Damage control in abdominal vascular trauma

García, Alberto; Millán, Mauricio; Burbano, Daniela; Ordóñez, Carlos A.; Parra, Michael W.; González-Hadad, Adolfo; Herrera, Mario Alain; Pino, Luis Fernando; Rodríguez-Holguín, Fernando; Salcedo, Alexander; Franco, María Josefa; Ferrada, Ricardo; Puyana, Juan Carlos

doi:10.25100/cm.v52i2.4808

Cited by 6 publications

(6 citation statements)

References 64 publications

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“…When in the operating room, patients underwent a DCL (involving surgical control of bleeding and contamination plus packing with laparotomy pads plus leaving the abdominal wall open) if there was evidence of hypothermia, metabolic acidosis or hyperlactatemia (reflecting physiological exhaustion), hemoperitoneum and/or destructive intra-abdominal organ injuries. A detailed description on how we approach and provide surgical treatment to patients with abdominal injuries requiring damage-control surgery at our institution is described elsewhere [ 9 , 10 ].…”

Section: Methodsmentioning

confidence: 99%

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Hypertonic saline infusion does not improve the chance of primary fascial closure after damage control laparotomy: a randomized controlled trial

et al. 2023

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Background Previous observational studies showed higher rates of abdominal wall closure with the use of hypertonic saline in trauma patients with abdominal injuries. However, no randomized controlled trials have been performed on this matter. This double-blind randomized clinical trial assessed the effect of 3% hypertonic saline (HS) solution on primary fascial closure and the timing of abdominal wall closure among patients who underwent damage control laparotomy for bleeding control. Methods Double-blind randomized clinical trial. Patients with abdominal injuries requiring damage control laparotomy (DCL) were randomly allocated to receive a 72-h infusion (rate: 50 mL/h) of 3% HS or 0.9 N isotonic saline (NS) after the index DCL. The primary endpoint was the proportion of patients with abdominal wall closure in the first seven days after the index DCL. Results The study was suspended in the first interim analysis because of futility. A total of 52 patients were included. Of these, 27 and 25 were randomly allocated to NS and HS, respectively. There were no significant differences in the rates of abdominal wall closure between groups (HS: 19 [79.2%] vs. NS: 17 [70.8%]; p = 0.71). In contrast, significantly higher hypernatremia rates were observed in the HS group (HS: 11 [44%] vs. NS: 1 [3.7%]; p < 0.001). Conclusion This double-blind randomized clinical trial showed no benefit of HS solution in primary fascial closure rates. Patients randomized to HS had higher sodium concentrations after the first day and were more likely to present hypernatremia. We do not recommend using HS in patients undergoing damage control laparotomy. Trial registration The trial protocol was registered in clinicaltrials.gov (identifier: NCT02542241).

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Section: Methodsmentioning

confidence: 99%

“…The protocol for organ injury management and abdominal wall closure has been previously published [ 9 , 10 , 15 ]. In brief, delayed abdominal closure was considered a bridge to achieve three main goals: 1. compartment syndrome prevention, 2. definitive control of bleeding and contamination, and 3. definitive wound healing.…”

Section: Methodsmentioning

confidence: 99%

Hypertonic saline infusion does not improve the chance of primary fascial closure after damage control laparotomy: a randomized controlled trial

et al. 2023

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“…En pacientes hemodinámicamente normales, sin signos de peritonitis, se puede realizar una evaluación más detallada con el fin de determinar si existe una lesión específica, o si se desarrollan signos de peritonitis o hemorragia durante el período de observación. (Garcia et al, 2021)…”

Section: Evaluación Inicialunclassified

“…Figura 3 Traumatismo penetrante en la arteria ilíaca derecha. (Garcia et al, 2021) Se requiere juicio quirúrgico para determinar el momento y la necesidad de la laparotomía. Indicaciones para la laparotomía según el ATLS:…”

Section: Laparoscopiaunclassified

Revisión bibliográfica: manejo del Trauma Penetrante de Abdomen

Daniel¹,

Reyna²,

Valencia³

et al. 2023

Braz. J. Hea. Rev.

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El trauma de abdomen es uno de los principales causas de morbilidad a nivel mundial. Las lesiones graves producto de este, son una de las primeras causas de discapacidad en todo el mundo. Anteriormente, durante muchos años la laparotomía de rutina para todas las heridas abdominales potencialmente penetrantes era el estándar de oro, hoy en día la disponibilidad diversas tecnologías y estudios permiten tener un abordaje distinto según el estado del paciente, y por ende el tratamiento quirúrgico está basado principalmente en los hallazgos clínicos y en los parámetros hemodinámicos. En la siguiente revisión bibliográfica se abordará el manejo del trauma penetrante de abdomen.

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“…Once the emergent damage was contained, the surgeon made the determination of “damage control” to conclude the operation, allowing for physiological stabilization (García et al, 2021; Sartelli et al, 2015). The patient would return for multiple reconstructive surgeries.…”

Section: Case Presentationmentioning

confidence: 99%

Bison Goring Resulting in Abdominal Evisceration and Cervical Fracture: A Case Report

Miles

Quinlan

Daniel

2022

Journal of Trauma Nursing

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CASE REPORTL arge animal behavior is unpredictable. Direct contact with livestock places farmers and ranchers at risk (Fraser-Williams et al., 2016). Agricultural workers often have cattle management experience leading to increased comfort and complacency and less fear when working with the animals (Fraser-Williams et al., 2016). Traumatic perforation injuries from animal goring may result in severe intestinal damage requiring immediate surgical intervention (Lloyd, 2004). CASE PRESENTATIONA man who sustained a bison bull goring is presented using the SCARE 2020 Criteria guidelines (Agha et al., 2020). Patient consent was obtained. The patient was an active 83-year-old White man who owned and operated a bison ranch. His primary medical history included hypertension, hyperlipidemia, a hernia repair, and a vasectomy. He reported an allergy to hydrocodone. He had no history of smoking, alcohol, or recreational drug use.

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Damage control in abdominal vascular trauma

Cited by 6 publications

References 64 publications

Hypertonic saline infusion does not improve the chance of primary fascial closure after damage control laparotomy: a randomized controlled trial

Hypertonic saline infusion does not improve the chance of primary fascial closure after damage control laparotomy: a randomized controlled trial

Revisión bibliográfica: manejo del Trauma Penetrante de Abdomen

Bison Goring Resulting in Abdominal Evisceration and Cervical Fracture: A Case Report

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