., ... White, C. E. (2012). An experience in the management of the open abdomen in severely injured burn patients. Journal of Burn Care and Research, 33(4), 491-496. https://doi.org/10.1097/BCR.0b013e3182479b00

An experience in the management of the open abdomen in severely injured burn patients. / Hardin, Mark O.; Mace, James E.; Ritchie, John D.; Chung, Kevin K.; Markell, Katharine W.; Renz, Evan M.; Wolf, Steven; Blackbourne, Lorne H.; White, Christopher E.

In: Journal of Burn Care and Research, Vol. 33, No. 4, 01.07.2012, p. 491-496.

Research output: Contribution to journalArticle

Hardin, MO, Mace, JE, Ritchie, JD, Chung, KK, Markell, KW, Renz, EM, Wolf, S, Blackbourne, LH & White, CE 2012, 'An experience in the management of the open abdomen in severely injured burn patients', Journal of Burn Care and Research, vol. 33, no. 4, pp. 491-496. https://doi.org/10.1097/BCR.0b013e3182479b00
Hardin, Mark O. ; Mace, James E. ; Ritchie, John D. ; Chung, Kevin K. ; Markell, Katharine W. ; Renz, Evan M. ; Wolf, Steven ; Blackbourne, Lorne H. ; White, Christopher E. / An experience in the management of the open abdomen in severely injured burn patients. In: Journal of Burn Care and Research. 2012 ; Vol. 33, No. 4. pp. 491-496.
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