The role of open abdomen in non-trauma patient: WSES Consensus Paper.

Federico Coccolini, Giulia Montori, Marco Ceresoli, Fausto Catena, Ernest E Moore, Rao Ivatury, Walter Biffl, Andrew Peitzman, Raul Coimbra, Sandro Rizoli, Yoram Kluger, Fikri M Abu-Zidan, Massimo Sartelli, Marc De Moya, George Velmahos, Gustavo Pereira Fraga, Bruno M Pereira, Ari Leppaniemi, Marja A Boermeester, Andrew W Kirkpatrick, Ron Maier, Miklosh Bala, Boris Sakakushev, Vladimir Khokha, Manu Malbrain, Vanni Agnoletti, Ignacio Martin-Loeches, Michael Sugrue, Salomone Di Saverio, Ewen Griffiths, Kjetil Soreide, John E Mazuski, Addison K May, Philippe Montravers, Rita Maria Melotti, Michele Pisano, Francesco Salvetti, Gianmariano Marchesi, Tino M Valetti, Thomas Scalea, Osvaldo Chiara, Jeffry L Kashuk, Luca Ansaloni

Journal: World journal of emergency surgery : WJES 2018;12():39

PMID: 28814969

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Abstract

The open abdomen (OA) is defined as intentional decision to leave the fascial edges of the abdomen un-approximated after laparotomy (laparostomy). The abdominal contents are potentially exposed and therefore must be protected with a temporary coverage, which is referred to as temporal abdominal closure (TAC). OA use remains widely debated with many specific details deserving detailed assessment and clarification. To date, in patients with intra-abdominal emergencies, the OA has not been formally endorsed for routine utilization; although, utilization is seemingly increasing. Therefore, the World Society of Emergency Surgery (WSES), Abdominal Compartment Society (WSACS) and the Donegal Research Academy united a worldwide group of experts in an international consensus conference to review and thereafter propose the basis for evidence-directed utilization of OA management in non-trauma emergency surgery and critically ill patients. In addition to utilization recommendations, questions with insufficient evidence urgently requiring future study were identified.

Address: General, Emergency and Trauma Surgery dept., Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127 Bergamo, Italy.; Emergency and Trauma Surgery, Parma Maggiore hospital, Parma, Italy.; Denver Health, Denver, CO 80204 USA.; Trauma Surgery, Virginia Commonwealth University, Richmond, VA 23284 USA.; Acute Care Surgery, The Queen's Medical Center, Honolulu, HI 96813 USA.; Department of Surgery, Trauma and Surgical Services, University of Pittsburgh School of Medicine, Pittsburgh, 15213 USA.; Department of Surgery, UC San Diego Health System, San Diego, 92103 USA.; Trauma & Acute Care Service, St Michael's Hospital, Toronto, ON Canada.; Division of General Surgery Rambam Health Care Campus, Haifa, Israel.; Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.; Department of Surgery, Macerata Hospital, Macerata, Italy.; Department of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Boston, MA 02114 USA.; Faculdade de Ciências Médicas (FCM) - Unicamp Campinas, São Paulo, Brazil.; Second Department of Surgery, Meilahti Hospital, Helsinki, Finland.; Academic Medical Center Amsterdam, Amsterdam, The Netherlands.; Department of Surgery, Foothills Medical Centre, Calgary, Canada.; Department of Surgery, Harborview Medical Centre, Seattle, 98104 USA.; General Surgery Department, Hadassah Medical Centre, Jerusalem, Israel.; First Clinic of General Surgery, University Hospital/UMBAL/St George Plovdiv, Plovdiv, Bulgaria.; General Surgery, Mozir Hospital, Mozir City, Belarus.; ICU and High Care Burn Unit, Ziekenhius Netwerk Antwerpen, Antwerpen, Belgium.; ICU Department, Bufalini Hospital, Cesena, Italy.; Critical Care Centre, Corporasiò Sanitaria Park Tauli, Sabdel, Spain.; General Surgery Department, Letterkenny Hospital, Letterkenny, Ireland.; General and Trauma Surgery Department, Maggiore Hospital, Bologna, Italy.; Upper Gatrointestinal Surgery, Birmigham Hospital, Birmigham, UK.; Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.; Department of Clinical Medicine, University of Bergen, Bergen, Norway.; Department of Surgery, School of Medicine, Washington University, Saint Louis, MO 63130 USA.; Departments of Surgery and Anesthesiology, Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN 37232 USA.; Département d'Anesthésie-Réanimation, CHU Bichat Claude-Bernard-HUPNVS, Assistance Publique-Hôpitaux de Paris, University Denis Diderot, Paris, France.; ICU department Sant'Orsola-Malpighi University Hospital, Bologna, Italy.; ICU Department, Papa Giovanni XXIII Hospital, Bergamo, Italy.; Trauma Surgery department, University of Maryland School of Medicine, Baltimore, MD 21201 USA.; Emergency and Trauma Surgery department, Niguarda Hospital, Milan, Italy.; General Surgery department, Assuta Medical Centers, Tel Aviv, Israel.

DOI: 10.1186/s13017-017-0146-1

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MeSH Terms: Abdominal Wound Closure Techniques, Consensus, Critical Illness, Humans, Lower Body Negative Pressure, Pancreatitis