open abdomen management and candida infections: a very likely link

open abdomen management and candida infections: a very likely link

;Savino Occhionorelli;Monica Zese;Rosario Cultrera;Domenico Lacavalla;Marco Albanese;Giorgio Vasquez
colloids and surfaces a: physicochemical and engineering aspects 2017 Vol. 2017 pp. -
139
occhionorelli2017gastroenterologyopen

Abstract

Objective. Laparostomy can be applied in trauma, abdominal sepsis, intra-abdominal hypertension, or compartment syndrome. Systemic infections, especially if complicated by Candida, are associated with a high risk of mortality. Methods. This is a single-centre retrospective case series of 47 cases admitted to our Department, which required laparostomy procedure; we analyzed the type of surgery, temporary abdominal closure, duration of open abdomen, complications, SOFA score, mortality with Candida infections, and empirical or targeted antifungal therapy. Results. We found that patients with Candida infection were related with a statistically significant difference (p<0.05) with a complication after OA closure, total complications, time elapsed after OA application, time spent on the first surgical OA application, type of temporary abdominal closure that is used, and duration of the open abdomen. The use of empirical and targeted antifungal therapy is related to the duration of open abdomen too. Conclusions. Management of the OA is often burdened by sepsis or septic shock, especially when complicated by Candida infection. Candida score is a validated tool to identify patients who can be treated empirically, but every situation must be considered on an individual basis.

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166162
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10.1155/2017/5187620
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