title: Making a virtue of necessity: managing the open abdomen.
abstract: BACKGROUND
  The open abdomen, or laparostomy, is becoming increasingly used in the management of critically ill surgical patients.
  
  
  METHODS
  The published work on laparostomy is reviewed, in the light of personal experience, with particular attention to the history and pathophysiology associated with laparostomy.
  
  
  CONCLUSIONS
  The combination of an inert plastic sheet in contact with the viscera, and the application of subatmospheric pressure on the wound, is an effective combination to maximize the prospects of delayed primary wound closure while minimizing the chance of fistula and ventral hernia.
authors.affiliation: Department of Surgery, Cairns Base Hospital, Cairns Private Hospital, Mount Druitt Hospital Sydney, New South Wales, Australia.
authors.forename: Alan
authors.initials: A
authors.lastname: de Costa
mesh_terms: D034861:Abdominal Wall / Q000473:pathology / Q000601:surgery*; D003161:Compartment Syndromes / Q000209:etiology / Q000628:therapy; D016154:Digestive System Fistula / Q000209:etiology / Q000628:therapy; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects*; D013526:Surgical Mesh; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000628:therapy; D013536:Suture Techniques; D014618:Vacuum; D014945:Wound Healing