title: Experience of the MALA bag in the open abdomen management in an obstetrical intensive care unit.
abstract: BACKGROUND
  Current indications for open abdomen management are damage control surgery, severe intra-abdominal sepsis, abdominal compartment syndrome, abdominal wall closure under tension and mass loss of the abdominal wall.
  
  
  OBJECTIVE
  To describe the experience in open abdomen management using the MALA (mayor absorción de líquido abdominal [greater absorption of abdominal liquid]) bag at the Maternal-Perinatal Hospital Mónica Pretelini Saénz, Health Institute of the State of Mexico.
  
  
  METHODS
  This was a bidirectional, descriptive and observational study. All patients with the diagnosis of open abdomen managed with the MALA bag admitted to the Obstetric Intensive Care Unit from February 2009 to June 2012 were included.
  
  
  RESULTS
  From 25 cases identified in the period of the study, seven were eliminated for incomplete files, remaining 18 cases for the analysis. The mean age was 31.5 years. 78% of the patients were multigravidas, 50% of them with a history of 2 or more deliveries, 83% had a previous cesarean section and 78% were hysterectomized. Evisceration was present in one patient. The main indication for surgical management was damage control. One patient died and a second was transferred to another institution, the rest were discharged by clinical improvement. 12 patients (67%) spent less than 14 days in the Obstetric Intensive Care Unit, only one patient required more than 30 days in the unit.
  
  
  CONCLUSIONS
  Half the women who required this surgical alternative, were above 30 years of age. Stressing is the fact that from the 18 admitted patients, 14 (78%) had undergone obstetric hysterectomy, with the etiology of uterine atony in most cases. Damage control surgery seems to be the most elective surgical option to use MALA bag followed by ACS and abdominal sepsis.
  
  
  CONCLUSIONS
  The MALA bag can offer an economic and effective surgical option for the open abdomen management as well as a drainage technique.
authors.affiliation: Maternal-Perinatal Hospital Mónica Pretelini Sáenz. Health Institute of the State of Mexico. Toluca. México.
authors.forename: Ricardo Mauricio
authors.initials: RM
authors.lastname: Malagón Reyes
authors.affiliation: Maternal-Perinatal Hospital Mónica Pretelini Sáenz. Health Institute of the State of Mexico. Toluca. México.
authors.forename: Luis Emilio
authors.initials: LE
authors.lastname: Reyes Mendoza
authors.affiliation: Maternal-Perinatal Hospital Mónica Pretelini Sáenz. Health Institute of the State of Mexico. Toluca. México.
authors.forename: María de Jesús
authors.initials: Mde J
authors.lastname: Angeles Vásquez
authors.affiliation: Maternal-Perinatal Hospital Mónica Pretelini Sáenz. Health Institute of the State of Mexico. Toluca. México. & Asociación Científica Latina A.C. (ASCILA) and Ciprés Grupo Médico S.C. (CGM). Toluca. México.
authors.forename: Hugo
authors.initials: H
authors.lastname: Mendieta Zerón
mesh_terms: D000005:Abdomen; D034861:Abdominal Wall / Q000601:surgery*; D058107:Abdominal Wound Closure Techniques / Q000295:instrumentation*; D000328:Adult; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D011446:Prospective Studies; D012189:Retrospective Studies; D055815:Young Adult