{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T19:53:47Z","timestamp":1781553227115,"version":"3.54.5"},"reference-count":19,"publisher":"Media Sphere Publishing House","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pirogov Rus. J. Surg."],"published-print":{"date-parts":[[2026,6,15]]},"abstract":"<jats:p>Objective. To compare the results of staged surgical treatment of patients with disseminated secondary peritonitis and to clarify the indications for open abdomen technique. Material and methods. We analyzed treatment outcomes in 978 patients with disseminated peritonitis. The main causes of peritonitis were destructive appendicitis (430 patients, 43.9%) and gastroduodenal ulcer perforation (217 patients, 22.2%). Results. Staged debridement in patients with high risk of death (WSES SSS score \u2265 9) significantly reduces in mortality in this group of patients (from 82.5% with traditional tactics to 62.1%). Staged debridement in patients with lower probability of death (WSES SSS score 7\u20138) does not significantly affect the outcomes. Open abdomen method significantly reduces mortality in patients with abdominal sepsis and septic shock compared to primary suturing and elective re-laparotomy from 75% to 35.3%. Open abdomen method in patients with intra-abdominal pressure &gt;20 mmHg is associated with significantly lower mortality compared to primary suturing (traditional technique) and elective re-laparotomy. VAC systems significantly reduce mortality in patients with WSES SSS score \u22657 compared to anterior abdominal wall closure with local tissues during elective re-laparotomy. The benefit of VAC systems for milder manifestations of peritonitis is not significant. Conclusion. Indications for open abdomen technique include intraabdominal pressure &gt;20 mmHg or abdominal compartment syndrome. This method prevents tissue ischemia, formation of purulent pockets and, consequently, progression of peritonitis in postoperative period. Open abdomen technique is advisable if hemodynamic instability makes surgery impossible.<\/jats:p>","DOI":"10.17116\/hirurgia202606115","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T18:59:34Z","timestamp":1781549974000},"page":"15","source":"Crossref","is-referenced-by-count":0,"title":["Open abdomen as a method of source control in peritonitis: indications and risks"],"prefix":"10.17116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7745-1390","authenticated-orcid":false,"given":"N.V.","family":"Lebedev","sequence":"first","affiliation":[{"name":"Patrice Lumumba Peoples\u2019 Friendship University of Russia","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0001-8003","authenticated-orcid":false,"given":"A.E.","family":"Klimov","sequence":"additional","affiliation":[{"name":"Patrice Lumumba Peoples\u2019 Friendship University of Russia","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1050-7716","authenticated-orcid":false,"given":"D.S.","family":"Parshin","sequence":"additional","affiliation":[{"name":"Astrakhan State Medical University","place":["Astrakhan, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4236-2357","authenticated-orcid":false,"given":"K.M.","family":"Jaghnoun","sequence":"additional","affiliation":[{"name":"Patrice Lumumba Peoples\u2019 Friendship University of Russia","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0436-4938","authenticated-orcid":false,"given":"M.D.","family":"Synkova","sequence":"additional","affiliation":[{"name":"Patrice Lumumba Peoples\u2019 Friendship University of Russia","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3576-4815","authenticated-orcid":false,"given":"I.O.","family":"Abuladze","sequence":"additional","affiliation":[{"name":"Patrice Lumumba Peoples\u2019 Friendship University of Russia","place":["Moscow, Russia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6743","reference":[{"key":"key-10.17116\/hirurgia202606115-1","doi-asserted-by":"publisher","DOI":"10.19163\/1994-9480-2024-21-2-3-11"},{"key":"key-10.17116\/hirurgia202606115-2","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-019-01752-7"},{"key":"key-10.17116\/hirurgia202606115-3","unstructured":"Kirkpatrick AW, Delis S, Coccolini F, Tolonen TM. Re-laparotomies in patients with intra-abdominal infections: when and how. In: Sartelli M, Coccolini F, Catena F, Pagani L, eds. Global Infection Prevention and Management in Healthcare. 1st edn. Milan: Global Alliance for Infections in Surgery; 2024:412-421"},{"key":"key-10.17116\/hirurgia202606115-4","doi-asserted-by":"publisher","DOI":"10.23670\/IRJ.2023.138.86"},{"key":"key-10.17116\/hirurgia202606115-5","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-022-00427-x"},{"key":"key-10.17116\/hirurgia202606115-6","doi-asserted-by":"publisher","DOI":"10.1007\/s00104-015-0121-x"},{"key":"key-10.17116\/hirurgia202606115-7","doi-asserted-by":"publisher","DOI":"10.33029\/9704-8069-4-PAS-2023-1-164"},{"key":"key-10.17116\/hirurgia202606115-8","unstructured":"Sazhin AV, Ivakhov GB, Teplykh AV, Kalinina AA. Vacuum-assisted laparostomy in the complex treatment of widespread peritonitis: a literature review. Moskovskij khirurgicheskij zhurnal. 2020;4(74):65-74. (In Russ.)"},{"key":"key-10.17116\/hirurgia202606115-9","doi-asserted-by":"publisher","DOI":"10.23934\/2223-9022-2021-10-1-58-65"},{"key":"key-10.17116\/hirurgia202606115-10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0288"},{"key":"key-10.17116\/hirurgia202606115-11","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.20.276709"},{"key":"key-10.17116\/hirurgia202606115-12","doi-asserted-by":"crossref","unstructured":"Linder MM, Wacha H, Feldmann U, Wesch G, Streifensand RA, Gundlach E. The Mannheim peritonitis index: an instrument for the intraoperative prognosis of peritonitis. Chirurg. 1987;58(2):84-92","DOI":"10.1007\/978-3-642-73008-5_6"},{"key":"key-10.17116\/hirurgia202606115-13","doi-asserted-by":"publisher","DOI":"10.17116\/hirurgia202310141"},{"key":"key-10.17116\/hirurgia202606115-14","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-015-0055-0"},{"key":"key-10.17116\/hirurgia202606115-15","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-024-00551-w"},{"key":"key-10.17116\/hirurgia202606115-16","unstructured":"Ordo\u00f1ez CA, Caicedo Y. Damage control surgery in managing severe intra-abdominal infections. In: Sartelli M, Coccolini F, Catena F, Pagani L, eds. Global Infection Prevention and Management in Healthcare. 1st edn. Milan: Global Alliance for Infections in Surgery; 2024"},{"key":"key-10.17116\/hirurgia202606115-17","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-023-00509-4"},{"key":"key-10.17116\/hirurgia202606115-18","doi-asserted-by":"publisher","DOI":"10.23934\/2223-9022-2024-13-3-410-418"},{"key":"key-10.17116\/hirurgia202606115-19","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002011"}],"container-title":["Pirogov Russian Journal of Surgery"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T18:59:38Z","timestamp":1781549978000},"score":1,"resource":{"primary":{"URL":"https:\/\/mediasphera.ru\/issues\/khirurgiya-zhurnal-im-n-i-pirogova\/2026\/6\/1002312072026061015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":19,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6,15]]}},"alternative-id":["10.17116\/hirurgia202606115"],"URL":"https:\/\/doi.org\/10.17116\/hirurgia202606115","relation":{},"ISSN":["0023-1207"],"issn-type":[{"value":"0023-1207","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,15]]}}}