Atelectasis after free rectus transfer and abdominal wall reconstruction

Area of Science:

• Plastic Surgery
• Thoracic Surgery
• Abdominal Wall Reconstruction

Background:

• Atelectasis is a frequent complication following rectus abdominis tissue transfer.
• Primary closure of the anterior rectus sheath may exacerbate atelectasis.
• Surgical mesh augmentation is explored as a method to mitigate this complication.

Purpose of the Study:

• To evaluate the efficacy of anterior rectus sheath augmentation in reducing postoperative atelectasis.
• To compare outcomes between augmented and primary closure techniques after rectus abdominis free flap harvest.

Main Methods:

• Retrospective review comparing 32 patients with mesh or acellular dermis augmentation to 23 patients with primary rectus sheath closure.
• Radiographic detection of atelectasis was used as the primary outcome measure.

Main Results:

• While overall atelectasis rates were similar (91% vs. 83%), major atelectasis was significantly reduced in the augmented group (41% vs. 61%, p<.05).
• The incidence of atelectasis was not influenced by skin flap size or operative duration.

Conclusions:

• Augmenting the abdominal wall with acellular dermis or mesh can decrease the incidence of major postoperative atelectasis.
• This approach offers a potential strategy to improve patient recovery after rectus abdominis free flap procedures.