Management of the open abdomen.

The open abdomen has become the standard of care in damage-control procedures, the management of intra-abdominal hypertension, and in severe intra-abdominal sepsis. This approach has saved many lives but has also created new problems, such as severe fluid and protein loss, nutritional problems, enteroatmospheric fistulas, fascial retraction with loss of abdominal domain, and development of massive incisional hernias. Early definitive closure is the basis of preventing or reducing the risk of these complications. The introduction of new techniques and materials for temporary and subsequent definitive abdominal closure has improved outcomes in this group of patients.