Temporary abdominal wall closure in trauma patients

Indications, technique, and results

Thomas R. Howdieshell, Karen A. Yeh, Michael L. Hawkins, Jorge I. Cué

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

From 1988 to 1992 more than 5300 patients were admitted to a level I trauma center, with 36 of these patients requiring Silastic abdominal closure. Patients ages ranged from 13 to 75 years with a mean Injury Severity Score (ISS) of 30 (range 13-50). Nineteen patients (53%) suffered penetrating injuries, and 17 (47%) were victims of blunt trauma. Silastic closure was performed at admission laparotomy in 15 patients (42%) due to inability to close the fascia primarily. Twenty-one patients (58%) underwent Silastic closure at reexploration for inability to close primarily (12 patients), elevated intraabdominal pressure with deteriorating renal function (6 patients), and wound sepsis with fascial necrosis (3 patients). Twenty-six patients (72%) survived and 10 patients (28%) expired. The causes of death were multiple organ failure (9 patients) and exsanguination (1 patient). Of the 26 survivors, 8 patients (31%) underwent fascial closure at initial hospitalization, and 18 patients (69%) required split-thickness skin grafting to visceral granulation tissue. Of theses 18 patients, 13 (72%) have already undergone ventral herniorrhaphy at subsequent admission. No patient developed a complication attributable to the technique.

Original languageEnglish (US)
Pages (from-to)154-158
Number of pages5
JournalWorld Journal of Surgery
Volume19
Issue number1
DOIs
StatePublished - Jan 1 1995

Fingerprint

Abdominal Wall
Wounds and Injuries
Exsanguination
Skin Transplantation
Injury Severity Score
Multiple Organ Failure
Granulation Tissue
Trauma Centers
Herniorrhaphy
Fascia
Laparotomy

ASJC Scopus subject areas

  • Surgery

Cite this

Temporary abdominal wall closure in trauma patients : Indications, technique, and results. / Howdieshell, Thomas R.; Yeh, Karen A.; Hawkins, Michael L.; Cué, Jorge I.

In: World Journal of Surgery, Vol. 19, No. 1, 01.01.1995, p. 154-158.

Research output: Contribution to journalArticle

Howdieshell, Thomas R. ; Yeh, Karen A. ; Hawkins, Michael L. ; Cué, Jorge I. / Temporary abdominal wall closure in trauma patients : Indications, technique, and results. In: World Journal of Surgery. 1995 ; Vol. 19, No. 1. pp. 154-158.
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