General, Emergency and Trauma Surgery dept., Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127 Bergamo, Italy.
Emergency and Trauma Surgery, Parma Maggiore hospital, Parma, Italy.
World J Emerg Surg. 2017 Aug 14;12:39. doi: 10.1186/s13017-017-0146-1. eCollection 2017.
The open abdomen (OA) is defined as intentional decision to leave the fascial edges of the abdomen un-approximated after laparotomy (laparostomy). The abdominal contents are potentially exposed and therefore must be protected with a temporary coverage, which is referred to as temporal abdominal closure (TAC). OA use remains widely debated with many specific details deserving detailed assessment and clarification. To date, in patients with intra-abdominal emergencies, the OA has not been formally endorsed for routine utilization; although, utilization is seemingly increasing. Therefore, the World Society of Emergency Surgery (WSES), Abdominal Compartment Society (WSACS) and the Donegal Research Academy united a worldwide group of experts in an international consensus conference to review and thereafter propose the basis for evidence-directed utilization of OA management in non-trauma emergency surgery and critically ill patients. In addition to utilization recommendations, questions with insufficient evidence urgently requiring future study were identified.
开放性腹部(OA)定义为剖腹手术后故意决定不关闭腹部筋膜边缘。腹部内容物可能会暴露出来,因此必须用临时覆盖物来保护,这被称为临时腹部闭合(TAC)。OA 的使用仍然存在广泛的争议,许多具体细节值得详细评估和澄清。迄今为止,在腹部急症患者中,OA 尚未被正式批准常规使用;尽管如此,OA 的使用似乎在增加。因此,世界急诊外科学会(WSES)、腹腔间隔室综合征学会(WSACS)和多尼戈尔研究学院联合了一个全球专家小组,召开了一次国际共识会议,对 OA 在非创伤性急诊手术和危重症患者中的应用进行了回顾,并提出了基于循证的 OA 管理应用的依据。除了使用建议外,还确定了一些证据不足、急需进一步研究的问题。