[Late complications of open abdomen]

Open abdomen is the final result of a variety of diseases and their treatment strategies. The aim of this article is to present systematically late complications after open abdominal therapy and our own treatment results from 2003 to 2005. The main diagnoses for open abdomen are persistent peritonitis, abdominal compartment syndrome, and abdominal injuries. A perioperative mortality rate of 10-56%, long stays at the ICU, and a mean of 3-5 reoperations are characteristic for the severity of such diseases. Late complications may include incisional hernia (47-78%), gastrointestinal and pancreatic fistulas (8-41%), postoperative delayed abscess (10-21%), polyneuropathy (21%), psychic disorders (24%), indigestion (12%), and ossification (17%). These postoperative disorders may range in severity from clinically less significant to therapy-relevant with surgical consequences. Despite the high morbidity, approximately 75% of surviving patients achieve good quality of life. In our opinion, this justifies the extensive treatment concepts and associated high costs.