Comparison of early surgical alternatives in the management of open abdomen: a randomized controlled study

Abstract

BACKGROUND: Abdominal compartment syndrome (ACS) is a clinical syndrome characterized by progressive intraabdominal organ dysfunction resulting from an acute increase in intra-abdominal pressure (IAP). In the absence of prompt treatment, ACS can lead to lethal organ failure. Treatment of ACS is achieved by immediate decompression of the abdominal cavity. As to how and when decompression laparotomy should be performed depends on the clinical condition of the patients. There is limited data regarding outcomes of abdominal closure techiques. The present study aimed to investigate two different temporary closure methods, the vacuum assisted closure (VAC) and Bogota bag techniques, in 40 patients who underwent decompressive laparotomy as part of the management of ACS.

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery

“…There have been seven systematic reviews examining methods of TAC in the OA over the last 10 years [ 539 , 542 , 570 , 573 , 574 , 575 , 576 , 577 ] and three RCTs [ 559 , 578 , 579 ]. The overall strength of the reported outcomes is low due to the small number and poor quality of comparative observational studies.…”

“…There have been seven systematic reviews examining methods of TAC in the OA over the last 10 years[539,542,570,[573][574][575][576][577] and three RCTs[559,578,579]. The overall strength of the reported outcomes is low due to the small number and poor quality of comparative observational studies.Management of the OA requires a multidisciplinary approach, led jointly by the surgical and intensive care teams with input from a nutritional team, physiotherapists, complex wound and stoma nurses and guided by microbiology.Patients remain intubated following the creation of an OA after index laparotomy, primarily to facilitate repeated returns to…”