The comparison of skin closure with bogota bag, which are the techniques of Temporary Abdominal Closure (TAC)

PurposeThe TAC techniques are used very often for the patients with high intraabdominal pressure (IAP), abdominal compartment syndrome (ACS) and ischemic enteropathy (IE) which is suspected or needed a reoperation. The techniques (TAC), applied after open abdominal surgery, was developed as lifesaving techniques in situations such as trauma, diagnosed or suspected ischemic enteropathy (IE) and prevalent intraabdominal sepsis (IAS) in recent two decades. Today, the different techniques are used as TAC. Despite the fact that these techniques have disadvantages or superiorities to one another, yet; there has been no common agreement about which technique the best is. In this study, two different techniques of TAC, Bogota Bag and Skin Closure, were compared on the patients, followed up in the Intensive Care Unit, Department of General Surgery, the Faculty of Medicine, at Dicle University and underwent decompressive laparotomy because of various reasons.Material and MethodIn this study the records of 109 patients, underwent abdominal surgery with two techniques of TAC; Bogota Bag and Skin Closure; in the Department of General Surgery, the Faculty of Medicine, at Dicle University were scrutinized retrospectively between Jenuary 2006 and March 2011. The age, gender, diagnosis, IAP, Glasgow Coma Scale (GCS), Mannheim Peritonitis Index (MPI), APACHE II Score, C-reactive protein value (CRP), White Blood Cell count (WBC), hematocrit value (HCT), platelet count (PLT),serum albumin levels, organ failure, morbidity and mortality rates of the patients were investigated retrospectively.Results and DiscussionWhile the abdomens of 85 patients were enclosed with Skin Closure (i.e., group 1), the other 24 were treated with Bogota Bag (i.e., group 2). In each group there was no statistically significance in point of IAP, GCS, MPI, APACHE II Score, CRP value, WBC count, HCT value, PLT count, serum albumin levels, organ failure, and morbidity and mortality rates. Nonetheless, it was found that there was statistically significant difference between average number of surgeries and average length of stay in hospital of the patients. ivThe length of stay in hospital for the first group was found as 20,38 days while it was established as 34,46 days for the second group. As for average number of surgeries, they were found 1,92 and 2,50 for the patients underwent Skin Closure and Bogota Bag treatments respectively.ConclusionBy relying on the results above, it was established that there was no statistical difference between Skin Closure and Bogota Bag techniques from the point of mortality and morbidity rates. Consequently, it can be suggested that Bogota Bag is appropriate for the selective cases whereas Skin Closure fits better in other appropriate cases for the patients that TAC applied.Keywords; Bogota bag, Skin Closure, Abdominal Closure Technique, Intra abdominal hypertensionv