Risk Factors for the Development and Surgical Management of Abdominal Compartment Syndrome

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  • Abdominal Compartment Syndromeの発症要因と治療法
  • -Efficacy of Vacuum Packing Closure-
  • ─Vacuum packing closureの有用性─

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Background: Abdominal compartment syndrome (ACS) may lead to multiple organ failure if left undiagnosed, therefore, intra-abdominal pressure monitoring is recommended for high-risk patients. However, currently, epidemiologic factors predicting the development of ACS remain elusive, and no guidelines exist for selecting a method for temporary abdominal closure (TAC) after decompressive laparotomy (DL). We analyzed ACS patients treated at our institute to clarify the risk factors for the development of ACS. In addition, we examined trauma patients who underwent damage control surgery (DCS) and evaluated the advantage of vacuum packing closure (VPC). Methods：Medical records of ACS patients treated at our institute since 2004 were reviewed. Trauma patients who underwent DCS between 1994 and 2011 were categorized into two groups according to the method of TAC, namely VPC and skin closure, and evaluated the efficacy of VPC. Results: Massive fluid resuscitation, coagulopathy and metabolic acidosis were commonly seen among all ACS patients. Hypothermia and abdominal/pelvic trauma were also commonly seen in the trauma patients. After DCS, postoperative ACS was less frequent among the patients in the VPC group. Conclusion: Patients receiving massive fluid resuscitation, coagulopathy and metabolic acidosis should be monitored for the development of ACS. After DL, VPC is an excellent method for TAC.

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