title: How to deal with an open abdomen?
abstract: Appropriate open abdomen treatment is one of the key elements in the management of patients who require decompressive laparotomy or in whom the abdomen is left open prophylactically. Apart from fluid control and protection from external injury, fluid evacuation and facilitation of early closure are now the goals of open abdomen treatment. Abdominal negative pressure therapy has emerged as the most appropriate method to reach these goals. Especially when combined with strategies that allow progressive approximation of the fascial edges, high closure rates can be obtained. Intra-abdominal pressure measurement can be used to guide the surgical strategy and continued attention to intra-abdominal hypertension is necessary. This paper reviews recent advances as well as identifying the remaining challenges in patients requiring open abdomen treatment. The new classification system of the open abdomen is an important tool to use when comparing the efficacy of different strategies, as well as different systems of temporary abdominal closure.
authors.affiliation: Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium. Jan.DeWaele@UGent.be.
authors.forename: Jan J
authors.initials: JJ
authors.lastname: De Waele
authors.forename: Mark
authors.initials: M
authors.lastname: Kaplan
authors.forename: Michael
authors.initials: M
authors.lastname: Sugrue
authors.forename: Pablo
authors.initials: P
authors.lastname: Sibaja
authors.forename: Martin
authors.initials: M
authors.lastname: Björck
mesh_terms: D000005:Abdomen / Q000601:surgery*; D034841:Abdominal Cavity; D006801:Humans; D059325:Intra-Abdominal Hypertension; D007813:Laparotomy / Q000379:methods; D008150:Lower Body Negative Pressure / Q000379:methods*
keywords: damage control; laparostomy; negative pressure therapy; open abdomen