Reconstruction of the abdominal wall: a case series

This primary, retrospective, and descriptive study evaluated patients who underwent abdominal wall reconstruction at the Plastic Surgery Service of the Clinics Hospital of the Federal University of Pernambuco.

Results:

The medical records of 18 patients were reviewed, including 15 women (83.3%) and 3 men (16.7%), with a mean age of 41 years (range, 16-79 years). Seventeen patients (94.4%) had a history of previous surgery. The causes of abdominal injury were cesarean section in eight cases (44.4%), oncologic surgery in six (33.3%), trauma surgery in two (11.1%), and bariatric surgery in two (11.1%). The etiology of the defect was necrotizing fasciitis in eight cases (44.4%), incisional hernia in four (22.2%), trauma in two (11.1%), surgical wound dehiscence in two (11.1%), abdominal wall neoplasia in two (11.1%), and total thickness defect in one (5.5%). The surgical interventions included the component separation technique in seven cases (38.9%), simple VY advancement flap in six (33.3%), closure with abdominoplasty in three (16.7%), and tissue expander in two (11.1%). Four patients (22.2%) presented complications.

Conclusions:

Abdominal wall defects are challenging cases for plastic surgeons, as their treatment is difficult, but the results are satisfactory even in the most severe cases.

Keywords:
Abdominal wall; Reconstruction; Necrotizing fasciitis; Abdominal hernia; Ventral hernia.

Initials		Sex	Age	Comorbidities	History of smoking	History of surgery	Etiology of the defect	Depth of the defect	Treatment	Complications
01	EPLS	F	22	No	ES	Yes	Necrotizing fasciitis	Partial	Tissue expander	Expender extrusion
02	CMFV	F	58	SAH	No	Yes	Incisional hernia	Partial	Component separation with surgical mesh + abdominoplasty	Seroma
03	CCB	F	56	SAH	ES	Yes	Incisional hernia	Partial	Component separation with surgical mesh + abdominoplasty	Partial dehiscence
04	JSL	F	47	No	ES	Yes	Incisional hernia	Partial	Closing with surgical mesh + abdominoplasty	No
05	JLG	F	60	No	No	Yes	Incisional hernia	Partial	Closing with surgical mesh + abdominoplasty	No
06	SBS	F	27	No	No	Yes	Necrotizing fasciitis	Partial	Component separation with surgical mesh	No
07	RSM	F	30	No	ES	Yes	Necrotizing fasciitis	Partial	Component separation with surgical mesh	No
08	MJCF	F	60	No	ES	Yes	Necrotizing fasciitis	Partial	Component separation with surgical mesh	No
09	JBS	F	33	No	ES	Yes	Wound infection (skin and SCCT)	Total	Component separation with surgical mesh	No
10	MBS	F	37	No	ES	Yes	Necrotizing fasciitis	Partial	Component separation with surgical mesh	No
11	GTS	F	29	No	No	Yes	Necrotizing fasciitis	Partial	Simple VY advancement flap	No
				Schistosomiasis
12	ESO	M	30	and Chagas	No	Yes	Trauma	Partial	Tissue expander	No
				disease
13	RCS	F	30	No	No	Yes	Trauma	Partial	Closing with surgical mesh + abdominoplasty	No
14	KGF	F	16	No	No	Yes	Necrotizing fasciitis	Partial	Simple VY advancement flap	No
							Wound
15	JMM	F	34	No	No	Yes	infection (skin	Partial	Simple VY advancement flap	No
							and SCCT)
16	MEAM	F	47	SAH	ES	Yes	Necrotizing fasciitis	Partial	Simple VY advancement flap	Partial dehiscence
17	LF	M	43	No	No	No	Abdominal wall tumor	Partial	Simple VY advancement flap	No
18	RCL	M	79	No	ES	Yes	Abdominal wall tumor	Partial	Simple VY advancement flap	Absent

Sociedade Brasileira de Cirurgia Plástica Rua Funchal, 129 - 2º Andar / cep: 04551-060, São Paulo - SP / Brasil, Tel: +55 (11) 3044-0000 - São Paulo - SP - Brazil
E-mail: rbcp@cirurgiaplastica.org.br

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[1] *Corresponding author: Kelson Kawamura, Av. Professor Moraes Rego, 1235, Cidade Universitária - Recife, PE, Brazil Zip Code 50670-901, E-mail: kelson.1989k@hotmail.com

KK	Analysis and/or interpretation of data; statistical analyses; final approval of the manuscript; conception and design of the study; completion of surgeries and/or experiments; writing the manuscript or critical review of its contents.
ICGL	Analysis and/or interpretation of data; final approval of the manuscript; conception and design of the study; completion of surgeries and/ orexperiments; writing the manuscript or critical review of its contents.
PSL	Final approval of the manuscript; writing the manuscript or critical review of its contents.
RA	Final approval of the manuscript; writing the manuscript or critical review of its contents.
MBL	Final approval of the manuscript; writing the manuscript or critical review of its contents.

KK	Análise e/ou interpretação dos dados; análise estatística; aprovação final do manuscrito; concepção e desenho do estudo; realização das operações e/ou experimentos; redação do manuscrito ou revisão crítica de seu conteúdo.
ICGL	Análise e/ou interpretação dos dados; aprovação final do manuscrito; concepção e desenho do estudo; realização das operações e/ou experimentos; redação do manuscrito ou revisão crítica de seu conteúdo.
PSL	Aprovação final do manuscrito; redação do manuscrito ou revisão crítica de seu conteúdo.
RA	Aprovação final do manuscrito; redação do manuscrito ou revisão crítica de seu conteúdo.
MBL	Aprovação final do manuscrito; redação do manuscrito ou revisão crítica de seu conteúdo.