Abstract
The burst abdomen management has advanced significantly. Here we present a management of a burst abdomen of morbid obese patient with combination of modality including Bogota bag, vacuum assisted closure and tension suturing. The patient underwent laparotomy for removal of sigmoid tumor with local infiltration and had wound dehiscence associated with infection, tissue oedema and necrosis. As patient was morbidly obese and had large wound gap, we decided to manage it with Bogota bag principal and Vacuum Assisted Closing. After successful formation of granulation tissue, we were able to apply tension sutures. Hence using combination of above-mentioned options, the patient was successfully sent back to his normal routines without any complication.
Highlights
Dehiscence is a partial or total separation of previously approximated wound edges due to failure of proper wound healing
The risk factors for burst abdomen include local and systemic events which lead to poor wound healing
Pradeep G, et al [7] has shown in their study that malnutrition is a major risk factor
Summary
Dehiscence is a partial or total separation of previously approximated wound edges due to failure of proper wound healing. There are various methods of surgical intervention to address the burst abdomen which include tension suturing, mesh repair, Bogota bag and vacuum assisted closure. These methods should be tailor made to the patient. On the 6th postoperative day patient complained pain and mild discharge at the lower end of the abdominal wound. Other than that, he had no other constitutional symptoms. Three days later a thin layer of tissue was noted over the small bowel which was exposed at the lower end of the wound. The tension sutures were removed on the 18th day of suturing
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