J Acute Care Surg.  2021 Jul;11(2):64-70. 10.17479/jacs.2021.11.2.64.

Intra-Abdominal Gauze Packing for Uncontrolled Hemorrhage in Non-Trauma Patients

• Kim JM
• Kim CW
• Hong SK
• Lee HJ
• Yu CS
• Kim JC

• KMID: 2517675
• DOI: http://doi.org/10.17479/jacs.2021.11.2.64

Abstract

Purpose
The outcomes of non-trauma patients requiring intra-abdominal gauze packing for the management of uncontrollable hemorrhage following surgery, and the evaluation of survival risk factors were examined.
Methods
Data from patients who underwent intra-abdominal gauze packing to control bleeding during abdominal surgery between September 2012 and March 2019 were retrospectively reviewed.
Results
A total of 28 patients were included in the study population analysis. There were 9 patients who died during hospitalization. One patient died as a result of uncontrolled bleeding. In spite of gauze packing, 2 patients who had increasing blood transfusion requirements (> 4 packs/4 hours) were found to have arterial bleeding. Univariate analysis for hospital death showed that immunocompromised status, emergency surgery, a thrombocytopenic state prior to initial surgery, and a longer duration until gauze removal had a negative association with survival outcomes. Among these factors, only time to gauze removal > 36 hours was identified as an independent risk factor for survival outcome in the multivariate analysis.
Conclusions
Gauze packing could be considered as an effective method for the management of uncontrolled hemorrhage, in non-trauma patients. In cases of persistent bleeding after gauze packing, arterial bleeding should be suspected. Gauze removal after > 36 hours may indicate a poor survival outcome.

Keyword

abdomen, blood transfusion, hemorrhage, surgery