Khirurgiia · 2026
[Risk factors and algorithm for choosing abdominal closure strategy in staged treatment of penetrating wounds].
Аннотация на английскомСтатьяНазвание и аннотация: Оригинал на русском
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Paharev I V, Badalov V I, Goncharov A V, Pichugin A A, Suvorov V V, Markevich V Yu, Kuraev P I, Oganesyan R D
Аннотация
OBJECTIVE: To analyze the influence of local and systemic factors on reparative processes of laparotomy wound for optimized choice of abdominal closure strategy.
MATERIAL AND METHODS: A retrospective analysis enrolled 62 patients with penetrating abdominal wounds. Local (intra-abdominal complications, risk of abdominal compartment syndrome, number of relaparotomies) and systemic (total blood protein and urea) factors were assessed.
RESULTS: Statistical analysis revealed predictors of suture failure. Independent risk factors of aponeurotic suture failure were serum urea (odds ratio 0.754; p=0.020) and total protein (odds ratio 1.195; p=0.028) upon abdominal closure. Local factors (surgical site infection, peritonitis, abdominal compartment syndrome) were absolutely associated with failure (p<0.001).
CONCLUSION: A formalized algorithm consistently evaluates local factors and serum protein/urea with high predictive value of positive result (91.11%). Original algorithm objectifies the choice of abdominal closure strategy (primary suturing, controlled negative pressure or programmable hernia) and minimizes the risk of suture failure.
MATERIAL AND METHODS: A retrospective analysis enrolled 62 patients with penetrating abdominal wounds. Local (intra-abdominal complications, risk of abdominal compartment syndrome, number of relaparotomies) and systemic (total blood protein and urea) factors were assessed.
RESULTS: Statistical analysis revealed predictors of suture failure. Independent risk factors of aponeurotic suture failure were serum urea (odds ratio 0.754; p=0.020) and total protein (odds ratio 1.195; p=0.028) upon abdominal closure. Local factors (surgical site infection, peritonitis, abdominal compartment syndrome) were absolutely associated with failure (p<0.001).
CONCLUSION: A formalized algorithm consistently evaluates local factors and serum protein/urea with high predictive value of positive result (91.11%). Original algorithm objectifies the choice of abdominal closure strategy (primary suturing, controlled negative pressure or programmable hernia) and minimizes the risk of suture failure.