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IROA: International Register of Open Abdomen, preliminary results

Coccolini F 1 , Montori G 1 , Ceresoli M 1 , Catena F 2 , Ivatury R 3 , Sugrue M 4 Show all authors , Sartelli M 5 , Fugazzola P 1 , Corbella D 6 , Salvetti F 1 , Negoi I 7 , Zese M 8 , Occhionorelli S 8 , Maccatrozzo S 8 , Shlyapnikov S 9 , Galatioto C 10 , Chiarugi M 10 , Demetrashvili Z 11 , Dondossola D 12 , Yovtchev Y 13 , Ioannidis O 14 , Novelli G 15 , Nacoti M 16 , Khor D 17 , Inaba K 17 , Demetriades D 17 , Kaussen T 18 , Jusoh AC 19 , Ghannam W 20 , Sakakushev B 21 , Guetta O 22 , Dogjani A 23 , Costa S 24 , Singh S 25 , Damaskos D 26 , Isik A 27 , Yuan KC 28 , Trotta F 29 , Rausei S 30 , Martinez-Perez A 31 , Bellanova G 32 , Fonseca VC 33 , Hernández F 34 , Marinis A 35 , Fernandes W 36 , Quiodettis M 37 , Bala M 38 , Vereczkei A 39 , Curado RL 40 , Fraga GP 40 , Pereira BM 40 , Gachabayov M 41 , Chagerben GP 42 , Arellano ML 43 , Ozyazici S 44 , Costa G 45 , Tezcaner T 46 , Ansaloni L 1

Affiliations 

  • 1 General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127 Bergamo, Italy
  • 2 Emergency Surgery Department, Parma University Hospital, Parma, Italy
  • 3 Virginia Commonwealth University, Richmond, VA USA
  • 4 General Surgery, Letterkenny Hospital, Donegal, Ireland
  • 5 General and Emergency Surgery Department, Macerata Hospital, Macerata, Italy
  • 6 Neuro Intensive Care Unit Department, Papa Giovanni XXIII Hospital, Bergamo, Italy
  • 7 Emergency Surgery Hospital, Bucharest, Romania
  • 8 Emergency Surgery Department, Ferrara University Hospital, Ferrara, Italy
  • 9 Science Research of Emergency Care N. A., Djanelidze, Russia
  • 10 Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
  • 11 Kipshidze Central University Hospital, Kipshidze, Georgia
  • 12 HPB Surgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
  • 13 University Hospital "Prof Stoian Kirkovich" AD, Stara Zagora, Bulgaria
  • 14 Fourth Surgical Department, Hospital George Papanikolau, Aristotle University, Thessaloniki, Greece
  • 15 General Surgery, Infermi Hospital, Rimini, Italy
  • 16 Pediatric Intensive Care Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
  • 17 LAS + USC Medical Centre, Los Angeles, California USA
  • 18 Pediatric Intensive Care Unit, Hannover University Hospital, Hannover, Germany
  • 19 Khuala Krai Hospital, Kuala Krai, Malaysia
  • 20 Mansoura Faculty of Medicine, Mansoura, Egypt
  • 21 Medical University of Plovdiv, Plovdiv, Bulgaria
  • 22 Soroka Medical Centre, Beersheba, Israel
  • 23 University Hospital of Trauma, Tirana, Albania
  • 24 Emergency and General Surgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
  • 25 Oxford University Hospital, Oxford, UK
  • 26 John Radcliffe Hospital, Oxford, UK
  • 27 Erzincan University Faculty of Medicine Mengucek Gazi Training Research Hospital Erzincan, Erzincan, Turkey
  • 28 Chang Gung Memorial Hospital, Taoyuan, Taiwan
  • 29 Ospedale Maggiore, Lodi, Italy
  • 30 Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
  • 31 Hospital Universitario Doctor Peset, Valencia, Spain
  • 32 S.S. Annunziata Hospital, Taranto, Italy
  • 33 Hospital Santa Virgínia, São Paulo, Brazil
  • 34 Hospital Central Militar, Mexico City, Mexico
  • 35 Tzaneio General Hospital of Piraeus, Piraeus, Greece
  • 36 Hospital Regional de Sao Jose, San Jose, Brazil
  • 37 Hospital Santo Tomás, Panama City, Panama
  • 38 Hadassah Hebrew University Medical Center, Jerusalem, Israel
  • 39 Department of Surgery, Medical School University Pécs, Pécs, Hungary
  • 40 Hospital De Clinicas Da Unicamp, Campinas, Brazil
  • 41 Vladimir City Clinical Hospital of Emergency Medicine, Vladimir City, Russia
  • 42 University Hospital, Cuenca, Ecuador
  • 43 Hospital La Paz, Madrid, Spain
  • 44 Adana Numune Training and Research Hospital, Department of Surgery, Adana, Turkey
  • 45 Ospedale Sant' Andrea University Hospital Sapienza, Rome, Italy
  • 46 Baskent University School of Medicine, Ankara, Turkey
World J Emerg Surg, 2017;12:10.
PMID: 28239409 DOI: 10.1186/s13017-017-0123-8

Abstract

BACKGROUND: No definitive data about open abdomen (OA) epidemiology and outcomes exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) promoted the International Register of Open Abdomen (IROA).

METHODS: A prospective observational cohort study including patients with an OA treatment. Data were recorded on a web platform (Clinical Registers®) through a dedicated website: www.clinicalregisters.org.

RESULTS: Four hundred two patients enrolled. Adult patients: 369 patients; Mean age: 57.39±18.37; 56% male; Mean BMI: 36±5.6. OA indication: Peritonitis (48.7%), Trauma (20.5%), Vascular Emergencies/Hemorrhage (9.4%), Ischemia (9.1%), Pancreatitis (4.2%),Post-operative abdominal-compartment-syndrome (3.9%), Others (4.2%). The most adopted Temporary-abdominal-closure systems were the commercial negative pressure ones (44.2%). During OA 38% of patients had complications; among them 10.5% had fistula. Definitive closure: 82.8%; Mortality during treatment: 17.2%. Mean duration of OA: 5.39(±4.83) days; Mean number of dressing changes: 0.88(±0.88). After-closure complications: (49.5%) and Mortality: (9%). No significant associations among TACT, indications, mortality, complications and fistula. A linear correlationexists between days of OA and complications (Pearson linear correlation = 0.326 p<0.0001) and with the fistula development (Pearson = 0.146 p= 0.016). Pediatric patients: 33 patients. Mean age: 5.91±(3.68) years; 60% male. Mortality: 3.4%; Complications: 44.8%; Fistula: 3.4%. Mean duration of OA: 3.22(±3.09) days.

CONCLUSION: Temporary abdominal closure is reliable and safe. The different techniques account for different results according to the different indications. In peritonitis commercial negative pressure temporary closure seems to improve results. In trauma skin-closure and Bogotà-bag seem to improve results.

TRIAL REGISTRATION: ClinicalTrials.gov NCT02382770.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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