Management of massive defects of the abdominal wall

Full-thickness abdominal wall defects are mainly traumatic or infectious in origin. After adequate resuscitation, treatment of associated visceral trauma, antibiotic therapy and careful debridement to vital tissues, primary repair of the abdominal wall should be carried out by simple methods by using synthetic mesh and/or split skin grafts. Local pedicle skin flaps or musculocutaneous flaps are advocated for secondary repair of the abdominal wall and also used in elective tumour surgery when total resection of the abdominal wall is indicated.