Damage control surgery and open abdomen in Hinchey III–IV acute diverticulitis: current practice from a nationwide Italian survey - Scorecard - MDSpire
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Current Approaches to Damage Control Surgery and Open Abdomen Management in Hinchey III–IV Acute Diverticulitis: Insights from a Nationwide Italian Survey
Clinical Scorecard: Current Approaches to Damage Control Surgery and Open Abdomen Management in Hinchey III–IV Acute Diverticulitis: Insights from a Nationwide Italian Survey
At a Glance
Category
Detail
Condition
Hinchey III–IV Acute Diverticulitis
Key Mechanisms
Damage control surgery (DCS) and open abdomen (OA) management strategies for source control and physiological optimization.
Target Population
Patients with generalized purulent or fecal peritonitis due to perforated acute colonic diverticulitis.
Care Setting
Emergency and general surgery
Key Highlights
Hartmann’s procedure is the predominant surgical strategy reported.
Primary anastomosis is used in fewer than one-quarter of cases.
Damage control surgery may reduce permanent stoma formation.
Commercial negative-pressure systems are the most common temporary abdominal closure method.
Substantial variability exists in surgical approaches and techniques.
Guideline-Based Recommendations
Diagnosis
Assessment of the severity of diverticulitis and presence of peritonitis.
Management
Consideration of damage control surgery for unstable patients.
Use of Hartmann’s procedure or primary anastomosis based on patient stability.
Monitoring & Follow-up
Scheduled reassessment after initial damage control surgery.
Risks
Risks associated with open abdomen include enteroatmospheric fistula and failure of fascial closure.
Patient & Prescribing Data
Patients undergoing surgery for Hinchey III–IV diverticulitis.
Awareness and application of damage control surgery and open abdomen management vary among institutions.
Clinical Best Practices
Utilize damage control surgery for selected unstable patients.
by Alessio Giordano, Manuela Mastronardi, Andrea Mingoli, Hayato Kurihara, Eugenio Cucinotta, Mauro Zago, Massimo Chiarugi, Roberto Cirocchi, Paolo Prosperi, Alan Biloslavo, Gianluca Costa
Head and neck abscess incidence was more than 3-fold higher following the pandemic, while patient characteristics and treatment patterns remained largely similar.
