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The Open Abdomen: Management from Initial Laparotomy to Definitive Closure

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Acute Care Surgery

Abstract

A 67-year-old patient has undergone a prolonged and complicated operation for mesenteric ischemic (embolic etiology). Circulation has just been restored to the ischemic bowel; however, the patient is hypothermic (34°C), acidotic, and coagulopathic. Which of the following is the appropriate management at this time?

  1. (A)

    Wood’s lamp assessment of bowel viability

  2. (B)

    Repeated on-table angiography after 45 minutes

  3. (C)

    Administration of mannitol

  4. (D)

    Immediate fascial closure of the abdomen

  5. (E)

    Creative abdominal closure

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Author information

Authors and Affiliations

  1. Department of Surgery, Division of Trauma, Surgical Critical Care, and Burns, Loyola University Medical Center, Foster G. McGaw Hospital, Maywood, IL, USA

    Fred A. Luchette MD & Stathis J. Poulakidas MD

  2. Department of Surgery, Section of Trauma, Injury Analysis, and Prevention Programs, Loyola University Medical Center, Foster G. McGaw Hospital, Maywood, IL, USA

    Thomas J. Esposito MD, MPH

Authors
  1. Fred A. Luchette MD
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  2. Stathis J. Poulakidas MD
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  3. Thomas J. Esposito MD, MPH
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Editor information

Editors and Affiliations

  1. Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA

    L. D. Britt MD, MPH (Brickhouse Professor of Surgery and Chairman) (Brickhouse Professor of Surgery and Chairman)

  2. Department of Surgery, Oregon Health Sciences University, Portland, OR, USA

    Donald D. Trunkey MD (Professor) (Professor)

  3. Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA

    David V. Feliciano MD (Professor of Surgery, Chief of Surgery) (Professor of Surgery, Chief of Surgery)

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Luchette, F.A., Poulakidas, S.J., Esposito, T.J. (2007). The Open Abdomen: Management from Initial Laparotomy to Definitive Closure. In: Britt, L.D., Trunkey, D.D., Feliciano, D.V. (eds) Acute Care Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-69012-4_12

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  • DOI: https://doi.org/10.1007/978-0-387-69012-4_12

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-34470-6

  • Online ISBN: 978-0-387-69012-4

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