Open Abdomen pp 135-140 | Cite as

The Role of Instillation in Open Abdomen Management

  • Martin Rosenthal
  • Marc de MoyaEmail author
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)


  • Limited data to support direct peritoneal resuscitation (DPR).

  • DPR has been shown in animal models to decrease need for intravenous crystalloid.

  • DPR has been suggested to improve ability to perform delayed primary closure of open abdomen.


  1. 1.
    Harvin J, Mims M, Duchesne J, et al. Chasing 100%: the use of hypertonic saline to improve early, primary fascial closure after damage control laparotomy. J Trauma Acute Care Surg. 2013;74:426–32.CrossRefPubMedGoogle Scholar
  2. 2.
    Garrison R, Zakaria ER. Peritoneal resuscitation. Am J Surg. 2005;190:181–5.CrossRefPubMedGoogle Scholar
  3. 3.
    Smith JW, Garrison RN, Matheson PJ, et al. Adjunctive treatment of abdominal catastrophes and sepsis with a direct peritoneal resuscitation: indications for use in acute care surgery. J Trauma Acute Care Surg. 2014;77:393–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Cotton BA, Reddy N, Hatch QM, et al. Damage control resuscitation is associated with a reduction in resuscitation volumes and improvements in survival in 390 damage control laparotomy patients. Ann Surg. 2011;254:598–605.CrossRefPubMedGoogle Scholar
  5. 5.
    Smith JW, Garrison RN, Matheson PJ, et al. Direct peritoneal resuscitation accelerates primary abdominal wall closure after damage control surgery. J Am Coll Surg. 2010;210(5):658–67.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Zakaria ER, Garrison RN. Mechanisms of direct peritoneal resuscitation-mediated splanchnic hyperperfusion following hemorrhagic shock. Shock. 2007;27:436–42.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Zakaria ER, Hurt RT, Matheson PJ, et al. A novel method of peritoneal resuscitation improves organ perfusion after hemorrhagic shock. Am J Surg. 2003;186:443–8.CrossRefGoogle Scholar
  8. 8.
    D’Hondt M, D’Haeninck A, Dedrye L, et al. Can vacuum-assisted closure and instillation therapy (VAC-Instill therapy) play a role in the treatment of the infected abdomen? Tech Coloproctol. 2011;15:75–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Zakaria ER, Garrison RN, Kawabe T, et al. Direct peritoneal resuscitation from hemorrhagic shock: effect of time delay in therapy initiation. J Trauma. 2005;58:499–508.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Weaver J, Smith J. Direct peritoneal resuscitation: a review. Int J Surg. 2015;1–5.Google Scholar
  11. 11.
    Boyd JH, Forbes J, Nakada T, et al. Fluid resuscitation in septic shock: a positive fluid balance and elevated central venous pressure are associated with increased mortality. Crit Care Med. 2011;39(2):259–65.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Surgical Critical Care FellowMassachusetts General Hospital/Harvard Medical SchoolBostonUSA

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