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Abdominal sepsis

Boldingh, Quirine J.J.; de Vries, Fleur E.E.; Boermeester, Marja A.

Current Opinion in Critical Care: April 2017 - Volume 23 - Issue 2 - p 159–166
doi: 10.1097/MCC.0000000000000388
GASTROINTESTINAL SYSTEM: Edited by W. Joost Wiersinga
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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.

Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands

Correspondence to Prof. Marja A. Boermeester, Academic Medical Center, Department of Surgery (suite G4-132.1), PO Box 22660, Amsterdam 1100 DD, The Netherlands. Tel: +31205662766; e-mail: m.a.boermeester@amc.uva.nl

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