title: Abdominal wall reconstruction after temporary abdominal closure: A ten-year review.
abstract: Abdominal wall reconstruction (AWR) is often required for hernias created after temporary abdominal closure (TAC). Demographic and clinical data from patients undergoing TAC and AWR between January 1, 1992, and December 31, 2002, were collected and univariate analysis performed. Temporary abdominal closure and AWR were performed in 21 patients. Complications developed in 12 patients (57.1%) after TAC; associated risk factors were mesh placement (P = .04) and skin grafting (P = .04). Successful AWR included mesh (n = 6), component separation (n = 6), primary repair (n = 4), and 3 combination techniques. Six patients (28.6%) developed intraoperative complications, and 14 (66.7%) developed postoperative complications. Intraoperative complications were increased in patients with tissue expanders (P = .01). Postoperative complications (P = .04) were less likely with component separation. The complication rate with TAC and AWR is high. Tissue expanders are associated with an increased risk of intraoperative complications with AWR, whereas component separation is associated with a reduction in postoperative complications.
authors.affiliation: Carolinas Hernia Center, Division of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, Carolinas Medical Center, Charlotte, North Carolina 28203, USA.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Joels
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Vanderveer
authors.forename: William L
authors.initials: WL
authors.lastname: Newcomb
authors.forename: Amy E
authors.initials: AE
authors.lastname: Lincourt
authors.forename: John L
authors.initials: JL
authors.lastname: Polhill
authors.forename: David G
authors.initials: DG
authors.lastname: Jacobs
authors.forename: Ronald F
authors.initials: RF
authors.lastname: Sing
authors.forename: B Todd
authors.initials: BT
authors.lastname: Heniford
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome