Open abdomen and entero-atmospheric fistulae: An interim analysis from the International Register of Open Abdomen (IROA)

Federico Coccolini, Marco Ceresoli, Yoram Kluger, Andrew Kirkpatrick, Giulia Montori, Fracensco Salvetti, Paola Fugazzola, Matteo Tomasoni, Massimo Sartelli, Luca Ansaloni, Fausto Catena, Ionut Negoi, Monica Zese, Savino Occhionorelli, Sergei Shlyapnikov, Christian Galatioto, Massimo Chiarugi, Zaza Demetrashvili, Daniele Dondossola, Orestis IoannidisGiuseppe Novelli, Mirco Nacoti, Desmond Khor, Kenji Inaba, Demetrios Demetriades, Torsten Kaussen, Asri Che Jusoh, Wagih Ghannam, Boris Sakakushev, Ohad Guetta, Agron Dogjani, Stefano Costa, Sandeep Singh, Dimitrios Damaskos, Arda Isik, Kuo Ching Yuan, Francesco Trotta, Stefano Rausei, Aleix Martinez-Perez, Giovanni Bellanova, Vinicius Cordeiro Fonseca, Fernando Hernández, Athanasios Marinis, Wellington Fernandes, Martha Quiodettis, Miklosh Bala, Andras Vereczkei, Rafael Curado, Gustavo Pereira Fraga, Bruno M. Pereira, Mahir Gachabayov, Guillermo Perez Chagerben, Miguel Leon Arellano, Sefa Ozyazici, Gianluca Costa, Tugan Tezcaner, Matteo Porta, Yousheng Li, Faruk Karateke, Dimitrios Manatakis, Federico Mariani, Federic Lora, Ivan Sahderov, Boyko Atanasov, Sergio Zegarra, Luca Gianotti, Luca Fattori, Rao Ivatury

Research output: Contribution to journalArticlepeer-review

40 Citations (Scopus)


Introduction: No definitive data describing associations between cases of Open Abdomen (OA) and Entero-atmospheric fistulae (EAF) exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) thus analyzed the International Register of Open Abdomen (IROA) to assess this question. Material and methods: A prospective analysis of adult patients enrolled in the IROA. Results: Among 649 adult patients with OA 58 (8.9%) developed EAF. Indications for OA were peritonitis (51.2%) and traumatic-injury (16.8%). The most frequently utilized temporary abdominal closure techniques were Commercial-NPWT (46.8%) and Bogotà-bag (21.9%). Mean OA days were 7.9 ± 18.22. Overall mortality rate was 29.7%, with EAF having no impact on mortality. Multivariate analysis associated cancer (p = 0.018), days of OA (p = 0.003) and time to provision-of-nutrition (p = 0.016) with EAF occurrence. Conclusion: Entero-atmospheric fistulas are influenced by the duration of open abdomen treatment and by the nutritional status of the patient. Peritonitis, intestinal anastomosis, negative pressure and oral or enteral nutrition were not risk factors for EAF during OA treatment.

Original languageEnglish
Pages (from-to)160-166
Number of pages7
Issue number1
Publication statusPublished - Jan 1 2019
Externally publishedYes


  • Entero-atmospheric fistula
  • Fistula
  • IROA
  • Open abdomen
  • Intestinal Fistula/mortality
  • Prospective Studies
  • Negative-Pressure Wound Therapy
  • Humans
  • Middle Aged
  • Abdominal Wound Closure Techniques/mortality
  • Digestive System Surgical Procedures/methods
  • Male
  • Treatment Outcome
  • Abdominal Cavity/surgery
  • Young Adult
  • Adult
  • Female

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine


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