Cornelia Griggs1, Kathryn Butler2. 1. Massachusetts General Hospital, Boston, MA, USA cgriggs@partners.org. 2. Division of Trauma Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Boston, MA, USA.
Abstract
BACKGROUND: As strategies in acute care surgery focus on damage control to restore physiology, intensivists spanning all disciplines care for an increasing number of patients requiring massive transfusion, temporary abdominal closures, and their sequelae. OBJECTIVE: To equip the nonsurgical intensivist with evidence-based management principles for patients with an open abdomen after damage control surgery. DATA SOURCE: Search of PubMed database and manual review of bibliographies from selected articles. DATA SYNTHESIS AND CONCLUSIONS: Temporary abdominal closure improves outcomes in patients with abdominal compartment syndrome, hemorrhagic shock, and intra-abdominal sepsis but creates new challenges with electrolyte derangement, hypovolemia, malnutrition, enteric fistulas, and loss of abdominal wall domain. Intensive care of such patients mandates attention to resuscitation, sepsis control, and expedient abdominal closure.
BACKGROUND: As strategies in acute care surgery focus on damage control to restore physiology, intensivists spanning all disciplines care for an increasing number of patients requiring massive transfusion, temporary abdominal closures, and their sequelae. OBJECTIVE: To equip the nonsurgical intensivist with evidence-based management principles for patients with an open abdomen after damage control surgery. DATA SOURCE: Search of PubMed database and manual review of bibliographies from selected articles. DATA SYNTHESIS AND CONCLUSIONS: Temporary abdominal closure improves outcomes in patients with abdominal compartment syndrome, hemorrhagic shock, and intra-abdominal sepsis but creates new challenges with electrolyte derangement, hypovolemia, malnutrition, enteric fistulas, and loss of abdominal wall domain. Intensive care of such patients mandates attention to resuscitation, sepsis control, and expedient abdominal closure.
Authors: Maria Fernanda Escobar; Anwar H Nassar; Gerhard Theron; Eythan R Barnea; Wanda Nicholson; Diana Ramasauskaite; Isabel Lloyd; Edwin Chandraharan; Suellen Miller; Thomas Burke; Gabriel Ossanan; Javier Andres Carvajal; Isabella Ramos; Maria Antonia Hincapie; Sara Loaiza; Daniela Nasner Journal: Int J Gynaecol Obstet Date: 2022-03 Impact factor: 4.447
Authors: Andrew W Kirkpatrick; Federico Coccolini; Luca Ansaloni; Derek J Roberts; Matti Tolonen; Jessica L McKee; Ari Leppaniemi; Peter Faris; Christopher J Doig; Fausto Catena; Timothy Fabian; Craig N Jenne; Osvaldo Chiara; Paul Kubes; Braden Manns; Yoram Kluger; Gustavo P Fraga; Bruno M Pereira; Jose J Diaz; Michael Sugrue; Ernest E Moore; Jianan Ren; Chad G Ball; Raul Coimbra; Zsolt J Balogh; Fikri M Abu-Zidan; Elijah Dixon; Walter Biffl; Anthony MacLean; Ian Ball; John Drover; Paul B McBeth; Juan G Posadas-Calleja; Neil G Parry; Salomone Di Saverio; Carlos A Ordonez; Jimmy Xiao; Massimo Sartelli Journal: World J Emerg Surg Date: 2018-06-22 Impact factor: 5.469