Display options
Cite
Yetisir F, Sarer AE, Acar HZ, et al. Delayed Closure of 61 Open Abdomen Patients Based on an Algorithm. Indian J Surg. 2015;79(1):38-44doi: 10.1007/s12262-015-1422-5.
Yetisir, F., Sarer, A. E., Acar, H. Z., & Aygar, M. (2017). Delayed Closure of 61 Open Abdomen Patients Based on an Algorithm. The Indian journal of surgery, 79(1), 38-44. https://doi.org/10.1007/s12262-015-1422-5
Yetisir, Fahri, et al. "Delayed Closure of 61 Open Abdomen Patients Based on an Algorithm." The Indian journal of surgery vol. 79,1 (2017): 38-44. doi: https://doi.org/10.1007/s12262-015-1422-5
Yetisir F, Sarer AE, Acar HZ, Aygar M. Delayed Closure of 61 Open Abdomen Patients Based on an Algorithm. Indian J Surg. 2017 Feb;79(1):38-44. doi: 10.1007/s12262-015-1422-5. Epub 2015 Dec 23. PMID: 28331265; PMCID: PMC5346081.
Copy Download .nbib Format: NLM
Share it on

Indian J Surg. 2017 Feb;79(1):38-44. doi: 10.1007/s12262-015-1422-5. Epub 2015 Dec 23.

Delayed Closure of 61 Open Abdomen Patients Based on an Algorithm.

The Indian journal of surgery

Fahri Yetisir, A Ebru Sarer, Hasan Zafer Acar, Muhittin Aygar

Affiliations

  1. General Surgery Department, Atatürk Research and Training Hospital, Ankara, Turkey.
  2. Anesthesiology and Reanimation Department, Atatürk Research and Training Hospital, Ankara, Turkey.
  3. Natomed Private Hospital General Surgery Department, Ankara, Turkey.

PMID: 28331265 PMCID: PMC5346081 DOI: 10.1007/s12262-015-1422-5

Abstract

Hemodynamic resuscitation, source control, and delayed abdominal closure are the three fundamental steps for open abdomen (OA) management. When to start delayed abdominal closure and how to determine which delayed closure method should be applied to each OA patient are not clarified in the literature. We evaluated an algorithm that was developed to address these two questions. A retrospective chart review was conducted for OA patients treated for according to the algorithm. When hemodynamic stabilization and source control using negative pressure therapy resulted in regression of sepsis and decreased procalcitonin levels, patients were assigned to either the skin-only or fascial closure groups according to their Björck scores and open abdominal fascial closure (OAFC) scores. The novel OAFC scoring system was created by adding age and malignancy to the sequential organ failure assessment (SOFA) score. For skin-only closure, skin flaps and skin grafts were used; for fascial closure, an abdominal re-approximation anchor system (ABRA) or ABRA plus biologic mesh was applied. From January 2008 through September 2014, 108 OA patients were managed based on the algorithm; 61 were included in this study. Abdominal closure rate was 90.2 % (55/61). Overall hospital mortality rate was 11.4 % (7/61). Small hernias developed in only 12.5 % (4/32) of the fascial closure group. In this retrospective study, the algorithm with the novel OAFC score provided practical and valid guidance to clarify when to start delayed abdominal closure and which delayed closure method to use for each OA patient.

Keywords: ABRA; Björck score; Delayed abdominal closure; Open abdomen; SOFA score; VAC therapy

References

  1. World J Surg. 2012 Mar;36(3):497-510 - PubMed
  2. J Am Coll Surg. 2007 Oct;205(4):586-92 - PubMed
  3. Scand J Surg. 2007;96(4):263-71 - PubMed
  4. Intensive Care Med. 1999 Jul;25(7):686-96 - PubMed
  5. Int J Surg Case Rep. 2014;5(7):385-8 - PubMed
  6. Crit Care. 2008;12(6):R161 - PubMed
  7. Scand J Surg. 2013;102(2):61-8 - PubMed
  8. Br J Surg. 2011 May;98 (5):735-43 - PubMed
  9. Crit Care Med. 2009 May;37(5):1649-54 - PubMed
  10. Shock. 2010 Nov;34(5):525-34 - PubMed
  11. World J Surg. 2011 Oct;35(10):2348-55 - PubMed
  12. Eur J Vasc Endovasc Surg. 2014 Mar;47(3):279-87 - PubMed
  13. Am Surg. 2004 Jul;70(7):652-6 - PubMed
  14. Int J Surg Case Rep. 2014;5(3):164-8 - PubMed
  15. Hernia. 2014 Feb;18(1):99-104 - PubMed
  16. World J Surg. 2009 Feb;33(2):199-207 - PubMed
  17. Ann Surg. 2008 Mar;247(3):440-4 - PubMed
  18. J Antimicrob Chemother. 2011 Apr;66 Suppl 2:ii33-40 - PubMed
  19. Infection. 2010 Aug;38(4):255-60 - PubMed
  20. J Trauma. 2003 Dec;55(6):1155-60; discussion 1160-1 - PubMed
  21. World J Surg. 2009 Jun;33(6):1154-7 - PubMed
  22. J Trauma. 2003 May;54(5):848-59; discussion 859-61 - PubMed
  23. Intensive Care Med. 2013 Jul;39(7):1190-206 - PubMed
  24. Colorectal Dis. 2012 Aug;14 (8):e429-38 - PubMed
  25. Am Surg. 2011 Jul;77 Suppl 1:S58-61 - PubMed
  26. Ann Surg. 2003 Sep;238(3):349-55; discussion 355-7 - PubMed
  27. Crit Care Med. 1985 Oct;13(10):818-29 - PubMed

Publication Types