Factors Associated with Inability to Perform Delayed Primary Fascial Closure of Open Abdomen in Trauma Patients: a Retrospective Observational Study

It is advised that we should never hesitate in leaving the abdomen open when required. However, once the patient is stabilised, we should close it as soon as possible. But the factors which would hamper delayed primary fascial closure (DPFC) are not well studied. A retrospective 5-year analysis of patients with open abdomen (OA) after trauma laparotomy who survived was conducted. Patients were divided into 2 groups: those in which DPFC was possible and those in whom it was not. Out of the 58 patients that were recruited, DPFC could not be performed in 48 patients. Quantum of fluid resuscitation at 48 h was not associated with an inability to perform DPFC. Early definitive control of bleeding and damage control resuscitation are associated with the ability to perform DPFC in OA patients. Presence of blood stream infections (BSIs), ventilator-associated pneumonia (VAP), and intra-abdominal sepsis (IAS) precluded DPFC.