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


CONCLUSIONS
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.
Navsaria
P H
PH
Trauma Unit, Department of Surgery, Groote Schuur Hospital and the University of Cape Town, Cape Town, South Africa. navsaria@uctgsh1.uct.ac.za
Bunting
M
M
Omoshoro-Jones
J
J
Nicol
A J
AJ
Kahn
D
D
D000007:Abdominal Injuries / Q000601:surgery*; D034861:Abdominal Wall / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013525:Surgical Instruments; D013536:Suture Techniques; D007507:Therapeutic Irrigation / Q000379:methods; D016896:Treatment Outcome; D014618:Vacuum; D014945:Wound Healing; D014948:Wounds, Gunshot / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000601:surgery*; D014950:Wounds, Penetrating / Q000601:surgery*; D014951:Wounds, Stab / Q000601:surgery