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IROA: International Register of Open Abdomen, preliminary results

Article scientifique 2017 Anglais

Résumé

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). 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 . Four hundred two patients enrolled. Adult patients: 369 patients; Mean age: 57.39±18.37; 56% male. 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. 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. ClinicalTrials.gov NCT02382770

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Coccolini, F., Montori, G., Ceresoli, M., Catena, F., Ivatury, R., Sugrue, M., Sartelli, M., Fugazzola, P., Corbella, D., Salvetti, F., Negoi, I., Zese, M., Occhionorelli, S., Maccatrozzo, S., Shlyapnikov, S., Galatioto, C., Chiarugi, M., Demetrashvili, Z., Dondossola, D., Yovtchev, Y., Ioannidis, O., Novelli, G., Nacoti, M., Khor, D., Inaba, K., Δημητριάδης, Δ., Kaussen, T., Jusoh, A., Ghannam, W., Sakakushev, B., Guetta, O., Dogjani, A., Costa, S., Singh, S., Damaskos, D., Işık, A., Yuan, K., Trotta, F., Rausei, S., Martínez‐Pérez, A., Bellanova, G., Fonseca, V., Hernández, F., Marinis, A., Fernandes, W., Quiodettis, M., Bala, M., Vereczkei, A., Curado, R., Fraga, G., Pereira, B., Gachabayov, M., Chagerben, G., Arellano, M., Özyazıcı, S., Costa, G., Tezcaner, T., Ansaloni, L. (2017). IROA: International Register of Open Abdomen, preliminary results. https://doi.org/10.1186/s13017-017-0123-8

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Auteur(s)

Federico Coccolini Giulia Montori Marco Ceresoli Fausto Catena Rao R. Ivatury Michael Sugrue Massimo Sartelli Paola Fugazzola Davide Corbella Francesco Salvetti Ionuţ Negoi Monica Zese Savino Occhionorelli Stefano Maccatrozzo S. A. Shlyapnikov Christian Galatioto Massimo Chiarugi Zaza Demetrashvili Daniele Dondossola Yovcho Yovtchev Orestis Ioannidis Giuseppe Novelli Mirco Nacoti Desmond Khor Kenji Inaba Δημήτριος Δημητριάδης Torsten Kaussen Asri Che Jusoh Wagih Ghannam Boris Sakakushev Ohad Guetta Agron Dogjani Stefano Costa Sandeep Singh Dimitrios Damaskos Arda Işık Kuo-Ching Yuan Francesco Trotta Stefano Rausei Aleix Martínez‐Pérez Giovanni Bellanova Vinicius Cordeiro Fonseca Fernando Braz Tangerino Hernández Athanasios Marinis Wellington Fernandes Martha Quiodettis Miklosh Bala András Vereczkei Rafael Curado Gustavo Pereira Fraga Bruno M. Pereira Mahir Gachabayov Guillermo Pérez Chagerben Miguel León Arellano Sefa Özyazıcı Gianluca Costa Tugan Tezcaner Luca Ansaloni

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