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Revista Colombiana de Cirugía
Print version ISSN 2011-7582On-line version ISSN 2619-6107
Abstract
FERNANDEZ-BOLANOS, Daniel Alejandro et al. Management of the open abdomen in critically ill patients in a tertiary level hospital in Popayán. rev. colomb. cir. [online]. 2022, vol.37, n.1, pp.72-82. Epub Mar 31, 2022. ISSN 2011-7582. https://doi.org/10.30944/20117582.847.
Introduction.
The open abdomen is a useful resource for the treatment of patients with complex abdominal pathology, with the potential for complications. The aim of this study was to adapt the World Society of Emergency Surgery (WJES) 2018 guidelines, in a tertiary level hospital and compare the results obtained with those prior to its implementation.
Methods.
Experimental study in two measurements of patients with open abdomen and stay in critical care, during the months of April to October in 2018 and 2019, before and after the adaptation with the healthcare personnel of the WSES 2018 clinical practice guide. Descriptive statistics, Chi square test and SPSS V.25 software were used.
Results.
Ninety-nine critically ill patients were included, with a mean age of 53.2 years, with an indication of open abdomen due to traumatic etiology in 28.3%, infectious non-traumatic in 32.3%, and non-traumatic or infectious in 37.4 %. Overall mortality was 25.3%, of which 68% were due to causes other than abdominal pathology. Postoperative complications occurred in 10 patients with surgical site infection and 9 patients with enterocutaneous fistula. The use of the double Viaflex was implemented in 63.6%, achieving a closure of the abdominal wall in 79.8% (p=0.038) of the cases.
Conclusion.
The open abdomen requires a multidisciplinary approach. The use of double Viaflex is a simple and effective tool. The implementation of the guide decreased the percentage of mortality, the days of open abdomen and the stay in intensive care unit.
Keywords : open abdomen techniques; damage control; wounds and injuries; infections; emergencies; postoperative complications.