Temporary abdominal closure in trauma surgery: a comparative cohort study between open abdomen techniques with negative pressure therapy.

IF 2.1 3区医学 Q2 SURGERY

Langenbeck's Archives of Surgery Pub Date : 2025-05-16 DOI:10.1007/s00423-025-03725-5

Yuri Thomé Machado Petrillo, Gabrieli Flesch da Silva, Vitor Steffens Bracht, Neiva Baldissera, Mariana Kumaira Fonseca, Leandro Totti Cavazzola

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引用次数: 0

Abstract

Background: The use of negative pressure therapy (NPT) to maintain an open abdomen (OA) is a well-established practice in trauma surgery. The aim of this study was to compare two techniques for temporary closure of the OA using negative pressure therapy NPT with regard to the outcome of definitive closure of the abdominal wall, the incidence of complications and mortality.

Methodology: Controlled retrospective cohort study with trauma patients submitted to NPT as a method of maintaining OA. The groups were divided into "Group B", referring to the use of NPT by Barker dressing, and "Group V", referring to the use of NPT by RENASYS™ AB abdominal dressing.

Results: A total of 76 patients were analyzed (Group B, n = 48; Group V, n = 28), with mean age of 34 years, and 92% male. The groups were equivalent in their trauma severity scores. The overall rate of abdominal cavity closure was 38%, higher in Group V than in Group B (46%, n = 13 vs. 33%, n = 16, p = 0.374). The peritoneostomy outcome was significantly higher in group B (48%, n = 23 vs. 21%, n = 6, p = 0.028). Moderate negative correlation was observed between the duration of OA therapy and the rate of definitive closure of the abdominal cavity (ρ -0.637; p < 0.0001). Damage control surgery (DCS) and shorter duration of OA were identified as predictors of closure.

Conclusion: OA with NPT by industrial abdominal dressing decreases the rate of peritoniostomy as abdominal wall outcome compared to Barker dressing.

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创伤手术中的暂时腹部闭合：一项开腹技术与负压治疗的比较队列研究。

背景：使用负压疗法（NPT）来维持开放的腹部（OA）是创伤外科中一个公认的做法。本研究的目的是比较两种使用负压疗法暂时关闭OA的技术，关于腹壁最终关闭的结果，并发症的发生率和死亡率。方法：对照回顾性队列研究，创伤患者接受NPT作为维持OA的方法。将各组分为使用Barker敷料NPT的“B组”和使用RENASYS™AB腹部敷料NPT的“V组”。结果：共分析76例患者(B组，n = 48；V组，n = 28)，平均年龄34岁，92%为男性。两组的创伤严重程度评分相同。总腹腔闭合率为38%，V组高于B组（46%,n = 13 vs. 33%, n = 16, p = 0.374）。B组的腹膜造口成功率明显高于对照组（48%,n = 23 vs. 21%, n = 6, p = 0.028）。OA治疗时间与腹腔完全闭合率呈中度负相关(ρ -0.637；结论：与Barker敷料相比，经工业腹部敷料治疗的OA与NPT降低了腹膜造口作为腹壁结局的发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.