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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We read with interest the recent article by Gracias et al¹ describing abdominal compartment syndrome (ACS) in patients undergoing vacuum-pack temporary abdominal coverage (TAC) for abdominal catastrophes. The authors identified ACS in 5 of 20 patients undergoing TAC; despite early recognition and emergency abdominal decompression, recurring ACS in the study procedure group led to a mortality rate of 60%, compared with only 7% in a control group.

Gracias et al concluded that TAC did not prevent the recurrence of ACS and the associated high mortality but did not go on to describe the etiology suggested by the abnormalities found at reexploration. Abdominal compartment syndrome could have resulted from ongoing intra-abdominal bleeding, extensive packing, or expanding retroperitoneal hematomas,² but undersized TACs could also have constricted expansion, thereby promoting increased intra-abdominal pressure. The ability of the vacuum TAC to contain the expanding viscera while keeping intra-abdominal pressure low is questionable in this . . . [Full Text of this Article]

Corresponding author: James W. Jones, MD, PhD, Department of Surgery, M580 Health Sciences Center, University of Missouri-Columbia School of Medicine, One Hospital Drive, Columbia, MO 65212 (e-mail: jonesjw@health.missouri.edu).

RELATED ARTICLE

Temporary Abdominal Coverage and Abdominal Compartment Syndrome—Reply
Vicente H. Gracias, Benjamin Braslow, Rajan Gupta, and C. William Schwab
Arch Surg. 2003;138(5):565-566.
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