Open Abdomen: A Comprehensive Practical Manual

364 Pages·2018·15.98 MB·English

by  Federico Coccolini

Hot Topics in Acute Care Surgery and
Trauma
Series Editors
Federico Coccolini
Cesena, Italy
Raul Coimbra
Riverside, USA
Andrew W. Kirkpatrick
Calgary, Canada
Salomone Di Saverio
Cambridge, UK
Editorial Board:
Luca Ansaloni (Cesena, Italy); Zsolt Balogh (Newcastle, Australia); Walt
Biffl (Denver, USA); Fausto Catena (Parma, Italy); Kimberly Davis (New
Haven, USA); Paula Ferrada (Richmond, USA); Gustavo Fraga (Campinas,
Brazil); Rao Ivatury (Richmond, USA); Yoram Kluger (Haifa, Israel); Ari
Leppaniemi (Helsinki, Finland); Ron Maier (Seattle, USA); Ernest E. Moore
(Fort Collins, USA); Lena Napolitano (Ann Arbor, USA); Andrew Peitzman
(Pittsburgh, USA); Patrick Rielly (Philadelphia, USA); Sandro Rizoli (Toronto,
Canada); Boris Sakakushev (Plovdiv, Bulgaria); Massimo Sartelli (Macerata,
Italy); Thomas Scalea (Baltimore, USA); David Spain (Stanford, USA); Philip
Stahel (Denver, USA); Michael Sugrue (Letterkenny, Ireland); George
Velmahos (Boston, USA); Dieter Weber (Perth, Australia) This series covers the
most debated issues in acute care and trauma surgery, from perioperative
management to organizational and health policy issues. Since 2011, the founder
members of the World Society of Emergency Surgery’s (WSES) Acute Care and
Trauma Surgeons group, who endorse the series, realized the need to provide
more educational tools for young surgeons in training and for general physicians
and other specialists new to this discipline: WSES is currently developing a
systematic scientific and educational program founded on evidence-based
systematic scientific and educational program founded on evidence-based
medicine and objective experience. Covering the complex management of acute
trauma and nontrauma surgical patients, this series makes a significant
contribution to this program and is a valuable resource for both trainees and
practitioners in acute care surgery.
More information about this series at http://www.springer.com/series/15718
Editors Federico Coccolini, Rao Ivatury, Michael Sugrue and Luca Ansaloni
Open AbdomenA Comprehensive Practical Manual
Editors
Federico Coccolini
General, Emergency and Trauma Surgery Department, Bufalini Hospital,
Cesena, Italy
Rao Ivatury
General Surgery, Virginia Commonvealth University, Richmond, Virginia, USA
Michael Sugrue
Letterkenny General Hospital, Letterkenny, Donegal, Ireland
Luca Ansaloni
General, Emergency and Trauma Surgery Department, Bufalini Hospital,
Cesena, Italy
ISSN 2520-8284 e-ISSN 2520-8292
Hot Topics in Acute Care Surgery and Trauma ISBN 978-3-319-48071-8 e-
ISBN 978-3-319-48072-5
https://doi.org/10.1007/978-3-319-48072-5
Library of Congress Control Number: 2017963388
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Foreword to the Series
Since 2011, the founding members of the World
Society of Emergency Surgery (WSES) Acute Care
and Trauma Surgeons group, in collaboration with
the American Association for the Surgery of Trauma
(AAST), endorse the “Hot Topics in Acute Care
Surgery and Trauma,” realizing the need to provide
more educational tools for young in-training surgeons
and for general physicians and other surgical
specialists. These new forthcoming titles have been
selected and prepared with this philosophy in mind.
The books will cover the basics of pathophysiology
and clinical management, framed with the reference
that recent advances in the science of resuscitation,
surgery, and critical care medicine have the potential
to profoundly alter the epidemiology and subsequent
outcomes of severe surgical illnesses and trauma. In
particular, open abdomen requires detailed
understanding as to the potential benefits and
complications associated with this surgical approach.
There exists, implicit in use of the open abdomen
approach, a decision to adopt the damage control
paradigm in the management of the sickest patients.
No other management approach has been so
profoundly linked to changes in resuscitation, with
recent advances prompting a reassessment and
critique of all previously accepted principles.
Federico Coccolini Raul Coimbra Andrew W. Kirkpatrick
Salomone Di Saverio Cesena, Italy, Riverside, USA, Calgary, Canada,
Cambridge, UK
Foreword
It is an honor and great pleasure to write a foreword to the book Open Abdomen:
A Comprehensive Practical Manual edited by surgeons and professors Federico
Coccolini, Rao Ivatury, Michael Sugrue, and Luca Ansaloni. Textbooks focusing
on abdominal wall complications and hernia techniques do exist, but it is still a
challenge to treat an open abdomen patient who needs an abdominal wall
reconstruction. In the era of damage control surgery, complex abdominal wall
defects are more common. Most patients have consequences of complex trauma,
cancer, and necrotizing infections, resulting in abdominal catastrophes without
an abdominal wall.
New technologies are coming—vacuum-assisted systems have been used in
different countries; meshes and biological prostheses developed with biomedical
research have changed the options for surgical repair. The approach to treat
patients with open abdomen or complex abdominal wall defect is
multidisciplinary, and team experience is important to have good results, with
less complications.
This book presents, in its 22 chapters, the multiple aspects of the challenging
open abdomen and abdominal wall reconstruction. It covers the topic from its
beginning with historical hints; the anatomy; pathophysiology; indications;
management in infants, children, and adults; nutritional aspects, complications;
definitive closure; the use of biological prostheses; and quality of life. The
editors were very competent in bringing together a select group of surgeons and
teachers who present the subjects in an objective and practical way, facilitating
the learning of the readers.
There is an old aphorism in medicine that says “the surgeon should not be
the first to adopt a new technique and not be the last to abandon an old
technique.” This manual exhaustively describes when “to leave open and when
to close” an abdomen. These two key issues are analyzed based on the latest
evidence in literature, with the support of a strong tool: the WSES Guidelines
recently published. This book brings content in the right dose, helping the next
generation of surgeons to properly treat their patients, and it is a gift to the
readers and even more to their patients who will benefit from a more appropriate
treatment.
G. P. Fraga F. Catena Campinas, SP, Brazil, Parma, Italy
Preface
The treatment of patients with intra-abdominal catastrophes with an open
abdomen involves several potential complex management strategies. The open
abdomen is universally recognized as an option to improve outcomes in selected
patients. Firstly described in damage control procedures in trauma the open
abdomen is now increasingly used in nontrauma patients. The challenge and key
in decision making is balancing whether an open abdomen is going to benefit
patients yet not create counter-product morbidity. This book explores indications
for an open abdomen and offers practical tricks and techniques to minimize the
side effects.
The key to the open abdomen is to allow the patient’s physiology to return to
normal. Comprehending the pathophysiological mechanisms behind its
application is essential and explained in the book. The manual presents different
points of view from the clinicians involved in the management of the open
abdomen patients. It explores care from the very beginning of the treatment
through to rehabilitation. This will help the reader integrate the best information
into their practice, from recognized experts in their respective fields.
We would like to thank all the authors for sharing their precious experience
and hope it will enhance your patient’s outcome.
Federico Coccolini Rao Ivatury Michael Sugrue Luca Ansaloni Cesena, FC,
Italy, Richmond, VA, USA, Letterkenny, Ireland, Cesena, Italy