Open abdomen in trauma patients: a double-edged sword

Area of Science:

• Trauma Surgery
• Surgical Critical Care

Background:

• Open abdomen (OA) is a critical technique for managing exsanguinating trauma and abdominal catastrophes.
• While OA has demonstrated benefits in reducing trauma-related mortality, it is associated with severe complications such as enteroatmospheric fistula (EAF).

Purpose of the Study:

• To review the role of open abdomen (OA) in trauma management.
• To highlight the importance of specialized critical care and management strategies for OA patients.
• To discuss temporary abdominal closure (TAC) techniques, particularly negative pressure therapy (NPT).

Main Methods:

• Literature review of open abdomen (OA) techniques in trauma.
• Analysis of complications associated with OA, including enteroatmospheric fistula (EAF).
• Evaluation of temporary abdominal closure (TAC) methods, focusing on negative pressure therapy (NPT).

Main Results:

• Open abdomen (OA) has been utilized since the mid-19th century and gained prominence in trauma management since the 1980s.
• OA is associated with reduced mortality in trauma patients.
• Enteroatmospheric fistula (EAF) is a significant complication of OA, necessitating careful management.

Conclusions:

• Open abdomen (OA) is a valuable tool in trauma care but requires judicious use to mitigate risks.
• Effective critical care and specialized management are essential for patients undergoing OA.
• Temporary abdominal closure (TAC) techniques, especially negative pressure therapy (NPT), aid in wound healing and facilitate eventual fascial closure.