Hindawi Publishing Corporation Gastroenterology Research and Practice Volume 2013, Article ID 584378, 3 pages http://dx.doi.org/10.1155/2013/584378 Clinical Study Management of Open Abdomen: Single Center Experience Hakan Yanar and Emre Sivrikoz Department of General Surgery, Istanbul School of Medicine, Istanbul University, Millet Cad., Fatih, 34390 Istanbul, Turkey Correspondence should be addressed to Hakan Yanar; htyanar@yahoo.com Received 5 August 2013; Accepted 3 October 2013 Academic Editor: Teodossis Papavramidis Copyright © 2013 H. Yanar and E. Sivrikoz. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Aim. Te authors reviewed their experience in the management of open abdomen using the vacuum-assisted closure (VAC), in order to assess its morbidity, and the outcome of abdominal wall integrity. Methods. A retrospective review was performed using the trauma registry to identify patients undergoing temporary abdominal closure (TAC) either using Bogota Bag (BB) or VAC, from January 2006 to December 2012. Inclusion criteria were TAC and survival to defnitive abdominal closure. Data collected included age, indication for TAC, number of operating room procedures, primary fascial closure rate, and complications. Results. During the study period, 156 patients required one type of TAC. Mean number of operations required in BB group was 3.04 as compared to 1.96 in VAC group ( = 0.006). Survival was signifcantly increased in the VAC group ( < 0.001). Te diference in primary closure rates did not reach statistical signifcance (25% vs. 55%;  = 0.074). Complications were observed less frequently in the VAC group ( = 0.047). Te mean time for fascial closure was 21 (±12) days in the BB group, as opposed to 6 (±3) days in the VAC group ( < 0.001). Conclusion. Te vacuum assisted closure (VAC) has a signifcantly faster rate of closure, requires less number of operations, and is associated with a lower complication rate. 1. Introduction Damage control surgery has evolved two decades ago as a life-saving adjunct in the management of severe trauma requiring immediate surgical intervention. Te concept was frst described in 1993 by Rotondo et al. as “a promis- ing alternative” to defnitive laparotomy in exsanguinating patients with major vascular and multiple visceral penetrat- ing abdominal injuries [1]. Subsequently, it has been shown that initiating damage control early on before the patient reaches the extremis (massive blood loss (>10 packs RBC), severe trauma (ISS > 25), hypothermia (<34 ∘ C), acidosis (pH < 7.25), and coagulopathy (aPTT > 19 sec)) reduces mortality [2]. When damage control surgery is applied in an attempt to increase survival, surgeons are faced with a secondary problem, namely, the abdominal compartment syndrome (ACS). Early applications of damage control approach were concluded with abbreviated abdominal closure (quick run- ning suture and towel clips). Afer recognition of the mor- bidity and mortality attributed to ACS, several methods were developed to avoid this complication [3]. Te application of Bogota Bag (sterile serum bags) became the most popular and efective method of temporary abdominal closure. A decade ago, the concept of applying negative pressure was introduced by Barker et al. to promote primary fascial closure [4]. Following the introduction of the vacuum- pack technique, a more comprehensive method to deliver negative pressure therapy to an open abdominal wound was developed—the vacuum assisted closure (VAC) therapy. Tis technique was shown to enable late fascial closure in open abdomen patients up to a month afer initial laparotomy [5]. We aimed to review our experience in the management of “traumatic or nontraumatic open abdomen” as our practice transitioned from the Bogota Bag to the vacuum-assisted closure (VAC) in order to assess the morbidity and the outcome of abdominal wall integrity of both techniques. 2. Materials and Methods A retrospective review was performed using the trauma reg- istry to identify the patients undergoing temporary abdom- inal closure (TAC) either using Bogota Bag (BB) or VAC,