Coppola Andrea, Mottola Arianna, Della Corte Marcello, Valeriani Mariafelicia, Aprea Giovanni, Festa Patrizio, Palomba Giuseppe
Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno, 84131, Italy.
Trauma Center, "Antonio Cardarelli" Hospital, Via A. Cardarelli 9, Naples, 80131, Italy.
Langenbecks Arch Surg. 2025 May 16;410(1):160. doi: 10.1007/s00423-025-03729-1.
Abdominal trauma is the third leading cause of death in the young population, and liver trauma is among the most common. For major liver injury, perihepatic packing (PHP) is a life-saving procedure that allows rapid control of the hemorrhage. The use of the open abdomen (OA) represents a strategy for the management of major abdominal trauma. However, the effects of combined use with Negative Pressure Therapy (NPT) in patients with liver trauma are not yet clear. The aim of our study was to evaluate the safety and feasibility of OA with NPT.
This retrospective bicenter study enrolled all patients affected by liver trauma who underwent operative management from January 2019 to September 2023 at the Emergency Surgical Units of the "A. Cardarelli" Hospital in Naples and the "San Giovanni di Dio e Ruggi d'Aragona" in Salerno. The two groups were compared in terms of intra- and postoperative outcomes.
Out of a total of 213 patients with liver trauma, 43 patients were divided into two groups: group A (24 patients treated with PHP and OA) and group B (19 patients with PHP, OA and NPT). There were no significant differences in terms of demographic data, preoperative characteristics, length of stay, mortality, or intraoperative or postoperative complications. Hb increase at the time of depacking was higher in group B (p = 0.039).
Open Abdomen with Negative Pressure Therapy appears safe and feasible. Furthermore, it does not affect mortality or hospital stay but it seems to be associated with higher hemoglobin (Hb) levels during the depacking phase.
腹部创伤是年轻人群中第三大死因，肝创伤是最常见的创伤之一。对于严重肝损伤，肝周填塞术（PHP）是一种挽救生命的手术，可迅速控制出血。采用开放腹腔（OA）是治疗严重腹部创伤的一种策略。然而，肝创伤患者联合使用负压治疗（NPT）的效果尚不清楚。我们研究的目的是评估OA联合NPT的安全性和可行性。
这项回顾性双中心研究纳入了2019年1月至2023年9月在那不勒斯“A. Cardarelli”医院和萨勒诺“San Giovanni di Dio e Ruggi d'Aragona”医院急诊外科接受手术治疗的所有肝创伤患者。比较两组患者的术中及术后结果。
在总共213例肝创伤患者中，43例患者分为两组：A组（24例接受PHP和OA治疗）和B组（19例接受PHP、OA和NPT治疗）。两组在人口统计学数据、术前特征、住院时间、死亡率或术中及术后并发症方面无显著差异。B组在拆除填塞物时血红蛋白（Hb）升高幅度更高（p = 0.039）。
负压治疗的开放腹腔似乎是安全可行的。此外，它不影响死亡率或住院时间，但在拆除填塞物阶段似乎与较高的血红蛋白（Hb）水平相关。
