Management of the Open Abdomen During the Global War on Terror

Riha, Gordon M.; Király, László; Diggs, Brian S.; Cho, S. David; Fabricant, Loïc; Flaherty, Stephen; Kuehn, Reed; Underwood, Samantha J.; Schreiber, Martin A.

doi:10.1001/2013.jamasurg.4

Cited by 9 publications

(4 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Delayed fascial closure, defined as fascial abdominal closure over 9 days after initial OA procedure, is often performed through a form of planned ventral hernia repair [26]. Besides the primary disease, massive transfusion (also known as overload fluid resuscitation), early presence of complications during hospitalization and nonfascial traction technique were also attributed to the postponed closure [38, 39]. Generally, a definitive fascial closure would be performed at about 6–12 months after an open abdomen.…”

Section: The Open Abdomen In Treatment Of Intra-abdominal Infectionmentioning

confidence: 99%

Current Status of the Open Abdomen Treatment for Intra-Abdominal Infection

Yuan

Ren

2013

Gastroenterology Research and Practice

View full text Add to dashboard Cite

The open abdomen has become an important approach for critically ill patients who require emergent abdominal surgical interventions. This treatment, originating from the concept of damage control surgery, was first applied in severe traumatic patients. The ultimate goal is to achieve formal abdominal fascial closure by several attempts and adjuvant therapies (fluid management, nutritional support, skin grafting, etc.). Up to the present, open abdomen therapy becomes matured and is multistage-approached in the management of patients with severe trauma. However, its application in patients with intra-abdominal infection still presents great challenges due to critical complications and poor clinical outcomes. This review focuses on the specific use of the open abdomen in such populations and detailedly introduces current concerns and advanced progress about this therapy.

show abstract

Section: The Open Abdomen In Treatment Of Intra-abdominal Infectionmentioning

confidence: 99%

Current Status of the Open Abdomen Treatment for Intra-Abdominal Infection

Yuan

Ren

2013

Gastroenterology Research and Practice

View full text Add to dashboard Cite

show abstract

“…This topic included 20 related articles: one RCT, 93 and 19 were retrospective studies. 33 , 49 , 53 , 55 , 56 , 65 , 68 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 …”

Section: Recommendationsmentioning

confidence: 99%

“…The most complicated complication is an enteroatmospheric fistula, which has an incidence of 5%–75%. 105 Different TAC techniques have different rates of postoperative complications. One RCT showed that VSD-assisted TAC did not cause intestinal fistulas, 93 and a review suggested that VSD was better than the Bogota bag and Barker techniques in reducing complications and infection rates.…”

Section: Recommendationsmentioning

confidence: 99%

“…If the abdomen cannot be closed early, a series of complications may occur, including enteroatmospheric fistula, abdominal cavity infection, abdominal bleeding, and abdominal wall hernia. The most complicated complication is an enteroatmospheric fistula, which has an incidence of 5%–75% 105 . Different TAC techniques have different rates of postoperative complications.…”

Section: Recommendationsmentioning

confidence: 99%

See 1 more Smart Citation

Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries—Update and systematic review

Sun

et al. 2019

Chinese Journal of Traumatology

View full text Add to dashboard Cite

Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chinese Trauma Surgeon Association organized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries. Eleven questions regarding the use of VSD in abdominal surgeries were addressed: (1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions? (2) Can VSD be preventively used for a high-risk abdominal incision with primary suture? (3) Can VSD be used in severely contaminated/infected abdominal surgical sites? (4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome? (5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage? (6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula? (7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess? (8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects? (9) Does VSD increase the risk of bleeding? (10) Does VSD increase the risk of intestinal wall injury? (11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2–4. Weak recommendations were made regarding questions 1 and 5–11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.

show abstract