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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Albanian Society for Trauma and Emergency Surgery
2025-01-01
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| Series: | Albanian Journal of Trauma and Emergency Surgery |
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| Online Access: | http://journal.astes.org.al/AJTES/index.php/AJTES/article/view/423 |
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| author | Anthony J. Duncan Wade A. Hopper Mentor Ahmeti |
| author_facet | Anthony J. Duncan Wade A. Hopper Mentor Ahmeti |
| author_sort | Anthony J. Duncan |
| collection | DOAJ |
| description | 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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| format | Article |
| id | doaj-art-e00844077610426c9a151d4f255451a8 |
| institution | Kabale University |
| issn | 2521-8778 2616-4922 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Albanian Society for Trauma and Emergency Surgery |
| record_format | Article |
| series | Albanian Journal of Trauma and Emergency Surgery |
| spelling | doaj-art-e00844077610426c9a151d4f255451a82025-01-19T14:24:41ZengAlbanian Society for Trauma and Emergency SurgeryAlbanian Journal of Trauma and Emergency Surgery2521-87782616-49222025-01-019110.32391/ajtes.v9i1.423Damage Control Laparotomy in Trauma Patients: A Level I Trauma Center ExperienceAnthony J. Duncan0Wade A. Hopper1Mentor Ahmeti2School of Medicine & Health Sciences, Department of Surgery, University of North Dakota, USASchool of Medicine & Health Sciences, Department of Surgery, University of North Dakota, USADepartment of Trauma and Acute Care Surgery, Sanford Medical Center Fargo, North Dakota USAIntroduction: 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. http://journal.astes.org.al/AJTES/index.php/AJTES/article/view/423Damage control surgeryTraumaMortalityTrauma Center |
| spellingShingle | Anthony J. Duncan Wade A. Hopper Mentor Ahmeti Damage Control Laparotomy in Trauma Patients: A Level I Trauma Center Experience Albanian Journal of Trauma and Emergency Surgery Damage control surgery Trauma Mortality Trauma Center |
| title | Damage Control Laparotomy in Trauma Patients: A Level I Trauma Center Experience |
| title_full | Damage Control Laparotomy in Trauma Patients: A Level I Trauma Center Experience |
| title_fullStr | Damage Control Laparotomy in Trauma Patients: A Level I Trauma Center Experience |
| title_full_unstemmed | Damage Control Laparotomy in Trauma Patients: A Level I Trauma Center Experience |
| title_short | Damage Control Laparotomy in Trauma Patients: A Level I Trauma Center Experience |
| title_sort | damage control laparotomy in trauma patients a level i trauma center experience |
| topic | Damage control surgery Trauma Mortality Trauma Center |
| url | http://journal.astes.org.al/AJTES/index.php/AJTES/article/view/423 |
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