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

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.