title: Comparative study of abdominal cavity temporary closure techniques for damage control.
abstract: The damage control surgery, with emphasis on laparostomy, usually results in shrinkage of the aponeurosis and loss of the ability to close the abdominal wall, leading to the formation of ventral incisional hernias. Currently, various techniques offer greater chances of closing the abdominal cavity with less tension. Thus, this study aims to evaluate three temporary closure techniques of the abdominal cavity: the Vacuum-Assisted Closure Therapy - VAC, the Bogotá Bag and the Vacuum-pack. We conducted a systematic review of the literature, selecting 28 articles published in the last 20 years. The techniques of the bag Bogotá and Vacuum-pack had the advantage of easy access to the material in most centers and low cost, contrary to VAC, which, besides presenting high cost, is not available in most hospitals. On the other hand, the VAC technique was more effective in reducing stress at the edges of lesions, removing stagnant fluids and waste, in addition to acting at the cellular level by increasing proliferation and cell division rates, and showed the highest rates of primary closure of the abdominal cavity. RESUMO A cirurgia de controle de danos, com ênfase em peritoneostomia, geralmente resulta em retração da aponeurose e perda da capacidade de fechar a parede abdominal, levando à formação de hérnias ventrais incisionais. Atualmente, várias técnicas oferecem maiores chances de fechamento da cavidade abdominal, com menor tensão. Deste modo, este estudo tem por objetivo avaliar três técnicas de fechamento temporário da cavidade abdominal: fechamento a vácuo (Vacuum-Assisted Closure Therapy - VAC), Bolsa de Bogotá e Vacuum-pack. Realizou-se uma revisão sistemática da literatura com seleção de 28 artigos publicados nos últimos 20 anos. As técnicas de Bolsa de Bogotá e Vacuum-pack tiveram como vantagem o acesso fácil ao material, na maioria dos centros, e baixo custo, ao contrário do que se observa na terapia a vácuo, VAC, que além de apresentar alto custo, não está disponível em grande parte dos hospitais. A técnica VAC, por outro lado, foi mais eficaz na redução da tensão nas bordas das lesões, ao remover fluidos estagnados e detritos, além de exercer ação a nível celular, aumentando as taxas de proliferação e divisão celular, e apresentou as maiores taxas de fechamento primário da cavidade abdominal.
authors.affiliation: Medicine School, University of Santo Amaro (UNISA), Santo Amaro, SP, Brasil.
authors.forename: Marcelo A F
authors.initials: MA
authors.lastname: Ribeiro
authors.affiliation: Medicine School, University of Santo Amaro (UNISA), Santo Amaro, SP, Brasil.
authors.forename: Emily Alves
authors.initials: EA
authors.lastname: Barros
authors.affiliation: Medicine School, University of Santo Amaro (UNISA), Santo Amaro, SP, Brasil.
authors.forename: Sabrina Marques DE
authors.initials: SM
authors.lastname: Carvalho
authors.affiliation: Medicine School, University of Santo Amaro (UNISA), Santo Amaro, SP, Brasil.
authors.forename: Vinicius Pereira
authors.initials: VP
authors.lastname: Nascimento
authors.affiliation: Medicine School, University of Santo Amaro (UNISA), Santo Amaro, SP, Brasil.
authors.forename: José
authors.initials: J
authors.lastname: Cruvinel
authors.affiliation: Medicine School, University of Santo Amaro (UNISA), Santo Amaro, SP, Brasil.
authors.forename: Alexandre Zanchenko
authors.initials: AZ
authors.lastname: Fonseca
mesh_terms: D034841:Abdominal Cavity; D058107:Abdominal Wound Closure Techniques; D006801:Humans; D054843:Negative-Pressure Wound Therapy / Q000379:methods; D011143:Polyvinyl Chloride; D013997:Time Factors
chemical_list: D011143:Polyvinyl Chloride