Vacuum Pack Technique of Temporary Abdominal Closure: A 7-Year Experience with 112 Patients

Barker, Donald E.; Kaufman, Henry; Smith, Lisa A.; Ciraulo, David L.; Richart, Charles M.; Burns, Robert P.

doi:10.1097/00005373-200002000-00001

Cited by 418 publications

(305 citation statements)

References 15 publications

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“…Several reports have been published regarding the use of the vacuum pack system [90][91][92]. In the authors' institutions we prefer the method described by Barker and coworkers [93]. In the initial step during the index laparotomy when a decision for PR is made, a large sheet of polyethylene is used that is displayed laterally all the way into the colic gutters bilaterally, thus preventing the bowel from adhering to the abdominal cavity.…”

Section: Intra-abdominal Hypertensionmentioning

confidence: 99%

Management of Peritonitis in the Critically Ill Patient

Ordóñez

Puyana

2006

Surgical Clinics of North America

111

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Section: Intra-abdominal Hypertensionmentioning

confidence: 99%

Management of Peritonitis in the Critically Ill Patient

Ordóñez

Puyana

2006

Surgical Clinics of North America

111

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“…About 64% of (21), and greater than 12 hours in 7.5% of patients (8). At the beginning of DCR, the median temperature of the patients was 36.5°C (IQR = 36-37).…”

Section: Resultsmentioning

confidence: 96%

“…The decision to shorten the surgery must be taken: Packaging with towels and a temporary closure of the abdominal wall, a procedure known as DCS. 7,8 In the packing process, compresses need to be placed, doubled up on the bleeding surfaces of the abdominal and pelvic cavity, while applying manual compression with temporary closure of the cavity to reduce the surgical time and increase the volume of the cavity. In obstetrics, the decision to use packaging as part of DCS is usually taken after performing the hysterectomy and before the clinical diagnosis of coagulopathy.…”

Section: Introductionmentioning

confidence: 99%

Nonclinical, Observational Trauma Rotations in the United States provide International Students Multidisciplinary Trauma Program and Systems Education

Silva¹,

Gupta²,

Gracias³

et al. 2017

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Objective: The aim of this case series is to describe the experience of implementing damage control resuscitation (DCR) in patients with major obstetric hemorrhage (MOH) between January 2005 and December 2015 in the Fundación Valle del Lili, Cali, Colombia. Materials and methods:This is a prospective descriptive study of a case series from 108 patients with MOH who were subjected to DCR. All patients were operated on using a standardized surgical technique in accordance with the institutional protocol. Results:The median age was 28 years, with a gestational age of 38 weeks. The principal associated diagnosis was severe preeclampsia (in 39% of cases). A total of 96 patients presented massive postpartum hemorrhage, and 75% of these cases presented after a cesarean section. In all patients, normal control of bleeding was achieved, 60% during the first surgical period. The Acute Physiology and Chronic Health Evaluation score was 14, with an overall mortality of 6.48%, far below the expected mortality according to the clinical severity of these patients. Conclusion:This study includes the biggest series of pregnant women with MOH, in a critical condition, in whom DCR was used, during which rapid control of bleeding was achieved, associated with a significantly lower mortality than expected. Source of support: Nil Conflict of interest: None RESUMENObjetivo: El objetivo de esta serie de casos es describir la experiencia de la aplicación de la CCD (Cirugía de control de daños) en pacientes con hemorragia obstétrica mayor (HOM) entre enero del 2005 y diciembre del 2015 en la Fundación Valle del Lili, Cali, Colombia.Métodos: Estudio descriptivo prospectivo de una serie de casos de 108 pacientes con HOM sometidas a CCD. Todas las pacientes fueron operadas usando una técnica quirúrgica estandarizada, acorde al protocolo institucional.Resultados: La mediana de edad fue de 28 años, con edad gestacional de 38 semanas. El diagnosticó principal asociado fue pre eclampsia severa (en 39% de los casos). 96 presentaron hemorragia postparto masiva (HPP) y el 75% de los casos se presento después de cesárea. En todas las pacientes se logro el control del sangrado, 60% en el primer tiempo quirúrgico. El APACHE II promedio fue de 14 con una mortalidad global de 6,48%, muy por debajo de la mortalidad esperada para la severidad clínica de estas pacientes. Conclusiones:Este estudio incluye la serie más grande de gestantes con HOM en condiciones críticas, en quienes se utilizó CCD, con rápido control del sangrado, asociado a una mortalidad considerablemente menor a la esperada.Palabras Clave: Choque hipovolémico, Cuidados intensivos quirúrgicos, Hemorragia postparto, Tratamiento de urgencia. INTRODUCTIONPostpartum hemorrhage (PPH) is the principal cause of extreme maternal morbidity (EMM) and maternal mortality in developing countries, responsible for at least 303,000 deaths per year, a large proportion of which could be preventable with timely and adequate management.1 The approach for improving outcomes for this condition includes...

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“…In most cases, use of VAC technique allows primary fascia closure preventing formation of large ventral hernias [4]. Thereby, use of ring shaped black polyurethane foam of VAC system facilitates skin protection and [7,12,13]. These problems may be prevented using the Bogota-VAC: a recent in vitro study using bag silo closure measured a VRC of approximately 3,000 ml [9].…”

Section: Resultsmentioning

confidence: 99%

Bogota-VAC – A Newly Modified Temporary Abdominal Closure Technique

Rüden

Benninger

Mayer

et al. 2008

Eur J Trauma Emerg Surg

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Background: We present Bogota-VAC, a newly modified temporary abdominal closure (TAC) technique for open abdomen condition after abdominal compartment syndrome (ACS). Methods: A thin isolation bag (Bogota bag) and a vacuum assisted closure (VAC) system were combined. A matching bag was tension-free fixed on the abdominal fascia by fascia suture. A ring shaped black polyurethane foam of the VAC system was placed into the gap between Bogota bag, abdominal fascia and the wound edge. A constant negative topic pressure of 50-75 mmHg was used in the VAC system. Results: Intra-abdominal pressure (IAP: 22 ± 2 mmHg)of four patients with ACS after severe traumatic brain injury and one patient with isolated ACS after blunt abdominal trauma decreased significantly (p = 0.01)after decompressive laparotomy and treatment with Bogota-VAC (IAP: 10 ± 2 mmHg) and remained low, measured via urinary bladder pressure. Intracranial pressure (ICP) in the four traumatic brain injury patients decreased from 42 ± 13 mmHg to 15 ± 3 mmHg after abdominal decompression. Cerebral perfusion pressure (57 ± 14 mmHg) increased to 74 ± 2 mmHg. Conclusion: The advantage of the presented Bogota-VAC is leak tightness, wound conditioning (soft tissue/fascia), skin protection and facilitation of nursing in combinationwith highest volume reserve capacity (VRC), thus preventing recurrent increased intraabdominal and intracranial pressure in the initial phase after decompression of ACS compared to other TAC techniques. ACS).Methods: A thin isolation bag (Bogota bag) and a vacuum assisted closure (VAC) system were combined. A matching bag was tension-free fixed on the abdominal fascia by fascia suture. A ring shaped black polyurethane foam of the VAC system was placed into the gap between Bogota bag, abdominal fascia and the wound edge. A constant negative topic pressure of 50-75 mmHg was used in the VAC system. Results: Intra-abdominal pressure (IAP: 22 ± 2 mmHg) of four patients with ACS after severe traumatic brain injury and one patient with isolated ACS after blunt abdominal trauma decreased significantly (p = 0.01) after decompressive laparotomy and treatment with Bogota-VAC (IAP: 10 ± 2 mmHg) and remained low, measured via urinary bladder pressure. Intracranial pressure (ICP) in the four traumatic brain injury patients decreased from 42 ± 13 mmHg to 15 ± 3 mmHg after abdominal decompression. Cerebral perfusion pressure (57 ± 14 mmHg) increased to 74 ± 2 mmHg. Conclusion: The advantage of the presented Bogota-VAC is leak tightness, wound conditioning (soft tissue/ fascia), skin protection and facilitation of nursing in combination with highest volume reserve capacity (VRC), thus preventing recurrent increased intra-abdominal and intracranial pressure in the initial phase after decompression of ACS compared to other TAC techniques.

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Vacuum Pack Technique of Temporary Abdominal Closure: A 7-Year Experience with 112 Patients

Cited by 418 publications

References 15 publications

Management of Peritonitis in the Critically Ill Patient

Management of Peritonitis in the Critically Ill Patient

Nonclinical, Observational Trauma Rotations in the United States provide International Students Multidisciplinary Trauma Program and Systems Education

Bogota-VAC – A Newly Modified Temporary Abdominal Closure Technique

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