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

World J Emerg Surg. 2017 Aug 14:12:39. doi: 10.1186/s13017-017-0146-1. eCollection 2017.

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.

Keywords: Biological; Closure; Fistula; Laparostomy; Mesh; Non-trauma; Nutrition; Open abdomen; Pancreatitis; Peritonitis; Re-exploration; Re-intervention; Synthetic; Technique; Timing; Vascular emergencies.

Publication types

  • Review

MeSH terms

  • Abdominal Wound Closure Techniques / standards*
  • Abdominal Wound Closure Techniques / trends
  • Consensus*
  • Critical Illness
  • Humans
  • Lower Body Negative Pressure / methods
  • Pancreatitis / surgery