Abstract
Acute increase in intra‐abdominal pressure is a known complication of patients undergoing burns resuscitation. It can progress rapidly in the absence of primary abdominal pathology, causing multiple organ dysfunction. This is known as secondary abdominal compartment syndrome (ACS). Intravascular fluid replacement and decompressive laparotomy form the standard management practices for ACS. Despite these measures, survival rates of secondary ACS in burns patients remain extremely poor. The medical records of four severely burnt patients are reviewed. All four patients underwent decompressive laparotomy. Three patients had either vacuum‐assisted closure therapy or a Silastic bowel bag inserted and temporary abdominal wound closure was gained using an absorbable synthetic mesh. There was one survivor. Early recognition and alternatives to standard therapy may result in possible decrease in mortality figures. However, the poor outcome may be intrinsic to the severe burn injuries rather than a reflection of current practices. Patients that survive open laparotomy face a new set of complications on road to recovery that are often ignored.
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