Temporary closure of open abdominal wounds by the modified sandwich-vacuum pack technique

• Published in: British journal of surgery Vol. 90; no. 6; pp. 718 - 722
• Main Authors: Navsaria, P. H., Bunting, M., Omoshoro-Jones, J., Nicol, A. J., Kahn, D.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01-06-2003; Wiley
• Subjects: Abdomen; Abdominal Injuries - surgery; Abdominal Wall - surgery; Adolescent; Adult; Biological and medical sciences; Female; Humans; Laparotomy - methods; Male; Medical sciences; Middle Aged; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Surgical Instruments; Suture Techniques; Therapeutic Irrigation - methods; Treatment Outcome; Vacuum; Wound Healing; Wounds, Gunshot - surgery; Wounds, Nonpenetrating - surgery; Wounds, Penetrating - surgery; Wounds, Stab - surgery; Human; Costs; Prognosis; Indication; Decision making; Treatment efficiency; Vacuum technique; Surgical closure; Wound; Trauma; Abdomen; Temporary; Treatment; Abdominal disease; Surgery; Health economy; Abdominal wall; Technique; Public health
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1002/bjs.4101

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.
Modified technique of temporary abdominal closure fulfills requirements