Title

Delayed Closure of Ventral Abdominal Hernias after Severe Trauma

Document Type

Article

Publication Date

3-2006

Abstract

Background

Primary closure after trauma celiotomies is not always accomplished. We reviewed our experience with delayed closure in trauma patients.

Methods

Prospective data were collected on patients who had damage-control celiotomy and were discharged with open abdomens. The time to closure, repair methods, and complication data also were compiled.

Results

In the 6-year period, 84 patients underwent damage-control celiotomy. Thirty-one patients died and 33 patients had early closure. Twenty patients had closure during a subsequent hospitalization (mean time to delayed closure, 193 days): 8 patients (40%) had component separation, 3 (15%) had component separation with mesh, 4 (20%) had mesh alone, and primary closure occurred in 5 (25%). Nine patients (45%) had complications such as wound and mesh infections, hernias, and fistulas. Repair before or after 6 months showed no statistically significant difference for the presence of complications or enterotomies (P = .64 and .5743, respectively).

Conclusions

Open-abdomen reconstruction presents significant challenges. Closure within 6 months is possible; the presence of complications is not affected by early repair.

Comments

This paper was presented at the 48th Annual Meeting of the Midwest Surgical Association, Ontario, Canada, August 14–17, 2005.

DOI

DOI: 10.1016/j.amjsurg.2005.10.045