Document Detail

Open management of the septic abdomen: therapeutic and prognostic considerations based on APACHE II.
MedLine Citation:
PMID:  2721209     Owner:  NLM     Status:  MEDLINE    
We analyzed the results of open treatment in 30 patients with abdominal sepsis (11 patients after trauma [group 1], five patients with pancreatic abscess [group 2], and 14 patients with acute GI pathology [group 3]) uncontrolled by conventional methods as evidenced by continuing fever with leukocytosis and worsening organ functions. APACHE scores at the time of initial laparotomy and at the time of open management, respectively, were: group 1, 19.8 and 16.6; group 2, 8.4 and 12.4; and group 3, 14.2 and 15.0. Twenty-seven patients had multiple system failure. Sixteen (53%) of the 30 patients survived, 73% in group 1, 60% in group 2, and 36% in group 3. Survival correlated well with age less than 50 yr and the absence of multiple organ failure. The technique was easily performed and many of the pitfalls previously reported were not observed. In patients requiring fascial prosthesis, the absorbable polyglycol acid (Dexon) mesh was found to be superior to the nonabsorbable polypropylene. We conclude that the open technique is feasible, effective, and worthy of consideration in patients with extensive wound necrosis and uncontrolled abdominal sepsis.
R R Ivatury; M Nallathambi; P M Rao; M Rohman; W M Stahl
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  17     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1989 Jun 
Date Detail:
Created Date:  1989-06-27     Completed Date:  1989-06-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  511-7     Citation Subset:  AIM; IM    
Department of Surgery, New York Medical College, Lincoln Medical Mental Health Center, Bronx, NY.
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MeSH Terms
Abdominal Injuries / complications
Abscess / therapy
Aged, 80 and over
Drainage / methods
Infection / etiology,  mortality,  surgery*
Irrigation / methods
Middle Aged
Multiple Organ Failure
Pancreatic Diseases / complications
Postoperative Care
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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