title: Management of critically ill surgical patients Case reports.
abstract: The acute abdomen (AA) still remains a challenging situation for surgeons. New pathological conditions have been imposed to our attention in this field in recent years. The definition of abdominal compartmental syndrome (ACS) in surgical practice and the introduction of new biological matrices, with the concepts of tension-free (TS) repair of incisional hernias, prompted us to set up new therapeutic strategies for the treatment of patients with AA. Thus we reviewed the cases of AA that we observed in recent years in which we performed a laparostomy in order to prevent or to treat an ACS. They are all cases of acute abdomen (AA), but from different origin, including chronic diseases, as in the course of inflammatory bowel disease (IBD), and acute pancreatitis. In all the cases, the open abdominal cavity was covered with a polyethylene sheet. The edges of the wound were sutured to the plastic sheet, and a traction exerted by a device that causes a negative pressure was added. This method was adopted in several cases without randomization, and resulted in excellent patient's outcomes.
  
  
  BACKGROUND
  Abdominal compartmental syndrome, Acute abdomen, Laparostomy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Mangiante
authors.forename: Roberto
authors.initials: R
authors.lastname: Padoan
authors.forename: Valentina
authors.initials: V
authors.lastname: Mengardo
authors.forename: Maria
authors.initials: M
authors.lastname: Bencivenga
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Manzoni
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology; D000230:Adenocarcinoma / Q000150:complications / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D002430:Cecal Neoplasms / Q000150:complications / Q000601:surgery; D003082:Colectomy; D016638:Critical Illness; D003424:Crohn Disease / Q000601:surgery; D019468:Disease Management; D004322:Drainage; D005260:Female; D006801:Humans; D007081:Ileostomy; D007416:Intestinal Perforation / Q000601:surgery; D059325:Intra-Abdominal Hypertension / Q000150:complications / Q000601:surgery*; D007582:Jejunostomy; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D010051:Ovarian Neoplasms / Q000601:surgery; D010052:Ovariectomy; D010195:Pancreatitis / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery*; D013536:Suture Techniques