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.

Coccolini, F., Roberts, D., Ansaloni, L., Ivatury, R., Gamberini, E., Kluger, Y., et al. (2018). The open abdomen in trauma and non-trauma patients: WSES guidelines. WORLD JOURNAL OF EMERGENCY SURGERY, 13(1) [10.1186/s13017-018-0167-4].

The open abdomen in trauma and non-trauma patients: WSES guidelines

Ansaloni L.;Ceresoli M.;Chiara O.;
2018

Abstract

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.
Articolo in rivista - Articolo scientifico
Biological; Closure; Fistula; Guidelines; Intra-abdominal infection; Laparostomy; Mesh; Non-trauma; Nutrition; Open abdomen; Pancreatitis; Peritonitis; Re-exploration; Reintervention; Synthetic; Technique; Timing; Trauma; Vascular emergencies
English
2018
13
1
7
none
Coccolini, F., Roberts, D., Ansaloni, L., Ivatury, R., Gamberini, E., Kluger, Y., et al. (2018). The open abdomen in trauma and non-trauma patients: WSES guidelines. WORLD JOURNAL OF EMERGENCY SURGERY, 13(1) [10.1186/s13017-018-0167-4].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/283944
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