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

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

Free radicals and reproductive health

Studies performed during the last decades have focused on inflammation and on its involvement in many pathologies. Oxidative stress and reactive oxygen species have been put under close scrutiny in order to understand their effects on many biological processes: reproductive health is one of the fields in which research might lead to significant improvements. However, oxidative stress is required in order to achieve male fertility, and supplementation of antioxidants was associated with increased low birth weight: because of this, further studies are needed before confirming the hypothesis that antioxidants are a safe, inexpensive therapy for both male and female infertility