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

被引：201

作者：

Coccolini, Federico ^{[1
]}

Roberts, Derek ^{[2
]}

Ansaloni, Luca ^{[1
]}

Ivatury, Rao ^{[3
]}

Gamberini, Emiliano ^{[4
]}

Kluger, Yoram ^{[5
]}

Moore, Ernest E. ^{[6
]}

Coimbra, Raul ^{[7
]}

Kirkpatrick, Andrew W. ^{[2
]}

Pereira, Bruno M. ^{[8
]}

Montori, Giulia ^{[1
]}

Ceresoli, Marco ^{[1
]}

Abu-Zidan, Fikri M. ^{[9
]}

Sartelli, Massimo ^{[10
]}

Velmahos, George ^{[11
]}

Fraga, Gustavo Pereira ^{[8
]}

Leppaniemi, Ari ^{[12
]}

Tolonen, Matti ^{[12
]}

Galante, Joseph ^{[13
]}

Razek, Tarek ^{[14
]}

Maier, Ron ^{[15
]}

Bala, Miklosh ^{[16
]}

Sakakushev, Boris ^{[17
]}

Khokha, Vladimir ^{[18
]}

Malbrain, Manu ^{[19
,20
]}

Agnoletti, Vanni ^{[4
]}

Peitzman, Andrew ^{[21
]}

Demetrashvili, Zaza ^{[22
]}

Sugrue, Michael ^{[23
]}

Di Saverio, Salomone ^{[24
]}

Martzi, Ingo ^{[25
]}

Soreide, Kjetil ^{[26
,27
]}

Biffl, Walter ^{[28
]}

Ferrada, Paula ^{[3
]}

Parry, Neil ^{[29
]}

Montravers, Philippe ^{[30
]}

Melotti, Rita Maria ^{[31
]}

Salvetti, Francesco ^{[1
]}

Valetti, Tino M. ^{[32
]}

Scalea, Thomas ^{[33
]}

Chiara, Osvaldo ^{[34
]}

Cimbanassi, Stefania ^{[34
]}

Kashuk, Jeffry L. ^{[35
]}

Larrea, Martha ^{[36
]}

Martinez Hernandez, Juan Alberto ^{[37
]}

Lin, Heng-Fu ^{[38
]}

Chirica, Mircea ^{[39
]}

Arvieux, Catherine ^{[39
]}

Bing, Camilla ^{[40
]}

Horer, Tal ^{[41
,42
]}

机构：

[1] Bufalini Hosp, Gen Emergency & Trauma Surg, Viale Giovanni Ghirotti 286, I-47521 Cesena, Italy

[2] Foothills Med Ctr, Dept Surg, Calgary, AB, Canada

[3] Virginia Commonwealth Univ, Richmond, VA 23284 USA

[4] Bufalini Hosp, ICU Dept, Cesena, Italy

[5] Div Gen Surg, Rambam Hlth Care Campus, Haifa, Israel

[6] Denver Hlth, Trauma Surg, Denver, CO USA

[7] UC San Diego Hlth Syst, Dept Surg, San Diego, CA USA

[8] Unicamp Campinas, FCM, Campinas, SP, Brazil

[9] UAE Univ, Coll Med & Hlth Sci, Dept Surg, Al Ain, U Arab Emirates

[10] Macerata Hosp, Dept Surg, Macerata, Italy

[11] Massachusetts Gen Hosp, Dept Trauma Emergency Surg & Surg Crit Care, Boston, MA 02114 USA

[12] Meilahti Hosp, Dept Surg 2, Helsinki, Finland

[13] Univ Calif Davis, Dept Surg, Trauma & Acute Care Surg & Surg Crit Care Traum, Davis, CA 95616 USA

[14] McGill Univ, Hlth Ctr, Gen & Emergency Surg, Montreal, PQ, Canada

[15] Harborview Med Ctr, Dept Surg, Seattle, WA 98104 USA

[16] Hadassah Med Ctr, Gen Surg Dept, Jerusalem, Israel

[17] UMBAL St George Plovdiv, Univ Hospital, Clin Gen Surg 1, Plovdiv, Bulgaria

[18] Mozir Hosp, Gen Surg, Mozir City, BELARUS

[19] Ziekenhius Netwerk Antwerpen, ICU, Antwerp, Belgium

[20] Ziekenhius Netwerk Antwerpen, High Care Burn Unit, Antwerp, Belgium

[21] Univ Pittsburgh, Sch Med, Dept Surg, Trauma & Surg Serv, Pittsburgh, PA 15260 USA

[22] Tbilisi State Med Univ, Kipshidze Cent Univ Hosp, Dept Surg, Tbilisi, Georgia

[23] Letterkenny Hosp, Gen Surg Dept, Letterkenny, Ireland

[24] Addenbrookes Hosp, Cambridge, England

[25] Goethe Univ Frankfurt, Univ Klinikum, Klin Unfall Hand & Wiederherstellungschirurg, Frankfurt, Germany

[26] Univ Bergen, Dept Clin Med, Bergen, Norway

[27] Stavanger Univ Hosp, Dept Gastrointestinal Surg, Stavanger, Norway

[28] Queens Med Ctr, Acute Care Surg, Honolulu, HI USA

[29] Victoria Hosp, London Hlth Sci Ctr, Gen & Trauma Surg Dept, London, ON, Canada

[30] Univ Paris 07, CHU Bichat Claude Bernard, AP HP, HUPNVS,Dept Anesthesie Reanimat, Paris, France

[31] SantOrsola Malpighi Univ Hosp, ICU Dept, Bologna, Italy

[32] Papa Giovanni XXIII Hosp, ICU Dept, Bergamo, Italy

[33] Univ Maryland, Sch Med, Surg Dept, Baltimore, MD 21201 USA

[34] Osped Niguarda Ca Granda, Emergency & Trauma Surg Dept, Milan, Italy

[35] Assuta Med Ctr, Gen Surg Dept, Tel Aviv, Israel

[36] Habana Med Univ, Gen Surg Gen Calixto Garcia, Havana, Cuba

[37] Habana Med Univ, Med Fac Gen Calixto Garcia, Gen Surg, Havana, Cuba

[38] Far Eastern Mem Hosp, Dept Surg, Div Trauma, New Taipei, Taiwan

[39] UGA, CHU Grenoble Alpes, CHUGA, Clin Univ Chirurg Digest & Iurgence, Grenoble, France

[40] Empoli Hosp, Gen & Emergency Surg Dept, Empoli, Italy

[41] Orebro Univ Hosp, Dept Cardiothorac & Vasc Surg, Orebro, Sweden

[42] Orebro Univ, Orebro, Sweden

[43] Perpignan Hosp, Gen Surg, Perpignan, France

[44] Massachusetts Gen Hosp, Pediat Trauma Serv, Boston, MA 02114 USA

[45] Sergei Kirov Mil Acad, Gen & Emergency Surg, St Petersburg, Russia

[46] Henri Mondor Hosp, HPB Surg & Liver Transplant, Unit Digest Surg, Creteil, France

[47] Kyoto Univ, Grad Sch Med, Dept Primary Care & Emergency Med, Kyoto, Japan

[48] John Hunter Hosp, Dept Traumatol, Newcastle, NSW, Australia

[49] Univ Newcastle, Newcastle, NSW, Australia

[50] Westchester Med Ctr, Gen Surg Dept, Westchester, NY USA

来源：

WORLD JOURNAL OF EMERGENCY SURGERY | 2018年 / 13卷

关键词：

Open abdomen; Laparostomy; Non-trauma; Trauma; Peritonitis; Pancreatitis; Vascular emergencies; Intra-abdominal infection; Fistula; Nutrition; Re-exploration; Reintervention; Closure; Biological; Synthetic; Mesh; Technique; Timing; Guidelines; ABDOMINAL COMPARTMENT SYNDROME; ACELLULAR DERMAL MATRIX; DAMAGE CONTROL SURGERY; PRIMARY FASCIAL CLOSURE; VENTRAL HERNIA REPAIR; NEGATIVE-PRESSURE THERAPY; CRITICALLY-ILL; WALL RECONSTRUCTION; POLYPROPYLENE MESH; CONTROL LAPAROTOMY;

D O I：

10.1186/s13017-018-0167-4

中图分类号：

R4 [临床医学];

学科分类号：

100218 [急诊医学];

摘要：

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.

引用

页数：16

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