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World Journal of Surgery

, Volume 34, Issue 9, pp 2064–2068 | Cite as

Packing for Damage Control of Nontraumatic Intra-Abdominal Massive Hemorrhages

  • Filippo FilicoriEmail author
  • Salomone Di Saverio
  • Marco Casali
  • Andrea Biscardi
  • Franco Baldoni
  • Gregorio Tugnoli
Article

Abstract

Background

The Damage Control Surgery (DCS) approach to massive intraperitoneal hemorrhage has been shown to significantly reduce the morbidity and mortality in severely injured trauma patients. We applied the same principles to patients who developed a massive hemorrhage and the “lethal triad” (acidosis, hypothermia, coagulopathy) during a surgical procedure in order to assess feasibility and efficacy of DCS on nontraumatic grounds.

Methods

A retrospective analysis of eight consecutive cases was performed aimed at collecting information on laboratory parameters, fluids requirements, operative times, APACHE II score, damage control surgery procedure, angioembolization, morbidity, mortality, and need for repacking.

Results

Average APACHE II score was 25.5 (predicted mortality rate = 54%); overall and early mortality in the nontraumatic group was nil, while the intra-abdominal septic (packing-related) complication rate was 12.5%.

Conclusions

Intra-abdominal packing was shown to be feasible, safe, and effective for patients with intra-abdominal nontraumatic massive hemorrhage, and the application of the principles of DCS may improve survival in cases of surgical hemorrhage with development of the lethal triad.

Keywords

Compartment Syndrome Severe Acute Pancreatitis Open Abdomen Toxic Megacolon Injure Trauma Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflicts of interest statement

The authors declare no conflict of interest and/or relationships with people or businesses that could influence or bias the outcome of this paper.

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Copyright information

© Société Internationale de Chirurgie 2010

Authors and Affiliations

  • Filippo Filicori
    • 1
    Email author
  • Salomone Di Saverio
    • 1
  • Marco Casali
    • 1
  • Andrea Biscardi
    • 1
  • Franco Baldoni
    • 1
  • Gregorio Tugnoli
    • 1
  1. 1.Acute Care and Trauma Surgery UnitMaggiore Hospital Trauma CenterBolognaItaly

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