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Long-term impact of damage control laparotomy: a prospective study.
Megan Brenner1, Grant Bochicchio, Kelly Bochicchio
1R. Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD 21201, USA.
Archives of Surgery (Chicago, Ill. : 1960)
|December 22, 2010
Summary
Damage control laparotomy (DCL) improves long-term survival in trauma patients. Despite high complication and readmission rates, DCL is beneficial for patient outcomes.
Area of Science:
- Trauma Surgery
- Surgical Critical Care
- Abdominal Trauma Management
Background:
- Damage control laparotomy (DCL) is a critical intervention for severely injured patients.
- Its long-term effects on morbidity and survival require thorough evaluation.
Purpose of the Study:
- To assess the long-term outcomes of trauma patients undergoing DCL.
- To evaluate complications, mortality, readmissions, and functional recovery post-DCL.
Main Methods:
- Prospective study conducted at a Level I trauma center.
- Followed 88 trauma patients who underwent DCL over a 3-year admission period and an extended follow-up period.
- Assessed major/long-term complications, lengths of stay, mortality, readmissions, subsequent surgeries, and return to daily activities/work.
Main Results:
- The study included 88 patients (mean age 33, ISS 34), with 28% overall mortality.
- Survivors experienced significant complications, including intra-abdominal infections (44) and enterocutaneous fistulas (18).
- 81% of survivors returned to work and normal daily activities, despite high readmission rates (186 total) primarily for ventral hernia repair.
Conclusions:
- Damage control laparotomy is associated with substantial complication and readmission rates.
- Despite these challenges, DCL demonstrates indisputable overall benefit for trauma patient survival and functional recovery.
