Open Access

Federico Coccolini, Derek Roberts, Luca Ansaloni, Rao Ivatury, Emiliano Gamberini, Yoram Kluger, Ernest E. Moore, Raul Coimbra, Andrew Wallace Kirkpatrick, Bruno M. Pereira, Giulia Montori, Marco Ceresoli, Fikri M. Abu-Zidan, Massimo Sartelli, George C. Velmahos, Gustavo Pereira Fraga, Ari Leppaniemi, Matti Tolonen, Joseph Galante, Tarek Razek, Ron Maier, Miklosh Bala, Boris Sakakushev, Vladimir Khokha, Manu Malbrain, Vanni Agnoletti, Andrew B. Peitzman, Zaza Demetrashvili, Michael Sugrue, Salomone Di Saverio, Ingo Martzi, Kjetil Soreide, Walter Biffl, Paula Ferrada, Neil Parry, Philippe Montravers, Rita Maria Melotti, Francesco Salvetti, Tino M. Valetti, Thomas Scalea, Osvaldo Chiara, Stefania Cimbanassi, Jeffry L. Kashuk, Martha Larrea, Juan Alberto Martinez Hernandez, Heng-Fu Lin, Mircea Chirica, Catherine Arvieux, Camilla Bing, Tal Horer, Belinda De Simone, Peter T. Masiakos, Viktor Reva, Nicola De Angelis, Kaoru Kike, Zsolt J. Balogh, Paola Fugazzola, Matteo Tomasoni, Rifat Latifi, Noel Naidoo, Dieter Weber, Lauri Handolin, Kenji Inaba, Andreas Hecker, Kuo-Ching Yuan, Carlos A. Ordoñez, Sandro Rizoli, Carlos Augusto Gomes, Marc De Moya, Imtiaz Wani, Alain Chichom Mefire, Ken Boffard, Lena Napolitano, Fausto Catena

• Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a “planned second-look” laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption. The open abdomen in trauma and non-trauma patients has been proposed to be effective in preventing or treating deranged physiology in patients with severe injuries or critical illness when no other perceived options exist. Its use, however, remains controversial as it is resource consuming and represents a non-anatomic situation with the potential for severe adverse effects. Its use, therefore, should only be considered in patients who would most benefit from it. Abdominal fascia-to-fascia closure should be done as soon as the patient can physiologically tolerate it. All precautions to minimize complications should be implemented.