Management Strategies for the Open Abdomen Following Damage Control Laparotomy

Purpose of Review The resultant open abdomen following damage control laparotomy can present a challenging clinical scenario. Management strategies remain critically important to optimize patient recovery and mitigate long-term morbidities. Recent Findings The summation of recent data is largely limited to low-quality evidence, case series, and expert opinions on the optimal treatment strategies for patients with an open abdomen. Although a myriad of techniques have been studied in elective patients, there remains a paucity of data surrounding open abdominal closure. Recent guidelines from the European Hernia Society and the World Society of Emergency Surgery are limited based on the lack of high-quality data available. Summary High-quality data surrounding optimal treatment strategies for the open abdomen is lacking. Early primary fascial closure represents the strategy of choice; however, when not possible, temporary abdominal closure with negative pressure therapy should be performed. Sequential dynamic closure techniques allow for improved outcomes when complete abdominal closure is not possible.