Prolonged abdominal packing for trauma is associated with increased morbidity and mortality.
Abdominal packing and planned reoperation is a lifesaving technique for temporary control of hemorrhage in severely injured patients. Morbidity and mortality in this group of patients, however, remain significant. It is unclear whether the duration of packing impacts upon outcome. The purpose of this study is to evaluate the abscess, sepsis, and mortality rates associated with duration of abdominal packing. The records of 35 patients treated with abdominal packing between July 1994 and December 1995 who survived to reoperation were retrospectively reviewed. Evaluation included age; sex; mechanism; injuries; Abdominal Trauma Index; duration of packing; survival; and presence of abscess, sepsis or other infections. Patients packed for a total of 72 hours or less had lower abscess, sepsis, and mortality rates than those packed for more than 72 hours. The differences in abscess rate and mortality were statistically significant (P < 0.05). The Abdominal Trauma Index and mechanism of injury were similar for the two groups. Based on these results, we conclude that although abdominal packing is a useful technique in the severely injured patient, it is associated with greater morbidity and mortality when the duration of packing exceeds 72 hours.
Abikhaled
J A
JA
Cora and Webb Mading Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
Granchi
T S
TS
Wall
M J
MJ
Hirshberg
A
A
Mattox
K L
KL
D018784:Abdominal Abscess / Q000401:mortality; D000007:Abdominal Injuries / Q000401:mortality* / Q000601:surgery; D000328:Adult; D005260:Female; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D008297:Male; D009017:Morbidity; D009779:Occlusive Dressings; D012086:Reoperation; D012189:Retrospective Studies; D013526:Surgical Mesh; D013997:Time Factors; D014949:Wounds, Nonpenetrating / Q000401:mortality* / Q000601:surgery; D014950:Wounds, Penetrating / Q000401:mortality* / Q000601:surgery