Massive ventral hernias may result from a variety of clinical situations. One such clinical situation, a common problem in trauma patients, is abdominal compartment syndrome. Abdominal compartment syndrome frequently results in a massive abdominal defect when primary closure after surgical decompression is not possible. We offer a technique for repairing these massive ventral hernias by first expanding the lateral abdominal wall muscles, fasciae, and skin with tissue expanders and then closing the defect with elements of the “components separation” method. Additionally we present other clinical situations resulting in a massive ventral hernia that were repaired using this technique.
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References
1.
LambJP, VitaleT, KaminskiDL. Comparative evaluation of synthetic meshes used for abdominal wall replacement. Surgery1983;93:643–8.
2.
KaufmanZ, EngelbergM, ZagerM. Fecal fistula: A late complication of Marlex mesh repair. Dis Colon Rectum1981;24:543–4.
3.
NahaiF, HillHL, HesterTR. Experiences with the tensor fascia lata flap. Plast Reconstr Surg1979;63:788–99.
4.
CarlsonGW, HesterRT, ColemanJJ. The role of tensor fasciae latae musculocutaneous flap in abdominal wall reconstruction. Plast Surg Forum1988;11:151–4.
WeiCY, ChuangDC, ChenHC, . The versatility of free rectus femoris muscle flap: An alternative flap. Microsurgery1995;16:698–703.
7.
RamirezOM, RuasE, DellonAL. “Components separation” method for closure of abdominal-wall defects: An anatomic and clinical study. Plast Reconstr Surg1990;86:519–26.
BurchJ, MooreEE, MooreFA, FrancioseR. Complex and challenging problems in trauma surgery: The abdominal compartment syndrome. Surg Clin North Am1996;76:833–42.
10.
JacobsenWM, PettyPM, BiteU, JohnsonCH. Massive abdominal-wall hernia reconstruction with expanded external/internal oblique and transversalis musculofascia. Plast Reconstr Surg1997;100:326–35.
11.
AstonSJ, PickrellKL. Reconstructive surgery of the abdominal wall. In: ConverseJM, ed. Reconstructive Plastic Surgery, 2nd Ed, vol 7. Philadelphia: WB Saunders Company, 1977, pp 3727–9.
12.
ShawWW, AstonSJ, ZideBM. Reconstruction of the trunk. In: McCarthyJG, ed. Plastic Surgery. Philadelphia: WB Saunders Company, 1990; pp 3694–6.
13.
IvaturyRR, . Intra-abdominal hypertension and the abdominal compartment syndrome. Surg Clin North Am1997;77:939–51.
14.
RichardsonJD, TrinkleJK. Hemodynamic and respiratory alterations with increased intra-abdominal hydrostatic pressure. J Surg Res1976;20:401–4.
15.
HobarPC, RohrichRJ, ByrdHS. Abdominal-wall reconstruction with expanded musculofascial tissue in a posttraumatic defect. Plast Reconstr Surg1994;94:379–83.
16.
ByrdHS, HobarPC. Abdominal-wall expansion in congenital defects. Plast Reconstr Surg1989;84:347–52.
17.
CarlsonGW, ElwoodE, LoskenA, GallowayJR. The role of tissue expansion in abdominal wall reconstruction. Ann Plast Surg2000;44:147–53.
18.
PalettaCE, HuangDB, DehghanK, KellyC. The use of tissue expanders in staged abdominal wall reconstruction. Ann Plast Surg1999;42:259–65.
