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MultiCenter Study of Intra-Abdominal Abscess Formation After Major Operative Hepatic Trauma.

Alison A Smith1, Jennifer T Cone2, Allison G McNickle3

  • 1Surgery Department, Louisiana State University Health Sciences Center New Orleans, New Orleans, Louisiana.

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Summary
This summary is machine-generated.

Penetrating trauma, massive transfusion, bile leaks, and other abdominal injuries increase the risk of intra-abdominal abscesses (IAA) after operative liver trauma. Identifying these risk factors can help refine patient management strategies.

Keywords:
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Area of Science:

  • Trauma Surgery
  • Surgical Critical Care
  • Abdominal Surgery

Background:

  • Intra-abdominal abscesses (IAA) are a significant complication following operative liver trauma.
  • Identifying risk factors for IAA is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine independent risk factors associated with postoperative intra-abdominal abscesses (IAA) in patients with major operative liver trauma.

Main Methods:

  • Retrospective multi-institutional study involving 372 adult patients with major liver trauma (grade 3+) from 13 trauma centers (2012-2021).
  • Univariate and multivariate analyses were performed to identify risk factors for IAA.

Main Results:

  • 21.2% of patients developed IAA.
  • Independent risk factors for IAA included penetrating mechanism of injury, intraoperative massive transfusion protocol activation, biloma/bile leak, increased hospital length of stay, and additional intra-abdominal injuries.
  • Factors not associated with increased IAA risk included drains, damage control laparotomy, packed red blood cell units, open abdomen duration, total abdominal surgeries, and blood loss.

Conclusions:

  • Penetrating trauma, massive transfusion protocol, longer hospital stay, and concomitant intra-abdominal injuries are significant risk factors for IAA post-operative liver trauma.
  • These findings can inform and refine clinical guidelines for managing complex operative liver trauma.