title: Abdominal compartment syndrome and the open abdomen: any unresolved issues?
abstract: OBJECTIVE
  This article reviews the key principles of abdominal compartment syndrome and the open abdomen, exploring some of the unresolved issues. It reviews new concepts in care.
  
  
  RESULTS
  Recent use of peritoneal resuscitation, and benefits of mesh-mediated traction are discussed. Abdominal compartment syndrome remains a result of complex interaction between general haemorrhage, sepsis and fluid resuscitation. Improved resuscitation and sepsis control has decreased but not abolished the need for the open abdomen and progression for abdominal compartment syndrome. Fourth-generation abdominal wall dressings need to be combined with a dynamic closure system; currently, negative pressure wound therapy at the index open abdomen coupled with mesh-mediated tractions offers the best outcome.
  
  
  CONCLUSIONS
  The key to optimizing outcome is early abdominal closure within 7 days because failure to do so will increase morbidity, mortality and fistulae formation. Novel techniques complementing existing de-resuscitation techniques are discussed.
authors.affiliation: Department of Surgery, Letterkenny University Hospital, Donegal Clinical Research Academy Ireland, Donegal, Ireland.
authors.forename: Michael
authors.initials: M
authors.lastname: Sugrue
mesh_terms: D000005:Abdomen / Q000601:surgery*; D034841:Abdominal Cavity; D034861:Abdominal Wall; D003161:Compartment Syndromes / Q000209:etiology / Q000601:surgery*; D005440:Fluid Therapy; D006801:Humans; D059325:Intra-Abdominal Hypertension; D054843:Negative-Pressure Wound Therapy; D010538:Peritonitis; D018805:Sepsis / Q000601:surgery*