Chirurgia (Bucur). 2021 Dec;116(6 Suppl):S16-S27.
Abdominal sepsis remains the second most common source of sepsis, a life-threatening condition that became a global health priority in the medical field research. Open abdomen is part of the damage control surgery, a life-saving strategy in a well-selected group of surgical patients with severe abdominal sepsis and intra-abdominal hypertension. Definitions and recommendations in the management of abdominal sepsis and open abdomen have gradually evolved, as a reflection of the progress of both the comprehension of physiopathological mechanisms involved in sepsis and the technology of different temporary abdominal closure systems. The aim of this paper is to make an up-to-date literature narrative review of the definitions and current practice guidelines in abdominal sepsis, with illustration of clinical experience in the management of open abdomen wounds. In the past decades, progress has been made in the management of abdominal sepsis, with greatly ameliorated survival rates. Rapid diagnosis, extensive comprehension of the physiopathological mechanisms of sepsis, adapted fluid resuscitation, antimicrobial therapy and damage-control surgery, orchestrated by a multy-disciplinary team, play an equally important role in the prognosis of a patient.
腹腔脓毒症仍然是脓毒症的第二大常见病因，脓毒症是一种危及生命的疾病，已成为医学领域研究的全球卫生重点。开放性腹部是损伤控制性手术的一部分，对于严重腹腔脓毒症和腹腔内高压的选定手术患者群体，这是一种救命策略。腹腔脓毒症和开放性腹部的管理中的定义和建议逐渐演变，反映了对脓毒症相关生理病理机制的理解以及不同临时腹部闭合系统技术的进步。本文的目的是对腹腔脓毒症的定义和当前实践指南进行最新的文献叙述性综述，并说明在开放性腹部伤口管理中的临床经验。在过去几十年中，腹腔脓毒症的管理取得了进展，生存率大大提高。快速诊断、对脓毒症生理病理机制的广泛理解、适应性液体复苏、抗菌治疗和损伤控制性手术，由多学科团队协调，对患者的预后同样重要。
