Open management of the posttraumatic septic abdomen

Thirteen patients with abdominal trauma who developed abdominal sepsis resistant to conventional methods of reexploration and drainage were managed by an open method. Eleven of these patients had multiorgan failure. The extent of anatomic and physiologic injury was defined by Abdominal Trauma Index...

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Bibliographic Details
Published inThe American surgeon Vol. 56; no. 9; p. 548
Main Authors Ivatury, R R, Nallathambi, M, Rohman, M, Stahl, W M
Format Journal Article
LanguageEnglish
Published United States 01.09.1990
Subjects
Abdominal Injuries - complications
Abdominal Injuries - mortality
Abdominal Injuries - therapy
Adult
Bacterial Infections - complications
Bacterial Infections - mortality
Bacterial Infections - therapy
Bandages
Female
Humans
Male
Methods
Middle Aged
Survival Rate
Trauma Severity Indices
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Summary:Thirteen patients with abdominal trauma who developed abdominal sepsis resistant to conventional methods of reexploration and drainage were managed by an open method. Eleven of these patients had multiorgan failure. The extent of anatomic and physiologic injury was defined by Abdominal Trauma Index and Acute Physiology and Chronic Health Evaluation (APACHE) scores, respectively. Ten of the 13 patients (76.9%) survived, a significantly improved survival as compared with that predicted by APACHE (50%). Complications attributable to the open technique (enteric fistula and a subphrenic abscess) occurred in two of the ten survivors. It is concluded that the open method of management of abdominal sepsis is effective and feasible. It should be considered in patients with necrotizing wound infections, multiorgan failure, and ongoing abdominal sepsis uncontrolled by conventional methods. Larger, controlled series employing such systems as the APACHE are needed for a better definition of patient selection for the open method.
ISSN:0003-1348