Classification--important step to improve management of patients with an open abdomen.
This short report is a distillation of the proceedings from a consensus group meeting in January 2009. It outlines a proposed classification system for patients with an open abdomen (OA). The classification allows (1) a description of the patient's clinical course; (2) standardized clinical guidelines for improving OA management; and (3) improved reporting of OA status, which will facilitate comparisons between studies and heterogeneous patient populations. The following grading is suggested: grade 1A, clean OA without adherence between bowel and abdominal wall or fixity of the abdominal wall (lateralization); grade 1B, contaminated OA without adherence/fixity; grade 2A, clean OA developing adherence/fixity; grade 2B, contaminated OA developing adherence/fixity; grade 3, OA complicated by fistula formation; grade 4, frozen OA with adherent/fixed bowel, unable to close surgically, with or without fistula. We propose that this classification system will facilitate communication, clarify OA management, and potentially improve patient care.
Department of Vascular Surgery, Institution of Surgical Sciences, Uppsala University Hospital, Uppsala, SE-751 85, Sweden. martin@bjorck.pp.se
Martin
M
Björck
Andreas
A
Bruhin
Michael
M
Cheatham
Daniel
D
Hinck
Mark
M
Kaplan
Guiseppe
G
Manca
Thomas
T
Wild
Alastair
A
Windsor
D034861:Abdominal Wall / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects / Q000145:classification*; D017408:Guidelines as Topic; D006801:Humans; D013530:Surgical Wound Infection / Q000145:classification*; D000267:Tissue Adhesions / Q000145:classification