Delayed Closure of Ventral Abdominal Hernias After Severe Trauma

<p> <h4 id="x-x-absSec_1"> Background </h4> <p id="x-x-"> Primary closure after trauma celiotomies is not always accomplished. We reviewed our experience with delayed closure in trauma patients. <h4 id="x-x-absSec_2"> Methods </h4> <p id="x-x-"> Prospective data were collected on patients who had damage-control celiotomy and were discharged with open abdomens. The time to closure, repair methods, and complication data also were compiled. <h4 id="x-x-absSec_3"> Results </h4> <p id="x-x-"> In the 6-year period, 84 patients underwent damage-control celiotomy. Thirty-one patients died and 33 patients had early closure. Twenty patients had closure during a subsequent hospitalization (mean time to delayed closure, 193 days): 8 patients (40%) had component separation, 3 (15%) had component separation with mesh, 4 (20%) had mesh alone, and primary closure occurred in 5 (25%). Nine patients (45%) had complications such as wound and mesh infections, hernias, and fistulas. Repair before or after 6 months showed no statistically significant difference for the presence of complications or enterotomies ( <em> P </em> = .64 and .5743, respectively). <h4 id="x-x-absSec_4"> Conclusions </h4> <p id="x-x-"> Open-abdomen reconstruction presents significant challenges. Closure within 6 months is possible; the presence of complications is not affected by early repair. </p> </p> </p> </p></p>