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The open abdomen in trauma and non-trauma patients: WSES guidelines
General Emergency and Trauma Surgery, Bufalini Hospital, Cesena, Italy.
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Cardiothoracic and Vascular Surgery.
Emergency and Trauma Surgery, Parma Maggiore Hospital, Parma, Italy.
Number of Authors: 74
2018 (English)In: World Journal of Emergency Surgery, ISSN 1749-7922, E-ISSN 1749-7922, Vol. 13, article id 7Article, review/survey (Refereed) Published
Abstract [en]

Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a "planned second-look" laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption. The open abdomen in trauma and non-trauma patients has been proposed to be effective in preventing or treating deranged physiology in patients with severe injuries or critical illness when no other perceived options exist. Its use, however, remains controversial as it is resource consuming and represents a non-anatomic situation with the potential for severe adverse effects. Its use, therefore, should only be considered in patients who would most benefit from it. Abdominal fascia-to-fascia closure should be done as soon as the patient can physiologically tolerate it. All precautions to minimize complications should be implemented.

Place, publisher, year, edition, pages
BioMed Central, 2018. Vol. 13, article id 7
Keyword [en]
Open abdomen, Laparostomy, Non-trauma, Trauma, Peritonitis, Pancreatitis, Vascular emergencies, Intra-abdominal infection, Fistula, Nutrition, Re-exploration, Reintervention, Closure, Biological, Synthetic, Mesh, Technique, Timing, Guidelines
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-65026DOI: 10.1186/s13017-018-0167-4ISI: 000424151800001OAI: oai:DiVA.org:oru-65026DiVA, id: diva2:1183293
Available from: 2018-02-16 Created: 2018-02-16 Last updated: 2018-02-16Bibliographically approved

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Hörer, Tal M.

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