Detailed Instructions: Given a passage, construct a question on the basis of the information present in the passage. Construct the question in such a way that (i) it is unambiguous, (ii) it is answerable from the passage, (iii) its answer is unique (iv) it answer uses text phrases from the passage. Avoid creating questions that (i) can't be answered correctly without actually understanding the passage and (ii) uses the same words or phrases given in the passage.
Problem:The surgical treatment method in which the peritoneal cavity is opened anteriorly and deliberately left open, hence often called "open abdomen" has become the standard of care in damage-control procedures as well as in the management of intra-abdominal hypertension and in severe intra-abdominal sepsis. Whereas open abdomen has been closed in two stages traditionally, a modern trend is to close the fascial layers within the initial hospitalization to avoid complications like enterocutaneous fistula and hernia formation. The aim of this study was to determine crucial factors influencing the possibility of fascial closure after open abdomen.', 'Between 2003 and 2013, 355 adult patients were treated with open abdomen in our institution. Their data were collected and retrospectively analyzed. They were divided into two groups depending on fascial closure or not (fascial closure, n=137 (39%) vs. non-fascial closure, n=218 (61%)).', 'The patients who reached fascial closure had a significantly higher rate of initially performed open abdomen (97 patients (71%) vs. 118 (54%), p=0.002) and the periods of time until a second and a third look operation were significantly shorter (2.72.5 vs. 4.26.6 days, p=0.021 and 5.63.7 vs. 8.58.6 days, p=0.006). Furthermore, the presence of peritonitis (64 patients (47%) vs. 83 patients (38%), p=0.023) and large bowel resection (74 patients (54%) vs. 90 patients (41%), p=0.022) were significantly higher in this group. Rates of in-hospital mortality (97 patients (44%) vs. 38 patients (28%), p=0.002) and the presence of pancreatitis (19 patients (9%) vs. 3 patients (2%), p=0.013) were significantly higher in the non-fascial closure group.
Solution:
Are fascial closure after open abdomen : initial indication and early revisions decisive factors -- a retrospective cohort study?