• Eur J Trauma Emerg Surg · Dec 2021

    Open abdomen closure methods for severe abdominal sepsis: a retrospective cohort study.

    • Gaetano Poillucci, Mauro Podda, Giulia Russo, Sergio Gaetano Perri, Domenico Ipri, Gabriele Manetti, Maria Giulia Lolli, and Renato De Angelis.
    • Department of General and Specialized Surgery "Paride Stefanini", Policlinico Universitario Umberto I, Viale del Policlinico, 155, 00161, Rome, Italy. gaetano.poillucci@gmail.com.
    • Eur J Trauma Emerg Surg. 2021 Dec 1; 47 (6): 1819-1825.

    PurposeThe open abdomen (OA) procedure as part of damage control surgery represents a significant surgical advance in severe intra-abdominal infections. Major techniques used for OA are negative pressure wound therapy (NPWT) and non-NPWT. The aim of this retrospective study is to evaluate the effects of different abdominal closure methods and their outcomes in patients presenting with abdominal sepsis treated with OA.Materials And MethodsWe retrospectively analyzed clinical outcomes of patients affected by severe intra-abdominal sepsis treated with OA. Demographic features, mortality prediction score, abdominal closure methods, length of hospital stay, complications and mortality rates of patients were determined and compared.ResultsThis study included 106 patients, of whom 77 underwent OA with NPWT and 29 with non-NPWT. OA duration was longer in NPWT patients (p = 0.007). In-hospital mortality rates in NPWT and in non-NPWT patients were 40.3% and 51.7%, respectively (p = 0.126), with an overall 30-day mortality rate of 18.2% and 51.7%, respectively (p = 0.0002). After emergency colorectal surgery, patients who underwent OA with NPWT had a lower rate of colostomy (p = 0.025).ConclusionsNPWT is the best temporary abdominal closure technique to decrease mortality and colostomy rates in patients managed with OA for severe intra-abdominal infections.© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.

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