PROLONGED ABDOMINAL PACKING FOR TRAUMA IS ASSOCIATED WITH INCREASED MORBIDITY AND MORTALITY

Abdominal packing and planned reoperation is a lifesaving technique fo r temporary control of hemorrhage in severely injured patients. Morbid ity and mortality in this group of patients, however, remain significa nt. It is unclear whether the duration of packing impacts upon outcome . The purpose of this study is to evaluate the abscess, sepsis, and mo rtality rates associated with duration of abdominal packing. The recor ds of 35 patients treated with abdominal packing between July 1994 and December 1995 who survived to reoperation were retrospectively review ed. Evaluation included age; sex; mechanism; injuries; Abdominal Traum a Index; duration of packing; survival; and presence of abscess, sepsi s or other infections. Patients packed for a total of 72 hours or less had lower abscess, sepsis, and mortality rates than those packed for more than 72 hours. The differences in abscess rate and mortality were statistically significant (P < 0.05). The Abdominal Trauma Index and mechanism of injury were similar for the two groups. Based on these re sults, we conclude that although abdominal packing is a useful techniq ue in the severely injured patient, it is associated with greater morb idity and mortality when the duration of packing exceeds 72 hours.