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H. Harlan Stone, MD
Phoenix, Ariz

Arch Surg. 2001;136:681.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

This review of a 5-year experience with damage-control laparotomy by Offner et al provides concisely recorded data for thoughtful reflection. The results are quite good, yet I fear that avoidance of compartment syndrome at all costs is not an appropriate goal for many cases.

If, during initial exploration, the freshly shed blood clots and there is no ongoing complicating coagulopathy, then clearly the abdomen should be closed without such undo tension as would create a compartment syndrome and its attendant difficulties, ie, acute respiratory distress and/or multiple organ failure. Abdominal closure can thereby be selective and may be based on fascial approximation, mere skin closure, or insertion of some prosthesis, with overlying skin left either open or closed. However, if coagulopathy is overt, only the tamponading effect of an abdomen closed under tension can allay further massive bleeding, can obviate the need for infusion of even . . . [Full Text of this Article]

RELATED ARTICLE

Avoidance of Abdominal Compartment Syndrome in Damage-Control Laparotomy After Trauma
Patrick J. Offner, Almerindo Laurence de Souza, Ernest E. Moore, Walter L. Biffl, Reginald J. Franciose, Jeffrey L. Johnson, and Jon M. Burch
Arch Surg. 2001;136(6):676-681.
ABSTRACT | FULL TEXT