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World Journal of Surgery

Erschienen in:

01.03.2012

Surgical Strategies for Management of the Open Abdomen

verfasst von: Justin L. Regner, Leslie Kobayashi, Raul Coimbra

Erschienen in: World Journal of Surgery | Ausgabe 3/2012

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Abstract

Since the mid-1990s the surgical community has seen a surge in the prevalence of open abdomens (OAs) reported in the surgical literature and in clinical practice. The OA has proven to be effective in decreasing mortality and immediate postoperative complications; however, it may come at the cost of delayed morbidity and the need for further surgical procedures. Indications for leaving the abdomen open have broadened to include damage control surgery, abdominal compartment syndrome, and abdominal sepsis. The surgical options for management of the OA are now more diverse and sophisticated, but there is a lack of prospective randomized controlled trials demonstrating the superiority of any particular method. Additionally, critical care strategies for optimization of the patient with an OA are still being developed. Review of the literature suggests a bimodal distribution of primary closure rates, with early closure dependent on postoperative intensive care management and delayed closure more affected by the choice of the temporary abdominal closure technique. Invariably, a small fraction of patients requiring OA management fail to have primary fascial closure and require some form of biologic fascial bridge with delayed ventral hernia repair in the future.

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Titel: Surgical Strategies for Management of the Open Abdomen
verfasst von: Justin L. Regner
Leslie Kobayashi
Raul Coimbra
Publikationsdatum: 01.03.2012
Verlag: Springer-Verlag
Erschienen in: World Journal of Surgery / Ausgabe 3/2012
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-011-1203-7

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