Bedside open abdominal surgery. Utility and wound management.

Area of Science:

• Critical Care Medicine
• Surgical Critical Care
• Trauma Surgery

Background:

• Abdominal pathology in critically ill or injured patients often necessitates open abdominal techniques or surgery within the ICU.
• Management of open abdominal wounds requires specialized knowledge among ICU staff.

Purpose of the Study:

• To highlight the importance of open abdomen wound management techniques for ICU patients.
• To discuss the indications and feasibility of bedside abdominal surgery in the ICU.
• To emphasize the need for established protocols for Surgery Outside the Operating Room (SOR) programs.

Main Methods:

• Review of concepts and techniques for open abdomen wound management.
• Discussion of indications for ICU bedside abdominal surgery, including intra-abdominal hypertension (IAH) decompression.
• Consideration of feasibility for procedures like intra-abdominal packing changes at the bedside.

Main Results:

• ICU bedside abdominal surgery is indicated for unstable patients too critical for OR transport, especially for life-saving interventions like IAH decompression.
• Certain procedures, such as packing changes, can be safely performed at the bedside without OR use.
• Successful SOR programs rely on strong collaboration between surgeons and ICU staff.

Conclusions:

• All ICU personnel must be familiar with open abdomen wound management.
• Careful planning, including logistic details and scheduling protocols, is essential for implementing effective SOR programs.
• Bedside surgery in the ICU can be a life-saving option for critically ill patients when performed under appropriate conditions and with established protocols.