The role of the open abdomen procedure in managing severe abdominal sepsis: WSES position paper

Massimo Sartelli, Fikri M. Abu-Zidan, Luca Ansaloni, Miklosh Bala, Marcelo A. Beltrán, Walter L. Biffl, Fausto Catena, Osvaldo Chiara, Federico Coccolini, Raul Coimbra, Zaza Demetrashvili, Demetrios Demetriades, Jose J. Diaz, Salomone Di Saverio, Gustavo P. Fraga, Wagih Ghnnam, Ewen A. Griffiths, Sanjay Gupta, Andreas Hecker, Aleksandar KaramarkovicVictor Y. Kong, Reinhold Kafka-Ritsch, Yoram Kluger, Rifat Latifi, Ari Leppaniemi, Jae Gil Lee, Michael McFarlane, Sanjay Marwah, Frederick A. Moore, Carlos A. Ordonez, Gerson Alves Pereira, Haralds Plaudis, Vishal G. Shelat, Jan Ulrych, Sanoop K. Zachariah, Martin D. Zielinski, Maria Paula Garcia, Ernest E. Moore

Research output: Contribution to journalReview article

76 Citations (Scopus)

Abstract

The open abdomen (OA) procedure is a significant surgical advance, as part of damage control techniques in severe abdominal trauma. Its application can be adapted to the advantage of patients with severe abdominal sepsis, however its precise role in these patients is still not clear. In severe abdominal sepsis the OA may allow early identification and draining of any residual infection, control any persistent source of infection, and remove more effectively infected or cytokine-loaded peritoneal fluid, preventing abdominal compartment syndrome and deferring definitive intervention and anastomosis until the patient is appropriately resuscitated and hemodynamically stable and thus better able to heal. However, the OA may require multiple returns to the operating room and may be associated with significant complications, including enteroatmospheric fistulas, loss of abdominal wall domain and large hernias. Surgeons should be aware of the pathophysiology of severe intra-abdominal sepsis and always keep in mind the option of using open abdomen to be able to use it in the right patient at the right time.

Original languageEnglish
Article number35
JournalWorld Journal of Emergency Surgery
Volume10
Issue number1
DOIs
Publication statusPublished - 2015 Aug 12

All Science Journal Classification (ASJC) codes

  • Surgery
  • Emergency Medicine

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    Sartelli, M., Abu-Zidan, F. M., Ansaloni, L., Bala, M., Beltrán, M. A., Biffl, W. L., Catena, F., Chiara, O., Coccolini, F., Coimbra, R., Demetrashvili, Z., Demetriades, D., Diaz, J. J., Di Saverio, S., Fraga, G. P., Ghnnam, W., Griffiths, E. A., Gupta, S., Hecker, A., ... Moore, E. E. (2015). The role of the open abdomen procedure in managing severe abdominal sepsis: WSES position paper. World Journal of Emergency Surgery, 10(1), [35]. https://doi.org/10.1186/s13017-015-0032-7