Long-term consequences of open abdomen management

Richard c. Frazee, Stephen Abernathy, Daniel Jupiter, Matthew Davis, Justin Regner, Travis Isbell, Randall Smith

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

There is little data on the long-term results of the open abdomen technique regarding subsequent bowel obstruction, enterocutaneous fistula and ventral hernia rates. This study represents our follow-up of these complications. A retrospective review of patients undergoing open abdomen management was performed. Patient demographics and development of subsequent ventral hernia, enteric fistula and/or bowel obstruction were evaluated. Seventy-three men and 47 women with a mean age of 51 underwent open abdomen management; 85 for inflammatory conditions and 35 for haemorrhagic conditions. Only 27 patients did not achieve definitive fascial closure and were left open for secondary closure or had a biologic mesh bridge; 13 patients had component separation to achieve fascial closure. With a mean follow-up of 21 months, 30 patients (25%) developed a ventral hernia, 13 patients (11%) experienced an enterocutaneous fistula and two patients developed bowel obstruction. Ventral hernias and enterocutaneous fistulae occurred in 78% and 41%, respectively, of patients not definitively closed compared with 10% and 2%, respectively, of patients closed primarily at initial management (p < 0.05). There is a high incidence of ventral hernia and enterocutaneous fistula when open abdomen management necessitates leaving the abdomen open or using a biologic mesh bridge. Strategies for primary fascia closure including component separation should be employed.

Original languageEnglish (US)
Pages (from-to)37-40
Number of pages4
JournalTrauma
Volume16
Issue number1
DOIs
StatePublished - Jan 2014
Externally publishedYes

Keywords

  • Open abdomen management
  • bowel obstruction
  • enterocutaneous fistula
  • fascial closure
  • ventral hernia rates

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

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  • Cite this

    Frazee, R. C., Abernathy, S., Jupiter, D., Davis, M., Regner, J., Isbell, T., & Smith, R. (2014). Long-term consequences of open abdomen management. Trauma, 16(1), 37-40. https://doi.org/10.1177/1460408613507686