医学
损伤控制手术
损伤控制
腹腔隔室综合征
腹部
剖腹手术
腹部外伤
外科
腹部外科
急腹症
普通外科
作者
Jose J. Diaz,Daniel C. Cullinane,William D. Dutton,Rebecca N Jerome,Richard Bagdonas,Jarolslaw O. Bilaniuk,Bryan R. Collier,John J. Como,John Cumming,Maggie Griffen,Oliver L. Gunter,John P. Kirby,Larry Lottenburg,Nathan T. Mowery,William P. Riordan,Niels D. Martin,Jon Platz,Nicole A. Stassen,Eleanor S. Winston
出处
期刊:Journal of Trauma-injury Infection and Critical Care
[Ovid Technologies (Wolters Kluwer)]
日期:2010-06-01
卷期号:68 (6): 1425-1438
被引量:138
标识
DOI:10.1097/ta.0b013e3181da0da5
摘要
Background: The open abdomen technique, after both military and civilian trauma, emergency general or vascular surgery, has been used in some form for the past 30 years. There have been several hundred citations on the indications and the management of the open abdomen. Eastern Association for the Surgery of Trauma practice management committee convened a study group to organize the world's literature for the management of the open abdomen. This effort was divided into two parts: damage control and the management of the open abdomen. Only damage control is presented in this study. Part 1 is divided into indications for the open abdomen, temporary abdominal closure, staged abdominal repair, and nutrition support of the open abdomen. Methods: A literature review was performed for more than 30 years. Prospective and retrospective studies were included. The reviews and case reports were excluded. Of 1,200 articles, 95 were selected. Seventeen surgeons reviewed the articles with four defined criteria. The Eastern Association for the Surgery of Trauma primer was used to grade the evidence. Results: There was only one level I recommendation. A patient with documented abdominal compartment syndrome should undergo decompressive laparotomy. Conclusion: The open abdomen technique remains a heroic maneuver in the care of the critically ill trauma or surgical patient. For the best outcomes, a protocol for the indications, temporary abdominal closure, staged abdominal reconstruction, and nutrition support should be in place.
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