Ross S E, Morehouse P D
Am Surg. 1986 Jun;52(6):308-11.
In a 2-year period, 96 patients required laparotomy for trauma at the University of Kansas Medical Center. Fifteen patients required a total of 25 emergent and urgent reexplorations. Six patients required reoperation for bleeding, eight for intra-abdominal sepsis, and 3 for inadequate initial operation or missed injury. Forty per cent of patients undergoing multiple laparotomies died, versus 16 per cent for single operations. Factors predisposing to complications requiring re-laparotomy include multi-system trauma, blunt abdominal injury, and inadequate or delayed initial resuscitation and operation. Recognition of these factors and resuscitation and operation by personnel experienced in trauma care should lead to lower reoperation rates, and decreased morbidity and mortality when reoperation is necessary.
在两年时间里，堪萨斯大学医学中心有96例患者因创伤需要接受剖腹手术。15例患者共需要进行25次急诊和紧急再次探查手术。6例患者因出血需要再次手术，8例因腹腔内感染，3例因初次手术不充分或漏诊损伤。接受多次剖腹手术的患者死亡率为40%，而单次手术患者为16%。易引发需要再次剖腹手术并发症的因素包括多系统创伤、腹部钝性损伤以及初次复苏和手术不充分或延迟。认识到这些因素，并由有创伤护理经验的人员进行复苏和手术，应能降低再次手术率，并在必要时降低发病率和死亡率。
