title: [Temporary abdominal closure and early and late pathophysiological consequences of treating an open abdomen].
abstract: BACKGROUND
  The open abdomen (OA) is a severe disease pattern accompanied by high morbidity and mortality. It is either result of a surgical dis-ease or approach. The aim of this review article is to provide a systematic overview on the options of a temporary closure of the abdominal wall including early and late consequences in the treatment of an open abdomen based on the current medical literature.
  
  
  METHODS
  Topic-related, selective, PubMed-based literature search of the last decade including historically relevant references combined with own clinical experiences.
  
  
  RESULTS
  The initial course is marked by problems in intensive care. The most frequent causes of -death are ventilatory problems, acute renal fail-ure, persisting infections and sepsis as well as multiorgan failure. Intensive care duration ranges from 13 to 65 days. Perioperative mortality is account-ed for 10-52 %. Specific complications can be seen in surviving patients such as enteroatmospheric fistula (1.3-41 %), ventral hernia (32-100 %), intraabdominal abscess formation (2.1-21 %), intestinal adhesions and digestion disturbances, neurological und psychological problems (approximately 20 %) as well as heterotopic ossification (17-25 %).
  
  
  CONCLUSIONS
  Application of a temporary abdominal closure aims to avoid those complications. Furthermore, time and effort for care and treatment are recommended to be reduced as patients comfort should be improved, simultaneously. Primary fascial closure is of utmost importance to reach this goal. Procedures with highest fascial closure rate (Wittmann patch, STAR, 75-93 %; dynamic retention sutures, 61-91 %; V.A.C., 69-84 %) have lowest mortality.
  
  
  CONCLUSIONS
  Type and severity of the various early and late consequences in the treatment of an open abdomen are substantially determined by the complication-inducing causes and the basic disease as well as by the options of an efficient, even in some cases temporary closure of the abdominal wall.
authors.affiliation: Universitätsklinikum Magdeburg A. ö. R., Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Magdeburg, Deutschland. olof.jannasch@med.ovgu.de
authors.forename: O
authors.initials: O
authors.lastname: Jannasch
authors.forename: J
authors.initials: J
authors.lastname: Tautenhahn
authors.forename: H
authors.initials: H
authors.lastname: Lippert
authors.forename: F
authors.initials: F
authors.lastname: Meyer
mesh_terms: D058107:Abdominal Wound Closure Techniques; D002423:Cause of Death; D003422:Critical Care; D000071938:Fasciotomy; D046449:Hernia, Abdominal / Q000401:mortality / Q000517:prevention & control / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D007412:Intestinal Fistula / Q000401:mortality / Q000517:prevention & control / Q000601:surgery; D059325:Intra-Abdominal Hypertension / Q000401:mortality / Q000517:prevention & control / Q000601:surgery; D007902:Length of Stay / Q000706:statistics & numerical data; D009102:Multiple Organ Failure / Q000401:mortality / Q000517:prevention & control / Q000601:surgery; D054843:Negative-Pressure Wound Therapy / Q000379:methods; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control / Q000601:surgery; D012086:Reoperation; D018805:Sepsis / Q000401:mortality / Q000517:prevention & control / Q000601:surgery; D013530:Surgical Wound Infection / Q000401:mortality / Q000517:prevention & control / Q000601:surgery; D013537:Sutures; D014945:Wound Healing / Q000502:physiology