Safe mobilization and functional rehabilitation of adults with an open abdomen: A narrative review
DOI:
https://doi.org/10.62827/fb.v27i9.1319Keywords:
Open Abdomen Techniques; Early Ambulation; Postoperative Care; Physical Therapy Modalities; Intensive Care Units.Abstract
Introduction: Open abdomen management preserves surgical options in critical conditions but combines the risk of local complications with immobility and functional loss. Objective: To analyze evidence on safe mobilization, complication prevention, and functional rehabilitation in adults with an open abdomen. Methods: PubMed/MEDLINE and LILACS were searched in September 2026, and relevant guidelines and reference lists were examined. Publications from 2021 to 2026 were prioritized while earlier sources relevant to guidelines and direct open abdomen data were retained. Evidence from open abdomen patients was distinguished from studies in general critical care and abdominal surgery without peritoneostomy. Results: Specific guidelines do not define the optimal time to mobilize patients with an open abdomen; the specific guideline allows transfers to be considered in selected patients with negative pressure temporary closure, without comparative proof of safety. Studies in critical care and emergency laparotomy report feasible mobilization but do not establish equivalent safety during peritoneostomy. An intensive care trial found no additional functional benefit from a more intensive protocol and reported more adverse events. Long-term open abdomen cohorts documented physical limitations and hernias without testing rehabilitation programs. Conclusion: Mobilization should progress according to clinical stability, the integrity of temporary closure, and shared decisions with the surgical team. Rehabilitation after closure should monitor functional outcomes; direct evidence that mobilization prevents fistulas or improves fascial closure is lacking.
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Copyright (c) 2026 Rafael Viana dos Santos Coutinho, Matheus Augusto Nunes Ventura, Felipe de Souza Fontanella Bittencourt, Gabriel dos Santos Campos, Karla Karoline Ferreira dos Santos (Autor)
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