Outcome of open abdomen procedure with Bogota bag for temporary abdominal closure: our experience in Alexandria University Hospital

Abstract

Aim To evaluate the outcome of abdomen (OA) procedure with Bogota bag as a temporary measure to close the abdomen in patients with abdominal catastrophes in terms of mortality and morbidity. Patients and methods The study included adult patients who were treated for abdominal catastrophes with OA and Bogota bag for temporary abdominal closure during the period 2007–2016 in Alexandria Main University Hospital. Delayed definite abdominal closure was performed by edge-to-edge closure of the fascia if possible or by approximation of the fascia to the nearest available distance and filling the gap by Dexon mesh in a tension-free manner. Results A total of 74 patients were included, with a mean age of 38.19±13.60 years. The etiology was blunt trauma in 32.4%, whereas 67.6% had nontraumatic causes. Ten (13.5%) patients died: six patients owing to their original pathology and four patients owing to pulmonary embolism. Old age and high leukocyte count were significant factors for mortality. Regarding postoperative complications, no patients had abdominal compartment, nine patients had wound infection, two patients had intestinal fistulas, one patient had evisceration, whereas 24 patients had incisional hernia. Conclusion Bogota bag for temporary abdominal closure after OA is an easy and efficient technique for management of abdominal catastrophes by which serious complications of either exposure or closure under tension could be prevented. Postoperative mortality was 13.5% but not related to the technique. Old age and high leukocyte count were found to be significant risk factors affecting mortality.