Has Evolution in Awareness of Guidelines for Institution of Damage Control Improved Outcome in the Management of the Posttraumatic Open Abdomen?

Juan A. Asensio, Patrizio Petrone, Gustavo Roldán, Eric Kuncir, Emily Ramicone, Linda Chan, William G. Cheadle, Glen A. Franklin

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Hypothesis: Awareness of guidelines for damage control can improve patient outcomes after postraumatic open abdomen. Design: Retrospective (November 1992 to December 1998), prospective (January 1999 to July 2001), 104-month study. Setting: Los Angeles County and University of Southern California Medical Center, Los Angeles. Patients: All patients undergoing damage control resulting in posttraumatic open abdomen. Main Outcome Measures: The main outcome measure was survival. Data were also collected on surgical findings and indications for damage control, including organs injured, intraoperative estimated blood loss, and intraoperative fluids, blood, and blood products administered. Postoperative complications, length of time patients had an open abdomen, and surgical intensive care unit and hospital length of stay were also recorded. Results: No difference in mortality existed between patients admitted before awareness of guidelines (group 1; 21 [24%] of 86 patients died) and patients who underwent damage control following these suggested guidelines (group 2; 13 [24%] of 53 patients died) (P=.85). Of the 139 patients, 100 had penetrating injuries and 39 had blunt injuries. Estimated blood loss was 4764±5349 mL. Mean intraoperative fluid replacement was 22034 mL. One hundred one patients (73%) experienced 228 complications, for a mean of 2.26 complications per patient. Group 1 patients spent a longer time in the operating room (mean, 4.09±1.99 hours; range, 0.4-9.5 hours) vs group 2 patients (mean, 2.34±1.50 hours; range, 0.3-6.2 hours; P

Original languageEnglish
Pages (from-to)209-215
Number of pages7
JournalArchives of Surgery
Volume139
Issue number2
DOIs
StatePublished - Feb 2004
Externally publishedYes

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Abdomen
Guidelines
Los Angeles
Length of Stay
Outcome Assessment (Health Care)
Nonpenetrating Wounds
Operating Rooms
Critical Care
Intensive Care Units

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Has Evolution in Awareness of Guidelines for Institution of Damage Control Improved Outcome in the Management of the Posttraumatic Open Abdomen? / Asensio, Juan A.; Petrone, Patrizio; Roldán, Gustavo; Kuncir, Eric; Ramicone, Emily; Chan, Linda; Cheadle, William G.; Franklin, Glen A.

In: Archives of Surgery, Vol. 139, No. 2, 02.2004, p. 209-215.

Research output: Contribution to journalArticle

Asensio, Juan A. ; Petrone, Patrizio ; Roldán, Gustavo ; Kuncir, Eric ; Ramicone, Emily ; Chan, Linda ; Cheadle, William G. ; Franklin, Glen A. / Has Evolution in Awareness of Guidelines for Institution of Damage Control Improved Outcome in the Management of the Posttraumatic Open Abdomen?. In: Archives of Surgery. 2004 ; Vol. 139, No. 2. pp. 209-215.
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abstract = "Hypothesis: Awareness of guidelines for damage control can improve patient outcomes after postraumatic open abdomen. Design: Retrospective (November 1992 to December 1998), prospective (January 1999 to July 2001), 104-month study. Setting: Los Angeles County and University of Southern California Medical Center, Los Angeles. Patients: All patients undergoing damage control resulting in posttraumatic open abdomen. Main Outcome Measures: The main outcome measure was survival. Data were also collected on surgical findings and indications for damage control, including organs injured, intraoperative estimated blood loss, and intraoperative fluids, blood, and blood products administered. Postoperative complications, length of time patients had an open abdomen, and surgical intensive care unit and hospital length of stay were also recorded. Results: No difference in mortality existed between patients admitted before awareness of guidelines (group 1; 21 [24{\%}] of 86 patients died) and patients who underwent damage control following these suggested guidelines (group 2; 13 [24{\%}] of 53 patients died) (P=.85). Of the 139 patients, 100 had penetrating injuries and 39 had blunt injuries. Estimated blood loss was 4764±5349 mL. Mean intraoperative fluid replacement was 22034 mL. One hundred one patients (73{\%}) experienced 228 complications, for a mean of 2.26 complications per patient. Group 1 patients spent a longer time in the operating room (mean, 4.09±1.99 hours; range, 0.4-9.5 hours) vs group 2 patients (mean, 2.34±1.50 hours; range, 0.3-6.2 hours; P",
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