Temporary Abdominal Closure (TAG) for Planned Relaparotomy (Etappenlavage) in Trauma

Initial Experience of Laparostomy with Immediate Vacuum Therapy in Patients with Severe Peritonitis

“…18 Various methods for managing laparostomies have been described. 6,19,20 Many of these are difficult to apply and somewhat cumbersome to manage. There is a requirement for a temporary closure device that is not only simple to apply, but also actively removes wound and visceral exudates, promotes tissue granulation, minimises complications, and provides mechanical containment of abdominal contents.…”

“…Fistulas have been reported in up to 25% of patients who have had other types of laparostomy management. 18,19 Fistulas are attributed to desiccation and erosion of the bowel wall, possibly as a result of adhesions with the underlying dressing. 20 Rao et al 12 reported a 20% incidence of fistula development in their series of patients with open abdomens treated with negative pressure therapy; of these patients 66% eventually died.…”

Management of Peritonitis in the Critically Ill Patient

“…During the 1980s this was a procedure recommend often. More recent reviews indicate that laparotomy on demand may be as beneficial and may have lower morbidity; however, there is no definitive evidence indicating which strategy is better [77][78][79][80][81][82][83][84][85].…”

Topical negative pressure in managing severe peritonitis: A positive contribution?

“…While this concept of a planned second look following major abdominal trauma is well recognised [4] , its use following abdominal catastrophe due to severe peritonitis remains controversial [3] . Several different techniques have been tried to facilitate a second look [4][5][6] . Recently, topical negative pressure (TNP) with the VAC ® Abdominal Dressing System was introduced [3,7] .…”