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

Federico Coccolini, Derek Roberts, Luca Ansaloni, Rao Ivatury, Emiliano Gamberini, Yoram Kluger, Ernest E. Moore, Raul Coimbra, Andrew W. Kirkpatrick, Bruno M. Pereira, Giulia Montori, Marco Ceresoli, Fikri M. Abu-Zidan, Massimo Sartelli, George Velmahos, Gustavo Pereira Fraga, Ari Leppaniemi, Matti Tolonen, Joseph Galante, Tarek RazekRon Maier, Miklosh Bala, Boris Sakakushev, Vladimir Khokha, Manu Malbrain, Vanni Agnoletti, Andrew Peitzman, Zaza Demetrashvili, Michael Sugrue, Salomone Di Saverio, Ingo Martzi, Kjetil Soreide, Walter Biffl, Paula Ferrada, Neil Parry, Philippe Montravers, Rita Maria Melotti, Francesco Salvetti, Tino M. Valetti, Thomas Scalea, Osvaldo Chiara, Stefania Cimbanassi, Jeffry L. Kashuk, Martha Larrea, Juan Alberto Martinez Hernandez, Heng Fu Lin, Mircea Chirica, Catherine Arvieux, Camilla Bing, Tal Horer, Belinda De Simone, Peter Masiakos, Viktor Reva, Nicola DeAngelis, Kaoru Kike, Zsolt J. Balogh, Paola Fugazzola, Matteo Tomasoni, Rifat - Latifi, Noel Naidoo, Dieter Weber, Lauri Handolin, Kenji Inaba, Andreas Hecker, Yuan Kuo-Ching, Carlos A. Ordoñez, Sandro Rizoli, Carlos Augusto Gomes, Marc De Moya, Imtiaz Wani, Alain Chichom Mefire, Ken Boffard, Lena Napolitano, Fausto Catena

Research output: Contribution to journalReview article

16 Citations (Scopus)

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.

Original languageEnglish (US)
Article number7
JournalWorld Journal of Emergency Surgery
Volume13
Issue number1
DOIs
StatePublished - Feb 2 2018
Externally publishedYes

Fingerprint

Abdomen
Intra-Abdominal Hypertension
Guidelines
Fascia
Wounds and Injuries
Abdominal Wall
Decompression
Critical Illness
Resuscitation
Laparotomy
Edema
Infection

Keywords

  • Biological
  • Closure
  • Fistula
  • Guidelines
  • Intra-abdominal infection
  • Laparostomy
  • Mesh
  • Non-trauma
  • Nutrition
  • Open abdomen
  • Pancreatitis
  • Peritonitis
  • Re-exploration
  • Reintervention
  • Synthetic
  • Technique
  • Timing
  • Trauma
  • Vascular emergencies

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine

Cite this

Coccolini, F., Roberts, D., Ansaloni, L., Ivatury, R., Gamberini, E., Kluger, Y., ... Catena, F. (2018). The open abdomen in trauma and non-trauma patients: WSES guidelines. World Journal of Emergency Surgery, 13(1), [7]. https://doi.org/10.1186/s13017-018-0167-4

The open abdomen in trauma and non-trauma patients : WSES guidelines. / 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 Pereira; 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 Maria; Salvetti, Francesco; Valetti, Tino M.; Scalea, Thomas; Chiara, Osvaldo; Cimbanassi, Stefania; Kashuk, Jeffry L.; Larrea, Martha; Hernandez, Juan Alberto Martinez; 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 Augusto; De Moya, Marc; Wani, Imtiaz; Mefire, Alain Chichom; Boffard, Ken; Napolitano, Lena; Catena, Fausto.

In: World Journal of Emergency Surgery, Vol. 13, No. 1, 7, 02.02.2018.

Research output: Contribution to journalReview article

Coccolini, F, Roberts, D, Ansaloni, L, Ivatury, R, Gamberini, E, Kluger, Y, Moore, EE, Coimbra, R, Kirkpatrick, AW, Pereira, BM, Montori, G, Ceresoli, M, Abu-Zidan, FM, Sartelli, M, Velmahos, G, Fraga, GP, Leppaniemi, A, Tolonen, M, Galante, J, Razek, T, Maier, R, Bala, M, Sakakushev, B, Khokha, V, Malbrain, M, Agnoletti, V, Peitzman, A, Demetrashvili, Z, Sugrue, M, Di Saverio, S, Martzi, I, Soreide, K, Biffl, W, Ferrada, P, Parry, N, Montravers, P, Melotti, RM, Salvetti, F, Valetti, TM, Scalea, T, Chiara, O, Cimbanassi, S, Kashuk, JL, Larrea, M, Hernandez, JAM, Lin, HF, Chirica, M, Arvieux, C, Bing, C, Horer, T, De Simone, B, Masiakos, P, Reva, V, DeAngelis, N, Kike, K, Balogh, ZJ, Fugazzola, P, Tomasoni, M, Latifi, R, Naidoo, N, Weber, D, Handolin, L, Inaba, K, Hecker, A, Kuo-Ching, Y, Ordoñez, CA, Rizoli, S, Gomes, CA, De Moya, M, Wani, I, Mefire, AC, Boffard, K, Napolitano, L & Catena, F 2018, 'The open abdomen in trauma and non-trauma patients: WSES guidelines', World Journal of Emergency Surgery, vol. 13, no. 1, 7. https://doi.org/10.1186/s13017-018-0167-4
Coccolini F, Roberts D, Ansaloni L, Ivatury R, Gamberini E, Kluger Y et al. The open abdomen in trauma and non-trauma patients: WSES guidelines. World Journal of Emergency Surgery. 2018 Feb 2;13(1). 7. https://doi.org/10.1186/s13017-018-0167-4
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 Pereira ; 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 Maria ; Salvetti, Francesco ; Valetti, Tino M. ; Scalea, Thomas ; Chiara, Osvaldo ; Cimbanassi, Stefania ; Kashuk, Jeffry L. ; Larrea, Martha ; Hernandez, Juan Alberto Martinez ; 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 Augusto ; De Moya, Marc ; Wani, Imtiaz ; Mefire, Alain Chichom ; Boffard, Ken ; Napolitano, Lena ; Catena, Fausto. / The open abdomen in trauma and non-trauma patients : WSES guidelines. In: World Journal of Emergency Surgery. 2018 ; Vol. 13, No. 1.
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AU - Roberts, Derek

AU - Ansaloni, Luca

AU - Ivatury, Rao

AU - Gamberini, Emiliano

AU - Kluger, Yoram

AU - Moore, Ernest E.

AU - Coimbra, Raul

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AU - Inaba, Kenji

AU - Hecker, Andreas

AU - Kuo-Ching, Yuan

AU - Ordoñez, Carlos A.

AU - Rizoli, Sandro

AU - Gomes, Carlos Augusto

AU - De Moya, Marc

AU - Wani, Imtiaz

AU - Mefire, Alain Chichom

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AB - 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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KW - Closure

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KW - Guidelines

KW - Intra-abdominal infection

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KW - Nutrition

KW - Open abdomen

KW - Pancreatitis

KW - Peritonitis

KW - Re-exploration

KW - Reintervention

KW - Synthetic

KW - Technique

KW - Timing

KW - Trauma

KW - Vascular emergencies

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