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Observational Study
. 2019 Jan;50(1):160-166.
doi: 10.1016/j.injury.2018.09.040. Epub 2018 Sep 24.

Open abdomen and entero-atmospheric fistulae: An interim analysis from the International Register of Open Abdomen (IROA)

Federico Coccolini  1 , Marco Ceresoli  2 , Yoram Kluger  3 , Andrew Kirkpatrick  4 , Giulia Montori  5 , Fracensco Salvetti  6 , Paola Fugazzola  7 , Matteo Tomasoni  8 , Massimo Sartelli  9 , Luca Ansaloni  10 , Fausto Catena  11 , Ionut Negoi  12 , Monica Zese  13 , Savino Occhionorelli  13 , Sergei Shlyapnikov  14 , Christian Galatioto  15 , Massimo Chiarugi  15 , Zaza Demetrashvili  16 , Daniele Dondossola  17 , Orestis Ioannidis  18 , Giuseppe Novelli  19 , Mirco Nacoti  20 , Desmond Khor  21 , Kenji Inaba  21 , Demetrios Demetriades  21 , Torsten Kaussen  22 , Asri Che Jusoh  23 , Wagih Ghannam  24 , Boris Sakakushev  25 , Ohad Guetta  26 , Agron Dogjani  27 , Stefano Costa  28 , Sandeep Singh  29 , Dimitrios Damaskos  30 , Arda Isik  31 , Kuo-Ching Yuan  32 , Francesco Trotta  33 , Stefano Rausei  34 , Aleix Martinez-Perez  35 , Giovanni Bellanova  36 , ViniciusCordeiro Fonseca  37 , Fernando Hernández  38 , Athanasios Marinis  39 , Wellington Fernandes  40 , Martha Quiodettis  41 , Miklosh Bala  42 , Andras Vereczkei  43 , Rafael Curado  44 , Gustavo Pereira Fraga  44 , Bruno M Pereira  44 , Mahir Gachabayov  45 , Guillermo Perez Chagerben  46 , Miguel Leon Arellano  47 , Sefa Ozyazici  48 , Gianluca Costa  49 , Tugan Tezcaner  50 , Matteo Porta  51 , Yousheng Li  52 , Faruk Karateke  53 , Dimitrios Manatakis  54 , Federico Mariani  55 , Federic Lora  56 , Ivan Sahderov  57 , Boyko Atanasov  58 , Sergio Zegarra  59 , Luca Gianotti  60 , Luca Fattori  60 , Rao Ivatury  61
Affiliations
Observational Study

Open abdomen and entero-atmospheric fistulae: An interim analysis from the International Register of Open Abdomen (IROA)

Federico Coccolini et al. Injury. 2019 Jan.

Abstract

Introduction: No definitive data describing associations between cases of Open Abdomen (OA) and Entero-atmospheric fistulae (EAF) exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) thus analyzed the International Register of Open Abdomen (IROA) to assess this question.

Material and methods: A prospective analysis of adult patients enrolled in the IROA.

Results: Among 649 adult patients with OA 58 (8.9%) developed EAF. Indications for OA were peritonitis (51.2%) and traumatic-injury (16.8%). The most frequently utilized temporary abdominal closure techniques were Commercial-NPWT (46.8%) and Bogotà-bag (21.9%). Mean OA days were 7.9 ± 18.22. Overall mortality rate was 29.7%, with EAF having no impact on mortality. Multivariate analysis associated cancer (p = 0.018), days of OA (p = 0.003) and time to provision-of-nutrition (p = 0.016) with EAF occurrence.

Conclusion: Entero-atmospheric fistulas are influenced by the duration of open abdomen treatment and by the nutritional status of the patient. Peritonitis, intestinal anastomosis, negative pressure and oral or enteral nutrition were not risk factors for EAF during OA treatment.

Keywords: Entero-atmospheric fistula; Fistula; IROA; Open abdomen.

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