Trauma Laparotomy: A Surgical Odyssey

Surgical Health Collective

*Corresponding Author: Mark L Walker, M.D., F.A.C.S. Surgical Health Collective, 1691 Phoenix Boulevard Suite 120 Atlanta, Georgia 30349, USA, Phone: 404-761-7482, E-mail: [email protected]

Received Date: January 02, 2025

Published Date: February 18, 2025

Citation: Walker ML. (2025). Trauma Laparotomy: A Surgical Odyssey. Mathews J Surg. 8(1):35.

Copyrights: Walker ML. © (2025).

ABSTRACT

A retrospective analysis of 203 trauma patients undergoing laparotomy over an 18-year period by a single surgeon at a level 1 trauma center was performed. These were young (mean age=33.84+/-14.74) seriously injured (mean ISS=22.32+/-11.61) patients who sustained a mix of blunt (52%) and penetrating injury (48%). Many of these patients were in shock at the time of admission (mean base deficit 7.30+/-5.06). Patients requiring a massive transfusion protocol (MTP) were stratified. Those with a single laparotomy and MTP had more balanced resuscitation when compared to those with MTP and damage control. The overall mortality was 5.4%. A damage control laparotomy was performed in 34 patients with a mortality of 23.5%(8 patients). 4 patients received ultra-massive transfusion (more than 20 units of Packed red cells) during their initial operation. 3 of these patient survived. A stepwise regression analysis yielded GCS (Glasgow Coma Score) as the sole predictor of outcome. Individual trauma surgeons can continue the search for better outcomes by reviewing their overall care.

Keywords: Trauma Patients, Laparotomy, Hemodynamic Stability, Surgical Infection.