Use of the “Bogota Bag” for Temporary Abdominal Closure in Patients with Secondary Peritonitis

2007 ◽  
Vol 73 (3) ◽  
pp. 249-252 ◽  
Author(s):  
Boris Kirshtein ◽  
Aviel Roy-Shapira ◽  
Leonid Lantsberg ◽  
Solly Mizrahi
Keyword(s):  
Abdominal Sepsis ◽  
Secondary Peritonitis ◽  
Fistula Formation ◽  
Temporary Abdominal Closure ◽  
Abdominal Closure ◽  
Flap Repair ◽  
Abdominal Operations ◽  
Secondary Closure ◽  
Postoperative Problems ◽  
Temporary Closure

Various methods may be used for temporary closure of the abdomen. Use of the “Bogota bag” (BB) technique for abdominal closure has been reported primarily in the management of injuries. This review describes our experience using the BB technique in cases of secondary peritonitis. Abdomenal closure using BB was reviewed retrospectively in 152 patients with secondary peritonitis. Of the 152 cases of BB use reviewed, 79 patients had complications of previous abdominal operations, 57 had secondary peritonitis, 14 had complications of abdominal trauma, and 2 were cases of mesenteric events. The BB remained in situ from 1 to 19 days. Changes occurred between 1 and 11 times per patient (mean, 2.8). In nine patients, early diagnosis of leaking of small bowel content under the bag was noted, and 36 patients (24%) died from sepsis. In 12 patients, the resolution of abdominal sepsis permitted secondary closure 10 days later. In 16 patients, mesh repair was performed after 4 weeks. Musculocutaneal flap repair was used in one case, and 13 patients had skin grafts. Eleven patients eventually underwent ventral hernia repair. Early temporary closure of the abdominal wall using BB in patients with abdominal sepsis and planned re-explorations is simple, safe, inexpensive, and effective. This temporary abdominal cover provides good exposure of abdominal content between re-explorations and may prevent fistula formation. The development and subsequent repair of large hernias constitute one of the difficult postoperative problems requiring future solution.

scholarly journals Temporary abdominal closure for trauma and intra-abdominal sepsis

2017 ◽  
Vol 82 (2) ◽  
pp. 345-350 ◽  
Author(s):  
Tyler J. Loftus ◽  
Janeen R. Jordan ◽  
Chasen A. Croft ◽  
R. Stephen Smith ◽  
Philip A. Efron ◽  
...  
Keyword(s):  
Abdominal Sepsis ◽  
Temporary Abdominal Closure ◽  
Abdominal Closure

Should Negative Pressure Therapy Replace Any Other Temporary Abdominal Closure Device in Open-Abdomen Management of Secondary Peritonitis?

2021 ◽  
Author(s):  
Vincenzo Pappalardo ◽  
Stefano Rausei ◽  
Vincenzo Ardita ◽  
Luigi Boni ◽  
Gianlorenzo Dionigi
Keyword(s):  
Negative Pressure ◽  
Open Abdomen ◽  
Secondary Peritonitis ◽  
Fascial Closure ◽  
Temporary Abdominal Closure ◽  
Negative Pressure Therapy ◽  
Pressure Therapy ◽  
Advantages And Disadvantages ◽  
Abdominal Closure ◽  
Primary Fascial Closure

AIM: To clarify the advantages of negative pressure therapy (NPT) compared to other methods of temporary abdominal closure (TAC) in the management of secondary peritonitis. METHODS: We retraced the history of known methods of TAC, and analyzed their advantages and disadvantages. We evaluated as the NPT mechanisms, both from the macroscopic that bio-molecular point of view, well suits to manage this difficult condition. RESULTS: The ideal TAC technique should be quick to apply, easy to change, protect and contain the abdominal viscera, decrease bowel edema, prevent loss of domain and abdominal compartment syndrome, limit contamination, allow egress of peritoneal fluid (and its estimation) and not result in adhesions. It should also be cost-effective, minimize the number of dressing changes and the number of surgical revisions, and ensure a high rate of early closure with a low rate of complications (especially entero-atmospheric fistula). For NPT, the reported fistula rate is 7%, primary fascial closure ranges from 33 to 100% (average 60%) and the mortality rate is about 20%. With the use of NPT as TAC, it may be possible to extend the window of time to achieve primary fascial closure (for up to 20-40 days). CONCLUSION: NPT has several potential advantages in open-abdomen (OA) management of secondary peritonitis and may make it possible to achieve all the goals suggested above for an ideal TAC system. Only trained staff should use NPT, following the manufacturer’s instructions when commercial products are used. Even if there was a significant evolution in OA management, we believe that further research into the role of NPT for secondary peritonitis is necessary.

scholarly journals A polypropylene mesh coated with interpenetrating double network hydrogel for local drug delivery in temporary closure of open abdomen

RSC Advances ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 1331-1340 ◽  
Author(s):  
Ze Li ◽  
Changliang Wu ◽  
Zhen Liu ◽  
Zhenlu Li ◽  
Xingang Peng ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Drug Delivery ◽  
Polypropylene Mesh ◽  
Open Abdomen ◽  
Local Drug Delivery ◽  
Fistula Formation ◽  
Temporary Abdominal Closure ◽  
Double Network ◽  
Temporary Closure

Prosthetic materials are widely used for temporary abdominal closure after open abdomen (OA), but local adhesion, erosion and fistula formation caused by current materials seriously affect the quality of life of patients.

Challenges in the Management of the Open Abdomen

ICU Director ◽  
2012 ◽  
Vol 4 (1) ◽  
pp. 33-39 ◽  
Author(s):  
David J. Worhunsky ◽  
Gregory Magee ◽  
David A. Spain
Keyword(s):  
Open Abdomen ◽  
Damage Control ◽  
Original Description ◽  
Fascial Closure ◽  
Critically Ill Patient ◽  
Temporary Abdominal Closure ◽  
Recurrence Rates ◽  
Abdominal Closure ◽  
Intra Abdominal Infection ◽  
Temporary Closure

First described more than 60 years ago, the open abdomen has now become a relatively common entity in surgical ICUs. Although the indications for an open abdomen have evolved since the original description of the damage control laparotomy, the goal remains to provide an unstable or critically ill patient time to correct their physiologic derangements. Temporary abdominal closure is thus used as a bridge to definitive repair and closure. Unfortunately, the open abdomen is associated with significant morbidity and mortality, and recent studies have suggested an overuse of the technique. Once the decision is made to proceed with an open abdomen, multiple options exist for temporary abdominal closure. The hope is to obtain definitive closure shortly thereafter in an attempt to reduce potential complications including intra-abdominal infection or enteroatmospheric fistula. Options for temporary closure range from the Bogotá bag to vacuum-assisted techniques; a combined technique of sequential fascial closure with vacuum assistance has recently been shown to result in 100% fascial approximation. In situations where fascial closure is unattainable, temporary coverage with a skin graft may be employed, followed by late abdominal closure via complex abdominal herniorrhaphy. Even using advanced methods such as component separation or a “pork sandwich” technique, the complication and recurrence rates remain high. A careful understanding of the indications, optimal management, and potential complications of the open abdomen is necessary to limit its overuse and ultimately reduce some of the challenges associated with it.

scholarly journals OUTCOME OF SKIN ONLY TEMPORARY ABDOMINAL CLOSURE METHOD AND REPEATED PERITONEAL WASH IN PATIENTS WITH SECONDARY PERITONITIS

1969 ◽  
Vol 3 (2) ◽  
pp. 323-327
Author(s):  
LIAQAT ALI SHAH ◽  
MUNIR AHMAD ◽  
ASHFAQ UR REHMAN ◽  
TARIQ SOHAIL ◽  
NADIM KHAN ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Secondary Peritonitis ◽  
Fascial Closure ◽  
Categorical Variables ◽  
Skin Closure ◽  
Temporary Abdominal Closure ◽  
Female Ratio ◽  
Surgical Department ◽  
Abdominal Closure ◽  
Closure Method

OBJECTIVE: To determine the outcome of skin only temporary abdominal wall closure and repeatedperitoneal wash therapy in the management of secondary peritonitis in terms of fascial closure and mortality.MATERIAL AND METHODS: This prospective descriptive study was conducted on 80 patients withsecondary peritonitis, selected by convenience non probability sampling technique after fulfilling theinclusion and exclusion criteria, in emergency surgical department of Govt PGMI Lady Reading HospitalPeshawar from January 2011 to July 2012. Patients were diagnosed on the basis of history, clinicalexamination, heamatological and radiological investigations , operated in casualty and skin onlytemporary abdominal closure method was applied with prolene 2/0 and planned re-laparotomy was carriedout after 24 hours. Further re-laparotomies were decided by the operating surgeon till proper fascial closure.The impact of skin only closure and number of operations were analyzed postoperatively in terms of fascialclosure and mortality. The demographic and clinical ( intraoperative and postoperative ) data of the allpatients such as name, age, gender, duration of hospital stay, indication and number of operations wererecorded in a proforma.The data was analyzed with SPSS version 16. Frequency and percentages werecomputed for categorical variables such as gender and number of operations, fascial closure and mortalitywhile numerical variables such as age, hospital stay was presented with Mean ± SD.RESULTS: A total of 80 patients were included in the study and out of which 55 (68.8%) were male and 25(31.2% ) female with male to female ratio of 2.2:1 . The age of patients ranged from 18 to 65 years. The meanage was 37.83 ±1.194. The ranged of re-operations were 1 to 4 with mean 2.06± 0.785. The ranged ofhospital stay was 9- 50 days with mean 21± 7.719.The fascial closure was 82.5% and mortality was 13.8%.CONCLUSION: Peritoneal wash is life saving procedure in the treatment of secondary peritonitis and skinonly temporary abdominal closure is easy, quick and fascial preserving procedure. Both techniques shouldbe encouraged in secondary peritonitiscases.KEYWORDS:Peritonitis, Re-Laparatomy,Skin Closure.

The effect of different temporary abdominal closure techniques on fascial wound healing and postoperative adhesions in experimental secondary peritonitis

2007 ◽  
Vol 393 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Cagatay Aydin ◽  
Faruk O. Aytekin ◽  
Cigdem Yenisey ◽  
Burhan Kabay ◽  
Ergun Erdem ◽  
...  
Keyword(s):  
Wound Healing ◽  
Secondary Peritonitis ◽  
Temporary Abdominal Closure ◽  
Postoperative Adhesions ◽  
Abdominal Closure

Effect of Temporary Abdominal Closure on Colonic Anastomosis and Postoperative Adhesions in Experimental Secondary Peritonitis

2006 ◽  
Vol 30 (4) ◽  
pp. 612-619 ◽  
Author(s):  
Cagatay Aydin ◽  
Faruk O. Aytekin ◽  
Koray Tekin ◽  
Burhan Kabay ◽  
Cigdem Yenisey ◽  
...  
Keyword(s):  
Colonic Anastomosis ◽  
Secondary Peritonitis ◽  
Temporary Abdominal Closure ◽  
Postoperative Adhesions ◽  
Abdominal Closure

scholarly journals Open Abdomen Management and Candida Infections: A Very Likely Link

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Savino Occhionorelli ◽  
Monica Zese ◽  
Rosario Cultrera ◽  
Domenico Lacavalla ◽  
Marco Albanese ◽  
...  
Keyword(s):  
Antifungal Therapy ◽  
Open Abdomen ◽  
Case Series ◽  
Abdominal Sepsis ◽  
Temporary Abdominal Closure ◽  
Retrospective Case ◽  
Abdominal Closure ◽  
Closure Duration ◽  
Abdominal Hypertension ◽  
Significant Difference

Objective. Laparostomy can be applied in trauma, abdominal sepsis, intra-abdominal hypertension, or compartment syndrome. Systemic infections, especially if complicated by Candida, are associated with a high risk of mortality. Methods. This is a single-centre retrospective case series of 47 cases admitted to our Department, which required laparostomy procedure; we analyzed the type of surgery, temporary abdominal closure, duration of open abdomen, complications, SOFA score, mortality with Candida infections, and empirical or targeted antifungal therapy. Results. We found that patients with Candida infection were related with a statistically significant difference (p<0.05) with a complication after OA closure, total complications, time elapsed after OA application, time spent on the first surgical OA application, type of temporary abdominal closure that is used, and duration of the open abdomen. The use of empirical and targeted antifungal therapy is related to the duration of open abdomen too. Conclusions. Management of the OA is often burdened by sepsis or septic shock, especially when complicated by Candida infection. Candida score is a validated tool to identify patients who can be treated empirically, but every situation must be considered on an individual basis.

scholarly journals Temporary abdominal closure with zipper-mesh device for management of intra-abdominal sepsis

2015 ◽  
Vol 42 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Edivaldo Massazo Utiyama ◽  
Adriano Ribeiro Meyer Pflug ◽  
Sérgio Henrique Bastos Damous ◽  
Adilson Costa Rodrigues-Jr ◽  
Edna Frasson de Souza Montero ◽  
...  
Keyword(s):  
Wound Care ◽  
Necrotizing Pancreatitis ◽  
Vascular Occlusion ◽  
Abdominal Sepsis ◽  
Temporary Abdominal Closure ◽  
Abdominal Closure ◽  
Nylon Mesh ◽  
Abdominal Disease ◽  
The Mean ◽  
Planned Reoperation

OBJECTIVE: to present our experience with scheduled reoperations in 15 patients with intra-abdominal sepsis. METHODS: we have applied a more effective technique consisting of temporary abdominal closure with a nylon mesh sheet containing a zipper. We performed reoperations in the operating room under general anesthesia at an average interval of 84 hours. The revision consisted of debridement of necrotic material and vigorous lavage of the involved peritoneal area. The mean age of patients was 38.7 years (range, 15 to 72 years); 11 patients were male, and four were female. RESULTS: forty percent of infections were due to necrotizing pancreatitis. Sixty percent were due to perforation of the intestinal viscus secondary to inflammation, vascular occlusion or trauma. We performed a total of 48 reoperations, an average of 3.2 surgeries per patient. The mesh-zipper device was left in place for an average of 13 days. An intestinal ostomy was present adjacent to the zipper in four patients and did not present a problem for patient management. Mortality was 26.6%. No fistulas resulted from this technique. When intra-abdominal disease was under control, the mesh-zipper device was removed, and the fascia was closed in all patients. In three patients, the wound was closed primarily, and in 12 it was allowed to close by secondary intent. Two patients developed hernia; one was incisional and one was in the drain incision. CONCLUSION: the planned reoperation for manual lavage and debridement of the abdomen through a nylon mesh-zipper combination was rapid, simple, and well-tolerated. It permitted effective management of severe septic peritonitis, easy wound care and primary closure of the abdominal wall.

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