Abdominal sepsis

被引:32
作者
Boldingh, Quirine J. J. [1 ]
de Vries, Fleur E. E. [1 ]
Boermeester, Marja A. [1 ]
机构
[1] Acad Med Ctr, Dept Surg, Suite G4-132-1,POB 22660, NL-1100 DD Amsterdam, Netherlands
关键词
abdominal sepsis; relaparotomy; source control; surgical treatment; temporary abdominal closure; COMPLICATED INTRAABDOMINAL INFECTIONS; INTERNATIONAL CONSENSUS DEFINITIONS; LAPAROSCOPIC LAVAGE; SEPTIC SHOCK; PERFORATED DIVERTICULITIS; ANTIMICROBIAL THERAPY; PURULENT PERITONITIS; GUIDELINES; MANAGEMENT; RESECTION;
D O I
10.1097/MCC.0000000000000388
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Purpose of review To summarize the recent evidence on the treatment of abdominal sepsis with a specific emphasis on the surgical treatment. Recent findings A multitude of surgical approaches towards abdominal sepsis are practised. Recent evidence shows that immediate closure of the abdomen has a better outcome. A short course of antibiotics has a similar effect as a long course of antibiotics in patients with intra- abdominal infection without severe sepsis. Summary Management of abdominal sepsis requires a multidisciplinary approach. Closing the abdomen permanently after source control and only reopening it in case of deterioration of the patient without other ( percutaneous) options is the preferred strategy. There is no convincing evidence that damage control surgery is beneficial in patients with abdominal sepsis. If primary closure of the abdomen is impossible because of excessive visceral edema, delayed closure using negative pressure therapy with continuous mesh- mediated fascial traction shows the best results.
引用
收藏
页码:159 / 166
页数:8
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