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Titolo:
STAGED PHYSIOLOGICAL RESTORATION AND DAMAGE CONTROL SURGERY
Autore:
MOORE EE; BURCH JM; FRANCIOSE RJ; OFFNER PJ; BIFFL WL;
Indirizzi:
DENVER HLTH MED CTR,DEPT SURG,777 BANNOCK ST DENVER CO 80204 UNIV COLORADO,HLTH SCI CTR DENVER CO 80220
Titolo Testata:
World journal of surgery
fascicolo: 12, volume: 22, anno: 1998,
pagine: 1184 - 1191
SICI:
0364-2313(1998)22:12<1184:SPRADC>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
ABDOMINAL COMPARTMENT SYNDROME; ELEVATED INTRAABDOMINAL PRESSURE; CRITICALLY ILL PATIENTS; TRAUMA PATIENTS; ABBREVIATED LAPAROTOMY; PLANNED REOPERATION; INJURED PATIENTS; BLOOD-FLOW; HYPOTHERMIA; COAGULOPATHY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
47
Recensione:
Indirizzi per estratti:
Citazione:
E.E. Moore et al., "STAGED PHYSIOLOGICAL RESTORATION AND DAMAGE CONTROL SURGERY", World journal of surgery, 22(12), 1998, pp. 1184-1191

Abstract

The fundamental objective of staged laparotomy is to accomplish definitive operative management in a calculated, stepwise fashion based on the patient's physiologic tolerance. This important concept has emerged from collective experience with massive acute abdominal injuries butclearly extends to elective operative procedures and surgical challenges in other torso compartments. Whereas the inability to achieve hemostasis is due most frequently to a recalcitrant coagulopathy followingtrauma, other scenarios include inaccessible venous injuries, coexisting extraperitoneal life-threatening injuries, uncertain viability of abdominal contents, and the inability to reapproximate abdominal fascia due to reperfusion-induced visceral edema. There are five critical decisionmaking phases of staged laparotomy;: I, patient selection; II, intraoperative reassessment; III, physiologic restoration in the surgical intensive care unit; IV, return to the operating room for definitive procedures; and V, abdominal wall reconstruction. The abdominal compartment syndrome (ACS) is a common, often insidious complication of staged Laparotomy. In fact, during phases II and III there is often a delicate balance between effective pressure tamponade of capillary bleeding and the untoward effects of the ACS. During phases IV and V a frequent dilemma is how to enclose the abdominal contents to reduce protein Loss and facilitate patient mobilization.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 03:12:07