Temporary abdominal closure using transfer bag in the management of patients with open abdomen

Context Open abdomen is associated with significant morbidity and mortality. Leaving the abdomen open may be necessary in case of severe peritonitis and associated wound dehiscence. Many techniques are available for temporary abdominal closure (TAC), but none has been proven to be superior. Aim In our work, we propose early TAC using a transfer bag that can prevent the eviscerartion of the abdominal contents. Moreover, it will allow continuous drainage of the patient’s septic wound with continuous serial assessment. Setting and design It was a prospective case series study. Patients and methods The study included 25 patients with difficult abdominal closure in whom a double-layered large transfer bag was used for TAC. Statistical analysis Continuous variables were expressed as mean±SD. Categorical variables were expressed as frequencies and percentage. Results The average timing of the application of TAC ranged from first to fourth operation, with a mean±SD of 2±1.38. Early mortality occurred in six patients, whereas delayed mortality occurred in two patients. The net survivors included 17 (68%) patients. Of them, two patients were subjected to simple skin closure, six were subjected to split thickness skin graft, and nine were subjected to early fascial closure with lateral release and mesh application. Average timing for closure or coverage was 10–45 days, with a mean±SD of 25.8±11.8 days. An intestinal fistula was seen in three (12%) patients. The average length of hospital stay was 38.84±11.75 days. Conclusion The use of transfer bag TAC for open abdomen is a safe, cheap, available, simple, and effective procedure that can provide an easy access to the abdomen when needed.