2012, Number 1
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ABSTRACTObjective: To present a modification to the placement of the Bogota bag, which, aside from retaining the useful characteristics of this technique, adds more strength to the support or resistance of the polyvinyl layer in patients with open abdomen.
Setting: Second level health care hospital. Hospital General de Zona 53, Mexican Institute of Social Security (IMSS, for its initials in Spanish).
Design: Pilot study.
Statistical analysis: Percentage as summary measure for qualitative variables.
Patients and methods: From December 2008 to March 2009 we treated six patients with this modified technique of the Bogota bag. Age of patients ranged from 40 to 78 years; three were men. Five patients coursed with abdominal sepsis and the other lost the abdominal wall. We included those patients with indications of open abdomen and, consequently, a possibility of reoperation. With our technique, we searched for early mobilization and deambulation of patients, as safe support of abdominal content, without using compressive abdominal bandaging, which is needed to avoid evisceration, as usually happens with the placement of the traditional Bogota bag, aside from preventing evisceration in a case with ventilatory support.
Results: In five patients, there were antecedents of 1 or 2 previous surgeries. Only in one patient was this modification applied in the first surgery. There was one death not related with the procedure but due to hepatic failure. This case had ventilatory support, and was supported by the modified Bogota bag without evisceration. In the five remaining patients the modification allowed for early mobilization and deambulation without requiring abdominal bandaging. No patients was reoperated, and wall closure was performed as for planned ventral hernia. All patients tolerated early mobilization and/or use of ventilatory support without evisceration.
Conclusions: This modification improves de performance of the Bogota bag, standing out the greater resistance and, in consequence, early mobilization and deambulation without the risk of evisceration.
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