title: A defect of the abdominal wall with intestinal fistulas after the repair of incisional hernia using Composix Kugel Patch.
abstract: BACKGROUND
  In the present paper, we show a rare case of the large abdominal wall defect and enterocutaneous fistulas after the tension free repair using prostheses for incisional hernia.
  
  
  METHODS
  The patient, a 70-year-old man, had a history of a hemicolectomy for a perforating colon cancer, complicated by a large incisional hernia that was closed primarily but recurred. Three years later, the hernia was repaired at the time of a second colectomy using a Composix Kugel Patch. His course was complicated by a chronic postoperative wound infection with eventual development of enterocutaneous fistulas. The patient was successfully treated with extirpation of the prosthesis, resection of the fistulized bowel, and placement of a tensor fasciae latae myocutaneous flap.
  
  
  CONCLUSIONS
  Enterocutaneous fistulas are a known complication of incisional hernia repairs using prostheses. Additional clinical data are required to confirm the safety and efficacy of this procedure as it becomes more widely adopted.
  
  
  CONCLUSIONS
  Extirpation of the prosthesis should be performed without delay to prevent serious complications. Reconstruction with a tensor fasciae latae myocutaneous flap was useful for the large abdominal wall defect.
authors.affiliation: Department of Surgery, Nara Medical University, Nara, Japan. Electronic address: tkuni0118@yahoo.co.jp.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kunishige
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Takayama
authors.forename: Sohei
authors.initials: S
authors.lastname: Matumoto
authors.forename: Kohei
authors.initials: K
authors.lastname: Wakatsuki
authors.forename: Koji
authors.initials: K
authors.lastname: Enomoto
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tanaka
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Migita
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Kuwahara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iioka
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nakajima
keywords: Abdominal incisional hernia; Abdominal wall defect; Small intestinal fistula
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