“Acute postoperative open abdominal wall”: Nosological concept and treatment implications

Abstract

The so-called “burst abdomen” has been described for many years and is a well-known clinical condition, whereas the concept of the “open abdomen” is relatively new. In clinical practice, both nosological entities are characterized by a complex spectrum of symptoms apparently disconnected, which in many cases poses a great challenge for surgical repair. In order to assess the management of these disorders in a more comprehensive and integral fashion, the concept of “acute postoperative open abdominal wall” (acute POAW) is presented, which in turn can be divided into “intentional” or planned acute POAW and “unintentional” or unplanned POAW. The understanding of the acute POAW as a single clinical process not only allows a better optimization of the therapeutic approach in the surgical repair of abdominal wall-related disorders, but also the stratification and collection of data in different patient subsets, favoring a better knowledge of the wide spectrum of conditions involved in the surgical reconstruction of the abdominal wall.

Keywords: Burst abdomen, Open abdomen, Evisceration, Abdominal wall, Mesh, Negative pressure wound therapy, Incisional hernia, Enteroatmospheric fistula

Core tip: Burst abdomen and open abdomen are clinical conditions apparently disconnected. In order to assess the management of these disorders in a more comprehensive and integral fashion, the concept of “acute postoperative open abdominal wall” (acute POAW) is presented. The understanding of the acute POAW as a single clinical process allows stratification and collection of data in different patient subsets, favoring a better knowledge of conditions involved in the surgical reconstruction of the abdominal wall.