Making a Virtue of Necessity: Managing the Open Abdomen

Abstract

The combination of an inert plastic sheet in contact with the viscera, and the application of subatmospheric pressure on the wound, is an effective combination to maximize the prospects of delayed primary wound closure while minimizing the chance of fistula and ventral hernia.

Management of the open abdomen using combination therapy with ABRA and ABThera systems

“…The observed mortality of 25% is consistent with that of other cohorts of patients managed with an open abdomen. 2,17,19 No deaths in our study were directly attributable to the ABRA device. Pressure sores related to the ABRA buttons have been reported as a complication of the ABRA, with the study by Verdam and colleagues 11 reporting its occurrence in 12 of 18 patients.…”

Management of open abdomen with an absorbable mesh closure

“…1 [12][13][14][15][16][17][18]21 In this study, VPC was also used as a primary method in the management of open abdomen and DPFC was attempted later if visceral edema subsided. Nevertheless, the DPFC rate was low (33%) in the current study in comparison to other studies (Table 5).…”

“…Leaving the abdomen open may lead to several complications, the most serious being an enteroatmospheric fi stula (EAF). [1][2][3] The acceptance of damage control surgery and a decompressive laparotomy as a treatment of abdominal compartment syndrome (ACS) has resulted in more patients with open abdomen. 2,[4][5][6] Open abdomen may also result from nontrauma-related causes, such as severe peritonitis, acute necrotizing pancreatitis, 1,3 and ruptured abdominal aortic aneurysms.…”

Prospective Assessment of the Negative Pressure Wound Therapy of the Open Abdomen

“…[21][22][23] As more than 90% of fistulas are of iatrogenic origin, with their increasing incidence rate hand in hand with the prolongation of definite closure of OA, [21][22][23] the closure of OA should be performed as soon as possible. Even though there are debates over increased fistula rates in patient with OA managed by NPWT, 24 our latest paper did not support this opinion.…”