Component separation in the management of the difficult abdominal wall.

BACKGROUND

Abdominal compartment syndrome (ACS) and mesh implantation in abdominal wounds are creating abdominal wall problems not seen in the past. Component separation (CS) is an alternative technique used to manage these difficult wounds.

METHODS

From January 2001 to July 2003, 27 patients were identified who had undergone CS. Charts were reviewed for defect etiology and characterization, surgical results, and outcome from reconstruction.

RESULTS

Etiology of the defect was ACS in 14, infected mesh in 5, and multiple failed repairs in 8 patients. Twenty-three were closed completely with CS, 2 required prosthetic mesh, and 2 had a porcine implant placed. Three wound complications occurred that required reoperation. Three hernia recurrences have been identified. All patients are completely recovered and are currently functioning without limitation.

CONCLUSIONS

Large and/or complex abdominal wall defects can be managed with a single-stage procedure using CS, thus many complications associated with implantation of prosthetic mesh are avoided. Functional outcome is excellent.