Damage Control Laparotomy in Trauma Patients: A Level I Trauma Center Experience
Introduction: The surgical management of traumatic injury is an evolving and controversial topic. We present outcomes of laparotomy performed for blunt and penetrating trauma at a level I trauma center over a nearly 10-year period. Material and Methods: Retrospective single-center cohort study of...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Albanian Society for Trauma and Emergency Surgery
2025-01-01
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| Series: | Albanian Journal of Trauma and Emergency Surgery |
| Subjects: | |
| Online Access: | http://journal.astes.org.al/AJTES/index.php/AJTES/article/view/423 |
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| Summary: | Introduction: The surgical management of traumatic injury is an evolving and controversial topic. We present outcomes of laparotomy performed for blunt and penetrating trauma at a level I trauma center over a nearly 10-year period.
Material and Methods: Retrospective single-center cohort study of patients who received either damage control laparotomy or definitive laparotomy with fascial closure at the time of index procedure. The primary outcome was in-hospital mortality. Secondary outcomes were length of stay, complications, intensive care requirements, and vasopressor use.
Results: Out of 125 included patients, 69 received damage control laparotomy, and 56 received definitive laparotomy. Damage control laparotomy was associated with significantly higher mortality (20.9% vs 1.8%, p=.0015) and length of stay (16.1 vs. 9.3 days, p=.0005) than definitive laparotomy. Complications occurred significantly more frequently among damage control laparotomy patients (53.6% vs. 14.3%, p<.0001). Damage control laparotomy patients were substantially more likely to require intensive care unit admission, mechanical ventilation, and vasopressor support.
Conclusion: Patients undergoing damage control laparotomy are at significantly increased risk for adverse outcomes, including increased in-hospital mortality, prolonged length of stay, more significant complication burden, and increased need for mechanical ventilation and pressure support as compared to patients undergoing definitive laparotomy.
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| ISSN: | 2521-8778 2616-4922 |