Management of the open abdomen

Surg Clin North Am. 2014 Feb;94(1):131-53. doi: 10.1016/j.suc.2013.10.010.

Abstract

The open abdomen has become the standard of care in damage-control procedures, the management of intra-abdominal hypertension, and in severe intra-abdominal sepsis. This approach has saved many lives but has also created new problems, such as severe fluid and protein loss, nutritional problems, enteroatmospheric fistulas, fascial retraction with loss of abdominal domain, and development of massive incisional hernias. Early definitive closure is the basis of preventing or reducing the risk of these complications. The introduction of new techniques and materials for temporary and subsequent definitive abdominal closure has improved outcomes in this group of patients.

Keywords: Damage control; Enteroatmospheric fistula; Intra-abdominal hypertension; Open abdomen; Peritoneal sepsis; Temporary abdominal closure.

Publication types

  • Comparative Study

MeSH terms

  • Abdomen / surgery*
  • Acute Disease
  • Fasciotomy
  • Humans
  • Intestinal Fistula / diagnosis
  • Intestinal Fistula / etiology
  • Intestinal Fistula / surgery
  • Intra-Abdominal Hypertension / diagnosis
  • Intra-Abdominal Hypertension / etiology*
  • Intra-Abdominal Hypertension / surgery*
  • Negative-Pressure Wound Therapy
  • Peritonitis / diagnosis
  • Peritonitis / etiology*
  • Peritonitis / surgery*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Reoperation
  • Risk Factors
  • Sepsis / diagnosis
  • Sepsis / etiology*
  • Sepsis / surgery*
  • Suction
  • Suture Techniques