[Fascia lata transplant from cadaveric donor in the reconstruction of abdominal wall defects in children].
BACKGROUND
Abdominal wall closure is not possible in large congenital defects, even after extensively stretching in to enlarge its capacity. The skin coverage is usually adequate but the aponeurotic defect has to be closed temporally using synthetic patches. The use of these materials leads to increase complication such as infection, fistula formation and extrusion. In addition a second operation is required to remove the material and to perform a definitive closure. The role of fascia lata in reconstruction of abdominal wall is well established as free grafts, pedicled flaps or free flaps. Bank cadaveric fascia lata is used extensively in neurosurgical, ophtalmological, orthopaedic and urogynecological procedures. This is the first description of the use of cadaveric fascia lata for the closure of large abdominal wall defects.


METHODS
We present two cases of congenital diaphragmatic hernia. The first patient was a newborn who presented the impossibility to close the fascia, that was salvaged by a teflón patch. Five months later the wound opened, leaving the mesh exposed that had to be removed. A cadaveric fascia lata patch was used to cover the defect, closing the skin satisfactorily. The second case was a two days newborn. We performed the diaphragmatic closure, and the aponeurotic defect was closed using cadaveric fascia lata.


RESULTS
Cosmetic and functional appearance are satisfactory in both cases and no complications have been seen.


CONCLUSIONS
Fascia lata patches are revascularized in the abdominal wall and incorporates into receptor tissue. They have the following advantages with respect to synthetic materials: First, the risk of complications is lower. Second, their removal is not necessary. Finally, no intraperitoneal adhesions occur. The risks of disease transmission and rejection are minimized by the Centro Comunitario de Transfusiones donor selection and processing of the cadaveric fascia lata.
Peláez Mata
D
D
Servicio de Cirugía Pediátrica, Hospital Central de Asturias, Ovied.
Alvarez Zapico
J A
JA
Gutiérrez Segura
C
C
Fernández Jiménez
I
I
García Saavedra
S
S
González Sarasúa
J
J
Arriaga Flórez
M J
MJ
D000009:Abdominal Muscles / Q000601:surgery*; D002102:Cadaver; D005206:Fascia Lata / Q000637:transplantation*; D006801:Humans; D007231:Infant, Newborn; D008297:Male