Open Abdomen pp 205-213 | Cite as

The Nursing Management of Open Abdomen Patients

  • Rosemary Koehl LeeEmail author
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)


Nursing management of the patient with an open abdomen presents unique challenges. The goal of care for the open abdomen patient is to close the abdomen as soon as feasible. This chapter reviews the nurse’s role in stabilizing the patient’s hemodynamics, managing intra-abdominal hypertension, and supporting nutrition and mobility. Skin protection is a challenge with the open abdomen patient, and the nurse needs to use creative strategies due to the enteric drainage. The open abdomen patient is also confronted with psychosocial and financial issues, particularly if the patient requires to have a ventral hernia prior to definitive closure.


  1. 1.
    Nightingale F. Notes on nursing: what it is and what it is not. London: Harrison; 1860.Google Scholar
  2. 2.
    Burns SM, editor. AACN essentials of critical care nursing. 3rd ed. New York: McGraw Hill; 2014.Google Scholar
  3. 3.
    Abdominal Compartment Society: Accessed on 1 September 2016.
  4. 4.
    Burlew CC. The open abdomen: practical implications for the practicing surgeon. Am J Surg. 2012;204:826–35.CrossRefPubMedGoogle Scholar
  5. 5.
    Huang Q, Zhao R, Yue C, et al. Fluid volume overload negatively influences delayed primary facial closure in open abdomen management. J Surg Res. 2014;187:122–7.CrossRefPubMedGoogle Scholar
  6. 6.
    Malbrain M, DeWaele J. Cardiovascular system and IAH. In: Vuylsteke, editor. Intra-abdominal hypertension: core critical care. Cambridge: Cambridge University Press; 2013. p. 131–40.CrossRefGoogle Scholar
  7. 7.
    McLean B. Chapter 22 goal directed hemodynamics. In: Lough, editor. Hemodynamic monitoring: evolving technologies and clinical practice. Missouri: Elsevier; 2016. p. 713–26.Google Scholar
  8. 8.
    Mahjoub Y, et al. The passive leg-raising maneuver cannot accurately predict fluid responsiveness in patients with intra-abdominal hypertension. Crit Care Med. 2010;38(9):1824–9. doi: 10.1097/CCM.0b013e3181eb3c21.CrossRefPubMedGoogle Scholar
  9. 9.
    Lehman LH, Saeed M, Talmor D, Mark R, Malhotra A. Methods of blood pressure measurement in the ICU. Crit Care Med. 2013;41(1):34–40.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Malbrain M, De Laet I, DeWaele J. IAH/ACS: the rationale for surveilance. World J Surg. 2009;33(6):1110–5.CrossRefPubMedGoogle Scholar
  11. 11.
    Abdominal Compartment Syndrome: medical management algorithm. Accessed 1 September 2016.
  12. 12.
    Metheny N. AACN practice alert: initial and ongoing verification of feeding tube placement in adults. Crit Care Nurse. 2016;36(2):e8–e13. 10.4037/ccn2016141.CrossRefGoogle Scholar
  13. 13.
    Taylor BE, McClave SA, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). Crit Care Med. 2016;44(2):390–438. doi: 10.1097/CCM.0000000000001525.CrossRefPubMedGoogle Scholar
  14. 14.
    MacLeod JBA, Lefton J, Houghton D, Roland C, et al. Prospective randomized control trial of intermittent versus continuous gastric feeds for critically ill trauma patients. J Trauma. 2007;63:57–61.CrossRefPubMedGoogle Scholar
  15. 15.
    Marik PE (2016) Chapter 32 nutrition in the ICU: it’s whey cool. In: Marik (auth) Evidence based critical care 3. Springer, Heidelberg.Google Scholar
  16. 16.
    Vollman KM. Hemodynamic instability: is it really a barrier to turning critically ill patients? Crit Care Nurse. 2012;32(1):70–5.CrossRefPubMedGoogle Scholar
  17. 17.
    Malbrain M, DeWaele J. Principles of IAP management. In: Vuylsteke, editor. Intra-abdominal hypertension: core critical care. Cambridge: Cambridge University Press; 2013. p. 25–33.CrossRefGoogle Scholar
  18. 18.
    Society of Critical Care Medicine: ICU Liberation Accessed on 15 August 2016.
  19. 19.
    Curtis K, Judson K. Management of fistulae in patients with an open abdomen. Nurs Stand. 2014;28(25):56–64.CrossRefPubMedGoogle Scholar
  20. 20.
    Zarzaur BL, 2011, DiCocco JM, Shahan CP et al Quality of life after abdominal wall reconstruction following open abdomen. J Trauma. 70(2) p 285–291.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Clark JM, Cheatham ML, Safcsak K, Alban RF. Effects of race and insurance on outcomes of the open abdomen. Am Surg. 2013;79(9):928–32.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Intensive Care & Progressive Care UnitHomestead HospitalHomesteadUSA

Personalised recommendations