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Observational Study
. 2017 Feb 21:12:10.
doi: 10.1186/s13017-017-0123-8. eCollection 2017.

IROA: International Register of Open Abdomen, preliminary results

Federico Coccolini  1 , Giulia Montori  1 , Marco Ceresoli  1 , Fausto Catena  2 , Rao Ivatury  3 , Michael Sugrue  4 , Massimo Sartelli  5 , Paola Fugazzola  1 , Davide Corbella  6 , Francesco Salvetti  1 , Ionut Negoi  7 , Monica Zese  8 , Savino Occhionorelli  8 , Stefano Maccatrozzo  8 , Sergei Shlyapnikov  9 , Christian Galatioto  10 , Massimo Chiarugi  10 , Zaza Demetrashvili  11 , Daniele Dondossola  12 , Yovcho Yovtchev  13 , Orestis Ioannidis  14 , Giuseppe Novelli  15 , Mirco Nacoti  16 , Desmond Khor  17 , Kenji Inaba  17 , Demetrios Demetriades  17 , Torsten Kaussen  18 , Asri Che Jusoh  19 , Wagih Ghannam  20 , Boris Sakakushev  21 , Ohad Guetta  22 , Agron Dogjani  23 , Stefano Costa  24 , Sandeep Singh  25 , Dimitrios Damaskos  26 , Arda Isik  27 , Kuo-Ching Yuan  28 , Francesco Trotta  29 , Stefano Rausei  30 , Aleix Martinez-Perez  31 , Giovanni Bellanova  32 , Vinicius Cordeiro Fonseca  33 , Fernando Hernández  34 , Athanasios Marinis  35 , Wellington Fernandes  36 , Martha Quiodettis  37 , Miklosh Bala  38 , Andras Vereczkei  39 , Rafael L Curado  40 , Gustavo Pereira Fraga  40 , Bruno M Pereira  40 , Mahir Gachabayov  41 , Guillermo Perez Chagerben  42 , Miguel Leon Arellano  43 , Sefa Ozyazici  44 , Gianluca Costa  45 , Tugan Tezcaner  46 , Luca Ansaloni  1
Affiliations
Observational Study

IROA: International Register of Open Abdomen, preliminary results

Federico Coccolini et al. World J Emerg Surg. .

Erratum in

  • Erratum to: IROA: International Register of Open Abdomen, preliminary results.
    Coccolini F, Montori G, Ceresoli M, Catena F, Ivatury R, Sugrue M, Sartelli M, Fugazzola P, Corbella D, Salvetti F, Negoi I, Zese M, Occhionorelli S, Maccatrozzo S, Shlyapnikov S, Galatioto C, Chiarugi M, Demetrashvili Z, Dondossola D, Yovtchev Y, Ioannidis O, Novelli G, Nacoti M, Khor D, Inaba K, Demetriades D, Kaussen T, Jusoh AC, Ghannam W, Sakakushev B, Guetta O, Dogjani A, Costa S, Singh S, Damaskos D, Isik A, Yuan KC, Trotta F, Rausei S, Martinez-Perez A, Bellanova G, Fonseca VC, Hernández F, Marinis A, Fernandes W, Quiodettis M, Bala M, Vereczkei A, Curado RL, Fraga GP, Pereira BM, Gachabayov M, Chagerben GP, Arellano ML, Ozyazici S, Costa G, Tezcaner T, Ansaloni L. Coccolini F, et al. World J Emerg Surg. 2017 Mar 9;12:13. doi: 10.1186/s13017-017-0127-4. eCollection 2017. World J Emerg Surg. 2017. PMID: 28286545 Free PMC article.

Abstract

Background: No definitive data about open abdomen (OA) epidemiology and outcomes exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) promoted the International Register of Open Abdomen (IROA).

Methods: A prospective observational cohort study including patients with an OA treatment. Data were recorded on a web platform (Clinical Registers®) through a dedicated website: www.clinicalregisters.org.

Results: Four hundred two patients enrolled. Adult patients: 369 patients; Mean age: 57.39±18.37; 56% male; Mean BMI: 36±5.6. OA indication: Peritonitis (48.7%), Trauma (20.5%), Vascular Emergencies/Hemorrhage (9.4%), Ischemia (9.1%), Pancreatitis (4.2%),Post-operative abdominal-compartment-syndrome (3.9%), Others (4.2%). The most adopted Temporary-abdominal-closure systems were the commercial negative pressure ones (44.2%). During OA 38% of patients had complications; among them 10.5% had fistula. Definitive closure: 82.8%; Mortality during treatment: 17.2%. Mean duration of OA: 5.39(±4.83) days; Mean number of dressing changes: 0.88(±0.88). After-closure complications: (49.5%) and Mortality: (9%). No significant associations among TACT, indications, mortality, complications and fistula. A linear correlationexists between days of OA and complications (Pearson linear correlation = 0.326 p<0.0001) and with the fistula development (Pearson = 0.146 p= 0.016). Pediatric patients: 33 patients. Mean age: 5.91±(3.68) years; 60% male. Mortality: 3.4%; Complications: 44.8%; Fistula: 3.4%. Mean duration of OA: 3.22(±3.09) days.

Conclusion: Temporary abdominal closure is reliable and safe. The different techniques account for different results according to the different indications. In peritonitis commercial negative pressure temporary closure seems to improve results. In trauma skin-closure and Bogotà-bag seem to improve results.

Trial registration: ClinicalTrials.gov NCT02382770.

Keywords: Barker; Bogotà bag; Commercial; Compartment; IROA; Ischemia; Negative pressure; Non-commercial; Open abdomen; Peritonitis; Register; Skin; Trauma; Vascular emergencies; Witmann.

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Figures

Fig. 1
Fig. 1
IROA spread in the world
Fig. 2
Fig. 2
Open abdomen treatment indications
Fig. 3
Fig. 3
Overall negative event rate (NPWT: negative pressure wound therapy)
Fig. 4
Fig. 4
Negative event rate in peritonitis (NPWT: negative pressure wound therapy)
Fig. 5
Fig. 5
Negative event rate in trauma (NPWT: negative pressure wound therapy)
Fig. 6
Fig. 6
Time distribution of overall complication
Fig. 7
Fig. 7
Time distribution of fistula
Fig. 8
Fig. 8
Definitive closure rate and days of open abdomen among different TAC techniques. Those patients died during treatment never achieved definitive closure and had a duration of treatment = infinite (as a consequence asymptotic curve indicates also survival). (TAC: temporary abdominal closure, NPWT: negative pressure wound therapy)
Fig. 9
Fig. 9
Definitive closure rate and days of open abdomen among different TAC techniques in patients treated for peritonitis. Those patients died during treatment never achieved definitive closure and had a duration of treatment = infinite (as a consequence asymptotic curve indicates also survival). (TAC: temporary abdominal closure, NPWT: negative pressure wound therapy)
Fig. 10
Fig. 10
Definitive closure rate and days of open abdomen among different TAC techniques in patients treated for trauma. Those patients died during treatment never achieved definitive closure and had a duration of treatment = infinite (as a consequence asymptotic curve indicates also survival). (TAC: temporary abdominal closure, NPWT: negative pressure wound therapy)
See this image and copyright information in PMC

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