"Component separation" technique and panniculectomy for repair of incisional hernia.
BACKGROUND
Primary incisional hernia repair is rarely successful, with recurrence rates ranging from 18% to 62%. We describe the integration of "components separation" herniorrhaphy with panniculectomy.


METHODS
Twenty-two patients were treated. Standard panniculectomies and component separation were performed. Intravesical pressure was measured preoperatively, intraoperatively, and postoperatively. Measurement variations were compared using the Wilcoxon test. Complications or hernia recurrence were evaluated. The clinical appearance of the abdomen was subjectively evaluated by patients.


RESULTS
Secure abdominal defect closure with midline approximation of the fascia was achieved in all patients. No major early complications occurred. Hernia recurred in 1 patient (4.5%). Intra-abdominal pressure increased in all the patients in our series but remained well below the danger level. Fifteen patients were fully satisfied with the appearance of their abdomen, whereas 7 were satisfied.


CONCLUSIONS
Abdominal component separation provides a reliable autologous reconstructive option. Hernia repair combined with abdominoplasty provides functional and esthetic benefits.
Mazzocchi
Marco
M
Department of Plastic and Reconstructive Surgery, University of Perugia, Via Portuense 331, 00149 Rome, Italy. mazzocc@mclink.it
Dessy
Luca Andrea
LA
Ranno
Raul
R
Carlesimo
Bruno
B
Rubino
Corrado
C
D034861:Abdominal Wall / Q000601:surgery*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D015187:Lipectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing