Background: Definitive primary abdominal closure is often not possible nor desirable following trauma laparotomy. In such situations, temporary abdominal containment (TAC) is necessary. This audit reviews our experience with TAC and interrogates our use of the Vacuum Assisted Mesh Mediated Fascial Traction approach (VAMMFT) to achieve delayed closure of the Open Abdomen (OA). Methods: We conducted a retrospective study over a 4-year period of trauma patients who underwent a trauma laparotomy and who required a TAC. Results: Over the four-year period, 596 patients underwent a laparotomy for trauma. Of these trauma laparotomies, 463 (78%) underwent primary closure and 133 (22%) required a TAC. Of these 133 patients who required a TAC, 37 died, 41 underwent delayed primary fascial closure at repeat laparotomy and 55 were left with an OA. Of this cohort of 55 patients, 15 underwent a VAMMFT procedure. The VAMMFT procedure yielded a 60% closure rate, with failure to close being due to late mesh insertion and sepsis. Conclusion: Our initial results with VAMMFT are encouraging. The technique appears to be effective and safe. Ongoing audit will allow us to accrue more patients and to better refine our algorithms and strategies.

Cerebral gunshot wounds are associated with significant mortality and protracted delay to definitive care is common in our setting. Those who survive the delayed transfer to definitive care generally do well and have reasonably good clinical outcomes.

Introduction: central venous line insertion is associated with significant complications.Procedural complications relating to lung injury is relatively common, and these may require tube thoracostomy for management. Although a postprocedure chest X-ray is routinely undertaken in many centers, erroneous interpretation can lead to potentially incorrect and unnecessary further intervention. case report: We report a case of a 25-year-old male who had a central venous line inserted, with the chest X-ray appearance of a massive opacification of the hemithorax misdiagnosed as a hemothorax and planned tube thoracostomy. It was subsequently confirmed as a complete pulmonary collapse caused by a large mucus plug with obstruction of the main

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