title: Bogota-VAC - A Newly Modified Temporary Abdominal Closure Technique.
abstract: BACKGROUND
  We present Bogota-VAC, a newly modified temporary abdominal closure (TAC) technique for open abdomen condition after abdominal compartment syndrome (ACS).
  
  
  METHODS
  A thin isolation bag (Bogota bag) and a vacuum assisted closure (VAC) system were combined. A matching bag was tension-free fixed on the abdominal fascia by fascia suture. A ring shaped black polyurethane foam of the VAC system was placed into the gap between Bogota bag, abdominal fascia and the wound edge. A constant negative topic pressure of 50-75 mmHg was used in the VAC system.
  
  
  RESULTS
  Intra-abdominal pressure (IAP: 22 ± 2 mmHg) of four patients with ACS after severe traumatic brain injury and one patient with isolated ACS after blunt abdominal trauma decreased significantly (p = 0.01) after decompressive laparotomy and treatment with Bogota-VAC (IAP: 10 ± 2 mmHg) and remained low, measured via urinary bladder pressure. Intracranial pressure (ICP) in the four traumatic brain injury patients decreased from 42 ± 13 mmHg to 15 ± 3 mmHg after abdominal decompression. Cerebral perfusion pressure (57 ± 14 mmHg) increased to 74 ± 2 mmHg.
  
  
  CONCLUSIONS
  The advantage of the presented Bogota-VAC is leak tightness, wound conditioning (soft tissue/fascia), skin protection and facilitation of nursing in combination with highest volume reserve capacity (VRC), thus preventing recurrent increased intra-abdominal and intracranial pressure in the initial phase after decompression of ACS compared to other TAC techniques.
authors.affiliation: Division of Trauma Surgery, Department of Surgery, University Hospital Zurich, Zurich, Switzerland. christian.vonrueden@usz.ch.|Division of Trauma Surgery, Department of Surgery, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland. christian.vonrueden@usz.ch.
authors.forename: Christian
authors.initials: C
authors.lastname: von Rüden
authors.affiliation: Division of Trauma Surgery, Department of Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Emanuel
authors.initials: E
authors.lastname: Benninger
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Dieter
authors.initials: D
authors.lastname: Mayer
authors.affiliation: Division of Trauma Surgery, Department of Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Otmar
authors.initials: O
authors.lastname: Trentz
authors.affiliation: Division of Trauma Surgery, Department of Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Labler
keywords: Abdominal compartment syndrome (ACS); Intraabdominal pressure (IAP); Temporary abdominal closure (TAC); Vacuum-assisted closure (VAC); Volume reserve capacity (VRC)
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