Medicina

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Avaliação da morbidade e mortalidade dos pacientes submetidos à peritoneostomia no Hospital Regional de São José – SC
(2019) Dorigon, Manuella de Siqueira
Objective: Analyze the morbidity and mortality of patients undergoing peritoneostomy at the São José Regional Hospital (HRSJ). Methods: Cross-sectional study conducted at the HRSJ General Surgery Service with one hundred and eleven patients undergoing peritoneostomy, from July 2013 to July 2018, through data collection in medical records. Results: Overall mortality was 59.45% (66.7% trauma vs. 57.5% nontrauma). The average peritoneostomy time was 18.5 days (trauma 13.29 days vs. non-trauma 19.94 days, p = 0.03). The mean number of surgeries was 3.88 (2.67 trauma vs. 4.22 nontrauma, p <0.0001). The most used technique for peritoneostomy was Negative Pressure Therapy, recommended by Barker (63.9%). Fistulas and surgical site infections were the most frequent (64.1% and 33.3%, respectively). Complete closure of the abdominal wall was 50.5% (33.3% trauma vs. 55.2% nontrauma, p = 0.05). In patients who survived, the abdominal closure rate was 86.66%. The most used technique for wall closure was the progressive fascial approach with mesh (37.5%). Conclusion: Peritoneostomy is an effective technique for managing open abdomen, despite the related high morbidity and mortality. For this reason, it’s indication should be judicious and performed by experienced surgeons.