A national survey on temporary and delayed abdominal closure in Norwegian hospitals

A questionnaire was sent to all 50 Norwegian hospitals with acute care general surgical services.The response rate was 88%. A very limited number of hospitals had treated more than one trauma patient with TAC (5%) or one patient with ACS (14%) on average per year. Most hospitals preferred vacuum assisted techniques, but few reported having formal protocols for TAC or ACS. Although most hospitals would refer patients with TAC to a trauma centre, more than 50% reported that they would perform a secondary reconstruction procedure themselves.This study shows that most Norwegian hospitals have limited experience with TAC and ACS. However, the long distances between hospitals mandate all acute care hospitals to implement formal treatment protocols including monitoring of IAP, diagnosing and decompression of ACS, and the use of TAC. Assuming experience leads to better care, the subsequent treatment of these patients might benefit from centralization to one or a few regional centers.Damage control techniques as well as prevention and treatment of abdominal compartment syndrome (ACS) includes the use of temporary abdominal closure (TAC), resulting in the clinical challenges of open abdomen-related morbidity. A wide variety of TAC techniques exists, including commercial or improvised vacuum-assisted closure, permanent or absorbable prosthetic mesh insertion, Bogota bag, or strategies using native tissue only, leaving the optimal TAC yet to be defined. There is no standardization of terminology or accepted guidelines for when to leave the abdomen open, and controversy exists among surgeons as to which of the different options for TAC to select [1].All TAC techniques are associated with a range of complications, as surgical site infections, sepsis, prolonged stay in the intensive care unit (ICU), enteroatmospheric fistulas and large hernias [2-9]. Follow-up of patients with an open abdomen demands multidisciplinary teamwork. The optimal management of the open abdomen remains on