Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar;92(3):283-296.
doi: 10.1007/s00104-020-01322-4.

[Laparostoma-Avoidance and treatment of complications]

[Article in German]
Ulrich A Dietz  1 , Johannes Baur  2 , Rein Jan Piso  3 , Arnulf Willms  4 , Robert Schwab  4 , Armin Wiegering  5
Affiliations

[Laparostoma-Avoidance and treatment of complications]

[Article in German]
Ulrich A Dietz et al. Chirurg. 2021 Mar.

Abstract
in English, German

The open abdomen (OA) is an established concept for treating severe abdominal diseases. The most frequent reasons for placement of an open abdomen are abdominal sepsis (e.g. from intestinal perforation or anastomotic leakage), severe abdominal organ injury and abdominal compartment syndrome. The pathophysiology is much more complex than the surgeon's eye can see in an OA. The temporary closure of the abdominal wall ensures sufficient drainage of infected ascites, protection of the intestinal loops and conditioning of the abdominal wall in order to be able carry out definitive closure of the abdominal wall at the end of the surgical treatment. Negative peritoneal pressure therapy combined with fascia traction (with or without mesh) is well-established in the management of an open abdomen.

Das offene Abdomen (OA) ist ein etabliertes Konzept zur Therapie schwerer Abdominalerkrankungen. Die häufigsten Ursachen für die Anlage eines offenen Abdomens sind abdominelle Sepsis (z. B. Darmperforation oder Anastomoseninsuffizienz), schwere abdominelle Organverletzungen und das abdominelle Kompartmentsyndrom. Die Pathophysiologie ist dabei weit komplexer als das Chirurgenauge beim OA sehen kann. Der temporäre Bauchdeckenverschluss dient der sicheren Drainage von infiziertem Aszites, dem Schutz von Darmschlingen sowie der Konditionierung der Bauchdecke, um am Ende der chirurgischen Therapie einen Bauchdeckenverschluss durchführen zu können. Zum Management des offenen Abdomens hat sich die negative peritoneale Drucktherapie mit Faszientraktion (mit oder ohne Netz) bewährt.

Keywords: Abdominal compartment syndrome; Enteroatmospheric fistula; Intra-abdominal hypertension; Negative peritoneal pressure therapy; Open abdomen.

PubMed Disclaimer

References

Literatur

    1. Leppäniemi A, Kimball EJ, De Laet I et al (2015) Management of abdominal sepsis—a paradigm shift? Anaesthesiol Intensive Ther 47:400–408 - DOI
    1. Kreis BE, de Mol van Otterloo AJ et al (2013) Open abdomen management: a review of its history and a proposed management algorithm. Med Sci Monit 19:524–533 - DOI
    1. Strobel O, Werner J, Büchler MW (2011) Chirurgische Therapie der Peritonitis. Chirurg 82:242–248 - DOI
    1. Kirkpatrick AW, Roberts DJ, De Waele J et al (2013) Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med 39:1190–1206 - DOI
    1. Chiara O, Cimbanassi S, Biffl W et al (2016) International consensus conference on open abdomen in trauma. J Trauma Acute Care Surg 80:173–183 - DOI