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    The open abdomen in trauma and non-trauma patients: WSES guidelines

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    Authors
    Coccolini, Federico
    Roberts, Derek
    Ansaloni, Luca
    Ivatury, Rao
    Gamberini, Emiliano
    Kluger, Yoram
    Moore, Ernest E
    Coimbra, Raul
    Kirkpatrick, Andrew W
    Pereira, Bruno M
    Montori, Giulia
    Ceresoli, Marco
    Abu-Zidan, Fikri M
    Sartelli, Massimo
    Velmahos, George
    Fraga, Gustavo P
    Leppaniemi, Ari
    Tolonen, Matti
    Galante, Joseph
    Razek, Tarek
    Maier, Ron
    Bala, Miklosh
    Sakakushev, Boris
    Khokha, Vladimir
    Malbrain, Manu
    Agnoletti, Vanni
    Peitzman, Andrew
    Demetrashvili, Zaza
    Sugrue, Michael
    Di Saverio, Salomone
    Martzi, Ingo
    Soreide, Kjetil
    Biffl, Walter
    Ferrada, Paula
    Parry, Neil
    Montravers, Philippe
    Melotti, Rita M
    Salvetti, Francesco
    Valetti, Tino M
    Scalea, Thomas
    Chiara, Osvaldo
    Cimbanassi, Stefania
    Kashuk, Jeffry L
    Larrea, Martha
    Hernandez, Juan A M
    Lin, Heng-Fu
    Chirica, Mircea
    Arvieux, Catherine
    Bing, Camilla
    Horer, Tal
    De Simone, Belinda
    Masiakos, Peter
    Reva, Viktor
    DeAngelis, Nicola
    Kike, Kaoru
    Balogh, Zsolt J
    Fugazzola, Paola
    Tomasoni, Matteo
    Latifi, Rifat
    Naidoo, Noel
    Weber, Dieter
    Handolin, Lauri
    Inaba, Kenji
    Hecker, Andreas
    Kuo-Ching, Yuan
    Ordoñez, Carlos A
    Rizoli, Sandro
    Gomes, Carlos A
    De Moya, Marc
    Wani, Imtiaz
    Mefire, Alain C
    Boffard, Ken
    Napolitano, Lena
    Catena, Fausto
    Show allShow less
    Issue Date
    2018-02-02
    Keywords
    Laparostomy
    TRAUMA
    Local subject classification
    ABDOMINAL CAVITY
    
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    Citation
    World Journal of Emergency Surgery. 2018 Feb 02;13(1):7
    URI
    http://dx.doi.org/10.1186/s13017-018-0167-4
    http://hdl.handle.net/10147/622784
    Abstract
    Abstract Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a “planned second-look” laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption. The open abdomen in trauma and non-trauma patients has been proposed to be effective in preventing or treating deranged physiology in patients with severe injuries or critical illness when no other perceived options exist. Its use, however, remains controversial as it is resource consuming and represents a non-anatomic situation with the potential for severe adverse effects. Its use, therefore, should only be considered in patients who would most benefit from it. Abdominal fascia-to-fascia closure should be done as soon as the patient can physiologically tolerate it. All precautions to minimize complications should be implemented.
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