Floating stoma: An alternative strategy in the context of damage control surgery.
BACKGROUND
Floating stoma (FS) is a strategy to be considered in the context of damage control surgery (DCS). The purpose of this study is to describe the technique used and the results of a series of patients where FS was used.


METHODS
Case series of relaparotomized patients at two emergency services in Temuco, Chile (2005-2014). In all of them, once drainage of septic focus or damage was controlled, the abdomen was left open with a Bogota bag (BB) and FS. Outcome variables were FS indications, morbidity, time to first replacement of BB, definitive maturation of the stoma (DMS), time to withdraw the BB and mortality.


RESULTS
FS was performed in 46 patients with a mean age of 49.3±21.1 years; 63% were female. The indication of FS was abdominal sepsis by secondary peritonitis (69.6%), abdominal trauma (17.4%), and mesenteric ischemia (13.0%). Morbidity was 37.0%. Median time to first replacement of BB, DMS and time to withdraw the BB were 84hours, 3.5 days and 49 days, respectively. Mortality was 19.6%.


CONCLUSIONS
FS is a temporary resource reserved for special surgical cases. It is associated with morbidity and mortality inherent with the severity of the patients on whom it can be used.
Department of Surgery and CEMyQ, Universidad de La Frontera, Manuel Montt 112, office 408, Temuco, Chile; Center for Morphological and Surgical Studies (CEMyQ), Universidad de La Frontera, Chile; Center for Biomedical Research, Universidad Autónoma, Chile. Electronic address: carlos.manterola@ufrontera.cl.
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Manterola
Clínica Mayor. Red de Clínicas Regionales, Temuco, Chile.
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Flores
Center for Morphological and Surgical Studies (CEMyQ), Universidad de La Frontera, Chile; Center for Biomedical Research, Universidad Autónoma, Chile; Universidad Científica del Sur, Peru.
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Otzen
D000007:Abdominal Injuries / Q000401:mortality / Q000601:surgery*; D058107:Abdominal Wound Closure Techniques; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy; D008297:Male; D065666:Mesenteric Ischemia / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D010538:Peritonitis / Q000401:mortality / Q000601:surgery*; D018805:Sepsis / Q000401:mortality / Q000601:surgery*; D054047:Surgical Stomas
Bogota bag; Damage control surgery; Floating stoma; Open abdomen; Relaparotomies