J Korean Surg Soc.
2013 Jan;84(1):61-65.
Repair of a postappendectomy massive ventral hernia using tissue expanders
- Affiliations
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- 1Department of General Surgery, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey. yelizemineersoy@yahoo.com
- 22nd General Surgery Clinic, Bagcilar Training and Research Hospital, Istanbul, Turkey.
- 31st General Surgery Clinic, Haseki Training and Research Hospital, Istanbul, Turkey.
- 4Department of Plastic and Reconstructive Surgery, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey.
- 5General Surgery Clinic, Universal Aksaray Hospital, Istanbul, Turkey.
Abstract
- Reconstruction of large abdominal wall defects is a challenging problem. Various reconstructive techniques have been described in the surgical literature each with its advantages and disadvantages. In this report we describe our experience in treating a patient with large abdominal wall defect by staged abdominal wall reconstruction utilizing prosthetic mesh in conjunction with tissue expanders. A 41-year-old male presented with abdominal pain. Exploratory laparotomy showed perforated appendicitis with intraabdominal abscess of 1,500 mL. Postoperatively, he developed intraperitoneal sepsis. To prevent abdominal compartment syndrome, he was reoperated and left with "open abdomen". After several open abdomen lavages, his abdominal wall defect was allowed to granulate. After epithelization of the defect, the abdominal wall was reconstructed using prosthetic mesh and tissue expanders. The tissue expansion process was well tolerated. We suggest that the use of tissue expanders provides reliable and well-vascularized soft-tissue coverage in abdominal wall reconstruction.
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MeSH Terms
Figure
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Fig. 1 Preoperative appearance of patient (before tissue expansion).
Fig. 2 Appearance after inflation of tissue expanders to total volume of 2,350 mL each.
Fig. 3 Appearance after removal of expanders and granulation tissue over intestines.
Fig. 4 Appearance after prosthetic mesh placement.
Fig. 5 Appearance of patients two months later.
Reference
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