Damage control laparotomy
Background: Damage Control Surgery (DCS) is well established in the management of trauma. This study assessed the results of DCS in the management of critically ill patients who had not had trauma. Methods: This was a prospective series of patients treated by DCS. The Physiological and Operative Sev...
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| Veröffentlicht in: | British journal of surgery 2004-01, Vol.91 (1), p.83-85 |
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| creator | Finlay, I. G. Edwards, T. J. Lambert, A. W. |
| description | Background:
Damage Control Surgery (DCS) is well established in the management of trauma. This study assessed the results of DCS in the management of critically ill patients who had not had trauma.
Methods:
This was a prospective series of patients treated by DCS. The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and Portsmouth predictor equation (P‐POSSUM) were used to predict the risk of death, which was compared with the observed mortality rate.
Results:
Fourteen patients were studied. Nine had sepsis from gastrointestinal perforation. Eight of these underwent bowel resection without anastomosis or stoma formation at the initial laparotomy. Six patients later underwent bowel anastomosis and two had an end stoma formed at second laparotomy. A further three patients had a ruptured aortic aneurysm, one had a reactionary haemorrhage after elective aortic surgery, and one had a retroperitoneal bleed; all required haemostatic packing that was removed at second laparotomy. Mortality rates predicted by POSSUM and P‐POSSUM scoring were 64·5 and 49·6 per cent respectively. One patient (7·1 per cent) died after operation, giving an observed mortality rate significantly lower than predicted (P = 0·002 and P = 0·038 versus values predicted by POSSUM and P‐POSSUM, respectively).
Conclusion:
The use of DCS in the treatment of critically ill patients resulted in a lower mortality rate than that predicted by POSSUM or P‐POSSUM. DCS should not be restricted to trauma. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Not just for trauma |
| doi_str_mv | 10.1002/bjs.4434 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_80092894</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>80092894</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3864-253731cb8cd3756723d69e80433c76d5401cfd80de9f70b3215fb79d1f45a3a83</originalsourceid><addsrcrecordid>eNpF0EtPwkAUBeCJ0QiiiVs3ho3uijNz57lUFNQQJb5I2Eym06kpthQ7Jcq_t0SU1VncLzc5B6FjgnsEY3oRz0KPMWA7qE1A8IgSoXZRG2MsIwIUWugghBnGBDCn-6hFmCRCat1GJ9e2sO--68p5XZV5N7cLW5V1WawO0V5q8-CPNtlBr4Obl_5tNHoc3vUvR5EDJVhEOUggLlYuAcmFpJAI7RVmAE6KhDNMXJoonHidShwDJTyNpU5IyrgFq6CDzn__Lqryc-lDbYosOJ_ndu7LZTAKY02VZg083cBlXPjELKqssNXK_JVpwNkG2OBsnlZ27rKwdVxxAVo0Lvp1X1nuV9s7NusxTTOmWY9pru6f17n1Waj997-31YcRsiltJg9DM5Xjp8n4bWoG8AO0aHJy</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>80092894</pqid></control><display><type>article</type><title>Damage control laparotomy</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Finlay, I. G. ; Edwards, T. J. ; Lambert, A. W.</creator><creatorcontrib>Finlay, I. G. ; Edwards, T. J. ; Lambert, A. W.</creatorcontrib><description>Background:
Damage Control Surgery (DCS) is well established in the management of trauma. This study assessed the results of DCS in the management of critically ill patients who had not had trauma.
Methods:
This was a prospective series of patients treated by DCS. The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and Portsmouth predictor equation (P‐POSSUM) were used to predict the risk of death, which was compared with the observed mortality rate.
Results:
Fourteen patients were studied. Nine had sepsis from gastrointestinal perforation. Eight of these underwent bowel resection without anastomosis or stoma formation at the initial laparotomy. Six patients later underwent bowel anastomosis and two had an end stoma formed at second laparotomy. A further three patients had a ruptured aortic aneurysm, one had a reactionary haemorrhage after elective aortic surgery, and one had a retroperitoneal bleed; all required haemostatic packing that was removed at second laparotomy. Mortality rates predicted by POSSUM and P‐POSSUM scoring were 64·5 and 49·6 per cent respectively. One patient (7·1 per cent) died after operation, giving an observed mortality rate significantly lower than predicted (P = 0·002 and P = 0·038 versus values predicted by POSSUM and P‐POSSUM, respectively).
Conclusion:
The use of DCS in the treatment of critically ill patients resulted in a lower mortality rate than that predicted by POSSUM or P‐POSSUM. DCS should not be restricted to trauma. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Not just for trauma</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.4434</identifier><identifier>PMID: 14716799</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Adult ; Aged ; Anastomosis, Surgical ; Aortic Aneurysm, Abdominal - mortality ; Aortic Aneurysm, Abdominal - surgery ; Aortic Rupture - mortality ; Aortic Rupture - surgery ; Biological and medical sciences ; Critical Illness ; Female ; General aspects ; Humans ; Intestinal Perforation - mortality ; Intestinal Perforation - surgery ; Laparotomy - methods ; Male ; Medical sciences ; Middle Aged ; Prospective Studies ; Risk Factors ; Sepsis - mortality ; Sepsis - surgery ; Severity of Illness Index</subject><ispartof>British journal of surgery, 2004-01, Vol.91 (1), p.83-85</ispartof><rights>Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</rights><rights>2004 INIST-CNRS</rights><rights>Copyright 2004 British Journal of Surgery Society Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3864-253731cb8cd3756723d69e80433c76d5401cfd80de9f70b3215fb79d1f45a3a83</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.4434$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.4434$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,4010,27900,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15856396$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14716799$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Finlay, I. G.</creatorcontrib><creatorcontrib>Edwards, T. J.</creatorcontrib><creatorcontrib>Lambert, A. W.</creatorcontrib><title>Damage control laparotomy</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background:
Damage Control Surgery (DCS) is well established in the management of trauma. This study assessed the results of DCS in the management of critically ill patients who had not had trauma.
Methods:
This was a prospective series of patients treated by DCS. The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and Portsmouth predictor equation (P‐POSSUM) were used to predict the risk of death, which was compared with the observed mortality rate.
Results:
Fourteen patients were studied. Nine had sepsis from gastrointestinal perforation. Eight of these underwent bowel resection without anastomosis or stoma formation at the initial laparotomy. Six patients later underwent bowel anastomosis and two had an end stoma formed at second laparotomy. A further three patients had a ruptured aortic aneurysm, one had a reactionary haemorrhage after elective aortic surgery, and one had a retroperitoneal bleed; all required haemostatic packing that was removed at second laparotomy. Mortality rates predicted by POSSUM and P‐POSSUM scoring were 64·5 and 49·6 per cent respectively. One patient (7·1 per cent) died after operation, giving an observed mortality rate significantly lower than predicted (P = 0·002 and P = 0·038 versus values predicted by POSSUM and P‐POSSUM, respectively).
Conclusion:
The use of DCS in the treatment of critically ill patients resulted in a lower mortality rate than that predicted by POSSUM or P‐POSSUM. DCS should not be restricted to trauma. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Not just for trauma</description><subject>Adult</subject><subject>Aged</subject><subject>Anastomosis, Surgical</subject><subject>Aortic Aneurysm, Abdominal - mortality</subject><subject>Aortic Aneurysm, Abdominal - surgery</subject><subject>Aortic Rupture - mortality</subject><subject>Aortic Rupture - surgery</subject><subject>Biological and medical sciences</subject><subject>Critical Illness</subject><subject>Female</subject><subject>General aspects</subject><subject>Humans</subject><subject>Intestinal Perforation - mortality</subject><subject>Intestinal Perforation - surgery</subject><subject>Laparotomy - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Sepsis - mortality</subject><subject>Sepsis - surgery</subject><subject>Severity of Illness Index</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpF0EtPwkAUBeCJ0QiiiVs3ho3uijNz57lUFNQQJb5I2Eym06kpthQ7Jcq_t0SU1VncLzc5B6FjgnsEY3oRz0KPMWA7qE1A8IgSoXZRG2MsIwIUWugghBnGBDCn-6hFmCRCat1GJ9e2sO--68p5XZV5N7cLW5V1WawO0V5q8-CPNtlBr4Obl_5tNHoc3vUvR5EDJVhEOUggLlYuAcmFpJAI7RVmAE6KhDNMXJoonHidShwDJTyNpU5IyrgFq6CDzn__Lqryc-lDbYosOJ_ndu7LZTAKY02VZg083cBlXPjELKqssNXK_JVpwNkG2OBsnlZ27rKwdVxxAVo0Lvp1X1nuV9s7NusxTTOmWY9pru6f17n1Waj997-31YcRsiltJg9DM5Xjp8n4bWoG8AO0aHJy</recordid><startdate>200401</startdate><enddate>200401</enddate><creator>Finlay, I. G.</creator><creator>Edwards, T. J.</creator><creator>Lambert, A. W.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>200401</creationdate><title>Damage control laparotomy</title><author>Finlay, I. G. ; Edwards, T. J. ; Lambert, A. W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3864-253731cb8cd3756723d69e80433c76d5401cfd80de9f70b3215fb79d1f45a3a83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anastomosis, Surgical</topic><topic>Aortic Aneurysm, Abdominal - mortality</topic><topic>Aortic Aneurysm, Abdominal - surgery</topic><topic>Aortic Rupture - mortality</topic><topic>Aortic Rupture - surgery</topic><topic>Biological and medical sciences</topic><topic>Critical Illness</topic><topic>Female</topic><topic>General aspects</topic><topic>Humans</topic><topic>Intestinal Perforation - mortality</topic><topic>Intestinal Perforation - surgery</topic><topic>Laparotomy - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Sepsis - mortality</topic><topic>Sepsis - surgery</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Finlay, I. G.</creatorcontrib><creatorcontrib>Edwards, T. J.</creatorcontrib><creatorcontrib>Lambert, A. W.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Finlay, I. G.</au><au>Edwards, T. J.</au><au>Lambert, A. W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Damage control laparotomy</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2004-01</date><risdate>2004</risdate><volume>91</volume><issue>1</issue><spage>83</spage><epage>85</epage><pages>83-85</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background:
Damage Control Surgery (DCS) is well established in the management of trauma. This study assessed the results of DCS in the management of critically ill patients who had not had trauma.
Methods:
This was a prospective series of patients treated by DCS. The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and Portsmouth predictor equation (P‐POSSUM) were used to predict the risk of death, which was compared with the observed mortality rate.
Results:
Fourteen patients were studied. Nine had sepsis from gastrointestinal perforation. Eight of these underwent bowel resection without anastomosis or stoma formation at the initial laparotomy. Six patients later underwent bowel anastomosis and two had an end stoma formed at second laparotomy. A further three patients had a ruptured aortic aneurysm, one had a reactionary haemorrhage after elective aortic surgery, and one had a retroperitoneal bleed; all required haemostatic packing that was removed at second laparotomy. Mortality rates predicted by POSSUM and P‐POSSUM scoring were 64·5 and 49·6 per cent respectively. One patient (7·1 per cent) died after operation, giving an observed mortality rate significantly lower than predicted (P = 0·002 and P = 0·038 versus values predicted by POSSUM and P‐POSSUM, respectively).
Conclusion:
The use of DCS in the treatment of critically ill patients resulted in a lower mortality rate than that predicted by POSSUM or P‐POSSUM. DCS should not be restricted to trauma. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Not just for trauma</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>14716799</pmid><doi>10.1002/bjs.4434</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Aged Anastomosis, Surgical Aortic Aneurysm, Abdominal - mortality Aortic Aneurysm, Abdominal - surgery Aortic Rupture - mortality Aortic Rupture - surgery Biological and medical sciences Critical Illness Female General aspects Humans Intestinal Perforation - mortality Intestinal Perforation - surgery Laparotomy - methods Male Medical sciences Middle Aged Prospective Studies Risk Factors Sepsis - mortality Sepsis - surgery Severity of Illness Index |
| title | Damage control laparotomy |
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