SciELO - Scientific Electronic Library Online

vol.48 número4Incidence and histological features of colorectal cancer in the Northern Cape province, South AfricaOne-stage excision of inflamed sebaceous cyst versus the conventional method índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados



Links relacionados

  • En proceso de indezaciónCitado por Google
  • En proceso de indezaciónSimilares en Google


South African Journal of Surgery

versión On-line ISSN 2078-5151
versión impresa ISSN 0038-2361

S. Afr. j. surg. vol.48 no.4 Cape Town nov. 2010




Vacuum-assisted closure of the open abdomen in a resource-limited setting



A. M. CampbellI; W. P. KuhnII; P. BarkerIII

IM.B. Ch.B., M.R.C.S. (glasg.); Ngwelezane Hospital, KwaZulu-Natal
IIM.B. Ch.B.; Ngwelezane Hospital, KwaZulu-Natal
IIIM.B. B.S., M.S., F.R.C.S. (eng.), F.I.C.S., Dip. Theol.; Ngwelezane Hospital, KwaZulu-Natal




AIM: We describe our experience of developing a modified vacuum-assisted closure (VAC) dressing for open abdomens.
BACKGROUND: We see a high volume of trauma in our department. Massive delays in presentation of patients with acute abdomen are common. Closure at initial laparotomy is not possible in many cases, either because the patient has or will develop abdominal compartment syndrome, or because several re-look laparotomies will be required. A significant proportion of our patients who have undergone laparotomy therefore spend some of their stay in hospital with an open abdomen. The management of these patients is particularly labour intensive for nursing staff. The Opsite sandwich or Bogota bag invariably leaks, and sometimes needs changing daily. If a patient also has a temporary ileostomy, application can be difficult. The commercial VAC dressing is an improvement on the Opsite sandwich, but is prohibitively expensive. Financial constraints and the volume of abdominal trauma and sepsis we see mean that commercial VAC dressings for laparostomy are not affordable in our setting.
METHODS/RESULTS: We describe our adapted VAC dressing. It is inexpensive and easy to apply, has made a big difference in the nursing of patients with an open abdomen, and has enabled us to increase the rate of delayed primary closure (i.e. we have reduced the rate of ventral hernia).
CONCLUSION: The modified VAC dressing is now our department's method of choice for temporary abdominal closure.


“Full text available only in PDF format”



1. Moore EE, Burch JM, Franciose RJ, et al. Staged physiologic restoration and damage control surgery. World J Surg 1998; 22:1184-1191.         [ Links ]

2. Moeng S, Loveland JA, Boffard KD. Damage control beyond the limits of the abdominal cavity. A review. International Trauma Care (ITACCS) Fall 2005 p.185-189.         [ Links ]

3. Ghimenton F, Thomson SR, Muckart DJ, Burrows R. Abdominal content containment: practicalities and outcome. Br J Surg 2000; 87: 106-109.         [ Links ]

4. °Ogilvie WH. The late complications of abdominal war wounds. Lancet 1940; 2: 253-256.         [ Links ]

5. Fernandez L, Norwood S, Roettger R, et al. Temporary intravenous bag silo closure in severe abdominal trauma. J Trauma 1996; 40: 258-260.         [ Links ]

6. Navsaria PH, Bunting M, Omoshoro-Jones J, Nicol AJ, Kahn D. Temporary closure of open abdominal wounds by the modified sandwich-vacuum pack technique. Br J Surg 2003; 90: 718-722.         [ Links ]

7. Barker DE, Kaufman HJ, Smith LA, Ciraulo DL, Richart CL, Burns RP. Vacuum pack technique of temporary abdominal closure: a 7-year experience with 112 patients. J Trauma 2000; 48: 201-206.         [ Links ]

8. Lee JC, Peitzman AB. Damage control laparotomy. Curr Opin Crit Care 2006; 12(4): 346-350.         [ Links ]

9. Garner GB, Ware DN, Cocanour CS, et al. Vacuum assisted wound closure provides early fascial re-approximation in trauma patients with open abdomens. Am J Surg 2001; 182: 630-638.         [ Links ]

Creative Commons License Todo el contenido de esta revista, excepto dónde está identificado, está bajo una Licencia Creative Commons