Palabras clave
Terapia de presión negativa
Fístula
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Resumen
Objetivo: Analizar las evidencias científicas sobre el manejo del abdomen abierto con terapia de presión negativa, con énfasis en los criterios de cierre fascial, la relaparotomía/reintervención y las complicaciones infecciosas asociadas. Métodos: Se trata de una revisión integradora, descriptiva y cualitativa, realizada en las bases PubMed/MEDLINE y SciELO, con búsqueda de estudios publicados entre 2016 y 2026. Se incluyeron estudios en humanos, disponibles en texto completo, en portugués, inglés o español, relacionados con abdomen abierto, cierre abdominal temporal, terapia de presión negativa, cierre fascial, relaparotomía, fístulas y complicaciones infecciosas. Resultados: Se identificaron 232 registros, de los cuales 30 estudios compusieron la muestra final. Los hallazgos indicaron que la terapia de presión negativa es relevante para el cierre abdominal temporal, especialmente cuando se asocia con técnicas dinámicas de tracción fascial. El abdomen abierto prolongado, múltiples reintervenciones, sepsis persistente, isquemia intestinal y resecciones se asociaron con peores desenlaces. Conclusión: El manejo del abdomen abierto debe ser individualizado, protocolizado y orientado por el control de la fuente, la protección visceral y el cierre fascial precoz.
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