title: Definitive reconstruction of full-thickness abdominal wall defects initially treated with skin grafting of exposed intestines.
abstract: BACKGROUND
  The reconstruction of wide, full-thickness abdominal wall defects of the midline presents a continuing challenge, and consensus concerning the appropriate surgical treatment is lacking.
  
  
  METHODS
  In this retrospective review, we describe a simple method of reconstruction in full-thickness defects initially treated with skin grafting directly on to the surface of the intestines. Instead of removing the split-thickness grafts from the surface of the intestines, the abdominal wall was reconstructed by inverting the grafted area and advancing the rectus muscles towards the midline.
  
  
  RESULTS
  Four patients with full-thickness transverse defects larger than 10 cm at the level of the waist and extending from the xiphoid to the suprapubic region were operated with this method. All healed uneventfully. In one case, microscopic examination of the inverted skin showed transformation to normal connective tissue.
  
  
  CONCLUSIONS
  Reconstruction of abdominal wall defects previously treated with skin grafting directly on to the intestines can be safely done by reposition of the skin-grafted intestines into the abdominal cavity and realignment of the rectus muscles in the midline.
authors.affiliation: Department of Reconstructive Plastic Surgery, Institution of Molecular, Medicine and Surgery, Karolinska Institute at the Karolinska University Hospital, Solna, 16175 Stockholm, Sweden. Birgit.Stark@karolinska.se
authors.forename: B
authors.initials: B
authors.lastname: Stark
authors.forename: K
authors.initials: K
authors.lastname: Strigård
mesh_terms: D000007:Abdominal Injuries / Q000150:complications / Q000601:surgery; D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D046449:Hernia, Abdominal / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007422:Intestines / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012421:Rupture; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps; D013536:Suture Techniques; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000150:complications / Q000601:surgery