Bogota bag - Forum

User avatar
A Doctor

Re: Bogota bag - Ärzteforum

Post#11 »

Dear all interested in the Bogota bag thread,

I had an anecdotal experience somewhat similar to that of Iain. A
debilitated patient who had complicated parastomal hernia with a massively
prolapsing tranverse colon with gangrene and peritonitis. I ended up with
placing a plastic bag for closure. Every 2-3 days I took the patient back to
the OR, examined for for abscess pockets and evacuated as necessary,
performed generous irrigation, and attempted to tighten the plastic sheet.
After about 5 such procedures, the bowels were all encased in a fibrinous
layer with no residual abscesses, and the fascial edges got somewhat closer.
At that point I removed the bag and used bedside wet-to-wet dressing changes
and left the area to granulate. The most important thing is that the
dressing had to be absolutely non-adherent (used vaselinized gauze and
sometimes Adaptec), otherwise a fistula is a given. The patient did well,
coverage was achieved with split-thickness skin graft, and the patient was
left with a good hernia. I lost his follow-up, (because I completed my
residency then)


User avatar
Lady Surgeon

Re: Bogota bag - Ärzteforum

Post#12 »

I don't think that a fistula is a given with regular gauze moist dressings at this point. I have used them twice on open abdomens without creating fistulae.

User avatar
A Doctor

Re: Bogota bag - Ärzteforum

Post#13 »

Lady Surgeon wrote:I don't think that a fistula is a given with regular gauze moist dressings at this point. I have used them twice on open abdomens without creating fistulae.


Yes, but has to be religiously kept wet-to-wet. There is a possibilty that this will not be fool-proof, and therefore I preferred to eliminate the possibilty of gauze sticking to the bowel.

Noro

Re: Bogota bag - Ärzteforum

Post#14 »

1. But--it is YOUR way that requires such a study before performing it
2. WHAT is the failure rate "under these circumstances"? My guess is this
statement is totally out of your imagination, and you can't cite a number OR a
reference to support it. Such is the stuff patients are subjected to these days

Return to “General surgery”

Who is online

Users browsing this forum: No registered users and 0 guests

cron