LAPAROSTOMY AND ABDOMINAL CONTENT CONTAINMENT

Abstract

Background: Alternatives to fascial closure of the abdominal
wall are increasingly used in critically ill patients. They pose practical and logistical problems in management of
seriously ill patients. Objectives: (1) To define the role of laparostomy in intra abdominal sepsis. (2) To
highlight the importance of economical method of temporary abdominal content containment using plastic bag.
Setting: Surgical Unit III Allied Hospital/PMC Faisalabad Period: March 2003 to February 2004, Methods:
Thirteen patient, 08 male and 05 female patients underwent temporary abdominal content containment (t-ACC)
following Emergency laparotomies. Indications for t-ACC were severe sepsis requiring reoperation, abdominal
wall tissue loss or a combination of these. Results: Three patients underwent early definitive abdominal closure
within 15 days. Eight patients had a protracted hospital stay (mean 26 days).Two patients died (on 10th and 17th
post-op day) due to MODS. Conclusion: Plastic bags are cheaper and as effective as polyglactin mesh and
other methods of t-ACC. Survivors require a multidisciplinary approach in management, undergo a protracted
hospital stay and later need complex incisional hernia repairs.