This short report is a distillation of the proceedings from a consensus group meeting in January 2009. It outlines a proposed classification system for patients with an open abdomen (OA). The classification allows (1) a description of the patient's clinical course; (2) standardized clinical guidelines for improving OA management; and (3) improved reporting of OA status, which will facilitate comparisons between studies and heterogeneous patient populations. The following grading is suggested: grade 1A, clean OA without adherence between bowel and abdominal wall or fixity of the abdominal wall (lateralization); grade 1B, contaminated OA without adherence/fixity; grade 2A, clean OA developing adherence/fixity; grade 2B, contaminated OA developing adherence/fixity; grade 3, OA complicated by fistula formation; grade 4, frozen OA with adherent/fixed bowel, unable to close surgically, with or without fistula. We propose that this classification system will facilitate communication, clarify OA management, and potentially improve patient care.

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The most efficient temporary abdominal closure techniques are NPWT kits with or without a dynamic closure procedure. Evidence-based recommendations will help to tailor its use in a complex treatment pathway for the individual patient.

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New techniques and devices have revolutionized the treatment of wounds during the last years. For the treatment of wounds we have nowadays a great variety of new gadgets, tools and methods. Complex wounds require specific skills, given the fact that a great number of different promising methods are on the market to enable an optimal wound management. Well educated "wound experts" are required to overcome the problems of very complicated and chronic wound problems. The importance of an interdisciplinary team increases while facing the problems of special wound disorders such as a diabetic food, food ulcers or the problems of open abdomen in case of severe peritonitis. In this overview the main principles of modern wound treatment are outlined. The aim of this article is to present a good summary of wound judgement and treatment for the practioner. Increasingly important is it to point out the situation of complexe wounds which should be judgded and treated with the help of a "wound expert".

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