title: Abdominal wall reconstruction after temporary abdominal wall closure in trauma patients.
abstract: We retrospectively analyzed 36 patients requiring temporary abdominal wall closure on admission to a level I trauma center from 1988 to 1992. There were 10 deaths (28%) in the study population. Of the 26 survivors, 8 patients (31%) had primary fascial closure at initial hospitalization, whereas 18 patients (69%) required split-thickness skin grafting to visceral granulation tissue. Of these 18 patients, 13 have had ventral herniorrhaphy at subsequent admission. Eight of these patients had primary fascial closure, 4 required primary fascial approximation with prosthetic onlay reinforcement, and 1 required multiple operations including prosthetic reconstruction and eventual complex tissue transfer. Complications occurred in 3 patients (14%) and included two wound seromas, which were drained nonoperatively, and a wound infection necessitating removal of prosthetic material and subsequent reconstruction with complex tissue transfer. Follow-up reveals no recurrent hernia at 24 months. Abdominal wall reconstruction after temporary closure can be done safely and promptly, with good functional and esthetic results.
authors.affiliation: Department of Surgery, Medical College of Georgia, Augusta, 30912, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Yeh
authors.forename: R
authors.initials: R
authors.lastname: Saltz
authors.forename: T R
authors.initials: TR
authors.lastname: Howdieshell
mesh_terms: D000007:Abdominal Injuries / Q000601:surgery*; D000009:Abdominal Muscles / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D004322:Drainage; D004954:Esthetics; D005122:Exudates and Transudates; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006097:Granulation Tissue / Q000601:surgery; D006555:Hernia, Ventral / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011095:Polyethylenes; D011126:Polypropylenes; D011183:Postoperative Complications / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods; D013526:Surgical Mesh; D013530:Surgical Wound Infection / Q000209:etiology / Q000601:surgery; D015996:Survival Rate; D015626:Tissue Expansion; D014193:Trauma Centers; D014781:Viscera
chemical_list: C016674:Plastipore; D011095:Polyethylenes; D011126:Polypropylenes