Preventing loss of domain: a management strategy for closure of the "open abdomen" during the initial hospitalization.

Background: In the management of the abdominal compartment syndrome resulting in an open abdomen, the so-called "planned ventral hernia" is considered an acceptable outcome. We describe a technique of surgical management of the abdominal wound that allows fascial closure in most cases during the initial admission.

Methods: Consecutive trauma patients with abdominal compartment syndrome managed with an open abdomen over a 3-year period were identified.