Outcomes of primary fascial closure after open abdomen for nontrauma emergency general surgery patients

Lindsay O'Meara, Sarwat B. Ahmad, Jacob Glaser, Jose J. Diaz, Brandon R. Bruns

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1126-1131
Number of pages6
JournalAmerican journal of surgery
Volume210
Issue number6
DOIs
StatePublished - Dec 1 2015
Externally publishedYes

Keywords

  • Fascial complication
  • Open abdomen
  • Surgical site infection

ASJC Scopus subject areas

  • Surgery

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