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

4 Citations (Scopus)

Abstract

Background: 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. Methods: 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. Results: 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). Conclusions: 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 (United Kingdom)
Volume16
Issue number1
DOIs
StatePublished - Jan 2014
Externally publishedYes

Fingerprint

Abdomen
Ventral Hernia
Intestinal Fistula
Fascia
Fistula
Demography
Incidence

Keywords

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

ASJC Scopus subject areas

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

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 (United Kingdom), 16(1), 37-40. https://doi.org/10.1177/1460408613507686

Long-term consequences of open abdomen management. / Frazee, Richard C.; Abernathy, Stephen; Jupiter, Daniel; Davis, Matthew; Regner, Justin; Isbell, Travis; Smith, Randall.

In: Trauma (United Kingdom), Vol. 16, No. 1, 01.2014, p. 37-40.

Research output: Contribution to journalArticle

Frazee, RC, Abernathy, S, Jupiter, D, Davis, M, Regner, J, Isbell, T & Smith, R 2014, 'Long-term consequences of open abdomen management', Trauma (United Kingdom), vol. 16, no. 1, pp. 37-40. https://doi.org/10.1177/1460408613507686
Frazee RC, Abernathy S, Jupiter D, Davis M, Regner J, Isbell T et al. Long-term consequences of open abdomen management. Trauma (United Kingdom). 2014 Jan;16(1):37-40. https://doi.org/10.1177/1460408613507686
Frazee, Richard C. ; Abernathy, Stephen ; Jupiter, Daniel ; Davis, Matthew ; Regner, Justin ; Isbell, Travis ; Smith, Randall. / Long-term consequences of open abdomen management. In: Trauma (United Kingdom). 2014 ; Vol. 16, No. 1. pp. 37-40.
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