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Massive traumatic abdominal hernia repair with biologic mesh.

Simon R Davey1, Neil J Smart2, James J Wood2

  • 1Department of Coloproctology, Bristol Royal Infirmary, Bristol BS2 8HW, UK drsdavey@googlemail.com.

Journal of Surgical Case Reports
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Summary

Traumatic abdominal wall hernias (TAWHs) are rare injuries resulting from significant trauma. This case highlights a high-impact road traffic accident leading to a TAWH and associated thoracic injuries, managed surgically.

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Area of Science:

  • Trauma surgery
  • Surgical innovation

Background:

  • Traumatic abdominal wall hernias (TAWHs) are uncommon injuries.
  • TAWHs can result from high or low impact trauma and may involve severe associated injuries.

Observation:

  • A 27-year-old male sustained a TAWH following a high-impact road traffic accident.
  • The patient presented with extensive abdominal wall disruption and concurrent thoracic cage injuries.
  • Initial management focused on stabilizing the patient and addressing life-threatening injuries.

Findings:

  • Surgical exploration revealed significant abdominal wall compromise requiring complex reconstruction.
  • A porcine dermal collagen mesh was utilized for abdominal wall defect repair.
  • The mesh was applied using a bridge technique to span the defect and facilitate healing.

Implications:

  • This case underscores the potential severity of TAWHs and the importance of a multidisciplinary approach in trauma care.
  • Porcine dermal collagen mesh offers a viable biological option for reconstructing large abdominal wall defects in traumatic settings.
  • The bridge technique represents a surgical strategy for managing extensive TAWHs when primary closure is not feasible.