Delayed closure of ventral abdominal hernias after severe trauma
Akpofure Peter Ekeh1, Mary C McCarthy, Randy J Woods
1Department of Surgery, Wright State University, CHE 7000, Miami Valley Hospital, 1 Wyoming Street, Dayton, OH 45459, USA. peter.ekeh@wright.edu
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.
