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Open Abdomen after Two Trauma Laparotomies: Do Diuretics Help?

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Diuretics did not improve primary fascial closure rates in trauma patients with an open abdomen (OA) after two laparotomies. This study found no significant association between diuretic use and successful abdominal closure in this patient group.

Keywords:
Trauma acute caredamage controldiuresisopen abdomen

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Area of Science:

  • Trauma Surgery
  • Surgical Critical Care

Background:

  • The open abdomen (OA) presents a challenge in trauma care, often requiring multiple surgical interventions.
  • Data on the utility of diuretics in facilitating primary fascial closure (PFC) for OA management are limited.

Purpose of the Study:

  • To investigate the association between diuretic use and the rate of primary fascial closure in trauma patients with an OA after two laparotomies.

Main Methods:

  • Retrospective review of trauma laparotomy patients over seven years.
  • Identified patients with an OA after two laparotomies.
  • Analyzed PFC rates based on diuretic administration prior to the third laparotomy.

Main Results:

  • Of 321 patients, 30 (9%) had an OA after two laparotomies.
  • Thirteen patients (43%) received diuretics, with a median cumulative fluid balance of +12.6 L.
  • PFC rates were similar between diuretic (38%) and no diuretic (59%) groups (P = .46).

Conclusions:

  • Diuretic use was not associated with successful primary fascial closure in trauma patients with an open abdomen after two laparotomies.
  • Factors such as age, gender, fluid balance, and blood transfusions did not significantly correlate with PFC.