Atelectasis after free rectus transfer and abdominal wall reconstruction.
BACKGROUND
Atelectasis is commonly encountered in patients undergoing rectus abdominus tissue transfer. Primary closure of the anterior rectus sheath may contribute to this process. Augmentation of the closure with mesh may decrease the incidence of Atelectasis.


METHODS
In this retrospective review 32 patients with preoperative and postoperative augmentation were compared to 23 who had primary closure of the anterior rectus sheath.


RESULTS
Augmentation consisted of acellular dermis (25) or mesh (7). Postoperative atelectasis was radiographically detected in: 91% (n=29) of augmented patients versus 83% (n=19) of primary closure patients. Major atelectasis in 41% (n=13) of augmented patients versus 61% (n=14) of primary closure patients p<.05. The incidence of atelectasis was independent of skin flap size and operative times.


CONCLUSIONS
The use of acellular dermis or mesh to augment the abdominal wall appears to reduce the high incidence of postoperative atelectasis following rectus-free flap harvest.
Lo
Jamie O
JO
Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, Portland, Oregon 97239, USA.
Weber
Stephen M
SM
Andersen
Peter E
PE
Gross
Neil D
ND
Gosselin
Marc
M
Wax
Mark K
MK
D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003094:Collagen; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods*; D017568:Rectus Abdominis / Q000637:transplantation*; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps / Q000009:adverse effects*; D013526:Surgical Mesh; D016896:Treatment Outcome
C440568:Alloderm; D003094:Collagen