Table 1.

Advantages and disadvantages of different types of temporary abdominal closure (TAC) techniques

Technique	Equipment	Advantages	Disadvantages
Skin only closure	Skin staples, towel clips or sutures	Cheap, available, minimises heat and fluid loss	Damage to the skin, risk of evisceration, no control of fluid loss, incidence of ACS
‘Bogota’ bag	Sterile 3 litre Saline bag cut and shaped and sutured to fascial edges	Cheap, available, minimises heat and fluid loss	Damage to the fascial edges, risk of evisceration, no control of fluid loss. Allows some assessment of intestinal viability.
Opsite Sandwich technique	Polyethylene sheet, Opsite dressings, abdominal packs, 2 suction drains and wall suction.	Cheap, available, minimises heat and fluid loss is controlled and measurable	Incomplete fluid control and need for available wall suction.
Absorbable mesh	Vicryl or similar MESH	Absorbable mesh, infection resistance, protects from evisceration, can be skin grafted.	High rate of subsequent incisional herniation
Non-absorbable mesh or commercial ‘Zipper’	Commerical Whittman patch	Abdominal re-exploration is easy, maintains abdominal domain, gradual abdominal closure possible	Commercial equipment required and multiple trips to the operating theatre usually required for closure.
Vacuum Assisted Closure (VAC)	Commercial equipment	Prevents loss of abdominal domain, collects and monitors fluid loss, decreases ACS, no damage to skin or abdominal fascia.	Expensive commercial equipment required. Usually requires GA to change VAC system