Modified Opsite sandwich for temporary abdominal closure: a non-traumatic experience

Area of Science:

• Surgical Innovation
• Critical Care Medicine
• Abdominal Surgery

Background:

• Laparostomy techniques have evolved, particularly with damage control surgery.
• Existing literature on temporary abdominal closure (TAC) predominantly focuses on trauma patients.
• This study introduces a modified TAC technique for critically ill non-trauma patients.

Purpose of the Study:

• To describe and evaluate a modified laparostomy technique for temporary abdominal closure (TAC).
• To assess the safety and efficacy of this technique in critically ill patients without trauma.
• To determine the impact of this modified TAC on in-hospital mortality.

Main Methods:

• A standardized, modified Opsite sandwich vacuum pack technique for TAC was applied.
• Eleven critically ill non-trauma patients underwent TAC over a 36-month period.
• Patient severity was assessed using the Portsmouth variant of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM).

Main Results:

• Nineteen TACs were performed across 11 patients with diverse critical surgical conditions.
• Zero in-hospital mortality was observed, even in patients with high predicted mortality (P-POSSUM > 50%).
• The modified laparostomy dressing was simple to construct, aided nursing care, and was well-tolerated.

Conclusions:

• Laparostomy is a valuable technique beyond trauma applications.
• The modified Opsite sandwich vacuum pack is effective for TAC in critically ill non-trauma patients.
• Selective use of TAC may potentially decrease surgical mortality.