TY - JOUR
T1 - Outcomes of primary fascial closure after open abdomen for nontrauma emergency general surgery patients
AU - O'Meara, Lindsay
AU - Ahmad, Sarwat B.
AU - Glaser, Jacob
AU - Diaz, Jose J.
AU - Bruns, Brandon R.
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background Emergency general surgery patients are increasingly being managed with an open abdomen (OA). Factors associated with complications after primary fascial closure (PFC) are unknown. Methods Demographic and operative variables for all emergency general surgery patients managed with OA at an academic medical center were prospectively examined from June to December 2013. Primary outcome was complication requiring reoperation. Results Of 58 patients, 37 managed with OA achieved PFC. Of these, 14 needed re-exploration for dehiscence, compartment syndrome, infection, or other. Complications after PFC were not associated with age, type of operative intervention, time to closure, re-explorations, comorbidities, or mortality. Complications correlated with higher body mass index (P =.02), skin closure (P =.04), plasma infusion (P =.01), and less intraoperative bleeding (P =.05). Deep surgical site infection correlated with fascial dehiscence (P =.02). Conclusions Reoperation after PFC was more likely in obese and nonhemorrhagic patients. Recognition of these factors and strategies to reduce surgical site infection may improve outcomes.
AB - Background Emergency general surgery patients are increasingly being managed with an open abdomen (OA). Factors associated with complications after primary fascial closure (PFC) are unknown. Methods Demographic and operative variables for all emergency general surgery patients managed with OA at an academic medical center were prospectively examined from June to December 2013. Primary outcome was complication requiring reoperation. Results Of 58 patients, 37 managed with OA achieved PFC. Of these, 14 needed re-exploration for dehiscence, compartment syndrome, infection, or other. Complications after PFC were not associated with age, type of operative intervention, time to closure, re-explorations, comorbidities, or mortality. Complications correlated with higher body mass index (P =.02), skin closure (P =.04), plasma infusion (P =.01), and less intraoperative bleeding (P =.05). Deep surgical site infection correlated with fascial dehiscence (P =.02). Conclusions Reoperation after PFC was more likely in obese and nonhemorrhagic patients. Recognition of these factors and strategies to reduce surgical site infection may improve outcomes.
KW - Fascial complication
KW - Open abdomen
KW - Surgical site infection
UR - http://www.scopus.com/inward/record.url?scp=84955693585&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84955693585&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2015.06.030
DO - 10.1016/j.amjsurg.2015.06.030
M3 - Article
C2 - 26520871
AN - SCOPUS:84955693585
SN - 0002-9610
VL - 210
SP - 1126
EP - 1131
JO - American journal of surgery
JF - American journal of surgery
IS - 6
ER -