Classification-Important Step to Improve Management of Patients with an Open Abdomen
Classification-Important Step to Improve Management of Patients with an Open Abdomen
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DOI：
10.1007/s00268-009-9996-3
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发表时间：
2009-06-01
影响因子：
2.6
通讯作者：
Windsor, Alastair
中科院分区：
文献类型：
--
作者：
Bjorck, Martin;Bruhin, Andreas;Windsor, Alastair
这份简短的报告是2009年1月一次协商一致小组会议的总结。它概述了一个拟议的分类系统，病人与开放的腹部（OA）。该分类允许(1)描述患者的临床过程；(2)规范临床指南，提高OA管理水平；(3)改善OA状态的报告，这将有助于研究和异质患者人群之间的比较。建议以下分级：1A级，OA干净，无肠与腹壁粘连或腹壁固定（侧化）；1B级，受污染的OA无粘附性/固定性；2A级，干净的OA形成粘连/固定；2B级，受污染的OA出现粘附性/固定性；3级，OA合并瘘管形成；4级，冰冻OA伴黏附/固定肠，无法手术闭合，伴或不伴瘘管。我们建议这个分类系统将促进沟通，明确OA管理，并有可能改善患者护理。
This short report is a distillation of the proceedings from a consensus group meeting in January 2009. It outlines a proposed classification system for patients with an open abdomen (OA). The classification allows (1) a description of the patient's clinical course; (2) standardized clinical guidelines for improving OA management; and (3) improved reporting of OA status, which will facilitate comparisons between studies and heterogeneous patient populations. The following grading is suggested: grade 1A, clean OA without adherence between bowel and abdominal wall or fixity of the abdominal wall (lateralization); grade 1B, contaminated OA without adherence/fixity; grade 2A, clean OA developing adherence/fixity; grade 2B, contaminated OA developing adherence/fixity; grade 3, OA complicated by fistula formation; grade 4, frozen OA with adherent/fixed bowel, unable to close surgically, with or without fistula. We propose that this classification system will facilitate communication, clarify OA management, and potentially improve patient care.