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Tissue expanders for abdominal wall reconstruction following severe trauma: technical note and case reports
D H Livingston1, P K Sharma, A I Glantz
1Department of Surgery, UMD-New Jersey Medical School, Newark.
The Journal of Trauma
|January 1, 1992
Summary
This study presents a novel abdominal wall reconstruction technique using autologous tissue, avoiding prosthetics. The method successfully restored abdominal integrity in two patients, preventing hernia formation post-surgery.
Area of Science:
- Surgical innovation in reconstructive surgery
- Trauma surgery and abdominal wall repair
Background:
- Severe abdominal trauma often necessitates complex abdominal wall reconstruction.
- Traditional methods may involve prosthetic materials or myocutaneous flaps, carrying potential risks.
- A need exists for techniques utilizing autologous tissues to minimize complications.
Observation:
- A two-stage technique involving tissue expanders followed by a fascial graft was employed.
- Tissue expanders were used to increase local tissue availability for coverage.
- The abdominal wall defect was reconstructed using a dermal-elements-denuded skin graft as a fascial graft, sutured to the rectus fascia.
Findings:
- The described technique successfully reconstructed the abdominal wall in two patients.
- Procedures included concurrent colostomy closure and enterocutaneous fistula closure.
- Excellent wound healing without infection was observed, with no hernia formation at 3 and 12 months postoperatively.
Implications:
- This autologous tissue technique offers a viable alternative for abdominal wall reconstruction post-trauma.
- It potentially reduces complications associated with prosthetic materials.
- The method demonstrates promising long-term outcomes regarding hernia prevention.