About Open Abdomen
- Awareness of intra-abdominal hypertension, abdominal compartment syndrome and abdominal infections has led to increased frequency of open abdomen procedures. Leaving the abdomen open has been shown to increase survival.1,2
- Cost savings and better quality of life outcomes are shifting the treatment paradigm toward achieving primary closure during the same admission versus the traditional goal of a planned hernia with reconstruction.3,4
- Nevertheless, the management of these open abdomen patients to achieve primary fascial closure can pose significant challenges:1
- Active management and removal of peritoneal fluid
- Preservation of fascial integrity and prevention of fascial retraction
- Containment and protection of the abdominal contents
- Prolonged exposure to environment, resulting in high complications rates, including infection, sepsis and fistula formation
1 Kaplan M, Banwell P, Orgill DP, Ivatury RR, Demetriades D, Moore FA, Miller P, Nicholas J, Henry S. Guidelines for the Management of the Open Abdomen. WOUNDS. 2005 Oct;17(Suppl 1):S1 S24.
2 Cheatham ML, White MW, Sagraves SG, Johnson JL, Block EF (2000) Abdominal perfusion pressure: a superior parameter in the assessment of intra-abdominal hypertension. J Trauma. 2000 Oct;49:621–626.
3 Schecter WP, Ivatury RR, Rotondo MF, Hirshberg A. Open abdomen after trauma and abdominal sepsis: a strategy for management. J Am Coll Surg. 2007 Jan;204(1):190-1.
4Frazee RC, Abernathy SW, Jupiter DC et al. Are commercial negative pressure systems worth the cost in open abdomen management? J Am Coll Surg. 2013 April; 216(4): 730-3.