Reconstruction of the abdominal wall for incisional hernia repair.
BACKGROUND
Abdominal wall reconstruction with mobilization of autologous tissue has evolved as a reliable option for patients with incisional hernias.


METHODS
With the aim of evaluating morbidity and recurrence rates in patients who underwent abdominal wall reconstruction for incisional hernia repair, we retrospectively reviewed the charts of 188 patients treated between 1996 and 2003.


RESULTS
Primary approximation of the fascial defect was achieved in 77% and was reinforced by either mesh placement or rectus muscle advancement. The remaining 23% were reconstructed either by mesh placement, components separation, or distant flap mobilization. Median follow-up was 15 months. Overall morbidity rate was 38%; recurrence rate was 13%. Dimensions of the hernia and intraoperative enterotomies were associated with postoperative complications. Lack of complete restoration of the myofascial abdominal wall continuity was associated with recurrence.


CONCLUSIONS
In patients with incisional hernias, techniques involving autologous tissue mobilization are safe and associated with low recurrence rates.
Espinosa-de-Los-Monteros
Antonio
A
Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
de la Torre
Jorge I
JI
Ahumada
Leonik A
LA
Person
David W
DW
Rosenberg
Laurence Z
LZ
Vásconez
Luis O
LO
D034861:Abdominal Wall / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D046449:Hernia, Abdominal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods