title: The open abdomen, indications, management and definitive closure.
abstract: The indications for Open Abdomen (OA) are generally all those situations in which is ongoing the development an intra-abdominal hypertension condition (IAH), in order to prevent the development of abdominal compartmental syndrome (ACS). In fact all those involved in care of a critically ill patient should in the first instance think how to prevent IAH and ACS. In case of ACS goal directed therapy to achieve early opening and early closure is the key: paradigm of closure shifts to combination of therapies including negative pressure wound therapy and dynamic closure, in order to reduce complications and avoid incisional hernia. There have been huge studies and progress in survival of critically ill trauma and septic surgical patients: this in part has been through the great work of pioneers, scientific societies and their guidelines; however future studies and continued innovation are needed to better understand optimal treatment strategies and to define more clearly the indications, because OA by itself is still a morbid procedure.
authors.affiliation: General Surgery Department, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127 Bergamo, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Coccolini
authors.affiliation: Denver Health Medical Center, Denver, CO USA.
authors.forename: Walter
authors.initials: W
authors.lastname: Biffl
authors.affiliation: General surgery Department, Ospedale Maggiore, Parma, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Catena
authors.affiliation: General Surgery Department, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127 Bergamo, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ceresoli
authors.affiliation: Niguarda Trauma Center, Ospedale Niguarda Ca'Granda, Milan, Italy.
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Chiara
authors.affiliation: Niguarda Trauma Center, Ospedale Niguarda Ca'Granda, Milan, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Cimbanassi
authors.affiliation: Unità Operativa di Chirurgia d'Urgenza, Azienda Ospedaliera "San Gerardo", Monza, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Fattori
authors.affiliation: Department of Abdominal Surgery, University of Helsinki, Helsinki, Finland.
authors.forename: Ari
authors.initials: A
authors.lastname: Leppaniemi
authors.affiliation: General Surgery Department, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127 Bergamo, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Manfredi
authors.affiliation: General Surgery Department, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127 Bergamo, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Montori
authors.affiliation: Unità Operativa di Chirurgia d'Urgenza, Azienda Ospedaliera "San Gerardo", Monza, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pesenti
authors.affiliation: Letterkenny Hospital and the Donegal Clinical Research Academy, Donegal, Ireland ; University College Hospital, Galway, Ireland.
authors.forename: Michael
authors.initials: M
authors.lastname: Sugrue
authors.affiliation: General Surgery Department, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127 Bergamo, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Ansaloni
keywords: Closure; Management; Open abdomen; Pancreatitis; Peritonitis; Trauma