Closed or Open Abdomen for the Management of Abdominal Sepsis
Abdominal Sepsis, Abdominal Infection
About this trial
This is an interventional treatment trial for Abdominal Sepsis focused on measuring sepsis, abdominal infection, open abdomen management, Negative pressure peritoneal therapy
Eligibility Criteria
Inclusion Criteria:
- Presence of purulent, feculent, or enteric spillage over at least 2 intra-peritoneal quadrants intra-operatively;
- Septic shock, or
- Predisposition-Infection-Response-Organ Dysfunction Score > 3, or
- World-Society-of-Emergency-Surgery-Sepsis-Severity-Score > 8
Exclusion Criteria:
- Pregnant;
- Confirmed or strongly suspected severe IAH (IAP>20 mmHg);
- No intentional of providing ongoing care;
- pancreatitis as the source of peritonitis;
- uncontrolled bleeding
Sites / Locations
- Foothills Medical CentreRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Sham Comparator
Open Abdomen Management with ANPPT dressing
Closed Abdomen Management
The abdominal fascia will not be closed, but a temporally abdomenal closure (TAC) dressing (such as AbThera dressing) will be placed to protect the viscera with active Negative Pressure Peritoneal drain. Formal abdominal closure or dressing change at 24-72 hours from placement should be performed.
Primary closure of the abdominal fascia with placement of an intra-peritoneal drain (such as a Jackson-Pratt drain). Any decision to perform a re-laparotomy will be at the discretion of the treating surgical team.