The Open Abdomen: Indications and Techniques
| Autor: | Antonella Puzzovio, Federica Scarno, Sergio Ribaldi |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
general emergency surgery
education medicine.medical_specialty Resuscitation trauma care Abdominal compartment syndrome business.industry Volume overload Hemodynamics multiple injury medicine.disease Sepsis Abdominal wall medicine.anatomical_structure Damage control surgery multiple injury trauma care general emergency surgery abdominal sepsis damage control education abdominal sepsis medicine Acute pancreatitis damage control Intensive care medicine business |
| Zdroj: | Trauma Centers and Acute Care Surgery ISBN: 9783030731540 |
| Popis: | The open abdomen (OA) can be a life-saving treatment option, but it is not without complications and challenges. The role of the multidisciplinary team is crucial to create the physiological environment that can promote early closure of the abdominal wall, considering that the reduction of the OA timing is beneficial for success. The patient with OA will require strict management of fluids to ensure resuscitation without volume overload: for this reason, it is important to consider advanced hemodynamic monitoring to guide fluid resuscitation. Early nutrition in patients with OA without intestinal injury is a goal to be achieved to increase protein uptake in a condition of protein loss. The systemic signs of inflammation that should be checked in this class of patients are the development of acute respiratory distress syndrome, the presence of intra-abdominal infection, and recurrent abdominal compartment syndrome, all of which must be managed promptly. In this scenario, antibiotic therapy should be adapted to the underlying infection. Attention to all these factors increases the probability of obtaining an earlier closure, fewer intra-abdominal infectious complications, and reduced resource utilization. |
| Databáze: | OpenAIRE |
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