Open AccessEarly Definitive Closure of the Open Abdomen: A Quiet Revolution
Author(s) -
Bradford G. Scott,
Mark A. Feanny,
Asher Hirshberg
Publication year - 2005
Publication title -
scandinavian journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.774
H-Index - 50
eISSN - 1799-7267
pISSN - 1457-4969
DOI - 10.1177/145749690509400104
Subject(s) - medicine , abdomen , surgery , negative pressure wound therapy , surgical mesh , damage control surgery , general surgery , abdominal compartment syndrome , ventral hernia , hernia , resuscitation , alternative medicine , pathology
Contrary to the management strategy recommended only 2-3 years ago, temporarily covering the open abdomen with an absorbable mesh or a plastic sheath without preserving the peritoneal space is no longer considered in the patient's best interest. The use of the vacuum pack, in conjunction with vacuum-assisted wound management and new biological prostheses now offer patients with an open abdomen a better and simpler alternative to the giant "planned ventral hernia". With very few exceptions in the most critically ill patients, the survivors of damage control surgery or infected pancreatic necrosis should not be sent home with a huge defect only to undergo a complex reconstruction a year later. Simpler and better alternatives exist. The new concepts and technologies presented in this review, when widely adopted, will rapidly translate into safer and better management of the patient with an open abdomen.