Open abdomen in gastrointestinal surgery: Which technique is the best for temporary closure during damage control?

Table 1 Etiologies for abdominal compartmental syndrome

Primary	Secondary
Abdominopelvic causes[5]:	Extra-abdominal causes[5]:
Complex abdominal trauma[5]	Sepsis[5]
Ruptured Aneurysm aorta[5]	Acidosis (pH < 7.2)[5]
Hemoperitoneum[5]	Hypothermia[5]
Pancreatitis[5]	Politransfused (> 10 IU of packed red blood cells in 24 h)[5]
Peritonitis[5]	Coagulopathies (platelets < 55000/mm3 or aPTT > 2x/normal or TAP < 50% - INR > 1.5 )[5]
Retroperitoneal bleeding[5]	Great chest, vascular and orthopedic trauma[5]
Hepatic transplants[5]	Great burnt[5]
Primary closure under tension[5]	Vigorous hydration (> 5 U/24 h)[5]

Table 2 Comparison of the advantages of each technique

Bogota bag	Allows greater number of reviews of the abdominal cavity than the direct synthesis; better control of septic focuses by easy access; abdominal decompression; and functional restoration of the abdominal wall; has low cost; immediate availability; flexibility and high resistance; is not adhered to the tissues; does not cause allergic or inflammatory reactions; has quick and easy installation; can be used in any part of the body; allows the visualization of organs; is used in trauma, cancer surgery, and various abdominal surgeries; is a protector against water loss and heat
Barker technique	It is an inexpensive technique; uses material found in the surgical center and easily applicable; has moderate fluid control; allows closure of the abdominal wall with less tension; has low rates of complications
Vacuum-assisted closure therapy	It prevents contamination; allows dissection of the wound; protects the wound from external injuries; reduces the interstitial pressure; increases blood flow to the lesion; reduces the expression of matrix metalloproteinases in chronic wounds; promotes wound healing; removes stagnant fluids and debris; increases proliferation and cell division rates; induces granulation tissue formation; and brings greater comfort to the patient with infrequent complications. In selected cases it can be used as an outpatient procedure; allows shorter hospital stay and better quality of life

Table 3 Comparison between the disadvantages of each technique

Bogota bag	Use of more drains and rinses; presents a certain risk of eviscerations and difficulty in mobilizing the patient; it can cause skin lacerations; bowel adhesion to abdominal wall; it needs gas sterilization of the bag; there is a difficult control of the third space; leaks under the bag can wet the bed increasing the risk of hypothermia
Barker technique	In some cases, it does not allow adequate approach of the abdominal wall; it has moderate fluid control; greater difficulty in detecting complications that occur with bleeding and the maintaining of continuous pressure
Vacuum-assisted closure therapy	High cost; it can cause skin irritation due to the use of the adhesive; it can cause pain, infection and bleeding; it can lead to toxic shock syndrome (rare) and can cause thrombosis