Treatments and other prognostic factors in the management of the open abdomen: A systematic review.

Background: The open abdomen (OA) is an important approach for managing intra-abdominal catastrophes and continues to be the standard of care. Despite this, challenges remain with it associated with a high incidence of complications and poor outcomes. The objective of this article is to perform a systematic review in accordance with PRISMA guidelines to identify prognostic factors in OA patients in regards to definitive fascial closure (DFC), mortality and intra-abdominal complications. Methods: An electronic database search was conducted involving Medline, Excerpta Medica, Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature and Clinicaltrials.gov. All studies that described prognostic factors in regards to the above outcomes in OA patients were eligible for inclusion. Data collected were synthesised by each outcome of interest and assessed for methodological quality. Results: Thirty-one studies were included in the final synthesis. Enteral nutrition, organ dysfunction, local and systemic infection, number of re-explorations, worsening ISS and the development of a fistula appeared to significantly delay DFC. Age and APACHE II score were predictors for in-hospital mortality. Failed DFC, large bowel resection and > 5-10 litres of intravenous fluids in 5-10 and > 10 litres of intravenous fluids in

from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2h3klW5