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01-03-2018 | Original Scientific Report

Early Versus Delayed Source Control in Open Abdomen Management for Severe Intra-abdominal Infections: A Retrospective Analysis on 111 Cases

Authors: Stefano Rausei, Vincenzo Pappalardo, Laura Ruspi, Antonio Colella, Simone Giudici, Vincenzo Ardita, Francesco Frattini, Francesca Rovera, Luigi Boni, Gianlorenzo Dionigi

Published in: World Journal of Surgery | Issue 3/2018

Abstract

Background

Time to source control plays a determinant prognostic role in patients having severe intra-abdominal infections (IAIs). Open abdomen (OA) management became an effective treatment option for peritonitis. Aim of this study was to analyze the correlation between time to source control and outcome in patients presenting with abdominal sepsis and treated by OA.

Methods

We retrospectively analyzed 111 patients affected by abdominal sepsis and treated with OA from May 2007 to May 2015. Patients were classified according to time interval from first patient evaluation to source control. The end points were intra-hospital mortality and primary fascial closure rate.

Results

The in-hospital mortality rate was 21.6% (24/111), and the primary fascial closure rate was 90.9% (101/111). A time to source control ≥6 h resulted significantly associated with a poor prognosis and a lower fascial closure rate (mortality 27.0 vs 9.0%, p = 0.04; primary fascial closure 86 vs 100%, p = 0.02). We observed a direct increase in mortality (and a reduction in closure rate) for each 6-h delay in surgery to source control.

Conclusion

Early source control using OA management significantly improves outcome of patients with severe IAIs. This damage control approach well fits to the treatment of time-related conditions, particularly in case of critically ill patients.

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Title: Early Versus Delayed Source Control in Open Abdomen Management for Severe Intra-abdominal Infections: A Retrospective Analysis on 111 Cases
Authors: Stefano Rausei
Vincenzo Pappalardo
Laura Ruspi
Antonio Colella
Simone Giudici
Vincenzo Ardita
Francesco Frattini
Francesca Rovera
Luigi Boni
Gianlorenzo Dionigi
Publication date: 01-03-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 3/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-4233-y

At a glance: The STEP trials

Springer Medicine

Early Versus Delayed Source Control in Open Abdomen Management for Severe Intra-abdominal Infections: A Retrospective Analysis on 111 Cases

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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