Abstract
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 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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
World Society for Abdominal Compartment Syndrome Consensus: Definitions and Recommendations. http://www.wsacs.org.
Shapiro MB, Jenkins DH, Schwab CW. Damage control: collective review. J Trauma 2000;49:969–978.
Collicott PE, Hughes I. Training in advanced trauma life support. JAMA 1980;243:1156–1159.
Labler L, Zwingmann J, Mayer D, Stocker R, Trentz O, Keel M. V.A.C.® abdominal dressing system. Eur J Traum 2005;31:488–494.
Howdieshell TR, Yeh KA, Hawkins ML, Cué JI. Temporary abdominal wall closure in trauma patients: indications, technique, and results. World J Surg 1995;19:154–158.
Cuesta MA, Doblas M, Castañeda L, Bengoechea E. Sequential abdominal reexploration with the zipper technique. World J Surg 1991;15:74–80.
Brock WB, Barker DE, Burns RP. Temporary closure of open abdominal wounds: the vacuum pack. Am Surg 1995;61:30–35.
Fernandez L, Norwood S, Roettger R, Wilkins HE. Temporary intravenous bag silo closure in severe abdominal trauma. J Trauma 1996;40:258–260.
Benninger E, Labler L, Seifert B, Trentz O, Menger MD, Meier C. In vitro comparison of intra-abdominal hypertension development after different temporary abdominal closure techniques. J Surg Res 2008;144:102–106.
Balogh Z, McKinley BA, Cox CS Jr, Allen SJ, Cocanour CS, Kozar RA, Moore EE, Miller CC III, Weisbrodt NW, Moore FA. Abdominal compartment syndrome: the cause or effect of postinjury multiple organ failure. Shock 2003;20:483–492.
Saggi BH, Sugerman HJ, Ivatury RR, Bloomfield GL. Abdominal compartment syndrome. J Trauma 1998;45:597–609.
Suliburk JW, Ware DN, Balogh Z, McKinley BA, Cocanour CS, Kozar RA, Moore FA, Ivatury RR. Vacuum-assisted wound closure achieves early fascial closure of open abdomens after severe trauma. J Trauma 2003;55:1155–1156.
Barker DE, Kaufman HJ, Smith LA, Ciraulo DL, Richart CL, Burns RP. Vacuum pack technique of temporary abdominal closure: a 7-year experience with 112 patients. J Trauma 2000;48:201–207.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
von Rüden, C., Benninger, E., Mayer, D. et al. Bogota-VAC – A Newly Modified Temporary Abdominal Closure Technique. Eur J Trauma Emerg Surg 34, 582–586 (2008). https://doi.org/10.1007/s00068-008-8007-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00068-008-8007-y