The Management of the Open Abdomen in Trauma and Emergency General Surgery: Part 1-Damage Control
The Management of the Open Abdomen in Trauma and Emergency General Surgery: Part 1-Damage Control
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DOI：
10.1097/ta.0b013e3181da0da5
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发表时间：
2010-06-01
影响因子：
--
通讯作者：
Winston, Eleanor S.
中科院分区：
文献类型：
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作者：
Diaz, Jose J., Jr.;Cullinane, Daniel C.;Winston, Eleanor S.
背景资料：在过去的30年里，在军事和民用创伤、紧急普通或血管手术后，开腹技术一直以某种形式使用。关于开腹手术的适应症和处理，已有数百篇引文。东部创伤外科协会实践管理委员会召集了一个研究小组，组织世界上关于开腹手术管理的文献。这项工作分为两个部分：损害控制和开放腹部的管理。本研究仅介绍损害控制。第一部分分为开腹手术的适应证、暂时性关腹、分期腹部修补术、开腹手术的营养支持。包括前瞻性和回顾性研究。排除了综述和病例报告。在1,200篇文章中，选出了95篇。17名外科医生按照4项规定标准对文献进行了审查。东部创伤外科协会的初级读本被用来分级的证据。结果：只有一个I级建议。一个有记录的腹腔间隔室综合征的患者应接受减压剖腹术。结论：开腹技术仍然是一个英雄的机动护理危重创伤或手术病人。为了获得最佳结果，应制定适应症、暂时性腹部闭合、分期腹部重建和营养支持方案。
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.