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World J Gastrointest Surg. Dec 27, 2013; 5(12): 314-320
Published online Dec 27, 2013. doi: 10.4240/wjgs.v5.i12.314
“Acute postoperative open abdominal wall”: Nosological concept and treatment implications
Manuel López-Cano, José A Pereira, Manuel Armengol-Carrasco
Manuel López-Cano, Manuel Armengol-Carrasco, Abdominal Wall Surgery Unit, Department of General Surgery, Hospital Universitari Vall d’Hebrón, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
José A Pereira, Department of General and Digestive Surgery, Parc de Salut Mar, Universitat Autònoma de Barcelona, 08003 Barcelona, Spain
José A Pereira, Department of Health and Experimental Sciences, Universitat Pompeu Fabra, 08002 Barcelona, Spain
Author contributions: López-Cano M was the principal investigator, designed the concept, wrote the paper, prepared the final draft and was responsible for editorial decisions including the selection of the journal; Pereira JA participated in the search and review of the literature, reviewed the manuscript and approved the final draft; Armengol-Carrasco M reviewed the manuscript and approved the final draft.
Correspondence to: Manuel López-Cano, MD, PhD, Abdominal Wall Surgery Unit, Department of General Surgery, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain. mlpezcano@gmail.com
Telephone: +34-93-2746000 Fax: +34-93-2746224
Received: July 3, 2013
Revised: August 12, 2013
Accepted: October 16, 2013
Published online: December 27, 2013
Processing time: 176 Days and 4.9 Hours
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.