Skin-Only Closure Versus Bogota Bag: A Comparative Study of Complete Fascial Approximation Rates

Background: Open abdomen is a life-saving technique often used to treat serious injuries and for general surgery in emergencies. Primary fascial closure is the basic aim of open abdomen by using different techniques of closure. Objective: To compare the frequency of achievement of primary fascial closure after skin-only closure versus a laparostomy (Bogota bag closure) among patients presenting with peritonitis or abdominal trauma at a tertiary care hospital. Methods: A prospective cohort study was conducted at Surgical Unit D of Lady Reading Hospital, Peshawar, Pakistan, over a period of six months. A total of 220 patients with peritonitis and blunt/penetrating abdominal trauma aged 15-75 years who required damage control surgery were consecutively selected, whereas obese patients and patients managed by other techniques were excluded. Patients were grouped into group A (skin-only closure) and group B (Bogota bag closure), operated by consultants. Primary fascial closure achievement was measured during index hospitalization. Data were analyzed using Statistical Product and Service Solutions (SPSS, version 25.0; IBM SPSS Statistics for Windows, Armonk, NY). Results: Of the 220 patients, 110 were treated with the skin-only closure technique and 110 with the Bogota bag closure technique. Primary fascial closure was achieved in 137 (62.3%) patients, out of which 89 (80.9%) patients were in group A and 48 (43.6%) patients were in group B (p<0.001). Conclusion: The skin-only closure technique is more effective in achieving primary fascial closure as compared to the Bogota bag closure technique in patients with peritonitis and blunt/penetrating abdominal trauma.