As adoption of the open abdomen surgical technique becomes more widespread, critical care nurses are treating more patients with open abdomens, according to Critical Care Nurse.
The open abdomen surgical technique involves leaving the abdomen exposed after surgery. The area is protected by a temporary covering until all necessary surgical procedures are completed, which can take weeks. The technique is considered a major surgical advancement in the treatment of traumatic injury, severe bleeding, infection and abdominal compartment syndrome.
"All types of critical care units will have patients with an open abdomen, because the indications for the procedure have increased dramatically," said Eleanor Fitzpatrick, RN, a clinical nurse specialist for surgical critical care at Thomas Jefferson University Hospital in Philadelphia. "Nurses need to become familiar with the technique and what it means for their patients. This is a temporary but necessary measure that can improve the viability of the organs and possibly prevent multiple organ failure."
Here are three things critical care nurses should know about the open abdomen technique.
1. Infection treatment in open abdomen patients should be aggressive and in accordance with critical care standards, institutional guidelines and the consensus statement of the Surviving Sepsis Campaign.
2. Nutritional support is a crucial intervention that should be implemented early on in the open abdomen intervention and maintained throughout the patient's hospitalization.
3. Critical care nurses should provide emotional support and guidance to patients and their families about the procedure.
"The patient and the patient's family will need education about many of the treatments the patient undergoes and about how they can be involved in discharge planning and resource use," wrote Ms. Fitzpatrick. "All of these elements come under the purview of critical care nurses to facilitate and coordinate as a patient's condition slowly improves."
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