Open AccessTemporary closure of open abdominal wounds by the modified sandwich–vacuum pack technique
Author(s) -
Navsaria P. H.,
Bunting M.,
OmoshoroJones J.,
Nicol A. J.,
Kahn D.
Publication year - 2003
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1002/bjs.4101
Subject(s) - medicine , surgery , abdominal wall , abdominal compartment syndrome , suction , negative pressure wound therapy , abdomen , blunt , mechanical engineering , alternative medicine , pathology , engineering
Background: A 5‐year experience with the modified sandwich–vacuum pack technique, using an opened 3‐litre urological irrigation bag and continuous high‐pressure suction, for temporary abdominal wall closure is presented. Methods: The records of all patients who underwent temporary abdominal wall closure using this method from January 1996 to December 2000 were examined. Results: The modified sandwich–vacuum pack was used 139 times in 55 patients. Forty patients sustained penetrating trauma while 15 patients sustained blunt trauma. The mean Injury Severity Score was 19 (range 9–34). Intra‐abdominal sepsis (51 per cent) was the commonest indication, followed by visceral oedema (18 per cent), abdominal compartment syndrome (16 per cent), intra‐abdominal packing (11 per cent) and abdominal wall defects (4 per cent). The overall mortality rate was 45 per cent. Three patients (5 per cent) developed enterocutaneous fistula. Of the 30 survivors, 16 patients underwent primary fascial closure. Conclusion: The modified sandwich–vacuum pack technique of temporary abdominal wall closure is easy and rapid, cost effective and provides an effective means of containing abdominal wall contents. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.