Abstract
The use of open abdomen (OA) as a technique in the treatment of exsanguinating trauma patients was first described in the mid-19th century. Since the 1980s, OA has become a relatively new and increasingly common strategy to manage massive trauma and abdominal catastrophes. OA has been proven to help reduce the mortality of trauma. Nevertheless, the OA method may be associated with terrible and devastating complications such as enteroatmospheric fistula (EAF). As a result, OA should not be overused, and attention should be given to critical care as well as special management. The temporary abdominal closure (TAC) technique after abbreviated laparotomy was used to improve wound healing and facilitate final fascial closure of OA. Negative pressure therapy (NPT) is the most commonly used TAC method.
Highlights
The use of open abdomen (OA) as a technique to manage exsanguination of trauma patients was first described by Ogilvie [1] in 1940 during World War II, but not much attention was paid to it until the 1980s
During the initial operation and resuscitation, the presence of the lethal triad of hypothermia, acidosis and coagulopathy may contribute to high mortality in major abdominal trauma patients
We present a perspective on the indications, advantages and complications of OA in critically ill trauma patients
Summary
The use of open abdomen (OA) as a technique to manage exsanguination of trauma patients was first described by Ogilvie [1] in 1940 during World War II, but not much attention was paid to it until the 1980s. In 1983, Stone et al [2] reported that abbreviated laparotomy with abdominal tamponade using sponges and with the abdomen left open was an effective technique to control organ injury and improve the survival rate. Steven et al [16] found that trauma patients in need of a damage control laparotomy who develop acidosis, coagulopathy, and hypothermia are at risk of IAH and ACS and require OA. Intra-abdominal infection Infection and sepsis-associated complications are major causes of late mortality for trauma patients. Decompression can frequently lead to good physiological response, and the reported survival rates range from 33 % to as high as 100 % [22] These positive results are due to decreased intra-abdominal pressure and improved organ oxygen supply. Intestinal tract secondary to trauma can be achieved in OA patients
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