title: Nutritional support in patients following damage control laparotomy with an open abdomen.
abstract: BACKGROUND
  Damage control laparotomy (DCL) and the open abdomen have been well accepted following either severe abdominal trauma or emergency surgical disease. As DCL is increasingly utilized as a therapeutic option, appropriate management of the post-DCL patient is important. Early caloric support by enteral nutrition (EN) in the critically ill patient improves wound healing and decreases septic complications, lung injury, and multi-system organ failure. However, following DCL, nutritional strategies can be challenging and, at times, even daunting.
  
  
  CONCLUSIONS
  Even though limited data exist, the use of early EN following DCL seems safe, provided that the patient is not undergoing active resuscitation or the bowel is not in discontinuity. It is unknown as to whether EN in the open abdomen reduces septic complications, prevents enterocutaneous fistula (ECF), or alters the timing of definitive abdominal wall closure. Future investigation in a prospective manner may help elucidate these important questions.
authors.affiliation: Division of Trauma, Surgical Critical Care and Burns, Department of Surgery, University of California San Diego Health Sciences, 200 West Arbor Drive, #8896, San Diego, CA, 92103, USA.
authors.forename: V
authors.initials: V
authors.lastname: Bansal
authors.affiliation: Division of Trauma, Surgical Critical Care and Burns, Department of Surgery, University of California San Diego Health Sciences, 200 West Arbor Drive, #8896, San Diego, CA, 92103, USA. rcoimbra@ucsd.edu.
authors.forename: R
authors.initials: R
authors.lastname: Coimbra
keywords: Damage control laparotomy; Enteral nutrition; Open abdomen
references.citation: J Trauma. 2003 Sep;55(3):551-4; discussion 554-5
references.pmid: 14501902
references.citation: JPEN J Parenter Enteral Nutr. 2007 Sep-Oct;31(5):410-5
references.pmid: 17712150
references.citation: Nutr Clin Pract. 2010 Oct;25(5):510-6
references.pmid: 20962311
references.citation: JPEN J Parenter Enteral Nutr. 1992 Jan-Feb;16(1):39-42
references.pmid: 1738217
references.citation: JPEN J Parenter Enteral Nutr. 2002 Jul-Aug;26(4):226-9
references.pmid: 12090686
references.citation: Nutr Clin Pract. 2004 Oct;19(5):511-7
references.pmid: 16215147
references.citation: J Trauma. 2005 Dec;59(6):1365-71; discussion 1371-4
references.pmid: 16394910
references.citation: World J Surg. 2012 Mar;36(3):516-23
references.pmid: 21976011
references.citation: J Trauma. 1993 Sep;35(3):375-82; discussion 382-3
references.pmid: 8371295
references.citation: J Trauma. 2011 Dec;71(6):1512-7; discussion 1517-8
references.pmid: 22182861
references.citation: Crit Care Med. 2010 Sep;38(9 Suppl):S421-30
references.pmid: 20724875
references.citation: Nutrition. 2003 Jun;19(6):563-6
references.pmid: 12781863
references.citation: Nutr Clin Pract. 2012 Aug;27(4):492-8
references.pmid: 22714062
references.citation: Ann Surg. 2004 May;239(5):608-14; discussion 614-6
references.pmid: 15082964
references.citation: Ann Surg. 1992 May;215(5):503-11; discussion 511-3
references.pmid: 1616387
references.citation: Surg Clin North Am. 2012 Aug;92(4):877-91, viii
references.pmid: 22850152
references.citation: Crit Care Med. 2008 Jun;36(6):1823-31
references.pmid: 18520642
references.citation: J Trauma. 2010 Jun;68(6):1425-38
references.pmid: 20539186
references.citation: Am J Surg. 2004 Dec;188(6):653-8
references.pmid: 15619479
references.citation: Crit Care Med. 2001 Dec;29(12):2264-70
references.pmid: 11801821
references.citation: Nutr Clin Pract. 2012 Aug;27(4):513-20
references.pmid: 22695712
references.citation: Nutr Clin Pract. 2003 Jun;18(3):253-8
references.pmid: 16215046
references.citation: Am J Surg. 2010 Mar;199(3):359-62; discussion 363
references.pmid: 20226910
references.citation: Clin Colon Rectal Surg. 2010 Sep;23(3):182-9
references.pmid: 21886468
references.citation: Crit Care Med. 2007 Jan;35(1):127-31
references.pmid: 17095940
references.citation: World J Surg. 2012 Mar;36(3):524-33
references.pmid: 22033622
references.citation: Best Pract Res Clin Anaesthesiol. 2004 Sep;18(3):439-54
references.pmid: 15212338
references.citation: J Am Coll Surg. 2008 Nov;207(5):690-7
references.pmid: 18954781
references.citation: J Trauma. 1989 Jul;29(7):916-22; discussion 922-3
references.pmid: 2501509
references.citation: JPEN J Parenter Enteral Nutr. 2003 Sep-Oct;27(5):355-73
references.pmid: 12971736
references.citation: J Trauma. 2001 Aug;51(2):261-9; discussion 269-71
references.pmid: 11493783
references.citation: Am Surg. 2010 Jun;76(6):637-9
references.pmid: 20583522
references.citation: J Trauma. 2007 Feb;62(2):307-10
references.pmid: 17297317
references.citation: J Trauma. 2010 Jul;69(1):46-52
references.pmid: 20622577
references.citation: Curr Opin Crit Care. 2008 Jun;14(3):327-33
references.pmid: 18467895
references.citation: J Intensive Care Med. 2012 May-Jun;27(3):161-71
references.pmid: 21436165
references.citation: Intensive Care Med. 2007 Jun;33(6):951-62
references.pmid: 17377769
references.citation: J Trauma. 1986 Oct;26(10):874-81
references.pmid: 3095557