Packing and re-exploration for patients with nonhepatic injuries

Susan Talbert, Stanley Trooskin, Thomas Scalea, Ernst Vieux, Nabil Atweh, Albert Duncan, Salvatore Sclafani

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

We retrospectively reviewed the clinical records of 11 patients admitted to the trauma service at Kings County Hospital who underwent packing and temporary closure for severe nonhepatic injuries. The mean ISS was 37 and the mean Abdominal Trauma Index value was 48. Operative findings included 17 major vascular injuries. Although the mean blood pressure was 105 mm Hg during the procedure, the patients required an average of 17 units of blood and all were acidotic, hypothermic, and coagulopathic. Acidosis persisted in all patients and the mean base excess was -13 at closure. A conscious decision was made to terminate the procedure when surgical bleeding was controlled. Patients were resuscitated and warmed in the ICU and returned to the operating room within 48 hours. Seven of the 11 patients survived. Of the eight patients who survived to return to the operating room, all required gastrointestinal procedures at re-exploration. This preliminary experience supports packing to control coagulopathic bleeding, use of temporary abdominal closure, and further ICU resuscitation with a planned second laparotomy for definitive management of gastrointestinal injuries in patients with severe nonhepatic injuries.

Original languageEnglish (US)
Pages (from-to)121-125
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume33
Issue number1
DOIs
StatePublished - Jan 1 1992
Externally publishedYes

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Wounds and Injuries
Operating Rooms
Hemorrhage
County Hospitals
Vascular System Injuries
Acidosis
Resuscitation
Laparotomy
Blood Pressure

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine
  • Surgery

Cite this

Talbert, Susan ; Trooskin, Stanley ; Scalea, Thomas ; Vieux, Ernst ; Atweh, Nabil ; Duncan, Albert ; Sclafani, Salvatore. / Packing and re-exploration for patients with nonhepatic injuries. In: Journal of Trauma - Injury, Infection and Critical Care. 1992 ; Vol. 33, No. 1. pp. 121-125.
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Packing and re-exploration for patients with nonhepatic injuries. / Talbert, Susan; Trooskin, Stanley; Scalea, Thomas; Vieux, Ernst; Atweh, Nabil; Duncan, Albert; Sclafani, Salvatore.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 33, No. 1, 01.01.1992, p. 121-125.

Research output: Contribution to journalArticle

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