Delayed closure of ventral abdominal hernias after severe trauma.
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.
Department of Surgery, Wright State University, CHE 7000, Miami Valley Hospital, 1 Wyoming Street, Dayton, OH 45459, USA. peter.ekeh@wright.edu
Akpofure Peter
AP
Ekeh
Mary C
MC
McCarthy
Randy J
RJ
Woods
Mbaga
M
Walusimbi
Jonathan M
JM
Saxe
Lisa A
LA
Patterson
D000007:Abdominal Injuries / Q000601:surgery*; D034861:Abdominal Wall / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D017768:Skin, Artificial; D013526:Surgical Mesh; D013997:Time Factors