Open Abdomen in Emergency General Surgery: Indications and Outcomes

Damage control laparotomy (DCL) has long been utilized and supported in the trauma population. Over the last decade Acute Care Surgeons have expanded its use as a tenant of care in the emergency general surgery (EGS) population with unclear indications and outcomes. The optimal clinical scenario and management of open abdomen (OA) in the EGS population is evolving as it is employed more frequently for this population.

OA in the EGS patient has a distinct complication profile and mortality. Previously utilized heavily for abdominal sepsis, recent literature does not support this as a routine indication; instead, it focuses on the evaluation of individual clinical factors to determine the use of DCL. Early and aggressive primary fascial closure should be the goal in management of OA in the EGS patient.

When applied to the right patients, open abdomen is a safe and effective tool in treatment of the critically ill emergency general surgery patient.