Negative Pressure Therapy for Management of the Open Abdomen

  • Erin Palm
  • Elizabeth R. BenjaminEmail author


  • Indications for the open abdomen include damage-control laparotomy, abdominal compartment syndrome (ACS), severe peritonitis, or need for second-look laparotomy to evaluate potentially compromised bowel (Fig. 33.1). In these situations, temporary abdominal closure (TAC) is performed.

  • Contemporary techniques for TAC utilize negative pressure therapy and are designed to prevent evisceration, remove fluid from the abdominal cavity, and preserve abdominal domain.

  • There are commercially available NPT devices, such as the ABThera© system, for TAC. Based on institutional availability, an alternative technique, called a Barker vacuum pack, can be constructed from local supplies. These systems have different mechanical properties. The ABThera© system maintains a more consistent negative pressure in the periphery and is more effective in removing peritoneal fluid than the Barker method.

  • There is evidence that the ABThera© system is associated with better survival, decreased complications, and shorter time to definitive fascial closure than the improvised Barker vacuum pack.

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Trauma, Emergency Surgery and Surgical Critical CareUniversity of Southern CaliforniaLos AngelesUSA

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