The open abdomen (OA) procedure is a significant surgical advance, as part of damage control techniques in severe abdominal trauma. Its application can be adapted to the advantage of patients with severe abdominal sepsis, however its precise role in these patients is still not clear. In severe abdominal sepsis the OA may allow early identification and draining of any residual infection, control any persistent source of infection, and remove more effectively infected or cytokine-loaded peritoneal fluid, preventing abdominal compartment syndrome and deferring definitive intervention and anastomosis until the patient is appropriately resuscitated and hemodynamically stable and thus better able to heal. However, the OA may require multiple returns to the operating room and may be associated with significant complications, including enteroatmospheric fistulas, loss of abdominal wall domain and large hernias. Surgeons should be aware of the pathophysiology of severe intra-abdominal sepsis and always keep in mind the option of using open abdomen to be able to use it in the right patient at the right time.

1st Surgical Department of 1st Faculty of Medicine General University Hospital Prague Charles University Prague Czech Republic

Abdominal Center University Hospital Meilahti Helsinki Finland

Centro de investigaciones clínicas Fundación Valle del Lili Cali Colombia

Clinic for Emergency Surgery Faculty of Medicine University of Belgrade Belgrade Serbia

Department of General and Emergency Surgery Riga East Clinical University Hospital Gailezers Riga Latvia

Department of General and Thoracic Surgery University Hospital of Giessen Giessen Germany

Department of General Surgery Rambam Health Care Campus Haifa Israel

Department of Surgery College of Medicine and Health Sciences UAE University Al Ain United Arab Emirates

Department of Surgery Edendale Hospital Pietermaritzburg Republic of South Africa

Department of Surgery Fundación Valle del Lili Hospital Universitario del Valle Universidad del Valle Cali Colombia

Department of Surgery Government Medical College and Hospital Chandigarh India

Department of Surgery Hospital San Juan de Dios La Serena Chile

Department of Surgery Macerata Hospital Via Santa Lucia 2 62100 Macerata Italy

Department of Surgery Mansoura Faculty of Medicine Mansoura University Mansoura Egypt

Department of Surgery Mayo Clinic Rochester MN USA

Department of Surgery MOSC Medical College Kolenchery Cochin India

Department of Surgery Post Graduate Institute of Medical Sciences Rohtak India

Department of Surgery Queen Elizabeth Hospital Birmingham UK

Department of Surgery Tan Tock Seng Hospital Singapore Singapore

Department of Surgery Tbilisi State Medical University Kipshidze Central University Hospital Tbilisi Georgia

Department of Surgery Trauma Research Institute University of Arizona Tucson AZ USA

Department of Surgery University Hospital of the West Indies Kingston Jamaica

Department of Surgery University of Colorado Denver Health Medical Center Denver USA

Department of Surgery University of Florida Gainesville FL USA

Department of Surgery Yonsei University College of Medicine Seoul South Korea

Department of Visceral Thorax and Transplant Surgery University of Innsbruck Innsbruck Austria

Division of Emergency and Trauma Surgery Ribeirão Preto Medical School Ribeirão Preto Brazil

Division of Trauma Surgery Hospital de Clinicas School of Medical Sciences University of Campinas Campinas Brazil

Division of Trauma Surgical Critical Care Burns and Acute Care Surgery University of California San Diego Health Science San Diego USA

Emergency Department Niguarda Ca' Granda Hospital Milan Italy

Emergency Surgery Department Maggiore Parma Hospital Parma Italy

General Surgery 1 Papa Giovanni XXIII Hospital Bergamo Italy

Shock Trauma Center University of Maryland School of Medicine Baltimore USA

Trauma and Acute Care Surgery Unit Hadassah Hebrew University Medical Center Jerusalem Israel

Trauma Emergency Surgery Surgical Critical Care University of Southern California Los Angeles USA

Trauma Surgery Unit Maggiore Hospital Bologna Italy

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The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections

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