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How to deal with an open abdomen?
Jan J De Waele1, Mark Kaplan, Michael Sugrue
1Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium. Jan.DeWaele@UGent.be.
Anaesthesiology Intensive Therapy
|May 15, 2015
Summary
Open abdomen treatment aims to control fluids and facilitate early closure. Abdominal negative pressure therapy, combined with progressive fascial approximation, achieves high closure rates in patients requiring decompressive laparotomy.
Area of Science:
- Surgical management
- Critical care medicine
Background:
- Open abdomen management is crucial for patients undergoing decompressive laparotomy or prophylactic abdominal opening.
- Current goals include fluid control, external protection, fluid evacuation, and early abdominal closure.
Purpose of the Study:
- To review recent advancements in open abdomen treatment.
- To identify remaining challenges in managing patients with an open abdomen.
- To highlight the role of negative pressure therapy and new classification systems.
Main Methods:
- Review of current literature on open abdomen treatment strategies.
- Discussion of abdominal negative pressure therapy and its combination with fascial approximation techniques.
- Emphasis on intra-abdominal pressure measurement for surgical guidance.
Main Results:
- Abdominal negative pressure therapy is highly effective for fluid evacuation and promoting early closure.
- Combining negative pressure therapy with progressive fascial approximation strategies yields high closure rates.
- Intra-abdominal pressure monitoring is essential for guiding surgical decisions.
Conclusions:
- Abdominal negative pressure therapy is a key method for achieving open abdomen treatment goals.
- New classification systems aid in comparing the efficacy of different open abdomen strategies.
- Continued attention to intra-abdominal hypertension and advanced closure techniques is necessary.