LAPAROSTOMY USING URINE BAGS AS A CONTAINER, CASE SERIES STUDY IN SULAIMANI EMERGENCY AND SULAIMANI TEACHING   

Sarmad Hiwa Arif a


a Department of Surgery, College of Medicine, University of Sulaimani. 

Submitted: 12/6/2017; Accepted: 13/12/2017; Published 15/4/2018
ABSTRACT


Background 

Laparotomy wound is usually closed at the end of the operation. However, in certain occasions, it is undesirable, difficult or even imapossible to do so. The abdomen may be left open for a while; a situation called (contained laparostomy). 


Objectives 

The aim of this paper is to describe a simple and cheap method of temporary abdominal closure.


Patients and Methods

Over a 7-year period (2008-2015), 11 patients underwent emergency laparotomy for trauma, abdominal sepsis or intra-abdominal compartment syndrome in Sulaimani, Iraq, after which the abdomen was temporarily, closed using a sterile urine bag. Daily change of dressing and irrigation of the wound with saline was performed until the time of definite closure of skin and fascia. 


Results

There were nine males (82%). Age ranged from 21 to 72 years with a mean of 43±15 year. Six patients (55%) had penetrating trauma, 4 (36.4%) had abdominal sepsis and one (9.1%) had abdominal compartment syndrome. The urine bag was kept for 7 days in 8 patients (72%), 12 days in 2 patients (18.2%) and 32 days in one patient (9.1%). Two patients (18.2%) had disruption of bag to skin sutures and another two (18.2%) had superficial wound infection. Two patients (18.2%) died due to multiple organ failure and pulmonary embolism. 


Conclusion

Laparostomy management using a urine bag is cheap, simple, effective and easy to perform with minimal morbidity.


KEYWORDS

Laparostomy, Open abdomen, Urine bag, Bogota Bag, Damage control surgery.